ACES Flashcards
In the United States, Public Law 111-256 (Rosa’s Law) changed all references to “mental retardation” in federal laws to “intellectual disability.”
Onset during the developmental period that includes both intellectual and adaptive functioning deficits in conceptual, social, and practical domains.
Intellectual Developmental Disorders
changed all references to “__________” in federal laws to “intellectual disability.”
Mental retardation
(reasoning, problem solving, planning, abstract thinking, judgment, academic learning, and learning from experience) confirmed by both clinical assessment and individualized, standardized intelligence testing.
Deficits in intellectual functions
Intellectual Developmental Disorders result in failure to meet developmental and sociocultural standards.
Onset of intellectual and adaptive deficits during the developmental period.
B. Deficits in adaptive functioning
What is the primary basis for defining specifiers and factor determines the level of support required for an individual ?
Adaptive functioning
Overly high scores due to out-of-date test norms
Flynn effect
Communication, language, and/or motor or sensory function disorders
disorders can affect test scores
Using clinical evaluation and individualized, culturally appropriate, psychometrically sound measures
adaptive functioning assessed?
Adaptive functioning is assessed using both ________ and ________, culturally appropriate, psychometrically sound measures.
clinical evaluation; individualized
What are the following are associated difficulties with this heterogeneous condition of Intellectual Developmental Disorders?
- Social judgment
- Assessment of risk
- Self-management of behavior and emotions
● overall general population prevalence of approximately 10 per 1,000; however.
● Global prevalence varies by country and level of development, being approximately 16 per 1,000 in middle-income countries and 9 per 1,000 in high-income countries.
Prevalence Intellectual Developmental Disorders
What developmental milestones may be delayed and identifiable within the first 2 years of life in severe cases of intellectual developmental disorders?
- Motor milestones
- Language milestones
- Social milestones
What term is used for children younger than 5 years who have deficits that will eventually meet the criteria for intellectual developmental disorder
Global developmental delay
Syndromes are associated with intellectual developmental disorders?
Down Syndrome
Rett syndrome
Sanfilippo syndrome
● Genetic and Physiological:
Prenatal etiologies include genetic syndrome.
Perinatal causes include a variety of labor and delivery–related events leading to neonatal encephalopathy.
Risk and Prognostic Factors of IDD
What gender is more likely to be diagnosed with intellectual developmental disorders, both mild and severe?
Males
What are the conditions frequently co-occur with intellectual developmental disorders?
- Mental disorders
- Cerebral palsy
- Epilepsy
This category is reserved for individuals OVER the age of 5 years when assessment of the
degree of intellectual developmental disorder.
Unspecified Intellectual Developmental Disorder (Intellectual Disability)
Persistent difficulties in the acquisition and use of language across modalities
Language abilities are substantially and quantifiably below those expected for age, resulting in functional limitations in effective communication, social participation, and academic achievement.
Onset of symptoms is in the early developmental period.
The difficulties are not attributable to hearing or other sensory impairment, motor dysfunction.
language disorder
(word knowledge and use) in Language disorder.
Reduced vocabulary
(ability to put words and word endings together to form sentences in language disorder.
Limited sentence structure
ability to use vocabulary and connect sentences to explain or describe a topic in language disorder
Impairments in discourse
● can be adept at accommodating to their limited language.
● may appear to be shy or reticent to talk.
● Affected individuals may prefer to communicate only with family members
● may co-occur with speech sound disorder
Associated Features language disorder
At what age does language disorder typically emerge?
Early developmental period
What age language disorder is diagnosed, It remains stable and typically persists into adulthood that is likely regarding its stability and persistence over time?
from 4 years of age
● Children with receptive language impairments have a poorer prognosis.
● Genetic and physiological. Language disorders are highly heritable.
Risk and Prognostic Factors of language disorder
This distinction may be difficult to make before 4 years of age.
Normal variations in language
Hearing impairment needs to be excluded as the primary cause of language difficulties.
Hearing or other sensory impairment
What condition is often characterized by language delay as the presenting feature pf language disorder
Intellectual disability (intellectual developmental disorder)
Which neurological disorder may be considered in the differential diagnosis of language disorder?
Epilepsy
Language regression, characterized by loss of speech and language in a child younger than 3 years, is often indicative of which disorder?
Autism spectrum disorder
What are the following disorders is language disorder strongly associated with?
- Specific learning disorder
- Attention-deficit/hyperactivity disorder
- Autism spectrum disorder
- Developmental coordination disorder
Interference with speech intelligibility
speech sound disorder
At what age should typically developing children have overall intelligible speech according to the provided information?
4 years
- Persistent difficulty with speech sound production that interferes with speech intelligibility.
- The disturbance causes limitations in effective communication.
- Onset of symptoms is in the early developmental period.
- The difficulties are not attributable to congenital or acquired conditions.
Speech Sound Disorder Diagnostic Criteria
should be considered in the differential diagnosis of speech sound disorder, involving variations in speech influenced by regional, social, or cultural/ethnic factors?
