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CPSE > Clinical Assessment and Evaluation > Flashcards

Clinical Assessment and Evaluation Flashcards

1
Q

Mental Status Exam

A

1) Orientation and Sensorium (x4: person, place, time, situation)
2) General appearance and behavior
3) Mood and affect
4) Attention, concentration, memory
5) Intellectual functioning
6) Insight and judgment
7) Thought content, process, perceptions

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2
Q

MMPI Validity scales

A

L- high: naive or unsophisticated attempt to present as positive

F- high: infrequently endorsed items, exaggeration or significant distress

K- high: defensiveness

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3
Q

MMPI Clinical Scales

A

1: Hypochondriasis
2: Depression
3: Hysteria (Physical complaints; denial of emotional problems)
4: Psychopathic Deviate
5: Male/Female
6: Paranoia
7: Psychastenia (fears, anxieties, compulsions, obsessions, indecisivness)
8: Schizophrenia
9: Hypomania
0: Social Introversion

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4
Q

WISC-IV age range

A

6.0 years to 16.11 years

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5
Q

WAIS-IV age range

A

16-89 years

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6
Q

Non-verbal tests of intelligence

A

Raven’s Progressive Matrices

Leiter International Performance Scale (2-20 years)

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7
Q

1-year prevalence rate for mental disorders in adults

A

20-25%

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8
Q

Prevalence rates are highest in adults for which disorders

A

Anxiety (16%)

Mood (7%)

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9
Q

Annual prevalence rate for mental disorders in children with at least mild functional impairment

A

20%

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10
Q

Prevalence rates are highest in children/adolescents for which disorders

A

Anxiety (13%)
Disruptive (10%)
Mood (6%)
Substance use (2%)

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11
Q

1-year prevalence rate for mental disorders in older adults

A

20%

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12
Q

Prevalence rates are highest in older adults for which disorders

A

Anxiety (11.5%)
Mood (4.5%)
Severe cognitive impairment (Alzheimer’s) (6.6%)

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13
Q

Mental retardation

A

1) IQ below 70
2) Concurrent deficits in adaptive functioning in at least 2 areas

  • Prevalence rate: 1%
  • Individuals with MR have 3-4x comorbid mental disorders compared to general population
  • Male to female is 1.5:1
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14
Q

Learning Disorders

A

1) Achievement score is substantially below that expected, schooling, and level of intelligence
2) More than 2 sd between IQ and achievement

  • Prevalence: 2-10%
  • More commonly diagnosed in males
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15
Q

Autistic Disorder

A

1) Impairment in social interaction
2) Impairment in communication
3) Restricted repertoire of activities
4) Onset prior to age 3
- 75% of all children with Autism are diagnosed with MR
- Male to female is 4 or 5: 1

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16
Q

Asperger’s Disorder

A

1) Impairment in social interaction
2) Restricted repertoire of activities
3) NO LANGUAGE DELAYS
- At least 5 times more diagnosed in males than females

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17
Q

ADHD

A

1) Persistent pattern of inattention and/or hyperactivity/impulsivity
2) Symptoms present for at least 6 months in 2 settings
3) Impairment present before 7 years of age
- Prevalence is 3-7% in school-aged children
- 6-9 times more common in males

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18
Q

Conduct Disorder

A

1) Repetitive and persistent pattern of behaviors in which the basic rights of others and major age-appropriate societal norms/rules are violated
2) 3 or more symptoms present for at least 12 months (aggression to people and animals, destruction of property, deceitfulness, theft, serious violations of rules)
- Prevalence: 1-10%
- More common in males

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19
Q

ODD

A

1) Recurrent pattern of negativistic, defiant, or disobedient and hostile bxs toward authority figures for at least 6 months
- Prevalence rates: 2-16%
- More common in males than females before puberty, but equally common after puberty

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20
Q

Separation Anxiety Disorder

A

1) Developmentally inappropriate and excessive anxiety around being away from home or away from attached individuals
2) Disturbance lasts at least 4 weeks
3) Onset prior to age 18
- Prevalence rates: 4% in children and young adolescents
- Equally common in males and females in clinic samples
- Higher in females in epidemiological samples
- May precede Panic Disorder with Agoraphobia

