337 DSM criteria Flashcards
Social Anxiety (SAD) criteria
(A) marked fear or anxiety about one or more social situations in which the individual is exposed to possible scrutiny by others
(B) fears that he or she will act in a way or show anxiety symptoms that will be negatively evaluated (i.e., will be humiliating or embarrassing; will lead to rejection or offend others)
(C) social situations almost always provoke fear or anxiety
(D) these situations are avoided or endured with great distress
(E) fear or anxiety is out of proportion to the actual threat posed by the social situation and to the sociocultural context
(F) fear or anxiety must have lasted for 6 months or more
(G) fear, anxiety, or avoidance must cause significant impairment in functioning
(H) not better explained by use of a substance
(I) not better explained by the symptoms of another mental disorder
(J) not better explained by a medical condition
Specify: performance only (public speaking, playing an instrument)
Panic attack
(A) surge of intense fear or discomfort that rises and peaks within minutes (cognitive sx may last longer)
(B) at least 4 sx:
- increased heart rate or palpitations
- perspiration
- trembling
- shortness of breath
- choking sensation
- discomfort or pain in the chest
- nausea or abdominal upset
- dizziness or light-headedness
- feeling significantly chilled or hot
- parasthesia: tingling or numbness
- derealization (sense of unreality) or depersonalization (sense of separation from others)
- dread of losing control or going crazy
- dread of dying
Specify: full-blown (at least 4 sx) or limited-symptom (less than 4)
Panic Disorder (PD)
(A) repeated and unexpected panic attacks (uncued)
(B) 1 month of worry about the persistent panic attacks or significant/maladaptive behavioural changes related to the attacks (like avoidance)
Specify: with/without agoraphobia
Agoraphobia
(A) Pronounced, disproportionate, and repeated fear about being in at least 2 of the following situations
- public transportation
- parking lots, bridges, other open spaces
- shops, theatres, other confined spaces
- lines or crowds
- away from home unaccompanied
(B) fear of such agoraphobic situations derives from a concern that it would be hard to escape or get help if panic, embarrassment, or disabling symptoms were to occur
(C) Avoidance of the agoraphobic situations
(D) Symptoms usually continue for at least 6 months
(E) Significant distress or impairment
Generalized Anxiety Disorder (GAD) criteria
(A) chronic and excessive worry about events, activities, topics occurring on more days than not (difficult to control the worry)
(B) Worry must persist for at least 6 months, and can involve a wide variety of topics such as work or school, finances, health, safety, and minor matters
(C) includes at least 3 physiological symptoms:
- feeling keyed up, restless, on edge
- difficulty concentrating or having one’s mind go blank due to worry
- disrupted sleep due to worry
- muscle tension
- irritability
- fatigue
(D) Not explainable by another disorder
(E) Excessive worry must predate another comorbid disorder and be present during remission of that disorder to be diagnosed (cannot only be present during a mood episode)
Obsessive-Compulsive Disorder (OCD)
(A) presence of obsessions and/or compulsions that produce significant distress and cause noticeable interference with various aspects of role functioning
(B) obsessions or compulsions are time-consuming or cause significant distress or impairment in social, occupational, or other important areas of functioning
(C ) Symptoms are not attributable to the physiological effects of a substance or another medical condition
(D) Symptoms are not better explained by the symptoms of another mental disorder
Specify: with good/fair insight, poor insight, absent insight/delusional beliefs
Specidy: if tic-related (current or past history of a tic disorder)
obsessions criteria
- persistent intrusive thoughts, ideas, images, impulses, or doubts that the person experiences as senseless and that evoke anxiety (unwanted, guilt-provoking, repugnant, ego-dystonic)
- Resisted; sense that they must be neutralized or avoided
compulsions criteria
- Repetitive behaviors (e.g., hand washing, ordering checking) or mental acts (e.g., praying, counting, repeating words silently) that the person feels driven to perform in response to an obsession, or according to the rules that must be applied rigidly
- The behaviors or mental acts are aimed at preventing or reducing distress or preventing some dreaded event or situation. However, these behaviors or mental acts either are not connected in a realistic way with what they are designed to neutralize or prevent or are clearly excessive
- not designed to bring pleasure or gratification
most common obsessions
- contamination
- uncertainty
- aggression
- responsibility for harm and mistakes
- incompleteness (order/exactness, symmetry)
- unacceptable taboo violent, sexual, blasphemous thoughts
- somatic (fear that one has an illness)
most common compulsions
- decontamination
- checking (including asking for reassurance)
- repeating routine activities
- ordering and arranging
- mental rituals
Body Dysmorphic Disorder
(A) intrusive, distressing thoughts concerning one’s appearance, and repeated checking might be observed in both OCD and BDD
Hoarding Disorder
(A) thoughts about acquiring and maintaining possessions
(B) thoughts that are not particularly intrusive or unwanted (generally emotionally positive or neutral and thus do not meet criteria for obsessions)
(C ) Excessive saving isn’t conceptualized as ritualistic, and this behaviour doesn’t neutralize obsessional anxiety
Obsessive-Compulsive Personality Disorder (OCPD)
(A) presence of personality traits such as excessive perfectionism, inflexibility, and need for control that negatively impact interpersonal relationships, occupational functioning, or other important domains
(B) ego-syntonic: consider their behaviours and urges as rational and appropriate
Post-Traumatic Stress Disorder (PTSD)
(A) experienced, witnessed, or learned about the traumatic event of a loved one, or have experienced repeated exposure to the aftermath of traumas
(B) at least 1 intrusion:
- persistent and distressing memories of the trauma
- recurrent distressing nightmares about the trauma
- dissociative reactions
- intense psychological or physiological responses to cues
(C) at least 1 avoidance:
- effortful avoidance of internal cues and efforts to avoid external reminders of the trauma like places, people, or situations
(D) at least 2 negative alterations in cognitions or mood:
- numbing and amnesia (and inability to have positive feelings)
- strong negative emotions like guilt, anger, fear
- distorted self-blame or erroneous blame of others who did not cause or intend the event
- negative beliefs about the self, others, and the world as a consequence of the trauma
(E) at least 2 alterations in arousal and reactivity:
- sleep difficulties
- impaired concentration
- exaggerated startle response and hypervigilance
- irritable or aggressive behaviours
- reckless or self-destructive bx
(F) all sx must have started/worsened after the trauma
(G) sx are present for at least 1 month, and perceived as causing distress or impairment
PTSD specifiers
- “with delayed impairment”: diagnostic threshold is not met or exceeded until at least 6 months after the traumatic event
- for kids 6 or younger: kids usually don’t display negative alterations in mood/cognition, so required symptoms are reduced (more behavioural symptoms)
- with prominent dissociative sx: also experience either persistent or frequent experiences of depersonalization or derealization
