Assessment Methods and Techniques Flashcards
beck depression inventory
a 21-item list test that assess the presence and degree of depression in adolescents and adults
- multiple choice
the Minnesota Multiphasic Personality Inventory (MMPI)
verbal inventory designed as a personality test for the assessment of psychopathology consisting of 550 statements, 16 of which are repeated
Myers-Briggs type indicator (MBTI)
forced-choice, self report inventory that attempts to classify individuals along four theoretically independent dimensions
- 1st dimension: general attitudes toward the world - extroverted (E) or introverted (I)
- 2nd dimension: perception - sensation (S) and intuition (I)
- 3rd dimension: processing - thinking (T) or feeling (F)
- 4th dimension: judging (J) or perceiving (P)
rorschach inkblot test
ct responses to inkblots are used to assess perceptual reactions and other psychological functioning
- most widely used projective tests
Stanford-Binet intelligence scale
designed for the testing of cognitive abilities
- provides verbal, performance, and full scale scored for children and adults
thematic apperception test (TAT)
contains pictures of ambiguous scenes. cts asked to make up stories or fantasies concerning what is happening and is going to happen along with a description of their thoughts and feelings
- widely used projective test
- provides information on a client’s perceptions and imagination for use in the understanding of a client’s current needs, motives, emotions, and conflicts, both conscious and unconscious
- generally a part of a larger batter of tests and interview data
Wechsler intelligence scale (WISC)
designed to measure a child’s intellectual and cognitive ability
- has fours index scales and a full scale score
psychological tests
measure an assortment of mental abilities and characteristics, such as personality, achievement, intelligence, and neurological functioning
educational tests
measure cognitive (thinking) abilities and academic achievement
- provide strengths and weaknesses that accurately identity areas for academic remediation and insight into the best learning strategies
- proved the necessary documentation for the legal purposes of establishing the presence of disabilities, but do not guarantee that finding will be accepted by school or that accommodations will be provided
social work assessment
a comprehensive process that may utilize the results from educational and psychological tests, but can also involve interviewing a client and/or family, reviewing client history, checking existing records, and consulting with previous or concurrent providers
achievement/aptitude tests
measure how much clients know (have achieved) in a certain subject(s) or have ability (aptitude) to learn
- typically used in education
intelligence tests
measure intelligence quotient (IQ)
job/occupational test
match interests with careers
personality tests
measure basic personality traits/charactersitics
neuropsychological tests
assess and measure cognitive functioning (e.g. how a particular problem with the brain affects recall, concentration, etc.)
specialized clinical tests
investigate areas of clinical interest, such as anxiety, depression, post-traumatic stress disorder, and so on
formula for suicide assessment
Significant loss + depressive symptoms = Conduct a suicide assessment
steps for suicide or homicide assessment
- Determine the threat – Assess if there is a real plan or intent.
- Plan & Means – If a plan is confirmed and they have access to carry it out, immediate action (call 911) is required.
- Safety Contracts – If no confirmed plan, establish a safety contract with the client, and monitor their feelings in future sessions.
duty to warn (Tarasoff Rule)
When there is a threat to kill a specific victim you are required to:
(1) Determine the nature of the threat (is there a plan)
(2) Notify the local law enforcement agency and the intended victim
(3) Keep detailed records of the threat and actions taken to protect the victim.
Precontemplation
Individuals in this stage are not aware of a problem or a need for change and are not considering making any changes in the foreseeable future.
-denial, ignorance of the problem
- Example: A person who smokes regularly and believes it’s not a problem and has no intention of quitting.
contemplation
Individuals in this stage are aware of a problem and are starting to consider making a change, but they haven’t made a commitment yet.
-ambivalence, conflicted emotion
- Example: A person who smokes regularly and is starting to think about the health risks and is considering quitting.
preparation
Individuals in this stage are actively preparing to take action and are making small changes towards their goal.
- experimenting with small changes, collecting information about change
- Example: A person who smokes regularly and has decided to quit, has researched different quit methods, and is preparing to set a quit date.
action
Individuals in this stage are actively making changes and taking actions to achieve their goal.
- taking direct action toward achieving a goal
- Example: A person who has quit smoking and is actively avoiding triggers and practicing new behaviors.
maintenance
Individuals in this stage have sustained the change for a significant period and are working to prevent relapse.
- maintaining a new behavior, avoiding temptation
- Example: A person who has quit smoking for several months and is actively working to maintain their quit status.
relapse
a return to old behaviors or patterns of substance use, or any other behavior change, after a period of abstinence or change
- feelings of frustration and failure
- A person who has been abstinent from alcohol for several months relapses and starts drinking again.
other specified diagnosis
the ct is missing one or two of the symptoms that are necessary for a diagnosis
**explanation required
- ex: generalized anxiety disorder requires that the ct experience anxiety most days than not. ct may have all other symptoms and anxiety may interfere with life but not show up on enough days to count as GAD. ct could be diagnosed with other specified anxiety disorder and social worker would add a note explaining why the diagnosis is not GAD
unspecified diagnosis
ct’s challenges fall within a certain group of disorders, but it is not clear exactly which diagnosis in that group best suits client
** does not include explanation for why the criteria for a specific diagnosis are not met
intellectual developmental disorder (IDD)/intellectual disability
Required Symptoms (All 3):
- Deficits in intellectual functions (e.g., reasoning, problem-solving, learning) confirmed by clinical assessment & testing.
- Deficits in adaptive functioning (e.g., communication, social skills, independent living) across multiple settings.
- Onset during the developmental period.
Specifiers: Mild, Moderate, Severe, Profound
Social (Pragmatic) Communication Disorder
Required Symptoms (All 4):
- Difficulty using communication for social purposes (e.g., greetings, sharing info).
- Trouble adjusting communication to different contexts or listeners.
- Issues following conversation rules (e.g., turn-taking, rephrasing, using verbal/nonverbal cues).
- Struggles with implied meanings, idioms, humor, and figurative language.
Other Criteria:
- Causes functional limitations in communication, relationships, academics, or work.
- Onset in early development (may become evident later).
Not due to another disorder (e.g., ASD, IDD, GDD).
Autism Spectrum Disorder (ASD)
ASD
Aloneness
Sameness
Developmental
Required Symptoms:
(All 3 social deficits):
- Impaired social-emotional reciprocity (e.g., abnormal conversation, reduced sharing, failure to initiate/respond).
- Deficits in nonverbal communication (e.g., poor eye contact, gestures, facial expressions).
- Difficulty with relationships (e.g., trouble adjusting behavior, lack of interest in peers).
(At least 2 repetitive behaviors):
- Repetitive movements, speech, or object use (e.g., echolalia, lining up toys).
- Insistence on sameness, rigid routines, or ritualized behavior.
- Intense, fixated interests.
- Hyper- or hyporeactivity to sensory input (e.g., sensitivity to sounds, fascination with lights).
Other Criteria:
- Onset in early development (may become evident later).
- Causes significant impairment in daily life.
- Not better explained by IDD/GDD (though they can co-occur).
