Abnormal Psychology

Question 1

Acute Stress Disorder

Answer 1

The diagnosis of Acute Stress Disorder the development of at least nine symptoms following exposure to actual or threatened death, severe injury, or sexual violation in at least one of four ways (direct experience of the event; witnessing the event in person as it happened to others; learning that the event occurred to a close family member or friend; repeated or extreme exposure to aversive details of the event). Symptoms can be from any of five categories (intrusion, negative mood, dissociative symptoms, avoidance symptoms, arousal symptoms), have a duration of three days to one month, and cause clinically significant distress or impaired functioning

Question 2

Adjustment Disorders

Answer 2

The Adjustment Disorders involve the development of emotional or behavioral symptoms in response to one or more identifiable psychosocial stressors within three months of the onset of the stressor(s). Symptoms must be clinically significant as evidenced by the presence of marked distress that is not proportional to the severity of the stressor and/or significant impairment in functioning, and they must remit within six months after termination of the stressor or its consequences

Question 3

Agoraphobia

Answer 3

A diagnosis of Agoraphobia requires the presence of marked fear of or anxiety about at least two of five situations (using public transportation, being in open spaces, being in enclosed spaces, standing in line or being part of a crowd, and being outside the home alone). The individual fears or avoids these situations due to a concern that escape might be difficult or help will be unavailable in case he/she develops incapacitating or embarrassing symptoms; and the situations nearly always provoke fear or anxiety and are actively avoided, require the presence of a companion, or are endured with intense fear or anxiety. The fear or anxiety is persistent, is not proportional to the threat posed by the situations, and causes clinically significant distress or impaired functioning).

Question 4

Alcohol-Induced Disorders (Withdrawal, Korsakoff Syndrome, Sleep Disorder)

Answer 4

Alcohol Withdrawal is diagnosed in the presence of at least two characteristic symptoms within several hours to a few days following cessation or reduction of alcohol consumption: autonomic hyperactivity; hand termor; insomnia; nausea or vomiting; transient illusions or hallucinations; anxiety; psychomotor agitation; generalized tonic-clonic seizures. The DSM-5 distinguishes between two types of Alcohol-Induced Major Neurocognitive Disorder- nonamnestic-confabulatory type and amnestic-confabulatory type. The amnestic-confabulatory type is also known as Korsakoff Syndrome, and is characterized by anterograde and retrograde amnesia and confabulation and has been linked to a thiamine deficiency. Alcohol-Induced Sleep Disorder is usually of the insomnia type and can be the result of either Intoxication or Withdrawal.

Question 5

Anorexia Nervosa

Answer 5

The essential features of Anorexia Nervosa are

a) a restriction of energy intake that leads to a significantly low body weight
b) an intense fear of gaining weight or becoming fat or behavior that interferes with weight gain
c) a disturbance in the way the person experiences his or her body weight or shape or a persistent lack of recognition of the seriousness of his/her low body weight

Question 6

Antisocial Personality Disorder

Answer 6

Antisocial Personality is characterized by a pattern of disregard for and violation of the rights of others that has occurred since age 15 at least three characteristic symptoms (e.g. failure to conform to social norms with respect to lawful behavior; deceitfulness; impulsivity; reckless disregard for the safety of self and others; lack of remorse. The person must be at least 18 years old and have a history of Conduct Disorder before age 15

Question 7

ADHD

Answer 7

ADHD is the appropriate diagnosis when the individual has at least six symptoms of inattention and/or six symptoms of hyperactivity-impulsivity and symptoms had an onset prior to 12 years of age, are present in at least two settings (e.g. home and school), and interfere with social, academic, or occupational functioning. About 15% of children with ADHD continue to meet the full diagnostic criteria for the disorder as young adults and another 60% meet the criteria for ADHD in partial remission. In adults, inattention predominates the symptom profile

Question 8

Autism Spectrum Disorder

Answer 8

For a diagnosis of Autism Spectrum Disorder, the individual must exhibit

a) persistent deficits in social communication and interaction across multiple contexts as manifested by deficits in social-emotional reciprocity, nonverbal communication, and the development, maintenance, and understanding of relationships
b) restricted, repetitive patterns of behavior, interests, and activities as manifested by at least two characteristic symptoms (e.g. stereotyped or repetitive motor movements, use of objects, or speech; inflexible adherence to routines, or ritualized patterns of behavior
c) the presence of symptoms during the early developmental period
d) impaired functioning as the result of symptoms. The best outcomes are associated with an ability to communicate by age 5 ot 6, an IQ over 70, and a later onset of symptoms.

