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MFT Clinical Review > Diagnosis > Flashcards

Diagnosis Flashcards

1
Q

Criteria for all DSM Dx

A
  • Clinically significant distress or impairment in functioning
  • Not attributable to another medical condition or substance/medication use
  • Not better explained by another disorder
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2
Q

(Neurodevelopmental Disorders)

Intellectual Disability (Intellectual Development Disorder)

A
  • Deficits in general mental abilities and adaptive functioning
  • Onset during development (childhood or even in utero)
  • Mild, Moderate, Severe, or Profound based on functioning
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3
Q

(Neurodevelopmental Disorders)

Children who can’t be assessed (temporary dx)*

A
  • Global developmental delay if under 5 years old

- Unspecified intellectual disability if 5 or older

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4
Q

(Communication Disorders)

Language disorder

A
  • Difficulty in acquisition, use of language across modalities
  • Early childhood onset (toddler)
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5
Q

(Communication Disorders)

Speech Sounds Disorder

A
  • Difficulty producing speech sounds impairs/prevents talking
  • Early childhood onset
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6
Q

(Communication Disorders)

Social (Pragmatic) Communication Disorder

A
  • Difficulty in communicating socially, including rules for conversation/storytelling
  • Difficulty understanding anything that is not explicitly said
  • Early childhood onset, not usually diagnosed until at least 4
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7
Q

Autism Spectrum Disorder

A
  • Deficits in social communication and interaction
  • Restricted, repetitive patterns of behavior
  • Symptoms present in early childhood, even if not diagnosed until later
  • Replaces DSM-IV Autistic Disorder, Aspergers’s Disorder, and PDD NOS
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8
Q

ADHD

A
  • Inattention sys persisting for at least 6 months
  • Hyperactivity/impulsivity sys persisting at least 6 months
  • Sxs present in multiple settings and were present before age 12
  • A lot of differential dx: ODD, IED, Autism spectrum, learning disorder, anxiety and more
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9
Q

Psychotic Disorders

A
  • Delusions - fixed beliefs unchanged by conflicting evidence
  • Hallucinations - perceptions w/o external stimulus
  • Disorganized thinking/speech - tangential, in coherent
  • Motor behavior - grossly disorganized or abnormal
  • Negative sys - diminished emotion, motivated activity
  • Also alogia (limited speech), anhedonia (not taking pleasure in pleasurable activities), asociality (lack of social interest)
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10
Q

(Psychotic Disorders)

Delusional disorder

A
  • Delusion w/o serious impairment and w/o other schizophrenia criteria
  • Sxs at least one month
  • Specify type of delusion, modifiers after one year
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11
Q

(Psychotic Disorders)

Brief psychotic disorder

A
  • Delusions, hallucinations, and/or disorganized speech ( negative sys not considered here)
  • At least 1 day and less than one month, with return to full functioning
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12
Q

(Psychotic Disorders)

Schizophreniform Disorder

A
  • Same 5 main criteria as schizophrenia

- At least 1 month, but less than 6 months

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13
Q

(Psychotic Disorders)

Schizophrenia

A
  • 5 main criteria
  • Continuous signs of disturbance for at least 6 months
  • Specify episodes
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14
Q

(Psychotic Disorders)

Schizoaffective disorder

A
  • mood episode concurrent w main criteria for schizophrenia

- psychotic symptoms persist w/o mood episode, but mood episode present more than half of the time

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15
Q

(Psychotic Disorders)

Substance/Medication-Induced Psychotic Disorder

A
  • delusions or hallucinations as direct result of substance/med
  • psychotic symptoms dominant, warrant clinical attention
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16
Q

Bipolar and Related Disorders

- For these and depressive disorders, know mood episodes
- Manic episode
- Hypomanic episode
- Major depressive episode
A
  • Manic episode: at least one week
    • risk-taking, grandiosity, less sleep, distractible
    • one+ manic episode is necessary for Bipolar I dx
    • episode requires hospitalization or includes psychotic sys, even if less than a week, it is a manic episode
  • Hypomanic episode: at least 4 days
    • generally same symptoms, but to lesser degree (manic causes marked impairment, hypomanic does not)
  • Major depressive episode
    • 5+ sxs over at least a 2-week period
    • at least one sxs is depressed mood (or irritable in kids) or anhedonia
    • depressed mood, anhedonia, weight change, sleep change, motor activity change, fatigue, worthlessness/guilt, poor concentration
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17
Q