Specifiers:
- Severity: Requiring support, substantial support, or very substantial support.
- With/without intellectual or language impairment.
- With a known genetic/medical condition or neurodevelopmental/behavioral disorder.
- With catatonia.
Attention-Deficit/Hyperactivity Disorder (ADHD)
FIDGETY
Functionally impairing
Inattention AND/OR
Disinhibition
Greater than normal
Excluding other disorders
Two or more settings
Young at onset (less than 12)
- Symptoms must persist for ≥6 months, be inappropriate for developmental level, and cause impairment.
- Children: ≥6 symptoms | Age 17+: ≥5 symptoms
Inattention Symptoms:
- Fails to give close attention to details or makes careless mistakes.
- Difficulty sustaining attention in tasks or play.
- Does not seem to listen when spoken to directly.
- Fails to follow through on tasks (e.g., incomplete schoolwork, chores).
- Difficulty organizing tasks and activities.
- Avoids/dislikes tasks requiring sustained mental effort.
- Often loses necessary items.
- Easily distracted by extraneous stimuli.
- Forgetful in daily activities.
Hyperactivity-Impulsivity Symptoms:
- Fidgets, taps hands/feet, or squirms in seat.
- Leaves seat when expected to remain seated.
- Runs/climbs in inappropriate situations (or feels restless in adults).
- Unable to play/engage in activities quietly.
- Acts “on the go” as if “driven by a motor.”
- Talks excessively.
- Blurts out answers before questions are completed.
- Difficulty waiting turn.
- Interrupts or intrudes on others.
Specific Learning Disorder
≥1 symptom for at least 6 months despite targeted interventions:
- Inaccurate/slow word reading
- Difficulty understanding read material
- Poor spelling
- Poor written expression (grammar, organization, clarity)
- Difficulty with number sense, math facts, or calculation
- Difficulty with mathematical reasoning
Criteria:
- Academic skills are significantly below expected for age and impact performance.
- Symptoms begin in school years but may not fully manifest until demands exceed capacity.
- Not better explained by intellectual disability, sensory deficits, mental disorders, or inadequate instruction.
Specifiers:
- With impairment in reading (Dyslexia): Word reading, fluency, comprehension
- With impairment in written expression: Spelling, grammar, organization
- With impairment in mathematics (Dyscalculia): Number sense, math facts, reasoning
Severity:
- Mild: Some difficulty but may function with support.
- Moderate: Marked difficulty, requiring intensive teaching and accommodations.
- Severe: Severe difficulties requiring ongoing, specialized intervention.
Delusional Disorder
Diagnostic Criteria:
- Presence of one or more delusions lasting 1+ months
- Criterion A for schizophrenia has never been met (hallucinations, if present, are minimal and related to the delusion).
- Functioning is not markedly impaired aside from delusions, and behavior is not obviously bizarre.
- If mood episodes occur, they are brief compared to delusions.
- Not due to substance use, medical conditions, or another mental disorder.
Subtypes:
- Erotomanic: Believes someone (often of higher status) is in love with them.
- Grandiose: Believes they possess great talent, insight, or an important discovery.
- Jealous: Believes a partner is unfaithful.
- Persecutory: Believes they are being conspired against, spied on, harassed, poisoned, etc.
- Somatic: Believes in bodily dysfunction (e.g., parasites, organ malfunction).
- Mixed: No single delusional theme dominates.
- Unspecified: Delusional theme is unclear.
Specifiers:
- With bizarre content: Delusions are implausible (e.g., organs replaced without scars).
Course specifiers (after 1 year of illness):
- First episode (acute, partial, full remission)
- Multiple episodes (acute, partial, full remission)
- Continuous (persistent symptoms)
- Unspecified
Severity:
- Rated based on delusions, hallucinations, disorganized speech, abnormal motor behavior, and negative symptoms.
Brief Psychotic Disorder
A. Presence of one or more of the following symptoms (at least one must be 1, 2, or 3):
1. Delusions
2. Hallucinations
3. Disorganized speech (e.g., incoherence, frequent derailment)
4. Grossly disorganized or catatonic behavior
B. Duration is at least 1 day but less than 1 month, with full return to previous functioning.
C: Not better explained by major depressive or bipolar disorder with psychotic features, schizophrenia, catatonia, or substance/medical condition effects.
Specifiers:
- With marked stressor(s) (“brief reactive psychosis”) – Symptoms occur due to extreme stress.
- Without marked stressor(s) – No obvious stressor involved.
- With peripartum onset – Onset during pregnancy or within 4 weeks postpartum.
- With catatonia – Specify if catatonia is present (use additional code F06.1).
Severity Rating:
- Rated based on delusions, hallucinations, disorganized speech, abnormal psychomotor behavior, and negative symptoms on a 0-4 scale (0 = not present, 4 = severe).
Schizophreniform Disorder
A: Two (or more) of the following symptoms, each present for a significant portion of time during a 1-month period (or less if successfully treated). At least one must be (1), (2), or (3):
- Delusions
- Hallucinations
- Disorganized speech (e.g., frequent derailment, incoherence)
- Grossly disorganized or catatonic behavior
- Negative symptoms (e.g., diminished emotional expression or avolition)
B: Episode lasts at least 1 month but less than 6 months.
- If diagnosis is made before full recovery, it should be labeled as “provisional.”
C: Schizoaffective disorder and depressive or bipolar disorder with psychotic features have been ruled out because:
- No major depressive or manic episodes occurred concurrently with active psychotic symptoms.
- If mood episodes have occurred, they were present for less than half of the total duration of the illness.
D: Symptoms are not due to substance use or another medical condition.
Specifiers:
With good prognostic features: Requires at least two of the following:
- Onset of psychotic symptoms within 4 weeks of first noticeable behavior change.
- Confusion or perplexity at peak of symptoms.
- Good premorbid social/occupational functioning before illness onset.
- Absence of blunted or flat affect.
- Without good prognostic features: If two or more of the above are not present.
With catatonia: If catatonic symptoms are present (use additional code F06.1).
Severity Rating:
- Rated based on delusions, hallucinations, disorganized speech, abnormal psychomotor behavior, and negative symptoms on a 0-4 scale (0 = not present, 4 = severe).
Schizophrenia
High-Def BS Network
Hallucinations*
Delusions*
Behavior (disorganized/catatonic)
Speech* (disorganized (e.g., frequent derailment, incoherence)
Negative Symptoms (e.g., diminished emotional expression or avolition)
2-4-6-ophrenia
2 or more symptoms
4 a period of
6 or more months
A: Two (or more) of the following symptoms, each present for a significant portion of time during a 1-month period (or less if successfully treated). At least one must be of this with *
B: For a significant portion of the time since the onset, functioning in one or more major areas (work, interpersonal relationships, self-care) is markedly below the prior level of functioning.
- If onset is in childhood or adolescence, failure to achieve expected academic, social, or occupational functioning.
C: Continuous signs of the disturbance persist for at least 6 months.
- This 6-month period must include at least 1 month of active-phase symptoms (Criterion A).