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21
Q

Delirium

A

1) Disturbance in consciousness and change in cognition or perceptual disturbance that develops over a short period of time and has a fluctuating course

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22
Q

Dementia

A

1) Impairments in memory and AT LEAST ONE of the following cognitive disturbances:

Aphasia, apraxia, agnosia, or disturbance in executive functioning

  • Highest prevalence in adults over 85 years old
  • 1.5% of adults 65-69 years old and 16-25% of people over 85 years old
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23
Q

Substance dependence

A

1) Cognitive, behavioral, and physiological symptoms occurring over 12 months that indicates the person continues to use the substance in spite of significant substance-related difficulties
2) Usually results in tolerance, withdrawal, and compulsive drug taking behavior

15% prevalence for alcohol

Male to female is 5:1

Ind 18-24 years of age have the highest prevalence rates

Rates of alcohol dependence are lowest in Asians, equal in blacks and whites, higher in Latino males, and lower in Latina females. Rates are highest for Native Americans

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24
Q

Substance abuse

A

1) Maladaptive pattern of substance use leading to impairment or distress with 1 or more of the following in a 12-month period:

Failure to fulfill major role obligations
Recurrent use in physically hazardous situations
Recurrent substance-related legal problems
Recurrent use in spite of social/interpersonal problems

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25
Q

Specifiers for substance dependence/abuse

A

1) Early full remission: At least 1 month and less than 12 months where no criteria is met
2) Early partial remission: At least 1 month and less than 12 months where one or more criteria have been met, but full criteria for dependence is not met
3) Sustained full remission: 12 months or more where no criteria is met
4) Sustained partial remission: 12 months or more where one or more criteria have been met, but does not meet criteria for dependence

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26
Q

Schizophrenia

A

1) Disturbance that lasts for at least 6 months and includes at least 1 month of active-phase symptoms
2) Active phase symptoms must include 2 or more of the following:

Delusions
Hallucinations
Disorganized speech
Grossly disorganized/catatonic behavior
Negative symptoms
  • Prevalence is .5-1.5%
  • First degree relatives have a risk of developing schizophrenia that is 10 times greater than that of the general population
  • Slightly higher in males than females
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27
Q

Subtypes of schizophrenia

A

1) Paranoid type: Preoccupation with one or more delusions or frequent auditory hallucinations
2) Disorganized type: Prominent disorganized speech, disorganized behavior, and flat/inappropriate affect
3) Catatonic type: At least 2 of the following: motoric immobility, excessive purposeless motor activity, negativism or mutism, peculiarities of voluntary movement, or echolalia
4) Undifferentiated type
5) Residual type: Had a least one episode of schizophrenia but there is an absence of prominent delusions, hallucinations, disorganized speech, but still some negative symptoms or milder forms of above described symptoms present

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28
Q

Schizophreniform

A

Presentation similar to schizophrenia, but disturbance lasts from 1-6 months

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29
Q

Schizoaffective disorder

A

Disturbance in which mood episode and active phase symptoms of schizophrenia occur together, which is preceded or followed by at least 2 weeks of delusions or hallucinations without mood symptoms

30
Q

Delusional Disorder

A

At least one month of NON-BIZARRE delusions without other active phase symptoms. Except for the delusion, the person’s functioning is otherwise not impaired

-Persecutory type is most common
Prevalence rate of .03%

31
Q

Subtypes of delusional disorder

A

Erotomanic: Another individual is in love with the person

Grandiose: Inflated self worth, power, knowledge

Jealous: Person believes partner is being unfaithful

Persecutory: Person or someone close to them is being persecuted or ill-treated

Somatic: Physical defect or medical problems

Mixed: Characteristics or more than one without any single theme dominating

Unspecified: Delusions not characteristic of any of the above themes

32
Q

Brief Psychotic Disorder

A

Psychotic disturbance that lasts more than one day and remits by one month

33
Q

Major depressive disorder

A

The presence of at least one Major Depressive Episode

Episode: 5 or more symptoms for 2 weeks or more

1) At least 1 symptom is depressed mood or loss of interest or pleasure
2) Significant weight loss or weight gain
3) Insomnia or hypersomnia
4) Psychomotor agitation or retardation
5) Fatigue or loss of energy
6) Feelings of worthlessness or guilt
7) Problems with thinking, concentration, or indecisiveness
8) Recurrent thoughts of death, suicidal ideation, plan, or attempt