(Bipolar and Related Disorders)

Bipolar I Dx

A
  • only requires manic episode

- differentials: substance/medication-induced bipolar, ADHD, anxiety disorders

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18
Q

(Bipolar and Related Disorders)

Bipolar II Dx

A
  • requires hypomanic episode AND major depressive episode

- differentials: MDD, cyclothymic, substance, anxiety disorder

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19
Q

(Bipolar and Related Disorders)

Cyclothymic Disorder

A
  • for at least 2 years, numerous periods of hypomanic sxs and depressive sxs
  • Sxs present at least half the time, never 2 months sxs free
  • But without EVER meeting criteria for hypomanic or depressive episode
  • (less severe, but longer lasting)
  • differentials: bipolar, substance, borderline
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20
Q

(Bipolar and Related Disorders)

Substance/Medication-Induced Bipolar

A

used when there is a clear link bw substance or medication use - timing and capability

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21
Q

(Depressive Disorders)

Major Depressive Disorder

A
  • At least one major depressive episode

- Differentials: Mood disorder due to another medical condition, ADHD, more

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22
Q

(Depressive Disorders)

Disruptive Mood Dysregulation Disorder

A
  • Frequent temper outbursts (inconsistent w developmental level and 3+ times/week), persistent angry/irritable mood in between
  • Present 12 months w/o any 3 months where criteria not met
  • Sxs present in at least 2 settings (e.g. school/home)
  • Age of onset is less than 10 years, don’t dx under 6 or 18+
  • differential: ODD, bipolar, autism spectrum. intermittent explosive disorder can be dx after 3 months. never give both dx.
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23
Q

(Depressive Disorders)

Persistent Depressive d/o (dysthymia)

A
  • persistent depressed mood for at least 2 years (1 in kids), with never 2 months sxs free
  • MDD, psychotic, due to AMC, substance, personality
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24
Q

(Depressive Disorders)

Premenstrual Dysphoric Disorder

A
  • affective sxs in majority of cycle at least 1 year
  • sxs track with menstrual cycle, become minimal or absent in week post-menses
  • different from premenstrual syndrome, which is less severe
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25
Q

(Anxiety Disorders)

Separation Anxiety Disorder

A
  • Sxs related to fear of being away from attachment figure
  • Manifests in refusal to go places(out, school) nightmares, physical sxs, worry about losing attachment figure
  • At least 4 weeks in kids/adolescents, “typically” 6 months or more in adults
  • Differential: other anxiety disorder, mood, ODD, psychotic, personality
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26
Q

(Anxiety Disorders)

Selective Mutism

A
  • Refusal to speak in social situations where expected for at least 1 month
  • Is speaking in other situations, like at home w close family
  • can’t be attributed to lack of knowledge or comfort w language
  • differential: communication disorder, social anxiety, neurodevelopment disorder
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27
Q

(Anxiety Disorders)

Specific Phobia

A
  • marked fear or anxiety about a specific object or situation, “typically” for 6 months or more
  • fear is disproportionate to actual danger posed
  • clinically significant distress or impaired functioning
  • differentials: agoraphobia, social anxiety, separation anxiety, panic, OCD, trauma, psychotic
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28
Q

(Anxiety Disorders)

Social Anxiety Disorder (Social Phobia)

A
  • fear that they will act in a way that will be negatively evaluated
  • for kids, must apply to peer settings, not just w adults
  • fear persistent “typically” for 6 months or more, fear out of proportion to threat
  • differentials: lots, but first on list: normative shyness. consider whether adverse impact on important areas of functioning. Other anxiety, delusional, BDD
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29
Q

(Anxiety Disorders)

Panic disorder

A
  • Recurrent, unexpected panic attacks
  • 1 month or more of worry about additional attacks or consequences, or maladaptive behavior change in response to attacks (like avoidance)
  • differential: other anxiety, other d/o w attacks as feature (specific phobia)
  • panic attack is not a disorder by itself, but can be noted as specifier
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30
Q

(Anxiety Disorders)

Agoraphobia

A
  • fear of being in public places( at least two of: public transportation, open spaces, enclosed spaces, standing in line/crowd, outside home alone)
  • fear that escape not possible, help not available if panic or embarrassing behavior occurs
  • fear disproportionate to danger, fear “typically” 6 months or more
  • differential: social anxiety, specific phobia(situational), separation anxiety, panic
  • also other medical, if realistic concern about becoming incapacitated
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31
Q