- It may also include prodromal or residual symptoms (e.g., odd beliefs, unusual perceptual experiences, only negative symptoms).
D: Schizoaffective disorder and depressive or bipolar disorder with psychotic features have been ruled out because:
- No major depressive or manic episodes occurred concurrently with active psychotic symptoms.
- If mood episodes occurred, they were present for less than half of the total duration of the illness.
E: Symptoms are not due to substance use or another medical condition.
F: If there is a history of autism spectrum disorder (ASD) or a childhood-onset communication disorder, schizophrenia is only diagnosed if there are prominent delusions or hallucinations present for at least 1 month (or less if successfully treated).
Specifiers (Only Used After 1 Year of Illness Duration):
- First episode, currently in acute episode → First occurrence with full symptom criteria met.
- First episode, currently in partial remission → Symptoms have improved but still partially present.
- First episode, currently in full remission → No symptoms remain after an episode.
- Multiple episodes, currently in acute episode → Two or more episodes, currently in full symptom phase.
- Multiple episodes, currently in partial remission
- Multiple episodes, currently in full remission
- Continuous → Symptoms persist for most of the illness course with only brief subthreshold symptom periods.
- Unspecified
Specify if:
- With catatonia
Severity Rating:
Based on delusions, hallucinations, disorganized speech, abnormal psychomotor behavior, and negative symptoms on a 0-4 scale (0 = not present, 4 = severe).
Schizoaffective Disorder
A: An uninterrupted period of illness in which a major mood episode (major depressive or manic) occurs concurrently with Criterion A of schizophrenia.
Note: The major depressive episode must include depressed mood (Criterion A1 of MDD).
B: Delusions or hallucinations must be present for at least 2 weeks without a major mood episode at some point during the lifetime duration of the illness.
C: Symptoms that meet criteria for a major mood episode are present for the majority of the total duration of the active and residual phases of the illness.
D: The disturbance is not due to substance use or another medical condition.
Subtypes:
- Bipolar Type → Includes manic episode (major depressive episodes may also occur).
- Depressive Type → Includes only major depressive episodes (no manic episodes).
Specifiers:
- With Catatonia: Use additional F06.1 to indicate comorbid catatonia.
Course Specifiers (Used After 1 Year of Illness Duration):
- First episode, currently in acute episode → First occurrence of full symptom criteria.
- First episode, currently in partial remission → Some symptoms persist, but improvement is evident.
- First episode, currently in full remission → No symptoms remain after a previous episode.
- Multiple episodes, currently in acute episode → Two or more episodes, currently in full symptom phase.
- Multiple episodes, currently in partial remission
- Multiple episodes, currently in full remission
- Continuous → Symptoms persist for most of the illness course, with only brief subthreshold symptom periods.
- Unspecified
Severity Rating:
Based on delusions, hallucinations, disorganized speech, abnormal psychomotor behavior, and negative symptoms on a 0-4 scale (0 = not present, 4 = severe).
Substance/Medication-Induced Psychotic Disorder
psychotic symptoms (hallucination, delusions, etc.) emerge due to substance intoxication, withdrawal, or after exposure to medication. The symptoms aer not better explained by a primary psychotic disorder
specify if: with once during intoxication, with onset during withdrawal, with onset after medication use
psychotic disorder due to another medical condition
psychotic symptoms arise as a result of a medical condition (such as a neurological disorder or endocrine disorder). The symptoms are not better explained by another primary psychotic disorder
specify whether: with delusions, with hallucinations
catatonia associated with another mental disorder (catatonia specifier)
catatonic symptoms, such as motor immobility or excessive motor activity, are present in the context of another mental disbar (ex: mood disorder, schizophrenia)
catatonia disorder due to another medical condition
catatonic symptoms are directly caused by a medical condition, such as neurodevelopment or neurological disorders
unspecified catatonia
diagnosis is applied when the catatonic symptoms are present and causing distress or impairment but they do not neatly fit into any of the more specific diagnostic categories within the catatonia-related disorders
other specified schizophrenia spectrum and other psychotic disorder
includes presentations of psychotic symptoms that do not fit neatly into the other defined categories but still warrant clinical attention
Bipolar I
Manic Episode + Hypomanic or Depressive episode
Manic/Hypomanic
DIG FAST
Euphoria/Irritability +
Distractibility
Impulsivity
Grandiosity
Flight of Ideas
Activity (goal-directed)
Sleep (decreased need)
Talkativeness
Manic
3-4/7 symptoms needed
“one fun week” = symptoms last for 1 or more weeks
Hypomanic
3-4/7 symptoms needed
symptoms last for 4 or more days
Depressive
SIGECAPS
Depressed mood +
Sleep (disturbed)
Interest (decreased)
Guilt
Energy (decreased)
Concentration (impaired)
Appetite changes
Psychomotor slowing
Suicidal thoughts and behaviors
5/9 symptoms needed
“two blue weeks” = symptoms last for 2 or more weeks
unspecified schizophrenia spectrum and other psychotic disorder
used when the symptoms do not meet the criteria for any specific psychotic disorder but still cause significant distress or impairment
Bipolar II
Hypomanic Episode and Depressive Episode
Hypomanic
DIG FAST
Euphoria/Irritability +
Distractibility
Impulsivity
Grandiosity
Flight of Ideas
Activity (goal-directed)
Sleep (decreased need)
Talkativeness
3-4/7 symptoms needed
symptoms last for 4 or more days
Depressive
SIGECAPS
Depressed mood +
Sleep (disturbed)
Interest (decreased)
Guilt
Energy (decreased)
Concentration (impaired)
Appetite changes
Psychomotor slowing
Suicidal thoughts and behaviors
5/9 symptoms needed
“two blue weeks” = symptoms last for 2 or more weeks
hypomanic episode
DIG FAST
Euphoria/Irritability +
Distractibility
Impulsivity
Grandiosity
Flight of Ideas
Activity (goal-directed)
Sleep (decreased need)
Talkativeness
3-4/7 symptoms needed
symptoms last for 4 or more days
**symptoms less severe and less impairing than mania
Cyclothymic Disorder
numerous periods of hypomanic symptoms and depressive symptoms that do not need the criteria for major depressive or hypomanic episodes
- 2 years periods for adults, 1 year for children and adolescents
- symptoms present for at least half of the time and individual as not been without the symptoms for more than 2 months at a time
- specify if: with anxious distress
- specify current severity: mild, moderate, moderate-severe, and severe
substance/medication-induced bipolar and related disorder
mood episodes (manic, depressive, or mixed) are caused by substance intoxication, withdrawal, or medication effects. the symptoms are not better explained by a primary mood disorder.
specify if: with once during intoxication, with onset during withdrawal, with onset after medication use
bipolar and related disorder due to another medical condition
mood disturbances, including manic or depressive symptoms, are directly attributed to the physiological effects of a medical condition, such as a neurological disorder or endocrine disorder
- specify if: with manic features, with manic- or hypomanic-like episode, with mixed features
other specified bipolar and related disorder
includes presentations of bipolar symptoms that do not fit neatly into the other defined categories but still warrant clinical attention. this could involve atypical symptom patterns or specific circumstances
unspecified bipolar and related disorder
when the symptoms do not meet criteria for any specific bipolar or related disorder but still cause significant distress or impairment
unspecified mood disorder
when a person experiences mood-related symptoms that don’t align with the specific criteria for disorders such as major depressive disorder, bipolar disorder, or others within the mood disorder category
Disruptive Mood Dysregulation Disorder (DMDD)
made in children and adolescents who experience severe and frequent temper outbursts that are out of proportion to the situation. the mood between outbursts is persistently irritable or angry. it is a way to differentiate this pattern from early-onset bipolar disorder
- Severe temper outbursts (verbal or physical) that are grossly disproportionate to the situation.
