Clinical Disorders

Question 1

Adjustment Disorders

Answer 1

A maladaptive reaction to an identified stressor that develops within 3 months of the onset of the stressor.

Characterized by significant impairment in social, occupational, or other important areas of functioning, or by states of emotional distress that exceed those normally induced by the stressor.

Question 2

Adjustment disorder with depressed mood

Answer 2

Sadness, crying, and feelings of hopelessness

Question 3

Adjustment disorder with anxiety

Answer 3

Worrying, nervousness, and jitters (or in children, fear of separation from primary attachment figures).

Question 4

Adjustment disorder with mixed anxiety and depressed mood

Answer 4

A combination of anxiety and depression.

Question 5

Adjustment disorder with disturbance of conduct

Answer 5

Violation of the rights of others or violation of social norms appropriate for one’s age; sample behaviors include vandalism, truancy, fighting, reckless driving, and defaulting on legal obligations (ex: stopping alimony payments).

Question 6

Adjustment disorder with mixed disturbance of emotion and conduct

Answer 6

Both emotional disturbance, such as depression or anxiety, and conduct disturbance.

Question 7

Adjustment disorder unspecified

Answer 7

A residual category that applies to people not classifiable in one of the other subtypes.

Question 8

Acute Stress Disorder

Answer 8

A traumatic stress reaction in which the person shows a maladaptive pattern of behavior for a period of 3 days to 1 month following exposure to a traumatic event.

Symptoms of acute stress disorder may include:

• Intrusive memories
• Disturbing dreams
• Reexperiencing/flashbacks
• Detachment/dissociation from surroundings or self
• Disturbance of sleep
• Irritable or aggressive behavior
• Exaggerated startle response

Question 9

Post-Traumatic Stress Disorder (PTSD)

Answer 9

Prolonged maladaptive reaction lasting longer than 1 month after traumatic experience.

Symptoms of PTSD may include:

• Intrusive memories
• Disturbing dreams
• Reexperiencing/flashbacks
• Detachment/dissociation from surroundings or self
• Disturbance of sleep
• Irritable or aggressive behavior
• Exaggerated startle response

Question 10

PTSD features

Answer 10

• Avoidance behavior
• Reexperiencing the trauma
• Emotional distress, negative thoughts, and impaired functioning
• Heightened arousal
• Emotional numbing

Question 11

Panic Disorder

Answer 11

Repeated panic attacks (episodes of sheer terror accompanied by strong physiological symptoms, thoughts of imminent danger or impending doom, and an urge to escape)

Fears of recurring attacks may prompt avoidance of situations associated with the attacks or in which help might not be available; attacks begin unexpectedly but may become associated with certain cues or specific situations; may be accompanied by agoraphobia, or general avoidance of public situations

Question 12

Diagnosis of Panic Disorder

Answer 12

The person must have experienced repeated, unexpected panic attacks, and at least one of the attacks must be followed by a period of at least one month that included either or both of the following

a) Persistent fear of subsequent attacks or of the feared consequences of an attack, such as losing control, having a heart attack, or going crazy
b) Significant maladaptive change in behavior, such as limiting activities or refusing to leave the house or venture into public for fear of having another attack.

Question 13

Generalized Anxiety Disorder

Answer 13

Persistent anxiety that is not limited to particular situations

Excessive worrying; heightened states of bodily arousal, tenseness, being on edge

• Excessive and uncontrolled worrying
• Worry about everyday, minor things
• Avoidance of situations in which they expect something “bad” might happen
• Marked emotional distress or significant impairment in daily functioning

Question 14

Specific Phobia

Answer 14

Excessive fears of particular objects or situations

Avoidance of phobic stimulus or situation

Fear of animals
- spiders, insects, or dogs
Fear of natural environments
- heights, storms, or water
Fear of blood-injection injury
- needles or invasive medical procedures
Fear of specific situations
- enclosed spaces, elevators, or airplanes

Question 15

Social Anxiety Disorder (Social Phobia)

Answer 15

Excessive fear of social interactions or situations

Characterized by an underlying fear
of rejection, humiliation, or
embarrassment in social situations

Question 16

Agoraphobia

Answer 16

Fear and avoidance of open, public places

Also described as fear over having a panic attack due to the fear of open/public places.

• One’s life is structured around avoiding exposure to fearful situations.
• May become household bound/isolated for months or years.

May occur secondarily to losses of supportive others to death, separation, or divorce

Question 17

Major Depressive Disorder

Answer 17

A severe mood disorder characterized by major depressive episodes in the absence of mania or hypomania.
- Diagnosis is based the occurrence of at least one major depressive episode in the absence of a history of mania or hypomania

Episodes of severe depression characterized by downcast mood, feelings of hopelessness and worthlessness, changes in sleep pattern or appetite, loss of motivation, loss of pleasure in usual activities

Question 18

Persistent Depressive Disorder (Dysthymia)

Answer 18

Feel “down in the dumps” most of the time but not as severely depressed as those with major depressive disorder

Diagnosed only in people who have never had episodes of mania or hypomania.

Generally thought of as “chronic depression”, with symptoms lasting at least two years.

• Symptoms are the same as Major Depressive Disorder.
• Symptoms may be less intense at times, but overall they are persistent for the vast majority of time over a minimum two-year period.

Question 19

Bipolar I Disorder

Answer 19

Characterized by mood swings between states of extreme elation and depression.

Applies to people who have had at least one full manic episode at some point in their lives.

Question 20

Bipolar II Disorder

Answer 20

Characterized by mood swings between states of extreme elation and depression.

Applies to people who have had hypomanic episodes AND at least one major depressive episode (without ever having a full-blown manic episode).

Question 21

Manic episode

Answer 21

Characterized by:

• Disorganized behavior
• Impaired judgment
• Extreme social behavior
• Overly demanding and argumentative communication style
• Rapid speech and flight of ideas
• Inability to weigh consequences of actions

Question 22

Hypomanic episode

Answer 22

Are generally less severe than manic episodes and are not accompanied by the social or occupational problems associated with full-blown mania.

Question 23

Cyclothymic Disorder

Answer 23

Chronic cyclical pattern of mild mood swings lasting at least two years.

• Usually begins in late adolescence or early adulthood.
• Elevated or depressed mood not severe enough for diagnosis of bipolar disorder.
• Periods of hypomanic and manic symptoms may be present, but do not reach diagnostic criteria to be officially considered a hypomanic or manic episode.
• Similarly, depressive symptoms do not meet diagnostic criteria for a major depressive episode.
• In other words, manic/hypomanic/depressive symptoms can be present, but not enough to be considered a respective episode as classified with major depressive disorder, or bipolar I or bipolar II disorder

Question 24

Diagnosis of Major Depressive Disorder

Answer 24

Five (or more) of the following symptoms have been present during the same two-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.