(Anxiety Disorders)

Generalized Anxiety Disorder

A
  • excessive worry, difficult to control, more days than not for at least 6 months
  • 3 of following (1 in kids): restless/keyed up/on edge, easily fatigued, difficulty concentrating, irritability, muscle tension, sleep disturbance
  • differentials: anxiety due to medical condition, substance/medication-induced(includes caffeine), anxiety, PTSD
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32
Q

(Obsessive-Compulsive and Related Disorders)

Obsessive Compulsive Disorder

A
  • Obsessions (intrusive, unwanted thoughts, urges, images)
  • Compulsions (repetitive behaviors) in response - behavior doesn’t realistically connect or is excessive
  • Distress or impairment OR time consuming (1+ hour/day)
  • Note no duration required in diagnostic criteria
  • Differentials: Anxiety, MDD, other o/c related, tic, psychotic
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33
Q

(Obsessive-Compulsive and Related Disorders)

Body Dysmorphic Disorder

A
  • Preoccupation w perceived physical defects or flaws slight/absent to others
  • Repetitive behaviors(mirror checking) or mental acts(comparing) in response
  • No duration requirement
  • Differential: normal appearance concerns, eating disorder, illness anxiety disorder, MDD
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34
Q

(Obsessive-Compulsive and Related Disorders)

Hoarding Disorder

A
  • Difficulty parting w possessions regardless of actual value
  • Accumulation that congests and clutters living areas
  • No duration specifier
  • Differential: Other medical, neurodev, psychotic, MDD, OCD
  • Don’t dx if accumulation is result of MDD-related fatigue
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35
Q

(Obsessive-Compulsive and Related Disorders)

Trichotillomania (Hair pulling disorder)

A
  • Recurrent pulling out of one’s hair, resulting in hair loss
  • Repeated attempts to decrease or stop
  • Differential: normal grooming or hair playing, OCD
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36
Q

(Obsessive-Compulsive and Related Disorders)

Excoriation (Skin Picking) Disorder

A
  • Recurrent skin picking resulting in lesions(injuries)
  • Repeated attempts to decrease or stop
  • Differential: Psychotic, other o/c
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37
Q

(Trauma and Stressor Related Disorders)

Reactive Attachment Disorder

A
  • Inhibited, withdrawn behavior toward adult caregivers, even during nonthreatening interaction
  • Rarely/minimally seeks/responds to comfort when distressed
  • Child experienced “pattern of extremes of insufficient care”, presumed responsible for withdrawn behavior (timing)
  • Evident bf age 5 - persistent if longer than 12 months - don’t dx after 5
  • Differential: Autism spectrum disorder, depression
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38
Q

(Trauma and Stressor Related Disorders)

Disinhibited Social Engagement Disorder

A
  • Child actively approaches and interacts w unfamiliar adults
  • Not checking back w adult caregiver, willing to go with unfamiliar adult
  • Behavior not limited to impulsivity
  • Child experienced “pattern of extremes of insufficient care” presumed responsible for withdrawn behavior (timing)
  • Differential: ADHD
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39
Q

(Trauma and Stressor Related Disorders)

Post-Traumatic Stress Disorder

A
  • Adults and kids 6 and over
  • Exposure to actual or threatened death, serious injury, or sexual violence
  • One+ intrusion symptoms(flashbacks, memories)
  • One+ avoidance symptoms (external reminders or thoughts/memories)
  • Two or more negative changes in mood or thought after trauma
  • Two or more arousal/reactivity changes
  • Symptoms at least 1 month
  • Differential: Adjustment disorder (differentiate by stressor), acute stress disorder (3 days to 1 month after exposure), anxiety disorder, MDD, psychosis, TBI
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40
Q

(Trauma and Stressor Related Disorders)

Acute Stress Disorder

A
  • Same stressors
  • Nine total sys from any of the five categories
  • Duration of disturbance is 3 days to 1 month after exposure
  • Differential: Adjustment (type of stressor), panic (only dx if panic unexpected), dissociative disorder, (if amnesia absent other stress sxs), TBI
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41
Q

(Trauma and Stressor Related Disorders)

Adjustment Disorder

A
  • Emotional or behavioral symptoms in response to identifiable stressor within 3 months of the onset of that stressor
  • Differential: MDD, PTSD, acute stress, personality d/o (review lifetime history of personality functioning), normal stress reactions
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42
Q