- Outbursts are developmentally inappropriate, occur 3+ times per week, and are persistently irritable/angry between episodes.
- Symptoms persist for 12+ months with no 3-month symptom-free period.
- Present in at least two settings (home, school, or peers) and severe in one.
- Onset before age 10; diagnosis only between ages 6–18.
- No history of full manic/hypomanic episodes lasting over 1 day.
Notes:
- Cannot coexist with ODD, bipolar disorder, or intermittent explosive disorder but can with MDD, ADHD, and conduct disorder.
- If mania/hypomania occurs, bipolar disorder is diagnosed instead.
Major Depressive Disorder (MDD)
SIGECAPS
Depressed mood +
- Sleep
- Interest
- Guilt
- Energy
- Concentration
- Appetite
- Psychomotor slowing
- Suicide
5/9 symptoms
“two blue weeks” = 2 or more weeks
Five+ symptoms in a 2-week period, including depressed mood or loss of interest/pleasure:
- Depressed or irritable mood most of the day, nearly every day.
- Loss of interest/pleasure in activities.
- Significant weight/appetite changes.
- Insomnia or hypersomnia.
- Psychomotor agitation or retardation.
- Fatigue or loss of energy.
- Feelings of worthlessness or excessive guilt.
- Difficulty concentrating or indecisiveness.
- Recurrent thoughts of death or suicide.
Symptoms cause significant distress or impairment in daily life.
Not caused by substance use or a medical condition.
Not better explained by schizophrenia spectrum disorders.
No history of manic or hypomanic episodes.
Specifiers:
- With anxious distress – Prominent anxiety symptoms.
- With mixed features – Some manic/hypomanic symptoms present.
- With melancholic features – Loss of pleasure, profound despair, early morning awakening, weight loss.
- With atypical features – Mood reactivity, increased appetite/sleep, sensitivity to rejection.
- With mood-congruent psychotic features – Delusions/hallucinations align with depressive themes.
- With mood-incongruent psychotic features – Delusions/hallucinations do not match depressive themes.
- With catatonia – Motor disturbances
- With peripartum onset – Onset during pregnancy or within 4 weeks postpartum.
- With seasonal pattern – Recurring depressive episodes tied to seasonal changes.
Persistent Depressive Disorder
SIGECAPS
Depressed mood +
- Sleep
- Interest
- Guilt
- Energy
- Concentration
- Appetite
- Psychomotor slowing
- Suicide
- Depressed mood for most of the day, more days than not, for at least 2 years (1 year for children/adolescents, where mood may be irritable).
- at least 2 symptoms
Symptoms persist without remission for more than 2 months at a time. - Major depressive episodes may be continuously present for 2 years.
- No history of manic or hypomanic episodes.
- Not better explained by schizophrenia spectrum disorders or another medical condition.
- Causes significant distress or impairment in daily life.
Specifiers
- With anxious distress – Prominent anxiety symptoms.
- With atypical features – Mood reactivity, increased sleep/appetite, rejection sensitivity.
- Remission status: Partial (some symptoms) or Full (no symptoms).
- Onset: Early (before 21) or Late (21+).
- Episode patterns (last 2 years):
1. Pure dysthymic – No major depressive episodes.
2. Persistent major depressive – Ongoing major depression.
3. Intermittent w/ current episode – Current major depressive episode, with past symptom-free periods.
4. Intermittent w/o current episode – Past major depressive episode, but not currently.
-Severity: Mild, Moderate, or Severe.
premenstrual dysphoric disorder
involves severe mood disturbances that occur in the week before menstruation and improve shortly after menstruation begins. symptoms include mood swings, irritability, anxiety, and physical symptoms like bloating or fatigue
substance/medication-induced depressive disorder
depressive symptoms emerge as a direct result of a medical condition, such as a neurological disorder or endocrine disorder. the symptoms are not better explained by another primary depressive disorder
specify if: with inset during intoxication, with onset during withdrawal, with onset after medication use
depressive disorder due to another medical condition
depressive symptoms arise as a result of a medical condition (such as a neurological disorder or endocrine disorder). The symptoms are not better explained by another primary psychotic disorder
specify whether: with depressive features, with major depressive-like episode, with mixed features
other specified depressive disorder
includes presentations of depressive symptoms that do not fit neatly into the other defined categories but still warrant clinical attention. this could involve atypical symptom patterns or specific circumstances
unspecified depressive disorder
when the symptoms do not meet criteria for any specific depressive disorder but still cause significant distress or impairment
unspecified mood disorder
when the presentation of symptoms is not well-defined or when the symptoms are atypical
separation anxiety disorder
primarily diagnosed in children, separation anxiety disorder involves excessive distress and anxiety related to separation from attachment figures or home. these fears of beyond what’s developmentally appropriate and impact daily functioning
selective mutism
characterized by constant failure to speak in specific social situations despite speaking in other settings. typically occurs due to anxiety or discomfort
specific phobia
involves an intense and irrational fear of a specific object or situation, such as heights, animals, or flying, this fear causes immediate anxiety and may lead to avoidance behavior
specify if: animal, natural environment, blood-injection-injury, fear of blood, fear of injections and transfusions, fear of other medical care, fear of injury, situational, other
social anxiety disorder
intense fear and anxiety in social situations due to a fear of being judged, embarrassed, or humiliated. fear leads to avoidance of social interactions
specify if: performance only
panic disorder
SURP-rise
Sudden
Unexpected
Recurrent
Panic attacks
give Rise to anxiety
recurrent and unexpected panic attacks, which are intense periods of fear or discomfort that reach a peak within minutes. panic attacks can be accompanied by physical symptoms such as heart palpitations, sweating, trembling, and a fear of losing control or dying
panic attack specifier
agoraphobia
marked by a fear of situations where escape might be difficult or help might not be available if a panic attack or other distressing symptoms occur. individuals often avoid places or situations that trigger this fear
Generalized Anxiety Disorder (GAD)
“EGADS, i’m so MISERA-ble”
Excessive
Generalized
Anxiety
Daily (or most days)
