diagnoses and populations

Question 1

Anxiety Disorders

Answer 1

features of excessive fear and anxiety

differ from one another in types of objects or situations that induce fear, anxiety, or avoidance behavior and cognitive ideation

highly comorbid with each other

excessive or persisting beyond dev appropriate periods

persistent (6 months or more)

many dev in childhood and persist

most occur in females 2:1

Question 2

selective mutism

Answer 2

consistent failure to speak in specific social situation

at least 1 month

associated features: excessive shyness, fear of social embarrassment, social isolation, withdrawal, clinging, compulsive traits, negativism, temper tantrums, mild oppositional behavior

DD: communication disorders, neurodev, schizophrenia, social anxiety

comorbidity: other anxiety disorders

Question 3

specific phobia

Answer 3

marked fear or anx about specific object or situation

object or situation almost always provokes immediate fear or anx

object or situation is actively avoided or endured with intense fear or anx

fear or anx is out of proportion to actual danger

persistent 6+ months

sometimes dev following traumatic event

DD: agoraphobia, social anxiety, separation anx, panic dis, ocd, trauma and stressor related, eating, schizophrenia

comorbidity: depression, anx, bipolar, substance related, somatic symptom, personality dis

Question 4

social anxiety disorder (social phobia)

Answer 4

fear or anx about one or more social situations in which ind is exposed to possible scrutiny by others

fear they will act in way or show anx symptoms that will be neg evaluated

social situations almost always provoke fear or anx

multiple DDs

comorbidity: other anx, major dep, substance use

Question 5

panic disorder

Answer 5

recurrent unexpected panic attacks

persistent concern or worry about additional panic attacks

Risk / prognostic: neg affect, anx, sex and phy abuse, smoaking, poss genes

comorbidity: anx, major dep, bipolar, mild alcohol use

Question 6

agoraphobia

Answer 6

fear or anxiety about two or five situations:
using public transportation
open spaces
enclosed places
standing in line or being in crowd
being outside home alone

thoughts that escape might be difficult or unavailable

resk / prog:
behavioral inhibition and neurotic desposition, anx sensitivity, ACEs, heritability 61%

comorbidity: anx, depressive, ptsd, alcohol use

Question 7

generalized anxiety disorder

Answer 7

excessive anxiety and worry occurring more days than for for number of events or activities

difficult to control worry

three symptoms:
restlessness
easily fativured
difficulty concentrating
irritability
muscle tension
sleep disturbance

risk/prog:
behavioral inhibition, negative affect, harm avoidance

comorbidity: anx, unipolar depressive

Question 8

substance / medication - induced anxiety disorder

Answer 8

panic attacks or anx is predominant

symptoms dev during or soon after substance intoxication or withdrawal

substance/med is capable of producing symptoms

Question 9

anxiety disorder dure to another medical condition

Answer 9

panic attacks or anx is predominant

disturbance is direct consequence of another med condition

lab assessments / medical exam necessary to confirm diagnosis

Question 10

other specified anxiety disorder

Answer 10

presentations in which symptoms characteristic of anxity disorder predominate but dont meet full criteria for other disorders

limited symptom attacks
generalized anxiety not occurring more days than not
“wind attacks”
“attack of nerves” ataque de nervios

Question 11

panic attack

Answer 11

abrupt surge of intense fear or intense discomfort that reaches peak within minutes, and during which time multiple physical symptoms arise

palpitations
sweating
trembling
shortness of breath
choking
chest pain
nausea
dizzyness
chills or heat
parasthesias (tingling)
derealization (unreality)
fear of losing control
fear of dying

Question 12

separation anxiety disorder

Answer 12

dev inappropriate and excessive fear or anxiety concerning separation from those whom ind is attached

may be associated w/ increased risk for suicide

children: highly comorbid with generalized anxiety and specific phobia

adults: common comorbidities specific phobia, ptsd, panic disorder, generalized anxiety, social anxiety, agoraphobia, ocd, personality disorders, depressive, bipolar

Question 13

fear

Answer 13

emotional response to real or perceived imminent threat

associated w/ surges of autonomic arousal necessary for fight or flight, thoughts of immediate danger, and escape behaviors