Normal variations in speech
What condition may result in abnormalities of speech due to hearing impairment or deafness?
Structural deficits
Speech impairment may be attributable to a motor disorder, such as cerebral palsy.
Dysarthria.
Limited use of speech may be a sign of this
Selective mutism
Disturbances in the normal fluency and time patterning of speech that are inappropriate for the individual’s age and language skills.
• Sound and syllable repetitions.
• Sound prolongations of consonants as well as vowels.
• Words produced with an excess of physical tension.
- The disturbance causes anxiety about speaking or limitations in effective communication.
- The onset of symptoms is in the early developmental period.
- The disturbance is not attributable to a speech-motor or sensory deficit.
Childhood-Onset Fluency Disorder (Stuttering)
Childhood-Onset Fluency Disorder (Stuttering) (e.g., pauses within a word).
Broken words
Childhood-Onset Fluency Disorder (filled or unfilled pauses in speech).
Audible or silent blocking
Childhood-Onset Fluency Disorder (word substitutions to avoid problematic words).
Circumlocutions
Childhood-Onset Fluency Disorder (e.g., “I-I-I-I see him”).
Monosyllabic whole-word repetitions
When is dysfluency often absent in individuals with childhood-onset fluency disorder (stuttering)?
During oral reading singing talking to inanimate objects or to pets.
How might individuals with childhood-onset fluency disorder attempt to avoid dysfluencies?
Through linguistic mechanisms
Which of the following associated features is commonly observed in childhood-onset fluency disorder (stuttering), where the speaker may anticipate the problem with fear?
Fearful anticipation of the problem
By what age does childhood-onset fluency disorder typically occur for 80%–90% of affected individuals?
Age 6
What is the age range for the onset of childhood-onset fluency disorder, also known as developmental stuttering?
2 to 7 years
Dysfluencies of speech may be associated with a hearing impairment or other
sensory deficit
The disorder distinguished because of this, that occur frequently in young children.
Normal speech dysfluencies
What condition must childhood-onset fluency disorder (stuttering) be distinguished from, which are normal dysfluencies frequently occurring in young children?
Normal speech dysfluencies
When differentiating childhood-onset fluency disorder from Tourette’s disorder, what distinguishing feature should be considered?
Vocal tics and repetitive vocalizations
If onset of dysfluencies is during or after adolescence, it is an ?
adult-onset dysfluency
Impairment of the ability to change communication to match context or the needs of the listener manifestations of persistent difficulties in the social use of verbal and nonverbal communication in?
social (pragmatic) communication disorder
When do the symptoms of social (pragmatic) communication disorder typically onset?
In the early developmental period
What is the most common associated feature of social (pragmatic) communication disorder?
Language impairment
At what age is social (pragmatic) communication disorder considered rare among children?
Younger than 4 years
By what age should most children have developed adequate speech and language abilities to allow identification of specific deficits in social communication?
Age 4 or 5 years
Which condition is the primary diagnostic consideration for individuals presenting with social communication deficits, overlapping with symptoms of social (pragmatic) communication disorder?
Autism spectrum disorder
What disorder may cause impairments in social communication and functional limitations due to its primary deficits?
Attention-deficit/hyperactivity disorder
- Persistent deficits in social communication and social interaction across multiple contexts, - Restricted, repetitive patterns of behavior, interests.
- Highly restricted, fixated interests that are abnormal in focus.
- Hyper- or hyporeactivity to sensory input or unusual interest in sensory aspects of the environment.
- Symptoms must be present in the early developmental period.
- Symptoms cause clinically significant impairment in social, occupational, or other important areas of current functioning.
- These disturbances are not better explained by intellectual developmental disorder or global developmental delay.
Autism Spectrum Disorder
In Autism spectrum disorder for example, from abnormal social approach and failure of normal back-and-forth conversation.
Deficits in social-emotional reciprocity
In Autism spectrum disorder for example, abnormalities in eye contact and body language or deficits in understanding and use of gestures.
Deficits in nonverbal communicative behaviors used for social interaction
In Autism spectrum disorder for example, difficulties in sharing imaginative play or in making friends.
Deficits in developing, maintaining, and understanding relationships
What is an example of stereotyped or repetitive motor movements, use of objects, or speech
flipping objects
What is an examples of Insistence on sameness, inflexible adherence to routines
Greeting rituals
Fixed beliefs that are not amenable to change in light of conflicting evidence.
Delusions
Belief that one is going to be harmed, harassed by an individual, organization, or other group.
Persecutory delusions
Belief that certain gestures, comments, environmental cues, directed at oneself.
Referential delusions
When an individual believes that they has exceptional abilities, wealth, or fame.
Grandiose delusions
Individual believes falsely that another person is in love with him or her.
Erotomanic delusions
A major catastrophe will occur.
Nihilistic delusions
Preoccupations regarding health and organ function.