Six months
Muscle tension
Irritability
Sleep disturbance
Energy
Restlessness
Attention
A. Persistent excessive anxiety and worry for 6+ months about various activities.
B. Difficulty controlling the worry.
C. Anxiety associated with 3+ symptoms (1+ in children):
- Restlessness
- Fatigue
- Difficulty concentrating
- Irritability
- Muscle tension
- Sleep disturbances
D. Causes significant distress or impairment.
E. Not due to a substance or medical condition.
F. Not better explained by another mental disorder
substance/medication-induced anxiety disorder
symptoms arise due to substance intoxication, withdrawal, or as a side effect of medication. these symptoms are not better explained by a primary anxiety disorder
specify if: with onset during intoxication, with onset during withdrawal, with onset after medication use
anxiety disorder due to another medical condition
anxiety symptoms emerge as a direct result of a medical condition, such as a neurological disorder or endocrine disorder. the symptoms are not better explained by another primary anxiety disorder
other specified anxiety disorder
includes presentations of anxiety symptoms that do not fit neatly into the other defined \categories but still warrant clinical attention. this could involve atypical symptom patterns or specific circumstances
unspecified anxiety disorder
when the symptoms do not meet criteria for any specific anxiety disorder but still cause significant distress or impairment
Obsessive-Compulsive Disorder (OCD)
I MURDER
Intrusive
Mind-based
Unwanted
Resistant
Distressing
Ego-dystonic
Recurrent
A. Presence of obsessions, compulsions, or both:
- Obsessions: Recurrent intrusive thoughts, urges, or images causing distress, with attempts to suppress them.
- Compulsions: Repetitive behaviors or mental acts aimed at reducing anxiety or preventing an event, though not realistically connected or excessive.
- Young children may not articulate the purpose of these behaviors.
B. Time-consuming (over 1 hour/day) or causes significant distress/impairment.
C. Not due to a substance or medical condition.
D. Not better explained by another mental disorder.
Specifiers:
- Insight: Good/Fair (recognizes beliefs may not be true), Poor (thinks beliefs are probably true), Absent (fully convinced beliefs are true).
- Tic-related: History or presence of a tic disorder.
body dysmorphic disorder (BDD)
Fix ME DOC
Fixation on flaw
Medical care-seeking
Ego-syntonic
Disabling
Obsessive thoughts
Compulsive behavior
having an intense preoccupation with perceived flaws or defects in their physical appearance, which are not noticeable to other or are very minor. this obsession leads to distress and often results in behaviors like checking mirrors excessively or seeking cosmetic procedures.
- specify if: with muscle dysmorphia
hoarding disorder
excessively accumulating and struggling to discard possessions, regardless of their value. the behavior leads to clutter that significantly impairs living spaces and daily functioning
- specify if: with excessive acquisition
trichotillomania
individuals repetitively pull out their own hair, often leading to noticeable hair loss. this behavior is usually driven any tension or an urge and may be an attempt alleviate distress
excoriation disorder
recurrent and compulsive picking of one’s own skin, resulting in skin lesions. this behavior is typically driven by the urge to remove perceived imperfections or relieve tensions
substance/medication-induced obsessive-compulsive and related disorder
obsessive-compulsive or related symptoms arise due to substance intoxication, withdrawal, or as a side effect of medication. these symptoms are not better explained by a primary obsessive-compulsive or related disorder
specify if: with obsessive-compulsive disorder-like symptoms, with appearance preoccupations, with hoarding symptoms, with hair-pulling symptoms, with skin-picking symptoms
other specified obsessive-compulsive and related disorder
includes presentations of obsessive-compulsive or related symptoms that do not fit neatly into the other defined categories but still warrant clinical attention. this could involve atypical symptom patterns or specific circumstances
unspecified obsessive-compulsive and related disorder
used when the symptoms do not meet criteria for any specific obsessive-compulsive or related disorder but still cause significant distress or impairment
reactive attachment disorder
typically diagnosed in children, this disorder involves significantly disturbed and developmentally inappropriate social interactions due to early neglect, deprivation, or other forms of trauma. children with this disorder may struggle to form appropriate emotional bonds
- specify if: persistent
- specify current severity: severe
disinhibited social engagement disorder
diagnosed in children, this disorder manifests as a pattern of overly familiar behavior with unfamiliar individuals, often due to a history of neglect or multiple caregivers. children with their disorder may lack appropriate social boundaries
specify if: persistent
specify current severity: severe
Posttraumatice Stress Disorder (PTSD)
TRAUMA
Traumatic event
Re-experiencing (intrusive)
Arousal
Unable to function
Month or more
Avoidance
over 6 years old
A. Trauma Exposure (one or more):
- Direct experience
- Witnessing trauma
- Learning about trauma affecting close others (must be violent/accidental)
- Repeated/extreme exposure to traumatic details (work-related only)
B. Intrusion Symptoms (one or more):
- Intrusive memories (repetitive play in children)
- Distressing dreams
- Flashbacks (trauma reenactment in children)
- Psychological distress to trauma cues
- Physiological reactions to trauma cues
C. Avoidance (one or both):
- Avoiding trauma-related thoughts/feelings
- Avoiding trauma-related external reminders
D. Negative Cognitions & Mood (two or more):
- Memory gaps about trauma
- Negative self/world beliefs
- Distorted blame (self or others)
- Persistent negative emotions
- Loss of interest in activities
- Detachment from others
- Inability to feel positive emotions
E. Arousal/Reactivity Changes (two or more):
- Irritability/anger outbursts
- Recklessness/self-destructive behavior
- Hypervigilance
- Exaggerated startle response
- Concentration problems
- Sleep disturbances
F. Duration: Symptoms persist >1 month
G. Distress/Impairment: Significant impact on life
H. Not due to substances/medical conditions
Specifiers:
- With dissociative symptoms: Depersonalization (feeling detached) or derealization (world feels unreal)
- With delayed expression: Full criteria met ≥6 months post-trauma
6 and younger
A. Trauma Exposure: Direct, witnessed (especially caregivers), or learning about parental trauma.
B. Intrusion Symptoms (one or more): Memories (play reenactment), distressing dreams, flashbacks, distress or reactions to trauma cues.
C. Avoidance/Negative Cognitions (one or more): Avoidance of trauma reminders, increased negative emotions, reduced interest/play, social withdrawal, lack of positive emotions.
D. Arousal/Reactivity Changes (two or more): Irritability/tantrums, hypervigilance, exaggerated startle, concentration issues, sleep disturbances.