Question 14

anxiety

Answer 14

anticipation of future threat

muscle tension and vigilance

cautious or avoidant behaviors

Question 15

Depressive Disorders

Answer 15

presenece of sad, empty, or irritable mood

accompanied by somatic and cognitive changes that significantly affect capacity to function

differences: duration, timing, or presumed etiology

Question 16

disruptive mod dysregulation disorder

Answer 16

severe recurrent temper outbursts manifested verbally and/ or behaviorally that are grossly out of proportion in intensity or duration to situation or provocation

temper outbursts inconsistent with dev level

temper outbursts occur three or more times / week
mood btwn outbursts is persistently irritable or angry

criteria are present in at least two settings and are severe in at least one

first diagnosis between 6 and 18 with age of onset before 10

risk / prog:
chronic irritability, ADHD

comorbidity:
ODD, mood, anx, ASD

Question 17

major depressive disorder

Answer 17

five or more symptoms during same 2 week period
depressed mood
loss of interest or pleasure
significant weight loss
insomnia or hypersomnia
psychomotor agitation
fatigue
feelings of worthlessness
diminished ability to think
recurrent thoughts of death

risk / prog:
neuroticism, ACEs, genetic, major nonmood disorders

comorbidity: substance related, panic, ocd, anorexia, builimia, borderline

Question 18

persistent depressive disorder

Answer 18

depressed mood for most of day for more days than not

presence, while depressed of two..
poor appetite or overeating
insomnia or hypersomnia
low energy or fatigue
low self esteem
poor concentration
feelings of hopelessness

criteria for MDD present for 2 yuears
never been manic episode or hypomanic episode

risk / prog: neuroticism, poorer global function, anx or conduct disorder, parental loss or separation, poss polysomnographic abnormalities

comorbidity: anx, substance use, personality disorders

Question 19

premenstrual dysphoric disorder

Answer 19

in majority of menstrual cycles, at least 5 symptoms in final week before onset on memses, start to improve w/in few days after, and become min or absent in week post
affective lability
irritability or anger
depressed mood
anxiety
decreased interest in usual activities
difficulty in concentration
easy fatigability
change in appetite
hypersomnia or insomnia
overwhelmed
breast tenderness, joint or muscle pain, bloating, or weight gain

risk and prog:
stress, interpersonal trauma, seasonal changes, oral contraceptives have fewer premenstrual complaints

comorbidity: MDD, wide range of medical or other mental disorders may worsen

Question 20

substance / dedication - induced depressive disorder

Answer 20

prominent and persistent disturbance in mood

symptoms dev during or soon after substance intoxication or withdrawal

substance is capable of producing symptoms

comorbidity: any mental disorder, pathological gambling and paranoid, histrionic, and antisocial personality disorders

Question 21

depressive disorder due to another medical condition

Answer 21

prominent and persistent period of depressed mood or markedly diminished interest or pleasure in all or almost all activities

disturbance is direct consequence of another medical condition

Question 22

other specified depressive disorder

Answer 22

recurrent brief depression

short duration depressive episode

depressive episode with insufficient symptoms

Question 23

Trauma and Stressor Related Disorders

Answer 23

exposure to a traumatic or stressful event is listed explicitly as diagnostic criterion

close relationship with anxiety, ocd, and dissociative disorders

Question 24

reactive attachment disorder

Answer 24

consistent pattern of inhibited, emotionally withdrawn behavior toward adult caregivers
child rarely or min seeks comfort when distressed
“ “ responds to comfort when distressed

persistent social and emotional disturbance
min social and emotional responsiveness to others
limited pos affect
episodes of unexplained irritability, sadness, or fearfulness

child has experienced pattern of extremes of insufficient care
social neglect or deprivation
repeated changes of primary caregivers
rearing in unusual settings

criteria not met for ASD and evident prior to 5 years

risk/ prog: serious social neg, prog depends on quality of caregiving environment following neg

comorbidity: cog delays, lang delays, stereotypies, medical condition, depressive symptoms

Question 25

disinhibited social engagement disorder

Answer 25

pattern of behavior in which child actively approaches and interact with unfamiliar adults
reduced or absent reticence in approaching and interacting with unfamiliar adults
overly familiar verbal or physical behavior
diminished or absent checking back with adult caregiver
willingness to go off with unfamiliar adult

not limited to impulsivity but include socially disinhibited behavior

child experienced pattern of extremes of insufficient care
social neg
repeated changes of primary caregivers
rearing in unusual settings

risk/prog: serious social neg, caregiving quality moderate course

comorbidity: cog delays, language delays, stereotypies, ADHD

Question 26

posttraumatic stress disorder

Answer 26

exposure to actual or threatened death, serious injury, or sexual violence in one of following ways…
directly
witnessing
learning it occurred to close family member or friend
repeated or extreme exposure to details

presence of 1+ symptoms
recurrent, involuntary, intrusive distressing memories
recurrent distressing dreams
dissociative reactions
intense or prolonged psychological distress at exposure to internal or external cues that symbolize or resemble aspect of event
marked physiological reactions to internal or external cues that “”

persistent avoidance of stimuli associated with event

neg alteration in cognitions and mood
inability to remember an important aspect of event
persistent and exaggerated neg beliefs
persistent, distorted cognitions about cause or consequences
neg emotional state
diminished interest or participation in significant activities
detachment or estrangement
inability to experience pos emotions