Somatic delusions
Belief that one’s thoughts have been “removed” by some outside force.
Thought withdrawal
Alien thoughts have been put into one’s mind.
Thought Insertion
Manipulated by some outside force.
Delusions of control
Perception-like experiences that occur without an external stimulus.
Hallucinations
Occur while falling asleep.
Hypnagogic
Waking up.
Hypnopompic
Typically inferred from the individual’s speech.
Disorganized thinking
Individual may switch from one topic to another.
Derailment
Answers to questions may be obliquely related or completely unrelated.
Tangentiality
Ranging from childlike “silliness” to unpredictable agitation.
Grossly disorganized
A marked decrease in reactivity to the environment.
Catatonic behavior
Resistance to instructions.
Negativism
A complete lack of verbal and motor responses.
Mutism and Stupor.
Reduction in the expressions of emotions (eye contact, intonation of speech).
Diminished emotional expression
Decrease in motivated self- initiated purposeful activities.
Avolition
Manifested by diminished speech output.
Alogia
Decreased ability to experience pleasure from positive stimuli.
Anhedonia
Apparent lack of interest in social interactions
Asociality
What is the minimum duration required for the presence of delusions in delusional disorder?
1 month
Which criterion distinguishes delusional disorder from schizophrenia?
Duration of symptoms
Applies when the central theme of the delusion is that another person is in love with the individual.
Erotomanic type
Having made some important discovery.
Grandiose type
Individual’s delusion that his or her spouse or lover is unfaithful.
Jealous type
Individual’s belief that he or she is being conspired against.
Persecutory type
Involves bodily functions or sensations
Somatic type
When no one delusional theme predominates
Mixed type
Dominant delusional belief not described in the specific types.
Unspecified type
Which phase of delusional disorder is defined as a period in which the symptom criteria are fulfilled for the first episode, with the disorder currently at its peak?
First episode, currently in acute episode
Which phase of delusional disorder refers to a period during which there is improvement after a previous acute episode, but the defining criteria of the disorder are only partially fulfilled?
First episode, currently in partial remission
Which phase of delusional disorder indicates a period after a previous episode during which no disorder-specific symptoms are present?
First episode, currently in full remission
symptoms must be present (at least one of these) for the diagnosis of brief of _______
- Hallucinations
- Delusions
- Disorganized speech
- Grossly disorganized behavior
psychotic disorder
What is the required duration for an episode of brief psychotic disorder?
At least 1 day but less than 1 month
What condition must be ruled out before diagnosing brief psychotic disorder?
Major depressive disorder with psychotic features
Which specifier for brief psychotic disorder indicates that symptoms occur in response to markedly stressful events?
With marked stressor
Which specifier for brief psychotic disorder should be used if the symptoms do not occur in response to markedly stressful events?
Without marked stressor
Which specifier for brief psychotic disorder indicates that the onset is during pregnancy or within 4 weeks postpartum?**
With postpartum onset
Which specifier for brief psychotic disorder should be used if the patient meets the criteria for catatonia associated with another mental disorder?
With catatonia
For a diagnosis of schizophreniform disorder, how many of the following symptoms must be present for a significant portion of time during a 1-month period, and which three are essential?
At least one of the following: Delusions, hallucinations, disorganized speech
What is the required duration for an episode of schizophreniform disorder?
At least 1 month but less than 6 months
Which conditions must be ruled out to diagnose schizophreniform disorder?
Schizoaffective disorder and depressive or bipolar disorder with psychotic features
What must not be the cause of the disturbance to diagnose schizophreniform disorder?
The physiological effects of a substance
Which specifier for schizophreniform disorder requires the presence of at least two of the following features: onset of prominent psychotic symptoms within 4 weeks of the first noticeable change in usual behavior?
With good prognostic features
Which specifier for schizophreniform disorder is applied if two or more of the features for a good prognosis have not been present?
Without good prognostic features
Which specifier for schizophreniform disorder should be used if the patient meets the criteria for catatonia associated with another mental disorder?
With catatonia
For a diagnosis of schizophrenia, how many symptoms must be present for a significant portion of time during a 1-month period, and which three are essential?
At least two of the following: Delusions, hallucinations, disorganized speech
How long must continuous signs of the disturbance persist for a diagnosis of schizophrenia?
At least 6 months
What must be significantly impaired since the onset of the disturbance for a diagnosis of schizophrenia?
Level of functioning in one or more major areas (e.g., work, self-care)
Which conditions must be ruled out to diagnose schizophrenia?
Schizoaffective disorder and depressive or bipolar disorder with psychotic features
If mood episodes have occurred during the active phase symptoms of schizophrenia, what must be the case for a proper diagnosis?
They must be shorter in duration than the psychotic symptoms
Which specifier for schizophrenia indicates a time period in which the symptom criteria are fulfilled during the first episode?
First episode, currently in acute episode
Which specifier for schizophrenia indicates a period of time during which an improvement after a previous episode is maintained during the first episode?