E. Duration: >1 month
F. Distress/Impairment: Affects relationships/school behavior.
G. Not due to substances/medical conditions
Specifiers:
- With dissociative symptoms: Depersonalization or derealization
- With delayed expression: Full criteria met ≥6 months post-trauma
acute stress disorder
involves symptoms like intrusion, negative mood, dissociation, avoidance, and arousal, but these symptoms arise immediately after exposure to a traumatic event and last up to a month, while PTSD symptoms present slower and last longer, especially if not treated
adjustment disorder
emotional or behavioral symptoms that arise in response to an identifiable stressor. symptoms include sadness, anxiety or behavior changes. the stressor’s impact exceeds what is typically expected in relation to the event
- specify if: acute, persistent (chronic)
- specify whether: with depressed miid, with anxiety, with mixed anxiety and depressed mood, with mixed disturbance of emotions and conduct, unspecified
prolonged grief disorder
an intense and prolonged form of grief that extends beyond the expected period of mourning. it is characterized by a persistent and sever longing for the deceased individual, along with emotional pain and difficulty adapting to life without them
other specified trauma and stressor related disorder
presentations of trauma or stressor-related symptoms that do not fit neatly into the other defined categories but still warrant clinical attention. this could involve atypical symptom patterns of specific circumstances
unspecified trauma and stressor related disorder
presentations of trauma or stressor related symptoms that do not fit neatly into the other defined categories but still warrant clinical attention. this could involve atypical symptom patterns or specific circumstances
Dissociative Identity Disorder (DID)
Deeper DREAMS
Depersonalization
Derealization
Retrograde amnesia
Errors of commission
Absorption
Motor automaticity
Suggestibility
A. Disrupted Identity
- Presence of two or more distinct personality states.
- May be described as possession in some cultures.
- Significant changes in self-perception, behavior, memory, emotions, cognition, and motor function.
- Symptoms may be noticed by others or reported by the individual.
B. Memory Gaps
- Recurrent gaps in recalling everyday events, personal history, or traumatic events.
- Memory loss is beyond normal forgetting.
C. Significant Impairment
- Symptoms cause distress or dysfunction in social, occupational, or other key areas of life.
D. Not Culturally or Religiously Normative
- Symptoms are not part of widely accepted cultural or religious practices.
- In children, symptoms cannot be explained by imaginary playmates or fantasy play.
E. Not Due to Substances or Medical Conditions
- Symptoms cannot be attributed to substance use (e.g., alcohol-related blackouts) or medical issues (e.g., seizures).
Dissociative Amnesia
involves memory gaps related to personal information, often about traumatic or stressful events. it can be localized (specific time period), selective (specific events), generalized (overall identity and life history), or continuous (ongoing inability to recall new informations)
specify if: with dissociative fugue
Depersonalization/derealization disorder
characterized by feelings of detachment from oneself, as it observing from outside the body. involves as sense of unreality or detachment from the surroundings. these experiences are distressing and can impair daily functioning
other specified dissociative disorder
presentations of dissociative symptoms that do not fit neatly into the other defined categories but still warrant clinical attention. this could involve atypical symptom pattern or specific circumstances
unspecified dissociative disorder
used when the symptoms do not meet criteria for any specific dissociative disorder but still cause significant distress or impairment
Somatic Symptom Disorder
SOME ATTIC
Symptoms
One or more
Medically unexplained
Excessive
Anxiety
Thinking about
Time-consuming
Impairing
Chronic (6+ months)
A. Distressing Somatic Symptoms
- One or more physical symptoms cause significant distress or daily disruption.
B. Excessive Preoccupation (At least one of the following):
- Persistent and excessive thoughts about the seriousness of symptoms.
- High levels of anxiety about health or symptoms.
- Excessive time and energy focused on symptoms or health concerns.
C. Chronic Condition
- Symptoms may vary but persist for at least 6 months.
Specifiers
- With Predominant Pain: Primary symptom is chronic pain (previously called pain disorder).
- Persistent: Severe, long-lasting symptoms (more than 6 months) causing significant impairment.
- Mild, Moderate, Severe
Illness Anxiety Disorder
formerly known as hypochondriasis. involves excessive worry about having a serious illness, despite minimal or no medical evidence to support the belief. individuals often misinterpret normal bodily sensations as a sign of a sever medical condition
specify whether: care-seeking type, care-avoiding type
functional neurological symptom disorder/conversion disorder
CAN’T-version
Clinically unexplained
Abnormality
Nervous Sytem
Trigger (sometimes)
A. Altered Motor or Sensory Function
- One or more symptoms affecting voluntary movement or sensory function.
B. Incompatibility with Medical Explanations
- Clinical evidence shows that symptoms do not align with known neurological or medical conditions.
C. Not Explained by Another Disorder
- Symptoms are not better accounted for by another medical or mental condition.
D. Significant Distress or Impairment
- The condition causes clinically significant distress or functional impairment in social, occupational, or other areas of life.
- If no impairment, medical evaluation is still warranted.
specify if: acute episode, persistent, with psychological stressor (specify stressor), without psychological stressor
specify symptom type: with weakness or paralysis, with abnormal movement, with swallowing symptoms, with speech symptom, with attacks or seizures, with anesthesia or sensory loss, with special sensory symptom, with mixed symptoms
psychological factors affecting other medical conditions
when a general medical condition is adversely affected by psychological or behavioral factors; the factors may precipitate or exacerbate the medical condition, interfere with treatment, or contribute to morbidity and mortality
specify current severity: mild, moderate, severe, and extreme
factitious disorder
FAC
Factitious
Always
Comes back
specify: single episode, recurrent episodes
Factitious disorder imposed on self
individuals intentionally falsify, exaggerate, or induce physical or psychological symptoms in themselves for the purpose of assuming “sick role”. there is no apparent external reward, such as financial gain
A. Intentional Falsification or Induction of Symptoms
- The individual fabricates or induces physical or psychological symptoms, illness, or injury.
- The deception is intentional and deliberate.
B. Presentation as Ill or Injured
- The person actively presents themselves to others as sick, injured, or impaired.
C. Deception Occurs Without External Rewards
- Unlike malingering (which involves external incentives like financial gain or avoiding responsibilities), the deceptive behavior occurs without obvious rewards.
D. Not Better Explained by Another Mental Disorder
- The behavior is not due to delusional disorder, another psychotic disorder, or a misunderstanding of one’s health condition.
Specify if: Single Episode, Recurrent Episodes
factitious disorder imposed on another
formerly known as Munchausen syndrome by proxy
individuals falsify, exaggerate, or induce physical or psychological symptoms in another person, often someone under their care to assume a caregiver role. there is no apparent external reward
A. Falsification or Induction of Symptoms in Another Person
- The individual fabricates or induces physical or psychological symptoms, illness, or injury in another person (the victim).
- The deception is intentional and deliberate.
B. Presentation of the Victim as Ill or Injured
- The perpetrator actively presents the victim to others (e.g., medical professionals, caregivers) as sick, impaired, or injured.
C. Deception Occurs Without External Rewards
- The behavior occurs without an obvious external incentive (e.g., financial gain, avoiding responsibilities).
D. Not Better Explained by Another Mental Disorder
- The behavior is not due to delusional disorder, another psychotic disorder, or a misunderstanding of the victim’s health.
other specified somatic symptom and related disorder
includes presentations of somatic and related symptoms that do not fit neatly into the other defined categories but still warrant clinical attention. this could involve atypical symptom patterns or specific circumctances
unspecified somatic symptoms and related disorder
used when the symptoms do not meet criteria for any specific somatic symptom and related disorder but still cause significant distress or impairment
Pica
eating non-nutritive, non-food substances over a period of at least one month, and the behavior is developmentally inappropriate. common substances might include paper, clay, hair, cloth, or string
rumination disorder
involved the repeated regurgitation of food, which may be re-chewed, re-swallowed, or spit out. it’s not due to a medical condition and lasts for at least one month
avoidant/restrictive food intake disorder (ARFID)
extreme limitation in food intake, often due to sensory sensitivities, concerns about adverse consequences, or lack of interest in eating. it is not driven by concerns about weight or body shape
Anorexia nervosa
UNDER-exia
Underweight
Nervous to gain weight
Distorted perception
Exercise, purging
Restricting intake
- Restricted food intake → Significantly low body weight.