(Dissociative Disorders)

Dissociative Identity Disorder

A
  • Two or more distinct personality states
  • Recurrent gaps in recall of everyday events
  • Not part of normal cultural or religious practice, or play (kids)
  • Associated w overwhelming experiences, trauma, and abuse in childhood (not a diagnostic criteria)
  • Differential: Depressive, bipolar, PTSD, psychotic, seizure disorder, factitious/malingering
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43
Q

(Dissociative Disorders)

Dissociative Amnesia

A
  • Inability to recall important autobiographical info, usually traumatic or stressful
  • Inconsistent w ordinary forgetting
  • May be with or without dissociative fugue, “purposeful travel or bewildered wandering” associated w amnesia for identity or autobiographical info
  • Differential: DID (DA has depersonalization, but not distinct states) PTSD
44
Q

(Dissociative Disorders)

Depersonalization/Derealization Disorder

A
  • Unreality or detachment regarding self or surroundings
  • Reality testing remains intact during experience
  • Differential: Illness anxiety disorder, MDD(numbers), OCD
45
Q

(Somatic Symptom and Related Disorders)

Somatic Symptom Disorder

A
  • One + somatic symptoms that are distressing or result in disruption of daily life
  • Excessive thoughts, feelings, behavior associated
  • Symptoms persist “typically” more than 6 months
  • Differential: other medical, panic (this is more persistent), GAD
  • Conversion: Symptom is loss of function, not distress
  • Delusions: behavior more intense than here
46
Q

(Somatic Symptom and Related Disorders)

Illness Anxiety Disorder (hypochondriac)

A
  • Preoccupation with having or getting a serious illness
  • Somatic sxs absent/mild - preoccupation disproportionate
  • High anxiety about health, easily alarmed about health status
  • Excessive health-related behaviors or avoidance (e.g. of MDs)
  • Preoccupation present for 6+ months
  • Differential: Other medical, adjustment, somatic sx disorder (when somatic sx present) anxiety, OCD
47
Q

(Somatic Symptom and Related Disorders)

Conversion Disorder (Functional neurological sx disorder)

A
  • Altered voluntary motor or sensory function
  • Sxs and recognized medical conditions not compatible
  • Don’t dx just bc sxs usual, unexplained
  • Assessment: Different forms of testing yield different results
  • Differential: Neurological disease, somatic sx d/o (that’s about distress, here incompatibility required), factitious/malingering
48
Q

(Somatic Symptom and Related Disorders)

Psychological Factors Affecting other Medical Conditions

A
  • Psychological or behavioral factors adversely affect known medical condition or interfere with treatment
  • Example: Anxiety makes someone’s asthma worse
  • Differential: Mental Disorders due to AMC - causality does the other way (medical causes psychological)
  • Abnormal psychological or behavioral symptoms in response to medical dx: adjustment disorder
49
Q

(Somatic Symptom and Related Disorders)

Factitious Disorder

A
  • “Making shit up” - falsifying sxs, presenting to others as ill or impaired
  • Present even in absence of obvious external rewards
  • Can be “imposed on self” or “imposed on another”
  • Differential: Somatic sxs (no evidence of falsifying)
  • Malingering: doing it for personal gain or obvious rewards
  • Borderline: manipulation, not deception
50
Q

(Feeding and Eating Disorders)

Pica

A
  • Eating non-nutritive non-foods for at least 1 month
  • When inappropriate to developmental level and culture
  • When part of another disorder, don’t dx unless warrants separate attentions
  • Differential: Anorexia (ex. eating paper to control appetite), factitious, NSSI
51
Q

(Feeding and Eating Disorders)

Rumination Disorder

A
  • Repeatedly regurgitating for at least 1 month
  • Regurgitated food may be chewed, re-swallowed, or spit out
  • Differential: Other feeding and eating disorders
52
Q

(Feeding and Eating Disorders)

Avoidant/Restrictive Food Intake Disorder

A
  • Avoidance of lack of interest in food and eating (no duration)
  • Weight loss (or in kids, fail to gain), nutritional deficiency, etc.
  • Not explained by lack of available food or another disorder
  • Can be applied to adolescents or adults as well as kids
  • Differential: Medical(including structural/feeding), reactive attachment (caregiver trust), autism spectrum, specific phobia, anorexia
53
Q

