Diagnoses Flashcards
Dissociative Amnesia Disorder & Dissociative Fugue
A. Unable to recall autobiographical memory associated with a traumatic event
1. Localized amnesia: failing to recall info from a very specific time period (events surrounding trauma)
2. Selective amnesia: only parts of the trauma are forgotten
3. Generalized amnesia: a person forgets all personal info from their past
4. Continuous amnesia: forgetting info from a specific date to the present
5. Systemized amnesia: person only forgets certain categories of info (certain ppl/places)
B. Symptoms cause functional distress/impairment
Dissociative Fugue: traveling as a result of memory loss
Dissociative Identity Disorder
A. 2 or more distinct personality states
- discontinuities in one’s sense of self
B. The alters lead to recurrent gaps in memory of:
1. every day events
2. trauma
3. important autobiographical info
C. Functional impairment
Hints: alters could correspond with sudden occurrence of emotions or behaviours ppl find perplexing/uncontrollable.
- self-destructive behaviour is common
Depersonalization/Derealization Disorder
A. Persistent or repeating experiences of depersonalization, derealization or both.
- the symptoms are persistent
B. The symptoms cause clinically significant impairment/distress
Hints:
- not characterized by memory impairment/identity
confusion
- chronic, begins in adolescence
- decreased emo reactivity to stressful or emo arousing
stimuli
Somatic Symptom Disorder
A. One or more somatic symptoms that cause significant
distress and functional impairment in daily life
B. Excessive thoughts, feelings, behaviours related to the somatic symptoms manifested in at least one of these 3:
1. Disproportionate thoughts about the seriousness of
one’s symptoms
2. Persistently high level of anxiety abt health/symptoms
3. Excessive time/energy devoted to these symptoms
C. Experience symptoms for more than 6 months
If they have a medical issue, the anxiety and impairment must far exceed the expectations
Hints:
- Give nonspecific, colourful descriptions of symptoms
- Attach importance to insignificant bodily symptoms,
and use these to confirm their fears of some disease
- Spend a lot of time thinking abt the meaning/etiology
of the somatic experiences
- Prone to periods of anxiety and depression
Illness Anxiety Disorder
A. Preoccupation with having or acquiring a serious illness
B. Somatic symptoms are not present. If there’s a risk of
developing the illness, the preoccupation is excessive
C. High level of anxiety about health; easily alarmed by
personal health status
D. Excessive health-related behaviours (doctor visits)
E. Symptoms persist for at least 6 months
Conversion Disorder
A. One or more symptoms of altered voluntary motor or sensory function.
B. Symptoms are incompatible with recognized conditions:
- the symptoms don’t match to their physical state
- there are inconsistencies in the symptoms
- the symptoms don’t match known physiological mechanisms
Factitious Disorder
A. Intentional induction or falsification of symptoms of an illness/injury to gain attention and sympathy
B. The individual presents themselves as ill, impaired or injured to others
C. The deceptive behavior persists even in the absence of external incentives or rewards
Hints: Hostility when challenged
Facticious Disorder Imposed on Another
A. Intentional induction or falsification of symptoms of an illness/injury in another person (typically a mother’s child) to gain attention and sympathy
B. The individual presents another individual (the victim) as ill, impaired or injured to others
C. The deceptive behavior persists even in the absence of external incentives or rewards
Psychological Factors Affecting Medical Conditions
A. The presence of a diagnosed medical condition