Lifetime prevalence: 10-25% for women; 5-12% for men

Periods of remission generally last longer early in the course of treatment

34
Q

Dysthymic Disorder

A

Chronically depressed mood that occurs for most of the day, more days than not for at least 2 years (one year in children)

Lifetime prevalence: 6%

Equally common in children, occurs 2-3 times more frequently in women than men

35
Q

Manic Episode

A

Abnormally and persistently elevated, expansive, or irritable mood for at least 1 week

Three or more of the following:

1) Inflated self-esteem
2) Decreased need for sleep
3) Pressured speech
4) Racing thoughts, flights of ideas
5) Distractibility
6) Psychomotor agitation
7) Excessive involvement in pleasurable activities

Causing marked impairment or requiring hospitalization

36
Q

Bipolar I

A

Occurrence of 1 or more manic episodes or mixed episodes

DOES NOT REQUIRE DEPRESSIVE EPISODE

Lifetime prevalence is .4-1.6%

Equally common in males/females and across different races/ethnicities

More than 90% of people who have a manic episode go on to have future episodes

37
Q

Bipolar II

A

1 or more major depressive episode and at least 1 hypomanic episode

Lifetime prevalence is about .5%

may be more common in women

38
Q

Cyclothymic disorder

A

Chronic fluctuating modd disturbance involving numerous hypomanic symptoms and numerous periods of depressive symptoms persistent at least 2 years (one year in children)

39
Q

Panic attack

A

Not a codable disorder

A discrete period of intense fear or discomfort in which 4 or more symptoms develop abruptly and peak within 10 minutes:

Palpitations
Sweating
Trembling
Shortness of breath
Chest pain
Dizziness
Derealization/ depersonalization
Fear of dying
40
Q

Agoraphobia

A

Not a codable disorder

Anxiety about being in places or situations from which escape might be difficult or embarassing

Situations are avoided or endured with marked distress or require the presence of a companion

41
Q

Panic Disorder with Agoraphobia

A

Agoraphobia without history of panic attack

42
Q

Panic Disorder without Agoraphobia

A

Recurrent Unexpected panic attacks

At least one attack followed by one month or more of concern about additional attacks or fear of going crazy

43
Q

Social phobia

A

Persistent fear of one or more social/performance situations where the person is exposed to unfamiliar people or the scrutiny by others

Fears actions will result in embarrassment

Can provoke situationally bound panic attack

Lifetime prevalence: 3-13%

More common in women

44
Q

OCD

A

1) Either obsessions or compulsions
- Obsessions are persistent thoughts, impulses, or images that are intrusive and cause distress
- Compulsions are repetitive bxs or mental acts that the person feels driven to perform
- Lifetime prevalence is 2.5%

45
Q

PTSD

A

1) Only when a person has been exposed to a traumatic event that involved actual or threatened death or serious injury
2) 3 broad categories

  • Persistent re-experiencing of the trauma
  • Persistent avoidance of stimuli/numbing
  • Persistent symptoms of increased arousal

3) Disturbance is more than 1 month

  • Less than 3 months (acute)
  • 3 months or more (chronic)

-Lifetime prevalence is about 8%

46
Q

Acute stress disorder

A

PTSD symptoms that occur within 4 weeks of the trauma and last between 2 days and 4 weeks

47
Q

GAD

A

1) At least 6 months of pervasive and excessive worry about a number of events or activities
2) Associated with at least 3 symptoms that include restlessness, fatigue, difficulty concentrating, irritability, muscle tension, and sleep disturbance
- Lifetime prevalence is about 5%
- Female to male is 3:2

48
Q

Somatization disorder

A

1) History of recurrent and multiple somatic complaints that begin before 30 years of age and are of at least several years duration

  • In men: less than .2%
  • In women: between .2 and 2%
49
Q

Undifferentiated somatoform disorder

A

1) 1 or more physical complaints that cannot be fully explained medically
2) Duration is at least 6 months