(Feeding and Eating Disorders)

Anorexia Nervosa

A
  • Restricted intake leading to low body weight
  • Intense fear of gaining weight, or persistent behavior interfering w weight gain
  • Disturbance in perception of body/weight
  • Specifier: binge-eating/purging type or restricting type
  • Differential: Medical, MDD(no desire for weight loss or fear of gain), schizophrenia, SUD
54
Q

(Feeding and Eating Disorders)

Bulimia Nervosa

A
  • Binge eating that feels out of control + compensatory behavior, at least 1x/wk for 3 months
  • Also includes self-evaluation “unduly influenced” by body shape and weight
  • Differential: Anorexia binge/purge type, binge eating disorder (no compensatory behavior)
55
Q

(Elimination Disorders)

Enuresis

A
  • Repeated urinating onto bed or clothes
  • 2x/week for at least 3 months or clinically significant distress or impairment
  • At least 5 years old (or equivalent developmental level)
  • Specify nocturnal (night only), diurnal (day only), or nocturnal and diurnal
  • Differential: Medical condition, medication side effects
56
Q

(Elimination Disorders)

Encopresis

A
  • Repeated defecating in inappropriate places (bed, clothes)
  • At least 1x/month for at least 3 months
  • At least 4 years old (or equivalent developmental age)
  • Differential: Other medical (just diagnose the medical issue)
57
Q

(Sleep-Wake Disorders)

Insomnia Disorder

A
  • Difficulty initiating or maintaining sleep, or waking too early
  • At least 3 nights/week for at least 3 months
  • Happens despite adequate opportunity for sleep
58
Q

(Sleep-Wake Disorders)

Hypersomnolence Disorder

A
  • Excessive sleepiness despite main sleep period of 7+ hours and at least one:
  • Recurrent periods of falling asleep in the same day
  • Sleep episode of 9+ hours that is non-restorative
  • Difficulty being fully awake after abrupt awakening
  • At least 3 times/week for at least 3 months
59
Q

(Sleep-Wake Disorders)

Narcolepsy

A
  • Irrepressible need to sleep, or falling asleep, repeatedly in day
  • Quick onset of sleep
  • At least 3x/week for at least 3 months
60
Q

(Sleep-Wake Disorders)

Breathing Related Sleep Disorders

A
  • All result in sleeping person not getting enough air supply
  • Apneas: obstructed breathing (snoring, snorting/gasping)

  • Hypoventilation can be obesity related
61
Q

(Sleep-Wake Disorders)

Circadian Rhythm Sleep Wake Disorders

A
  • Pattern of sleep disruption related to circadian rhythm disturbance
  • Leads to excessive sleepiness or insomnia
  • Several subtypes
62
Q

(Sleep-Wake Disorders)

Non-Rapid Eye Movement(NREM) Sleep Arousal Disorders

A
  • Parasomnia - unusual events associated w sleep
  • Recurring incomplete awakening, w blank stare (sleepwalking) or panic (terrors)
  • Individual is relatively unresponsive and difficult to awaken
  • No dream imagery is recalled (or very little)
  • Amnesia for the episodes
63
Q

(Sleep-Wake Disorders)

Nightmare Disorder

A
  • Repeated, extended, well-remembered dreams involving survival/security or “physical integrity” (serious injury, even body being torn)
  • Easily awaken and recall dreams well
  • Nightmares are usually during REM sleep, terrors during non-REM
  • Differential: Bereavement (results in insight and reflection)
64
Q

(Sleep-Wake Disorders)

Rapid Eye Movement (REM) Sleep Behavior Disorder

A
  • Repeated arousal during sleep, with vocalization or complex motor behavior
  • Typically later in sleep, not in first 90 minutes
  • Awake, alert and oriented upon awakening
  • Differential: Seizures, best assessed by sleep specialist or even EEG
65
Q

(Sleep-Wake Disorders)

Restless Legs Syndrome

A
  • Urge to move legs during rest or inactivity, relieved by movement, worse in evening
  • At least 3x/week for at least 3 months
66
Q

Sexual Dysfunctions

A
  • Do not diagnose any of these if the issue is inadequate sexual stimulation
  • Primary differential for all will be other sexual dysfunction and medical conditions
  • Duration specifier for all: 6 months (most say “approximately”)
67
Q

(Sexual Dysfunctions)