B. Evidence that the medical condition is adversely affected by some psych/behavioural factor. The factor either:
- influences the course of the condition
- interferes w the treatment of the condition
- poses an additional risk to patient’s health
- influences the disorder’s pathophysiology
Schizophrenia
———CRITERIA “A”—————————————-
A. At least 2 of the following symptoms must be mostly present for one month. At least 1 of the symptoms must be positive symptom (1), (2), or (3)
1. Delusions (+)
2. Hallucinations (+)
3. Disorganized speech (+)
4. Grossly disorganized or catatonic behaviour (unresponsive but conscious) (+)
5.Negative symptoms (the 5 a’s) (-)
Experiential negative symptoms:
#1. Apathy: lack of motivation and interest in daily activities
#2. Anhedonia: diminished ability to anticipate/experience pleasurable emotions
#3. Asociality: diminished interest in social interactions;
leads to social withdrawal
Expressive negative symptoms:
#4. Alogia: difficulty speaking or diminished desire to speak
#5. Affective flattening: lack of emotional expressivity and facial expression
—————CRITERIA “B”—————————
B. Functional impairment noticeably worse after onset
—————CRITERIA “C”—————————
C. Symptoms must continue for 6+ months, with:
1. At least 1 month of positive symptoms
2. The period outside that month must include either:
a) negative symptoms
b) residual/prodromal symptoms
—————CRITERIA “D”—————————
D. Rule out schizoaffective disorder, depressive disorders, and bipolar disorders with psychotic features if:
1. no major depressive/manic episodes have occurred
concurrently with the psychotic phase symptoms
2. if mood episodes occur during the psychotic phase,
the episode is only present for:
a) a minority of the psychotic phase
b) a minority of the residual/prodromal periods
—————CRITERIA “E”——————————
E. Symptoms cause a decline in functioning
—————Hints——————————————
Hints:
- Cognitive impairments (memory, attention, learning,
processing speed, problem solving)
- Motor impairments (catatonia, wavy flexibility)
- Impaired mental state inference
- Jump to conclusions/belief perseverance
Schizophreniform Disorder
Same diagnostic criteria as schizophrenia, with 2 key differences:
1. No requirement for a decline in functioning
2. Disorder lasts 1-6 months
Schizoaffective Disorder
Essentially schizophrenia with a mood episode that coincides with positive schizophrenia symptoms
A. The period of co-occurring symptoms must be preceded or followed by 2+ weeks of delusions/hallucinations without the mood symptoms
B. Differ between the specific diagnoses:
1. Bipolar type: episodes of mania
2. Depressive type: major depressive episodes
Delusional Disorder
A. The presence of one (or more) delusions with a duration
of 1 month or longer
B. Hallucinations, if present, are not prominent and are
related to the delusion theme
C. No other psychotic symptoms
D. Functioning not impaired outside of the delusions;
behaviour isn’t odd/bizzare
Substance/Medication-Induced Psychotic Disorder
A. Presence of one or both of the following symptoms:
Delusions
Hallucinations
B. Evidence of either (1) or (2)
1. The delusions/hallucinations developed during, or
within a month of, substance intoxication or
withdrawal
2. Medication used is etiologically related to the
disturbance
C. The disturbance causes clinically significant distress or impairment
Psychotic Disorder due to Another Medical Condition
A. Prominent hallucinations/delusions
B. Evidence that the symptoms are the direct physiological
consequence of a medical condition (epilepsy)
C. Causes clinically significant distress
Anorexia Nervosa
A. Restriction of food intake relative to bodily requirements
that leads to a body weight below the minimum normal
weight for the person’s height, gender and age.