- Intense fear of weight gain → Persistent behaviors preventing weight gain.
- Distorted body image → Overemphasis on weight/shape, denial of severity.
B. Subtypes
- Restricting Type: No binge/purge in 3 months; weight loss via dieting, fasting, or exercise.
- Binge-Eating/Purging Type (F50.02): Recurrent binge-eating or purging in 3 months.
C. Remission
- Partial: Weight restored, but fear/distorted body image persists.
- Full: No criteria met for a sustained period.
D. Severity (Based on BMI)
Mild, Moderate, Severe, Extreme
Bulimia Nervosa
BOWL-emia
Binging
Offsetting (purging)
Weekly for 3+ months
Linked to self-esteem
Recurrent binge eating:
- Eating excessive amounts within a short time.
- Feeling a lack of control during episodes.
Compensatory behaviors: Vomiting, laxatives, fasting, or excessive exercise to prevent weight gain.
Frequency: Bingeing and compensatory behaviors occur at least once a week for 3 months.
Self-evaluation: Overly influenced by body shape and weight.
Not exclusive to anorexia nervosa.
specify if: partial, full remission
severity (based on compensatory): mild, moderate, severe, extreme
binge-eating disorder (BED)
recurrent episodes of eating large amounts of food in a short period, with a sense of lack of control during the binge. there are no regular compensatory behaviors
other specified feeding or eating disorder
presentations of feeding and eating symptoms that do not fit neatly into the other defined categories but still warrant clinical attention. could involve atypical symptom patterns or specific circumstances
unspecified feeding or eating disorder
when the symptoms do not meet criteria for any specific feeding and eating disorder but still cause significant distress or impairment
enuresis
repeated involuntary urination in inappropriate places, typically occurring during sleep (nocturnal enuresis) or during waking hours (dinural enuresis). the behavior is considered developmentally inappropriate and typically occurs in children who are old enough to have bladder control
specify whether: nocturnal only, diurnal only, nocturnal and dinural
encopresis
the involuntary passage of feces in inappropriate places, often after the age when bowel control is expected. not due to a medical condition and typically occurs under children
specify whether: with constipation and overflow incontinence, without constipation and overflow incontinence
other specified elimination disorder with urinary symptoms
cases where the individual experiences problematic patterns related to urination, but the symptoms do not meet the criteria for enuresis or other well-defined disorders. the symptoms might involve tissues with urgency, frequency, or other urinary difficulties
other specified elimination disorder with fecal symptoms
cases where the individual experiences problematic patterns related to bowel movements or feces, but the symptoms do not meet the criteria for encopresis or other well-defined disorders. the symptoms might involve tissues with soiling, discomfort, or other fecal-related difficulties
insomnia disorder
difficulty falling asleep, staying asleep, or experiencing non-restorative sleep, despite having adequate opportunity for sleep. this pattern leads to significant daytime distress or impairment
specify if: with mental disorder, with medical condition, with another sleep disorder
hypersomnolence disorder
excessive daytime sleepiness, which often results in prolonged sleep episodes during the day. despite getting sufficient sleep, they struggle to stay awake and alert
specify if: with mental disorder, with medical condition, with another sleep disorder
narcolepsy
excessive daytime sleepiness and sudden uncontrollable episodes of falling asleep during the day. may also involve cataplexy (sudden loss of muscle tone), sleep paralysis, and hallucinations during sleep onset or upon awakening
unspecified sleep-wake disorder
presentations of sleep-wake symptoms that do not fit neatly into the other defined categories but still warrant clinical attention. could involve atypical symptom patterns or specific circumstances
delayed ejaculation
a significant delay or absence of ejaculation during sexual activity, despite adequate sexual arousal and stimulation. this issue causes distress or impairment
erectile disorder
previously known as erectile dysfunction
persistent difficulty achieving or maintaining and erection sufficient for satisfactory sexual performance. the issue causes distress or impairment
female orgasmic disorder
a delay, absence, or reduced intensity or orgasm during sexual activity even when arousal and stimulation are adequate. there difficulty in achieving orgasm causes distress or impairment
specify if: never experienced an orgasm under any situation
female sexual interest/arousal disorder
persistent or recurrent deficiency in sexual interest, thought or arousal. individuals may have difficulty becoming sexually aroused or maintaining arousal during sexual activity, leading to distress or impairment
genito-pelvic pain/penetration disorder
persistent or recurrent pain during intercourse, difficulty with vaginal penetration, or fear or anxiety about pain during sexual activity. the pain or fear causes distress or impairment
male hypoactive sexual desire disorder
a persistent or recurrent lack of interest in sexual activity, often accompanied by reduced sexual thoughts or fantasies. the lack of sexual desire causes distress or impairment
premature (early) ejaculation
involves the recurrent ejaculation before or shortly after penetration during sexual activity, often with minimal sexual stimulation. the time of ejaculation causes distress or impairment
substance/medication-induced sexual dysfunction
the development of sexual dysfunction as a result of substance use or medication. recognizes that certain substances and medication can have a direct impact on sexual function, leading to change in sexual desire, arousal, and performance
specify if: with onset during intoxication, with onset during withdrawal, with onset after medication use
other specified sexual dysfunction
presentation of sexual dysfunction symptoms that do not meet the criteria for any specific sexual dysfunction but still warrant clinical attention. could involve a typical symptom patterns nor specific circumstances
unspecified sexual dysfunction
when the symptoms of sexual dysfunction cause distress or impairment but the specific nature of the dysfunction or its relationship to other sexual disorders is not fully understood
Gender Dysphoria in children
given when a child experiences a marked incongruence between their experienced/expressed gender and their assigned sex at birth. the child may express a desire to be of a different gender, to be treated as a different gender, or assert that they are of a different gender
A. Core Criteria (≥6 months, at least one from A1)
- Strong desire or insistence on being another gender.
- Preference for cross-dressing or resisting assigned-gender clothing.
- Preference for cross-gender roles in play.
- Preference for toys/activities stereotypical of another gender.
- Preference for playmates of another gender.
- Rejection of gender-typical toys, games, and activities.
- Strong dislike of one’s sexual anatomy.
- Desire for sex characteristics of experienced gender.
B. Distress & Impairment
- Causes significant distress in social, school, or other areas.
Specifier
- With a disorder/difference of sex development (e.g., congenital adrenal hyperplasia).
Gender Dysphoria in adolescents and adults
given when adolescents and cults experience a marked incongruence between their experienced/expressed gender and their assigned sex at birth. the individual may experience significant distress related to the incongruence and may seek social, hormonal, or surgical interventions to bring their body and gender identity into alignment
specify if: posttransition
A. Core Criteria (≥6 months, at least two of the following)
- Incongruence between experienced gender and primary/secondary sex characteristics.