Female Sexual Interest/Arousal Disorder

A
  • No or reduced sexual interest, thoughts/fantasies, pleasure during activity
  • Differential (for both of these): other mental disorders, like MDD with its anhedonia
68
Q

(Sexual Dysfunctions)

Male Hypoactive sexual desire disorder

A
  • Deficient or absent sexual thoughts or fantasies, desire
  • To judge “deficient”, consider age, culture, other factors
  • Symptoms for at least “approximately” 6 months
  • Differential: Other mental disorders, like MDD with its anhedonia
69
Q

(Sexual Dysfunctions)

Erectile Disorder

A

-Difficulty obtaining or maintaining erection or decrease in rigidity in most/all sexual activity (note the lack of the word “partner” here)

70
Q

(Sexual Dysfunctions)

Genito-Pelvic Pain/Penetration Disorder

A
  • Recurrent or persistent difficulty with any of:
  • vaginal penetration during intercourse
  • vaginal/pelvic pain during vaginal intercourse or penetration attempts
  • fear or anxiety about same pain, including in anticipation of
  • tensing or tightening of pelvic floor during attempted penetration
71
Q

(Sexual Dysfunctions)

Female Orgasmic Disorder

A

-Delay, infrequency, or absence of orgasm, or reduced intensity of sensations

72
Q

(Sexual Dysfunctions)

Premature(Early) Ejaculation

A
  • Ejaculation w/i about 1 minute of vaginal penetration and b/f desired in almost all or all partner sexual activity
  • Duration criteria not established for other sexual activities
73
Q

(Sexual Dysfunctions)

Delayed Ejaculation

A

-Unwanted delay/absence of ejaculation in most/all partner activity

74
Q

Gender Dysphoria - only dx in category

A
  • Different diagnostic criteria for kids, adolescents, adults
  • Incongruent b/w experienced/expressed gender for assigned gender
  • Strong desire to be a different gender
  • Sxs present at least 6 months
  • Differential: nonconformity to gender roles, transvestic disorder (cross dressing, person gets sexual excitement, but does not want to be a different gender)
75
Q

(Disruptive, Impulse-Control, and Conduct Disorder)

Oppositional Defiant Disorder

A
  • Pattern of angry/irritable mood, defiant behavior, or vindictiveness for at least 6 months
  • Demonstrated w at least one person who is not a sibling
  • Differential: ADHD(make sure not just in response to filing at sustained effort or attention, or sitting still), Mood disorders
76
Q

(Disruptive, Impulse-Control, and Conduct Disorder)

Intermittent Explosive Disorder

A
  • Behavior outbursts showing failure to control impulsivity:
  • Verbal/physical aggression at least 2x/week for 3 months OR
 -3 outbursts involving damage, destruction, or injury within 12 months
  • Aggression grossly disproportionate to provocation
  • Aggression isn’t premeditated and is not goal-directed
  • At least 6 years old
77
Q

(Disruptive, Impulse-Control, and Conduct Disorder)

Conduct Disorder

A
  • Behavior pattern violating other’s rights, major social norms:
  • Aggression to people or animals
  • Destruction of property
  • Lies, thrift, serious rule violations
  • At least one symptom present in last 6 months
  • Aggression is premeditated
  • In adults, may be antisocial personality disorder instead
78
Q

(Disruptive, Impulse-Control, and Conduct Disorder)

One way of thinking about those 3 disorders

- IED
- CD
- ODD
A
  • IED is about poorly controlled emotion
  • CD is about poorly controlled behavior
  • ODD is more balanced, symptoms wise, between the two
79
Q

(Disruptive, Impulse-Control, and Conduct Disorder)

Pyromania

A
  • Purposeful fire setting more than once
  • Tension or arousal before, pleasure or gratification after
  • Fascination or attraction to fire and its contexts
  • Not done for another purpose (money, political statement, etc)
  • Differential: other causes of fire-setting (ex, cover up a crime)
80
Q

(Disruptive, Impulse-Control, and Conduct Disorder)

Kleptomania

A
  • Purposeful stealing of objects that aren’t needed for personal use or financial reasons
  • Tension or arousal before, pleasure or gratification after
  • Not done for another purpose(anger, vengeance, hallucination)
  • Differential: Ordinary theft(for object or monetary value), malingering (to avoid prosecution), manic episode
81
Q