B. Intense fear of gaining weight/obesity
C. Distorted perception of one’s body weight/shape, undue
influence of body weight on self-evaluation, not
recognizing the seriousness of their body weight
D. Differ between types:
1. Restricting type: no binge/purge in the last 3mo
2. Binge/purge type: recurrent episodes of b/p
Hints:
- Strict control
- Has a weight criteria
- Languo: lil body hair that grows to keep warmth
- In AN-b/p, dental problems from vomiting
- Treatment: FBT-E (fam-based therapies for EDs)
Bulimia Nervosa
A. Recurrent episodes of binge eating
B. Compensatory behaviours to prevent weight gain
C. Both A and B occur at least once a week for 3 months
D. Body image and body weight shape self-evaluation
Hints:
- Impulsivity
- Amenorrhea: missing 3 periods in a row
- Languo
- Dental problems
- Treatment: CBT-E (CBT for EDs)
Binge-Eating Disorder
A. Recurrent episodes of binge eating
B. Binge eating episodes are associated with +⅗ symptoms:
1. Eating much more rapidly than normal
2. Eating until feeling uncomfortably full
3. Eating large amounts of food when not hungry
4. Eating alone because of embarrassment of amount
5. Feeling disgusted with oneself, depressed or very
guilty after binge-eating
C. Marked distress regarding binge eating is present
D. The binge eating occurs 1+ times per week for 3 mo
E. The binge eating is not associated with
compensatory behaviours and does not occur
exclusively during BN or AN
Hints:
- Treatment: CBT-E
Paranoid PD (Cluster A)
A. At least 4/7 of the following symptoms:
1. Global suspicion of harm/deception from others
2. Preoccupation w doubts of loyalty/trust from friends
3. Believe ppl will use info against them if they confide
4. Perceiving innocuous stimuli as threats/demeaning
5. Persistently bearing grudges
6. Falsely think others are attacking their character, and
react aggressively to this
7. Recurrent, unjustified suspicions of infidelity
B. Functional Impairment
Hints:
- hostile attribution bias: maltreated kids perceive innocuous stimuli as threats and respond aggressively
Schizoid Personality Disorder (Cluster A)
A. At least 4/7+ of these symptoms:
1. No desire or enjoyment of close relationships
2. Indifferent to praise/criticism from others
3. Little to no interest in sexual experiences
4. Almost always choosing solitary activities
5. Lack of close friends other than immediate fam
6. Displaying emotional coldness, detachment, flat-affect
7. Taking pleasure in few, if any activities
B. Functional impairment
Hints: Alexithymia (difficulty identifying, describing, and communicating emotions)
Schizotypal Personality Disorder (Cluster A)
A. At least 5/9+ of these symptoms:
Cognitive/perceptual distortions
1. non-delusional ideas of reference
2. odd beliefs and magical thinking
3. paranoia
4. unusual perceptual or somatic experiences that involve magical thinking
Interpersonal symptoms
5. lacking close friends outside fam
6. persistent social anxiety (usually due to paranoia)
7. constricted/inappropriate affect (aloofness)
Disorganized symptoms
8. odd/eccentric behaviours and appearance
9. odd thinking/speech (vague speech/grandiosity)
B. Functional impairment
Hints: sexual abuse, emotional neglect
Antisocial Personality Disorder (Cluster B)
A. Embodied a pattern of disregard for others and violating their rights, occurring since 15yo that manifests in 3 or more of the following:
1. Repeated failure to conform to social norms and
lawful behaviour
2. Deceitfulness
3. Impulsivity
4. Irritability/aggressiveness
5. Reckless disregard for safety of self/others
6. Consistent irresponsibility
7. Lack of remorse
B. At least 18 years of age
C. Evidence of a conduct disorder with onset before 15yo
Hints:
50% inheritance
negative affect: perceiving situations as threatening/stressful—associated with poor emotional liability
Borderline Personality Disorder (Cluster B)
A. Pattern of relationship instability, poor self-image, onset by early adult hood, as indicated by 5 or more symptoms:
1. Frantic efforts to avoid real or imagined abandonment
2. A pattern of unstable and intense relationships
characterized by highs and lows
3. Markedly and persistently unstable sense of self
4. Impulsivity in at least 2 self-damaging areas
5. Recurrent deliberate self-injuring behaviours/suicidality
6. Affective lability (mood swings) and mood reactivity
7. Feeling empty
8. Inappropriate/intense anger; bad anger management
9. Stress-related paranoid ideation or severe dissociative
symptoms
B. Functional impairment
Hints:
- “invalidating caregiving environment”—learn emotions
must be inhibited, or they must be strongly expressed to
get a response from their caregiver
- Dialectical Behaviour Therapy: mindfulness, distress
tolerance, emotional regulation, healthy relationships
Histrionic Personality Disorder (Cluster B)
A. At least 5/8+ symptoms:
1. discomfort when not the centre of attention
2. inappropriate seductive or provocative behaviours
3. shallow and rapidly shifting emotional expressions
4. use of physical appearance to draw attention
5. vague and impressionistic style of speech
6. dramatic/theatrical, exaggerated emo expressions
7. highly influenced by others/external circumstances
8. considering relationships to be more intimate than
they are
B. Functional impairment
Hints: high heritability (0.62-0.79)