- Desire to remove/prevent primary/secondary sex characteristics.
- Desire for the primary/secondary sex characteristics of another gender.
- Desire to be another gender (or alternative gender).
- Desire to be treated as another gender.
- Conviction of having typical feelings/reactions of another gender.
B. Distress & Impairment
- Causes significant distress in social, occupational, or other areas.
Specifiers
- With a disorder/difference of sex development (e.g., congenital adrenal hyperplasia).
- Posttransition: Living full-time in experienced gender with/without legal recognition and undergoing/preparing for medical transition (e.g., hormone therapy, surgery).
other specified gender dysphoria
when an individual’s gender-related experiences do not fully meet the criteria for gender dysphoria in children, adolescents, or adults but they still warrant clinical attention. this could include atypical patterns of gender identity, expression, or incongruence that do not align with the specific criteria of other diagnoses. the individual may experience some degree of distress or impairment related to their gender identity
unspecified gender dysphoria
when an individual’s gender-related experiences do not fully meet the criteria for gender dysphoria in children, adolescents, or adults but they still warrant clinical attention. this could include atypical patterns of gender identity, expression, or incongruence that do not align with the specific criteria of other diagnoses. the individual may experience some degree of distress or impairment related to their gender identity
oppositional defiant disorder (ODD)
A. Ongoing pattern (6+ months) of at least 4 symptoms in interactions (not just with siblings), showing:
- Angry/Irritable Mood:
- Often loses temper
- Easily annoyed
- Often angry or resentful
Argumentative/Defiant Behavior:
- Argues with authority figures
- Refuses to follow rules
- Deliberately annoys others
- Blames others for mistakes
Vindictiveness:
- Spiteful or vindictive at least twice in past 6 months
B. Behavior causes distress or problems in social, school, or work settings.
C. Not due to another mental disorder (like psychosis, depression, bipolar, etc.).
Severity
- Mild: Symptoms in one setting
- Moderate: Symptoms in two settings
- Severe: Symptoms in three or more settings
Intermittent Explosive Disorder
A. Repeated aggressive outbursts, shown by either:
- Verbal or physical aggression (no injury/damage), happening twice a week for 3 months
OR
- 3 outbursts in a year that involve property damage or injury to people/animals
B. Reactions are much more intense than the situation calls for.
C. Outbursts are impulsive, not planned or goal-driven.
D. They cause distress, problems at work/school/relationships, or legal/financial issues.
E. Person is at least 6 years old (or developmentally equivalent).
F. Behavior isn’t better explained by another mental or medical condition, or substance use.
Note: This can be diagnosed alongside other disorders if the aggression is beyond what’s typical for those diagnoses.
conduct disorder
A. Ongoing pattern (12 months or more) of behavior that violates others’ rights or societal rules, with at least 3 of these behaviors (and 1 in the past 6 months):
Aggression to People/Animals:
- Bullies, fights, uses weapons
- Cruel to people/animals
- Steals with confrontation
- Forces sexual activity
Property Destruction:
- Fire setting or vandalism
- Deceit/Theft:
- Break-ins, lying for gain, stealing without confrontation
Serious Rule Violations:
- Breaks curfew (before age 13)
- Runs away
- Skips school (before age 13)
B. Behavior causes significant issues at school, work, or socially.
C. If 18 or older, doesn’t meet criteria for antisocial personality disorder.
Types (based on onset):
- Childhood-onset: At least one symptom before age 10
- Adolescent-onset: No symptoms before age 10
- Unspecified-onset: Not enough info to tell
Specifier – With Limited Prosocial Emotions (must have 2+ for 12+ months):
- No guilt or remorse
- Lack of empathy
- Doesn’t care about performance
- Shallow, fake, or manipulative emotions
Severity Levels:
- Mild: Minor harm (e.g., lying, truancy)
- Moderate: In between (e.g., stealing, vandalism)
- Severe: Serious harm (e.g., assault, forced sex, weapon use)
Tic disorder
TIC
Transient
Irresistible
Contraction
Tourette Syndrome
TWO-rette Syndrome
- two forms of tics (motor and vocal)
Neurocognitve Disorder
DIRE
Decline in cognition
Impairment
Rule out delirium
Exclude psychiatric
Delirium
Where The F AM I
Where (disorientation)
Transient
Fluctuating
Acute
Medical causes
Intoxicants
Intentionally Feigned Illness
MALingering or FACtitious disorder?
Malingering Always Leaves
Factitious Always Comes back
Substance Use Disorders
Time 2 CUT DOWN PAL
Time spent
(2 or more)
Cravings
Unable to Stop
Tolerance
Dangerous
Others affected
Withdrawal
Neglects responsibilities
Problem made worse
Activities stopped
Larger amounts or for longer
the 3 REAPers
- repeated use
- reinforcers (positive)
- repercussions
Cluster A Personality Disorder
PaSS on the invitation
Paranoid
Schizoid
Schizotypal
Cluster B Personality Disorder
BAHNed from the party
Borderline
Antisocial
Histrionic
Narcissistic
Cluster C Personality Disorders
party is Dead On Arrival
Dependent
Obsessive-compulsive
Avoidant
Schizoid Personality Disorder
- cluster A
- schizoid avoids
- detachment from social relationship, limited emotional expression, and preference for solitary activities
Schizotypal Personality Disorder
- cluster A
- schiz-o-typal is a type-o’-schizo(phrenia)
- eccentric behavior, odd beliefs or magical thinking, and discomfort with close relationships, along with perceptual distortions
Paranoid Personality Disorder
- cluster A
- a pattern of distrust and suspicion of other, interpreting their motives as malevolent, without justification
Borderline Personality Disorder
- cluster b
- instability in relationships, self-image, and emotions marked by impulsivity, self-destructive behavior, and intense fear of abandonment
I DESPAIR
identity disturbance
dysphoria/emptiness
emotional instability
suicide and self-harm
psychotic/dissociative
anger
impulsivity
relationships
antisocial personality disorder
- cluster b
- disregard for others’ rights, lack of empathy, manipulative behavior, impulsivity, and a history of conduct problems
histrionic personality disorder
- cluster b
- attention-seeking behavior, strong emotions, and exaggerated expressions, often seeking reassurance and approval
- Individuals crave attention and use dramatic, seductive, or provocative behaviors to achieve it
narcissistic personality disorder
- cluster b
- grandiosity, a need for admiration, lack of empathy and a sense of entitlement
- Individuals seek admiration and validation for their inflated sense of self-importance
dependent personality disorder
- cluster c
- excessive need to be cared for, submissive behavior, fear of separation, and difficulty making decisions independently
obsessive-compulsive personality disorder
- cluster c
- preoccupation with orderliness, perfectionism, and control, often at the expense of flexibility and interpersonal relationships
avoidant personality disorder
- cluster c
- extreme social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation, leading to avoidance of social interactions