First episode, currently in partial remission
Which specifier for schizophrenia indicates a period of time after a previous episode during which no disorder-specific symptoms are present during the first episode?
First episode, currently in full remission
Which specifier for schizophrenia indicates that there have been multiple episodes and the individual is currently in an acute episode?
Multiple episodes, currently in acute episode
An uninterrupted period of illness during which there is a major mood episode (major depressive or manic) concurrent with Criterion A of schizophrenia
Criterion A of schizoaffective disorder
What is the significance of the major depressive episode in schizoaffective disorder according to Criterion A?
It must include Criterion A1: Depressed mood
They must be present for 2 or more weeks in the absence of a major mood episode during the lifetime duration of the illness
Criterion B of schizoaffective disorder require regarding delusions or hallucinations
They are present for the majority of the total duration of the active and residual portions of the illness?
Criterion C of schizoaffective disorder specify about the symptoms of a major mood episode
Which subtype of schizoaffective disorder applies if a manic episode is part of the presentation, with major depressive episodes possibly also occurring?
Bipolar type
Which subtype of schizoaffective disorder applies if only major depressive episodes are part of the presentation?
Depressive type
For a diagnosis of cyclothymic disorder in adults, how long must there be periods of hypomanic and depressive symptoms that do not meet the full criteria for hypomanic or major depressive episodes?
At least 2 years
In children and adolescents, how long must there be periods of hypomanic and depressive symptoms that do not meet the full criteria for hypomanic or major depressive episodes for a diagnosis of cyclothymic disorder?
At least 1 year
During the required 2-year period (or 1-year period for children and adolescents) for cyclothymic disorder, how long must the hypomanic and depressive periods be present?
For at least half the time
During the specified period for cyclothymic disorder, what is the maximum amount of time an individual can be without symptoms?
No more than 2 months at a time
Which criteria must never have been met for a diagnosis of cyclothymic disorder?
- Criteria for a manic episode
- Criteria for a major depressive episode
- Criteria for a hypomanic episode
Which specifier can be applied to cyclothymic disorder?
With anxious distress
Severe recurrent temper outbursts that are grossly out of proportion in intensity or duration to the situation or provocation?
Disruptive Mood Dysregulation Disorder (DMDD)
They are inconsistent with developmental level
DMDD : Criterion B
How frequently must the temper outbursts occur on average to meet Criterion C of DMDD?
Three or more times per week
It is persistently irritable or angry most of the day, nearly every day
DMDD : Criterion D
For how long must Criteria A to D have been present to diagnose DMDD according to Criterion E?
12 months
In how many settings must Criteria A and D be present to meet Criterion F of DMDD?
At least two of three settings
At what age must the symptoms of DMDD not be first diagnosed, according to Criterion G?
Before age 6 years or after age 18 years
What is the maximum age at onset for symptoms of DMDD, according to Criterion H?
Before 10 years
How many of the following symptoms must be present during the same 2-week period to meet Criterion A for Major Depressive Disorder?
Five
Which symptom of Major Depressive Disorder involves markedly diminished interest or pleasure in all, or almost all, activities?
Criterion 2
What is the minimum change in body weight in a month required by Criterion 3 of Major Depressive Disorder?
More than 5% of body weight
Which symptom of Major Depressive Disorder involves feelings of worthlessness or excessive guilt nearly every day?
Criterion 7
What must never have occurred for a diagnosis of Major Depressive Disorder according to Criterion E?
Hypomanic episode & Manic episode
How long must an individual experience depressed mood for most of the day, for more days than not, to meet Criterion A of Persistent Depressive Disorder (Dysthymia)?
At least 2 years
What symptoms must be present, while depressed, to meet Criterion B of Persistent Depressive Disorder (Dysthymia)?
Low energy or fatigue
According to Criterion C of Persistent Depressive Disorder (Dysthymia), how long can an individual be without symptoms in Criteria A and B during the 2-year period of disturbance?
Up to 2 months at a time
For how long must criteria for a major depressive disorder be continuously present to consider a diagnosis of Persistent Depressive Disorder (Dysthymia) according to Criterion D?
2 years
What age defines “Early onset” for Persistent Depressive Disorder (Dysthymia)?
Before age 21 years
What age defines “Late onset” for Persistent Depressive Disorder (Dysthymia)?
Age 21 years or older
Which specification indicates that full criteria for a major depressive episode have not been met in at least the preceding 2 years?
With pure dysthymic syndrome
Which specification indicates that full criteria for a major depressive episode have been met throughout the preceding 2-year period?
With persistent major depressive episode
Which specification indicates that full criteria for a major depressive episode are currently met, but there have been periods of at least 8 weeks in at least the preceding 2 years with symptoms?
With intermittent major depressive episodes, with current episode
What is the minimum number of symptoms that must be present in the final week before the onset of menses to meet Criteria A for PMDD?
Five symptoms
Symptoms listed under what disorder?