Substance Related and Addictive Disorders

A
  • For substances, there’s use Disorder, Intoxication, and Withdrawal
  • No use disorder dx for caffeine
  • No withdrawal dx for hallucinogens or inhalants
  • No intoxication dx for tobacco
82
Q

(Substance Related and Addictive Disorders)

Drug classes (dx uses the specific drug class)

A
  • Alcohol
  • Caffeine
  • Cannabis
  • Hallucinogens
  • Inhalants
  • Opioids
  • Sedatives, Hypnotics, Anxiolytics
  • Stimulants(cocaine, amphetamine, etc)
  • Tobacco
  • Other or Unknown substance
83
Q

(Substance Related and Addictive Disorders)

Use Disorder

A
  • At least 2 symptoms in 12 months:
  • Tolerance, withdrawal, cravings, impact, can’t cut down
  • Withdrawal - either here as a symptoms, or as its own dx - not established for hallucinogens/inhalants
  • Tolerance and withdrawal criteria don’t apply to prescription medication taken under supervision
  • Differentials: Accidental exposure, adolescent experimentation
84
Q

(Substance Related and Addictive Disorders)

Intoxication

A
  • Recently induced substance
  • Significant, problematic psychological or behavioral changes
  • Behavior consistent with intoxication for that substance
85
Q

(Substance Related and Addictive Disorders)

Withdrawal

A
  • Reducing or stopping what had been regular use

- Multiple symptoms of withdrawal for that substance (specific number and type varies by substance)

86
Q

(Substance Related and Addictive Disorders)

Hallucinogen Persisting Perception Disorder

A

-Continuing to experience perceptual sys (usually visual) even after stopping use

87
Q

(Substance Related and Addictive Disorders)

Gambling Disorder

A
  • Only non-substance disorder in this chapter
  • 4+ symptoms in 12 months, similar symptoms to substance (preoccupation, unable to stop, impact)
  • Not better explained by a manic episode
  • Differential: Nondisordered gambling (limited risks, disciplined)
88
Q

Neurocognitive Disorders

A
  • All are conditions where imputed cognition NOT present since birth/early life
  • In many cases, exact course of the pathology can be identified
  • Relies on understanding cognitive domains
    • Complex attention
    • Executive function
    • Learning and memory
    • Language
    • Perceptual-motor
    • Social cognition
89
Q

(Neurocognitive Disorders )

Delirium

A
  • Disturbance in attention and cognition, develops fairly quickly and is variable
  • Direct physiological consequence of AMC, substance, toxin, or combination
  • Other specified and unspecified delirium
90
Q

(Neurocognitive Disorders )

Major and Mild Neurocognitive Disorder

Specify what the disorder is due to:

A
  • Alzheimer’s Disease - progressive, gradual cognitive decline without plateaus
  • Frontotemporal Lobar Degeneration - behavioral variant or language variant
  • Learning and memory, perceptual-motor function intact
  • Lewy Body Disease - visual hallucinations, spontaneous parkinson symptoms
  • Vascular Disease - problems in complex attention, executive function
  • Traumatic Brain Injury - identifiable TBI + amnesia, disorient, confusion
  • Substance/Medication Use
  • HIV Infection - established through testing
  • Prion Disease - (group of diseases) rapid progression, motor symptoms
  • Parkinson’s Disease - established through testing
  • Huntington’s Disease - established through testing or family history
  • AMC/Multiple etiologies/Unspecified
  • Major
    • Significant cognitive decline from previous performance
    • Decline interferes w indépendance in everyday tasks
  • Mild
    • Modest cognitive decline from previous performance
    • Decline DOES NOT interfere with independence in everyday tasks
91
Q

Personality Disorder

A
  • Enduring pattern of inner experience and outward behavior inconsistent w culture
  • Consistent, pervasive across social situations
  • Onset can be traced at least back to adolescent or early adulthood
92
Q

(Personality Disorder)

Cluster A: Primarily odd or eccentric behavior

A
  • Paranoid: distrustful and suspicious, assuming others have ill intent
  • Schizoid: doesn’t desire or enjoy social relationships (note distress/impairment criteria for dx)
  • Schizotypal: discomfort w relationships, behavioral eccentricities (“weirdo”)
93
Q

(Personality Disorder)

Cluster B: Dramatic, emotional, erratic

A
  • Antisocial: disregard for and violation of other’s rights, evident bf age 15 (must be adult to dx)
  • Histrionic: Excessive emotionality and attention-seeking (flamboyant)
  • Borderline: Unstable relationships, “frantic efforts to avoid real or imaged abandonment”
  • Narcissistic: grandiosity, lack of empathy, need for admiration
94
Q