50
Q

Conversion disorder

A

1) 1 or more symptoms or deficits affecting voluntary motor or sensory function that suggests a neurological or other general medical condition
2) Not intentionally produced and cannot be explained by physical etiology

51
Q

Pain disorder

A

1) Pain in 1 or more sites of sufficient severity to warrant clinical attention
2) Psychological factors are judged to have an important role in the onset, severity, exacerbation or maintenance of the pain

52
Q

Hypochondriasis

A

1) Preoccupation with fear of having or belief that one has a serious disease, based on a person’s misperception of their bodily symptoms
2) Belief is unsupported by medical examination and preoccupation lasts at least 6 months

53
Q

Body dysmorphic disorder

A

1) Person is preoccupied with an imagined deficit in appearance

54
Q

Factitious disorder

A

1) Characterized by physical or psychological symptoms that are intentionally produced or feigned
2) The goal appears to be to assume the sick role and there is an absence of external incentives for the behavior

55
Q

Dissociative amnesia

A

1) Characterized by 1 or more episodes of a sudden inability to recall important personal information that cannot be explained by ordinary forgetfulness

56
Q

Dissociative fugue

A

1) Sudden unexpected travel away from home with an inability to recall one’s past
2) Confusion about one’s identity or assumption of a new identity
3) Duration is usually brief, lasting from hours to days

57
Q

Dissociative identity disorder

A

1) Presence of 2 or more distinct identities or personalities, each with it’s own pattern of perceiving, relating to, and thinking about the environment and the self

58
Q

Depersonalization disorder

A

1) Persistent or recurrent episodes of depersonalization ( feeling detached from one’s mental process or body, or experiencing feelings like one is in a dream)

59
Q

Sexual dysfunctions

A

Characterized by a disturbance in sexual desire and in the psychophysiological changes that characterize the sexual response cycle

60
Q

Paraphilia

A

1) Recurrent intense sexual urges, fantasies, or behaviors that involve unusual objects, activities, or situations
- Diagnosed almost exclusively in males

61
Q

Gender identity disorder

A

A strong and persistent cross-gender identification accompanied by a persistent discomfort with one’s assigned sex

62
Q

Anorexia

A

1) Refusal to maintain minimally normal body weight (body weight is less than 85% of what is expected for age and height)
2) Intense fear of gaining weight, misperception of body size or shape, denial of seriousness of current low body weight, and absence of menstruation

  • Lifetime prevalence among females is .5%
  • Females 10 times more likely to be diagnosed than males
  • Much more prevalent in industrialized societies
63
Q

Bulimia

A

1) Repeated episodes of binge eating followed by inappropriate compensatory behaviors such as self-induced vomiting, misuse of laxatives, diuretics, or other medications, fasting, excessive exercising
2) Binge eating and compensatory behaviors occur at least 2 times per week for 3 months
- Prevalence among females is 1-3%
- Females 10 times more likely to be diagnosed than males

64
Q

Dyssomnia

A

Disturbance in the amount, quality, or timing of sleep (Primary insomnia, Narcolepsy)

  • Primary insomnia is about 1-10% in general pop and up to 25% in elderly
  • Complaints of insomnia are more prevalent among women
65
Q

Parasomnia

A

Abnormal behavior or physiological events that occur in association with sleep (sleepwalking, sleep terror disorder)

66
Q

Impulse control disorders

A

1) Failure to resist an impulse to perform an act that is harmful to the person or others

67
Q

Adjustment disorder

A

1) Maladaptive reaction to an identifiable psychosocial stressor, which occurs within 3 months of onset of the stressor
2) Once the stressor has terminated, the symptoms do not persist for more than an additional six months

68
Q

Personality Disorders cluster A

A

Odd/ Eccentric

1) Paranoid personality disorder
2) Schizoid personality disorder
3) Schizotypal personality disorder

69
Q

Personality Disorders cluster B

A

Dramatic/Erratic

1) Antisocial (disregard for others since at leas 15 years of age, but must be 18 to diagnose)
2) Borderline personality disorder
3) Histrionic personality disorder
4) Narcissistic personality disorder

70
Q

Personality Disorders Cluster C

A

Anxious/Avoidant

1) Avoidant personality disorder
2) Dependent personality disorder
3) Obsessive compulsive personality disorder

CPSE (4 decks)

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