- Marked affective lability (e.g., mood swings)
- Marked irritability or anger or increased interpersonal conflicts
- Marked depressed mood, feelings of hopelessness, or self-deprecating thoughts
Premenstrual dysphoric disorder
According to the diagnostic criteria, how soon after the onset of menses should symptoms of PMDD start to improve?
Within a few days
When should symptoms of PMDD become minimal or absent to meet the diagnostic criteria?
The week after menses
How frequently must the symptoms in Criteria A–C occur to meet the diagnostic criteria for PMDD?
In at least half of menstrual cycles in the preceding year
The emotional response to real or perceived imminent threat. More often associated with surges of autonomic arousal necessary for fight or flight, thoughts of immediate danger, and escape behaviors
Fear
The anticipation of future threat. Obviously, these two states overlap n more often associated with muscle tension and vigilance in preparation for future danger and cautious or avoidant behaviors
is anticipation of future threat.
Anxiety
It is an abrupt surge of intense fear or intense discomfort that reaches a peak within minutes, and during which time four or more of a list of 13 physical and cognitive symptoms occur
feature prominently within the anxiety disorders as a particular type of fear response.
Panic attacks
How many of the following symptoms must be present to meet Criterion A for Separation Anxiety Disorder?
Three symptoms
- Recurrent excessive distress when anticipating or experiencing separation
- Persistent reluctance to go out, away from home, or to school
- Fear of being alone or without major attachment figures
Criterion A for Separation Anxiety Disorder
According to the diagnostic criteria, how long must the fear, anxiety, or avoidance persist to meet Criterion B?
At least 4 weeks in children and adolescents, typically 6 months or more in adults
Clinically significant distress or impairment in various areas of functioning
Separation Anxiety Disorder Criterion C
According to Criterion D, the symptoms of Separation Anxiety Disorder should not be better explained by:
Another mental disorder
Consistent failure to speak in specific social situations
Selective Mutism
According to Criterion B, how does the disturbance affect individuals with Selective Mutism?
It interferes with educational or occupational achievement
How long must the duration of the disturbance be to meet Criterion C?
At least 6 months
According to Criterion D, why does the individual fail to speak in specific social situations?
Not attributable to a lack of knowledge of, or comfort with, the spoken language required
According to Criterion E, what condition should not better explain the disturbance of Selective Mutism?
A communication disorder
Marked fear or anxiety about a specific object or situation
Criterion A of Specific Phobia
According to Criterion B, how does the individual typically react when exposed to the phobic object or situation?
They experience immediate fear or anxiety
Actively avoiding or enduring the phobic object or situation with intense fear or anxiety
Criterion C of Specific Phobia
According to Criterion D, how should the fear or anxiety be in relation to the actual danger posed by the specific object or situation?
It should be out of proportion
It causes clinically significant distress or impairment
Criterion F Specific Phobia
The unique combination of behaviors, thoughts, and feelings that make up a specific disorder
clinical description
Maria should recover quickly with no intervention necessary. Without treatment, John will deteriorate _____
Prognosis
when the majority of symptoms that experts would agree are part of the disorder are present
Prototype
Three new cases of bulimia have been reported in this county during the past month and only one in the next county. ____________
Incidence
refers to a breakdown in cognitive, emotional, or behavioral functioning. That the behavior must be associated with distress to be classified as abnormal adds an important component and seems clear: the criterion is satisfied if the individual is extremely upset.
Psychological dysfunction
behavior is out of the individuals control, something that they do not want to do
Harmful dysfunction
disorder tends to last a long time, often a lifetime
chronic course
a psychological disorder characterized by marked and persistent fear of an object or situation
Phobia
What are 3 steps of a psychological disorder ?
psychological dysfunction, distress or impairment, atypical response
percentage of people within a population who have a specific mental disorder
Prevalence
The number or rate of new cases of a particular condition during a specific time.
incidence
receives PhD, PsyD and Ed.D. conduct research into the cause and treatment of psychological disorders and diagnose, assess and treat these disorders.
clinical psychologists and counseling psychologists
percentage of males and females who have the disorder
Sex ratio
behavior causes personal discomfort
personal distress
Biological, psychological, and social influences all contribute to a variety of disorders. ____________
etiology.
How many people in the population as a whole suffer from obsessive-compulsive disorder?
prevalence
DSM stands for ?
Diagnostic and Statistical Manual of Mental Disorder
The pattern a disorder follows can be chronic, timelimited, or episodic. _______
pattern of development and change of a disorder over time
Course
psychologist who treats people with adjustment problems and vocational issues from relative healthy people
counseling psychologists
a breakdown in emotional functioning.
a breakdown in behavioral functioning
a breakdown in cognitive functioning.
psychological dysfunction
Elizabeth visited the campus mental health center because of her increasing feelings of guilt and anxiety. _______________
presenting problem
Interferes with ability to function on a daily basis
maldaptive behavior
A scientific study of psychological disorders
Psychopathology
a psychological dysfunction within an individual associated with distress or impairment in functioning and a response that is not typical or culturally expected.