Question 9

Avoidant Personality Disorder

Answer 9

Characterized by a pervasive pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation, as indicated by at least four characteristic symptoms (e.g. avoids work activities involving interpersonal contact due to a fear of criticism, rejection, or disapproval; is unwilling to get involved with people unless certain of being liked; is preoccupied with concerns about being criticized or rejected; views self as socially inept, inferior, or unappealing to others

Question 10

Behavioral Pediatrics (Hospitalization, Compliance)

Answer 10

Hospitalized children are at increased risk for emotional and behavioral problems, and children ages one to four tend to have the most negative reactions to hospitalization. Children and adolescents with chronic medical conditions have higher rates of school-related problems (e.g. CNS irradiation and intrathecal chemotherapy for leukemia have been linked to impaired neurocognitive functioning and learning disabilities). Compliance with medical regimens is a particular problem for adolescents.

Question 11

Behavioral Therapy of Depression (Lewinsohn)

Answer 11

Lewinsohn’s behavior theory attributes depression to a low rate of response-contingent reinforcement

Question 12

Bipolar I Disorder

Answer 12

A diagnosis of Bipolar I Disorder requires at least one manic episode that lasts for at least one week, is present most of the day nearly every day, and includes at least three characteristic symptoms (e.g. inflated self-esteem or grandiosity; decreased need for sleep; flight of ideas). Symptoms must cause marked impairment in social or occupational functioning, require hospitalization to avoid harm to self or others, or include psychotic features. This disorder may include one or more episodes of hypomania or major depression. Treatment usually includes lithium or an anti-seizure medication and CBT or other form of therapy.

Question 13

Bipolar II Disorder

Answer 13

A diagnosis of Bipolar II Disorder requries at least one hypomanic episode and at least one major depressive episode. A hypomanic episode lasts for at least four consecutive days and involves at least three symptoms that are also associated with a manic episode but are not severe enough to cause marked impairment in functioning or require hospitalization. A major depressive episode lasts for at least two weeks and involves at least five characteristic symptoms, at least one of which must be a depressed mood or a loss of interest or pleasure.

Question 14

Borderline Personality Disorder

Answer 14

The essential feature of Borderline Personality Disorder is a pervasive pattern of instability in interpersonal relationships, self-image, and affect, and markedly impulsivity. At least five characteristic symptoms must be present- e.g. frantic efforts to avoid abandonment: pattern of unstable, intense interpersonal relationships that are marked by fluctuations between idealization and devaluation; an identity disturbance involving a persistence instability in self-image or sense of self; recurrent suicide threats or gestures; transient stress-related paranoid ideation or severe dissociative symptoms

Question 15

Brief psychotic disorder

Answer 15

Brief Psychotic Disorder is characterized by the presence of one or more of four characteristic symptoms (delusions, hallucinations, disorganized speech, grossly disorganized or catatonic behavior) with at least one symptom being delusions, hallucinations, or disorganized speech. Symptoms are present for at least one day but less than one month with an eventual return to full premorbid functioning

Question 16

Bulimia Nervosa

Answer 16

Bulimia Nervosa is characterized by

a) recurrent episodes of binge eating that are accomplished by a sense of a lack of control
b) inappropriate comepensatory behavior to prevent weight gain (e.g. self-induced vomiting, excessive exercise) and
c) self-evaluation that is unduly influenced by body shape and weight

Question 17

Concordance rates for schizophrenia

Answer 17

The rates of schizophrenia are higher among individuals with genetic similarit, and, the greater the similarity, the higher the concordance rates: For example, for biological siblings, the rate is 10%,; and, for identical (monozygotic) twins, the rate is 48%