Question 27

PTSD risk / prognostic

Answer 27

pretraumatic factors:
emotional problems prior to 6 years
mental disorders - panic, depressive, ptsd, OCD
lower ses
low edu
ACEs
minority
family psychiatric history
female
younger age

peritraumatic factors:
severity
perceived life threat
personal injury
interpersonal violence
dissociation

posttraumatic factors:
neg appraisals
inappropriate coping
scute stress
exposure to repeated reminders
adverse life events
losses

** social support is most protective factor that moderates outcomes **

Question 28

Acute Stress Disorder

Answer 28

exposure to actual or threatened death, serious injury, or sexual violation

resolve within 1 month after event

presentce of 9+ symptoms within
intrusion (memories, dreams, flashbacks, distress)
neg mood
dissociation
avoidance
arousal (sleep, irritability, hypervigilance, concentration, startle response)

Question 29

adjustment disorders

Answer 29

dev of emotional or behavioral symptoms in response to identifiable stressors

distress is out of proportion to severity of stressor

stressor may be single, multiple, recurrent, or continuous

increased risk of suicide

Question 30

Other Specified Trauma - and Stressor - Related Disorder

Answer 30

presentation in which symptoms do not meet full criteria for other disorders

adjustment disorders w/ delayed onset

” “ w/ prolonged duration

ataque de nervios

other cultural syndromes

persistent complex bereavement

Question 31

Bipolar and Related Disorders

Answer 31

bridge btwn schizophrenia and depressive disorders

Question 32

Bipolar 1 Disorder

Answer 32

manic episodes (required)

hypomanic episode ( common, but not required)

major depressive episode (common but not required)

risk / prog:
family history

comorbidity: anx disorder
ADHD
conduct
substance use
medical

Question 33

Bipolar 2 Disorder

Answer 33

Hypomanic episode (required)

Major Depressive Episode (required)

never been a manic episode

risk/prog
genetic factors
high suicide risk

comorbidity: anx disorders, substance use

Question 34

Cyclothymic disorder

Answer 34

for at least 2 years, hypomanic symptoms and depressive symptoms

symptoms present for at least half time

dont fit criteria for bipolar

risk/prog: genetic

comorbidity: substance use, sleep disorders

Question 35

Substance / Medication-induced Bipolar and Related Disorder

Answer 35

symptoms dev during or soon after substance intoxication or withdrawal

Question 37

manic episode

Answer 37

period of abnormally and persistently elevated, expansive, or irritated mood

increased goal directed activity or energy

last at least 1 week and present most of day, nearly every day

3+ of symptoms
inflated self-esteem
decreased need for sleep
talkative
racing thoughts
distractibility
involvement in activities with potential for painful consequences

Question 38

Hypomanic Episode

Answer 38

period of abnormally and persistently elevated, expansive, or irritable mood

abnormally and persistently increased activity or energy

lasting at least 4 consecutive days

same symptoms as manic

Question 39

Major Depressive Episode

Answer 39

5+ symptoms during 2-week period

depressed mood
diminished interest or pleasure in activates
significant weight loss
insomnia or hypersomnia
psychomotor agitation
fatigue
feelings of worthlessness
indecisiveness
recurrent thoughts of death

Question 40

Disruptive, Impulsive Control and Conduct Disorders

Question 41

Personality Disorders

Question 42

Neuro developmental Disorders (e.g., ASD, ADHD)

Question 43

Obsessive Compulsive and Related Disorders

Question 44

Substance Related and Addictive Disorders

Question 45

Psychotic Disorders

Question 46

Medical Conditions

Question 47

Feeding and Eating Disorders

Question 48

Neurocognitive Disorders (e.g., Delirium, Dementia

Question 49

General Population

Question 50

Trauma/Victims of Crime/Violence

Question 51

Grief, Loss, and Bereavement

Question 52

Multi-cultural families

Question 53

Lesbian, Gay, Bi-sexual, Transgender, Queer, Questioning, Intersex, Ally (LGBTQQIA)

Question 54

Dual Diagnosis/MICA

Question 55

Employee Assistance Programs (EAP)

Question 56

Understand current Diagnostic and Statistical Manual diagnoses