Psychological disorder
Amanda is 12 years old, and her sister Samantha is 5 years old. While riding in a car with their parents, the girls witness a major automobile accident where a number of people are injured. The girls react very differently to the accident. This is probably due to
developmental differences.
life events, in combination with an inherited tendency, that trigger a disorder.
“stress” in diathesis-stress model,
The idea that our inherited tendencies influence the probability that we will encounter stressful life events is a characteristic of the
reciprocal gene-environment model
an inherited tendency or condition that makes a person susceptible to developing a disorder.
“diathesis” in diathesis-stress model
The most accurate way to think of genes is that they
set boundaries for our development
Jan’s husband, Jinx, was an unemployed jerk who spent his life chasing women other than his wife. Jan, happily divorced for years, cannot understand why the smell of Jinx’s brand of aftershave causes her to become nauseated. Which influence best explains her response
Either behavioral & emotional
interaction of an inherited tendency and events in a person’s life.
In diathesis-stress model, psychopathology result
Inga is a charming and intelligent young lady who is well-liked by family and friends. Approximately _____ of Inga’s enduring personality traits and cognitive abilities can be attributed to genetic influence.
50%
The procedures referred to as quantitative genetics are used to determine the
effects of multiple genes.
influenced by many genes, with each individual gene contributing a relatively small effect.
behavior and personality as polygenic means that both are
The most recent estimates are that genetics contribute approximately _______ to the development of personality characteristics such as shyness or activity level.
30-50%
The model that describes the development of psychopathology as a combination of an inherited predisposition and the events that have occurred in the individual’s life is called
Diathesis- stress
Some people may be genetically predisposed to seek out difficult relationships. These difficult relationships may contribute to their experience of depression. This is an example of the
reciprocal gene-environment model
Most psychological disorders appear to be influenced by many individual genes rather than caused by one single gene. a process referred to as influence.
Polygenic
Nathan, age 16, finds it more difficult than his 7-yearold sister to adjust to his parents’ recent separation. This may be explained by what influences?
Developmental
John has inherited a personality trait that makes him more likely to keep to himself than to socialize. As a result, he does not have many friends and spends a lot of time alone. If John were to develop depression, the model that would probably best explain this situation and the cause of his depression is
reciprocal gene-environment
The fact that some phobias are more common than others (such as fear of heights and snakes) and may have contributed to the survival of the species in the past suggests that phobias may be genetically prewired. This is evidence for which influence?
biological
diathesis-stress model, monozygotic twins raised in the same household will
not necessarily have the same disorders because of potential differences in their stress.
Social influences in the multidimensional model include
the fact that illness usually gets attention.
The multidimensional integrative approach to pathology includes causal factors from which fields?
Genetics
Psychology
Neuroscience
In a landmark study by Caspi et. al. (2003), researchers studied the stressful life events and genetics of 847 individuals. For individuals who had at least four stressful life events, the risk of major depression
doubled if they possessed two short alleles of the gene being studied.
Behavioral influences in the multidimensional model include
conditioned Responses
First-degree family members of individuals with major depressive disorder have a risk for major depressive disorder two- to fourfold higher than that of the general population. Relative risks appear to be higher for early-onset and recurrent forms. Heritability is approximately 40%, and the personality trait neuroticism accounts for a substantial portion of this genetic liability
Genetic and physiological
• Significant weight loss when not dieting or weight gain
• Depressed mood most of the day, nearly every day
• Recurrent thoughts of death
Major depressive disorder
A more chronic form of depression, can be diagnosed when the mood disturbance continues for at least 2 years in adults or 1 year in children.
persistent depressive disorder (dysthymia)
Depressed affect and at least four of the other eight symptoms of a major depressive episode associated with clinically significant distress or impairment that persists for more than 4 days, but less than 14 days, in an individual whose presentation has never met criteria for any other depressive or bipolar disorder, does not currently meet active or residual criteria for any psychotic disorder, and does not meet criteria for recurrent brief depression
Short-duration depressive episode
möst reproducible finding in the epidemiology of major depressive disorder has been a higher prevalence in
Female
represents the classic condition in this group of disorders. It is characterized by discrete episodes of at least 2 weeks’ duration (although most episodes last considerably longer) involving clear-cut changes in affect, cognition, and neurovegetative functions and inter-episode remissions.
Major Depressive disorder
A well-established risk factor for the onset of major depressive disorder, and high levels appear to render individuals more likely to develop depressive episodes in response to stressful life events.
Neuroticism
Depressed mood for most of the day, for more days than not, for at least two years in adults and 1 year in children and adolescents, as characterized by at least two of the following: appetite changes, insomnia or hypersomnia, low energy or fatigue, low self-esteem, poor concentration, hopelessness.
*
Persistent depressive disorder
used in situations in which the clinician chooses to communicate the specific reason that the presentation does not meet the criteria for any specific depressive disorder.
