(A) Bouldger Flashcards
What does co-morbidity mean?
Two or more disorders are occurring in the same individual at this time
What are some common co-morbidities?
Mood & anxiety disorders
Substance abuse & antisocial personality disorder
ADHD & Conduct disorders
What is DSM-5 useful for?
Diagnosis and classification
Communication among professionals
Coding/billing
Research
What is the official coding system in the United states?
ICD!! International classification of disease by WHO
We use it because of our treaty obligations with WHO
Which codes are the same for DSM-5 and ICD-9?
290-319
What classifies and intellectual disability?
includes both a current intellectual deficit and a deficit in adaptive functioning with onset during the developmental period
When is a mental status exam indicated?
- Pts w/ documented brain lesions
- Pts w/ suspected brain lesions becuase of seizure, headache, behavioral change, etc
- ALL psychiatric patients
- Pts w/ vague complaints (memory, concentration, ect)
2 components of the mental status exam in psychiatry?
- Observation (areas assessed while obtaining historical data)
- formal cognitive testing = mini mental state exam (uses cognitive screening tools)
Components of observational data during psych interview (variables evaluated in the mental status examination)
Presentation Motor behavior & affect Cognitive Status Thought Mood
Presentation
- level of consciousness
- general appearance
- Attitude (degree of cooperation and effort
- eye contact
Motor Behavior and Affect
Motor behavior= akinesia, involuntary movements, mannerisms
Affect= facial expressions, gestures, speech characteristics, pressure, volume, prosody
Cognitive Status
Attention/Alertness Orientation Speech and Language Memory Constructional ability Calculations Reasoning
Screening tools for depression
Ham-D
PHQ-9
GDS (geriatric)
Screening tools for anxiety
Ham-A
GAD-7
Screening for alcohol abuse
AUDIT
Screening tool for ADHA and childhood behavior problems
SNAP-IV Rating Scale
-contains 90 questions to be answered by teachers
VANDERBILT ADHA DIAGNOSTIC rating scale (for teacher and parent)
Nominal Measurement
Least precise
assigns numbers or labels to identify categories
Only arithmetic operations that can be used is counting
Ordinal Measurement
Measure, arrange, sore in a series ranging from highest to lowest according to an observed characteristic
Cannot use arithmetical functions with a ordinal measurement
Interval measurement
gives number that order, and differences between numbers are meaningful.
NO ABSOLUTE ZERO
Ratio Scales
Highest level of measurement
All arithmetical operations can be used
Has true zero point
Reliability measures
reliability is a measure of repeatability- experimental replicaiton
Validity of measures
Reflects degree of accuracy of predicative statements
Most common IQ test for adults
Wechsler Adult Intelligence Scale
individually administered and take 75-110 minutes to be administered.
Personality assessment
Minnesota Multiphasic Personality Inventory (MMPI)
What is the Folstein mini mental state scored out of?
30
What test should be used to evaluate the intelectual functions of a five year-old child? (4-6)
McCarthy
What was one of the most controversial discussion about DSM-5 in its first iteration was the treatment of…
Personality disorders
autism spectrum disorder
bereavement
Portion of general population expected to have IQ score between 70 and 130?
95%
70-130 is two standard deviations away from the mean
Normal Range for IQ?
90-109
IQ less than what is considered mentally retarded?
Less than 70
IQ intervals of retardation
Mild 50-70
Moderate 35-55
Severe 20-40
Profound < 20
Most common objective personality test?
MMPI-2 - restricted response fromat (T/F etc)
Clinical scales for depression, paranoia, schizophrenia, hypochondriasis
Most common projective personality test?
Rorschach - designed to reveal hidden emotions and internal conflicts via the subjects response to ambiguous stimuli
Patients asked to interpret ink blots
Identifies thought disorders and defense mechanisms
Objective personality test
based on questions that are easily scored and statistically analyzied
Projective personality test
requires the subject to interpret the questions, responses assumed to be based on subjects motivational state and defense mechanisms