Question 18

Conduct Disorder

Answer 18

The diagnosis of Conduct Disorder requires a persistent pattern of behavior that violates the basic rights of others and/or age-appropriate social norms or rules as evidenced by the presence of at least three characteristic symptoms during the past 12 months and at least one symptom in the past six months. Symptoms are divided into four categories:

• aggression to people and animals
• destruction of property
• deceitfulness or theft
• serious violation of rules

Symptoms must cause significant impairment in functioning and the disorder cannot be assigned to individuals over age 18 who meet the criteria for Antisocial Personality Disorder

Question 19

Conversion Disorder

Answer 19

The symptoms of Conversion Disorder involve disturbances in voluntary motor or sensory functioning and suggest a serious neurological or other medical condition (e.g. paralysis, seizures, blindness, loss of pain sensation) with evidence of an incompatibility between the symptom and recognized neurological or medical conditions

Question 20

Cyclothymic Disorder

Answer 20

Cyclothymic Disorder involves fluctuating hypomanic symptoms and numerous periods of depressive symptoms that do not meet the criteria for a major depressive episode, with symptoms lasting for at least two years in adults or one year in children and adolescents. Symptoms cause significant distress or impairment in functioning.

Question 21

Delirium

Answer 21

A diagnosis of delirium requires

a) A disturbance in attention and awareness that develops over a short period of time, represents a change from baseline functioning, and tends to fluctuate in severity over the course of a day and
b) an additional disturbance in cognition (impaired memory, disorientation, impaired language, deficits in visuospatial ability, perceptual distortions)

Symptoms must not be due to another Neurocognitive Disorder and must not occur during a severely reduced level of arousal (e.g. during a coma), and there must be evidence that symptoms are the direct physiological consequence of a medical condition, substance intoxication or withdrawal, and/or exposure to a toxin

Question 22

Delusional Disorder

Answer 22

Involves one or more delusions that last at least one month. Overall psychosocial functioning is not markedly impaired, and any impairment is directly related to the delusions. The DSM-5 distinguishes between the following subtypes: erotomanic, grandiose, jealous, persecutory, somatic, mixed, and unspecified)

Question 23

Dependent Personality Disorder

Answer 23

Dependent Personality Disorder involves a pervasive and excessive need to be taken care of, which leads to submissive, clinging behavior and a fear of separation as manifested by at least five symptoms- e.g. has difficulty making decisions without advice and reassurance from others; fears disagreeing with others because it might lead to a loss of support; has difficulty initiating projects on his/own; goes to great lengths to gain nurturance and support form others; is unrealistically preoccupied with fears of being left to care for him/herself

Question 24

Depressive Cognitive Triad

Answer 24

According to Beck, the cognitive profile for depression involves a cognitive triad- i.e. negative beliefs about oneself, the world (situation), and the future

Question 25

Dialectical Behavior Therapy

Answer 25

Linehan’s DBT was designed as a treatment for Borderline Personality Disorder and incorporates three strategies:

a) group skills training to help clients regulate their emotions and improve their social and coping skills
b) individual outpatient therapy to strengthen clients’ motivation and newly acquired skills
c) telephone consultations to provide additional support and between sessions coaching. Research has confirmed that it reduces premature termination from therapy, psychiatric hospitalizations, and parasuicidal behaviors

Question 26

Diagnostic Uncertainty

Answer 26

When using the DSM-5, diagnostic uncertainty about a client’s diagnosis is indicated by coding one of the following:

• Other specified disorder is coded when the clinician wants to indicate the reason why the client’s symptoms do not meet the criteria for a specific diagnosis
• Unspecified disorder is coded when the clinician does not want to indicate the reason why the client’s symptoms do not meet the criteria for a specific diagnosis

Question 27

Dissociative Amnesia

Answer 27

A diagnosis of Dissociative Amnesia requires an inability to recall important personal information that cannot be attributed to ordinary forgetfulness and causes clinically significant distress or impaired functioning. It is often related to exposure to one or more traumatic events. The most common forms of amnesia are localized and selective.

Question 28

Dopamine Hypothesis

Answer 28

Attributes schizophrenia to elevated levels of or oversensitivity to dopamine