Other specified depressive disorder
Depressed affect and at least one of the other eight symptoms of a major depressive episode associated with clinically displus.sk significant distress or impairment persist for at least 2 weeks in an individual whose presentation has never met criteria for any other depressive or bipolar disorder, does not currently meet active or residual criteria for any psychotic disorder, and does not meet criteria for mixed anxiety and depressive disorder symptoms.
Depressive episode with insufficient symptoms:
In DMDD, The diagnosis should not be made for the first time before
age 6 years or after age 18 years
Five (or more) of the following symptoms have been present during the same 2-week period and represent a change from previous functioning: at least one of the symptoms is either
(1) depressed mood or
(2) loss of interest or pleasure
Major Depressive Disorder
include disruptive mood dysregulation disorder, major depressive disorder (including major depressive episode), persistent depressive disorder (dysthymia), premenstrual dysphoric disorder, substance/medication-induced depressive disorder, depressive disorder due to another medical condition, other specified depressive disorder, and imspecified depressive disorder.
Depressive Disorders
The presence of at least two of the following symptoms during the majority of days of a major depressive episode or persistent depressive disorder (dysthymia):
1. Feeling keyed up or tense.
2. Feeling unusually restless.
3. Difficulty concentrating because of worry.
4. Fear that something awful may happen.
5. Feeling that the individual might lose control of himself or herself
With anxious distress
In DMDD, Criteria A and D are present in at least how many setting?
2 of 3
presence of sad, empty, or irritable mood, accompanied by somatic and cognitive changes that significantly affect the individual’s capacity to function. What differs among them are issues of duration, timing, or presumed etiology.
Depressive Disorders
Concurrent presence of depressed mood and at least four other symptoms of depression for 2-13 days at least once per month (not associated with the menstrual cycle) for at least 12 consecutive months in an individual whose presentation has never met criteria for any other depressive or bipolar disorder and does not currently meet active or residual criteria for any psychotic disorder.
Recurrent brief depression
Children presenting to clinics with features of disruptive mood dysregulation disorder are predominantly
Male
This category applies to presentations in which symptoms characteristic of a depressive disorder that cause clinically significant distress or impairment in social, occupational, or other important areas of functioning predominate but do not meet the full criteria for any of the disorders in the depressive disorders diagnostic class
Other Specified Depressive Disorder
This category applies to presentations in which symptoms characteristic of a depressive disorder that cause clinically significant distress or impairment in social, occupational, or other important areas of functioning predominate but do not meet the full criteria for any of the disorders in the depressive disorders diagnostic class
Other Specified Depressive Disorder
Depressed mood most of the day, nearly every day and/or loss of interest or pleasure in all or almost all activities for at least two weeks, in addition to four or more of the following: significant weight changes, insomnia or hypersomnia, psychomotor agitation or retardation, fatigue, feelings of worthlessness or guilt, poor concentration, or recurrent thoughts of death.
MAJOR DEPRESSIVE DISORDER
used in situations in which the clinician chooses not to specify the reason that the criteria are not met for a specific depressive disorder, and includes presentations for which there is insufficient information to make a more specific diagnos
Unspecified Depressive Disorder
Essentially all major nonmood disorders increase the risk of an individual developing depression. Major depressive episodes that develop against the background of another disorder often follow a more refractory course
Course modifiers
Referring to the presentation of children with persistent irritability and frequent episodes of extreme behavioral dyscontrol, is added to the depressive disorders for children up to 12 years of age
disruptive mood dysregulation disorder
In the majority of menstrual cycles, at least five symptoms (affective lability, irritability or anger, depressed mood, anxiety, anhedonia, concentration difficulties, lethargy, change in appetite, hypersomnia or insomnia, overwhelm, physical symptoms) must be present in the final week before the onset of menses, start to improve within a few days after the onset of menses, and become minimal or absent in the week postmenses.
PREMENSTRUAL DYSPHORIC DISORDER
Many children with disruptive mood dysregulation disorder have symptoms that also meet criteria for
attention-deficit/hyperactivity disorder (ADHD) and for an anxiety disorder
A prominent and persistent mood disturbance characterized by depressed mood or markedly diminished interest or pleasure in all or almost all, activities, which developed during or soon after substance intoxication or withdrawal
SUBSTANCE/MEDICATION-INDUCED DEPRESSIVE DISORDER
Adverse childhood experiences, particularly when there are multiple experiences of diverse types, constitute a set of potent risk factors for major depressive disorder. Stressful life events are well recognized as précipitants of major depressive episodes, but the presence or absence of adverse life events near the onset of episodes does not appear to provide a useful guide to prognosis or treatment selection
Temperamental
A prominent and persistent mood disturbance characterized by depressed mood or markedly diminished interest or pleasure in all, or almost all, activities, which is the direct pathophysiological consequence of another medical condition.