(Personality Disorder)

Cluster C: Anxious or fearful

A
  • Avoidant: social inhibition, feelings or inadequacy, deep fear of criticism
  • Dependent: submissive and clinging behavior, need to be taken care of, fears separation
  • Obsessive-compulsive: orderliness, perfection (interferes w completion), control
95
Q

Paraphilic Disorders

A
  • Voyeuristic Disorder - spying on others in private activities
  • Exhibitonistic Disorder - displaying genitals, usually for strangers
  • Frotteuristic Disorder - touching or rubbing against consenting person
  • Sexual Masochism Disorder - Undergoing humiliation, bondage, or suffering
  • Sexual Sadism Disorder - Inflicting the same
  • Pedophilic Disorder - sexual focus on children (patient is 16 or older and at least 5 years older than children of interest)
  • Fetishistic Disorder - focus on objects or congenital body parts for arousal
  • Transvestic Disorder - sexually arousing cross-dressing
96
Q

Medication-Induced Disorders

A
  • Formally, Medication-Induced Movement Disorders and Other Adverse Effects of Medication
  • Neuroleptic-Induced Parkinsonism - AND - Other Med-Induced Parkinsonism
  • Neuroleptic Malignant Syndrome
  • Medication-Induced Acute Dystonia
  • Medication-Induced Acute Akathisia
  • Tardive Dyskinesia (associated w neuroleptic, must persist 8 weeks)
  • Tardive Dystonia
  • Tardive Akathisia
  • Medication-Induced Postural Tremor
  • Other Medication-Induced Movement Disorder
  • Antidepressant Discontinuation Syndrome
97
Q

Other Conditions (Z Codes)

A
  • Formally, Other Conditions That May Be a Focus of Clinical Attention
  • Straightforwardly named diagnostic codes for social, environmental, historical issues that may be focus of clinical attention but do not represent a mental disorder
  • Can affect the dx, course, prognosis, and treatment of a disorder
  • Not going to name them all here, but some examples
98
Q

(Other Conditions (Z Codes))

Relational problems

A
  • Parent-child relational problem
  • Sibling relational problem
  • Child affected by parental relationship distress
  • Relationship distress w spouse or intimate partner
  • Uncomplicated bereavement
99
Q

(Other Conditions (Z Codes))

Abuse and Neglect

A
  • Different codes when providing services to visit as opposed to perpetrator
  • Child physical abuse
  • Child sexual abuse
  • Child psychological abuse
  • Spouse or partner violence (physical, sexual, or psychological abuse)
100
Q

(Other Conditions (Z Codes))

Educational and Occupational Problems

A
  • Academic or educational problem

- Problem related to current military deployment status

101
Q

(Other Conditions (Z Codes))

Housing and Economic Problems

A
  • Homelessness
  • Discord w neighbor, lodger, or landlord
  • Lack of adequate food or safe drinking water
102
Q

(Other Conditions (Z Codes))

Other Problems Related to the Social Environment

A
  • Phase of life problem
  • Acculturation Difficulty
  • Social exclusion or rejection
  • Target of perceived discrimination or persecution
103
Q

(Other Conditions (Z Codes))

Problems Related to Crime or Interaction w the Legal System

A
  • Victim of crime
  • Imprisonment or Incarceration
  • Problems retailed to release from prison
104
Q

(Other Conditions (Z Codes))

Other Health Service Encounters for Counseling/Medical Advice

A
  • Sex Counseling

- Other counseling or consultation (spiritual/religious, nicotine cessation)

105
Q

(Other Conditions (Z Codes))

Problems Related to Other Psychosocial, Personal, and Environmental Circumstances

A
  • Religious or spiritual problem
  • Problems related to unwanted pregnancy
  • Discord w social service provider
  • Victim of terrorism or torture
106
Q

(Other Conditions (Z Codes))

Other circumstances of personal history

A
  • Personal history of self-harm
  • Personal history of military deployment
  • Problem related to lifestyle (Lack of exercise, poor sleep hygiene)

107
Q

(Other Conditions (Z Codes))

Nonadherence to medical treatment

A

Malingering (making up symptoms for an external incentive, like $ or time off work)

MFT Clinical Review (6 decks)

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