DEPRESSIVE DISORDER DUE TO ANOTHER MEDICAL CONDITION
higher rate of suicide attempts and suicidal ideation in the past 12 months
suicide risk associated w panic attacks
A. Panic attacks or anxiety is predominant in the clinical picture.
B. There is evidence from the history, physical examination, or laboratory findings that the disturbance is the direct pathophysiological consequence of another medical condition.
C. The disturbance is not better explained by another mental disorder.
D. The disturbance does not occur exclusively during the course of a delirium.
E. The disturbance causes clinically significant dist
Anxiety Disorder Due to Another Medical Condition
In S/M-Induced Anxiety Disorder, this specifier applies if criteria are met for intoxication with the substance and the symptoms develop during intoxication
With onset during intoxication
A. Consistent failure to speak in specific social situations in which there is an expectation for speaking (e.g., at school) despite speaking in other situations.
B. The disturbance interferes with educational or occupational achievement or with social communication.
C. The disturbance is not better explained by a communication disorder (e.g., childhoodonset fluency disorder) and does not occur exclusively during the course of autism spectrum disorder, schizophrenia, or another psychotic disorder
Selective mutism
Refers to recurrent unexpected panic attacks.
Panic disorder
The onset of selective mutism is usually before age ________, but the disturbance may not come to clinical attention until entry into school, where there is an increase in social interaction and performance tasks, such as reading aloud.
5 years
Include disorders that share features of excessive fear and anxiety and related behavioral disturbances.
Anxiety disorders
Marked fear or anxiety about a specific object or situation (e.g., flying, heights, animals, receiving an injection, seeing blood). Note: In children, the fear or anxiety may be expressed by crying, tantrums, freezing, or clinging.
Specific phobia
In S/M-Induced Anxiety Disorder, Symptoms may appear either at initiation of medication or after a modification or change in use
With onset after medication use
Separation anxiety disorder in children may be associated with an increased risk for suicide
suicide risk of Separation Anxiety disorder
Developmentally inappropriate and excessive fear or anxiety concerning separation from those to whom the individual is attached
Separation Anxiety Disorder
approximately _______ of individuals with specific phobia fear more than one situation or object
75%
In separation anxiety disorder, the fear, anxiety, or avoidance is persistent, lasting at least ______ in children and adolescents and typically ________ in adults
4 weeks in children; 6 or more months in adult
A. Panic attacks or anxiety is predominant in the clinical picture. B. There is evidence from the history, physical examination, or laboratory findings of both (1) and (2):
- The symptoms in Criterion A developed during or soon after substance intoxication or withdrawal or after exposure to a medication.
- The involved substance/medication is capable of producing the symptoms in Criterion A.
C. The disturbance is not better explained by an anxiety disorder that is not substance/ medication-induced. Such evidence of an independent anxiety disorder could include the following:
Substance/Medication-Induced Anxiety Disorder
This category applies to presentations in which symptoms characteristic of an anxiety disorder that cause clinically significant distress or impairment in social, occupational, or other important areas of functioning predominate but do not meet the full criteria for any of the disorders in the anxiety disorders diagnostic class.
Other Specified Anxiety Disorder
Marked fear or anxiety about two (or more) of the following five situations:
- Using public transportation (e.g., automobiles, buses, trains, ships, planes). 2. Being in open spaces (e.g., parking lots, marketplaces, bridges).
- Being in enclosed places (e.g., shops, theaters, cinemas).
- Standing in line or being in a crowd.
- Being outside of the home alone.
Agoraphobia
Individuals with specific phobia are up to 60% more likely to make a suicide attempt than are individuals without the diagnosis
suicide risk associated w Specific Phobia
In selective mutism, The duration of the disturbance is at least
1 month (not limited to the first month of school).
often characterized by socialevaluative concerns, fulfilling criteria for social anxiety disorder, that are associated with the fear that the individual makes other people uncomfortable (e.g., “My gaze upsets people so they look away and avoid me”), a fear that is at times experienced with delusional intensity. This symptom may also be found in non-Asian settings.
taijin kyofusho
In S/M-Induced Anxiety Disorder, this specifier applies if criteria are met for withdrawal from the substance and the symptoms develop during, or shortly after, withdrawal.
With onset during withdrawal
Excessive anxiety and worry (apprehensive expectation), occurring more days than not for at least 6 months, about a number of events or activities (such as work or school performance). The individual finds it difficult to control the worry.
Generalized Anxiety Disorder
Marked fear or anxiety about one or more social situations in which the individual is exposed to possible scrutiny by others. Examples include social interactions (e.g., having a conversation, meeting unfamiliar people), being observed (e.g., eating or drinking), and performing in front of others (e.g., giving a speech).
Social Anxiety Disorder (Social Phobia)
a breakdown of cognitive, emotional, or behavioral functioning
Psychological Dysfunction
deviates from the average
Abnormal
The meaning of the Acronym DSM is:
Diagnostic and Statistical Manual of Mental Disorders
