Diagnosis and abnormal psych Flashcards
The DSM is \_\_\_\_\_\_\_\_ in nature and, as such, only addresses the etiology of disorders for which the cause is clearly known (e.g., PTSD).
Atheoretical
Regarding multiaxial assessment, identify and describe the 5 axes used with each individual diagnosis.
Axis I: Clinical disorders and other conditions that may be a focus of clinical attention; Axis II: Mental retardation and personality disorders; Axis III: General medical conditions; Axis IV: Psychosocial and environmental problems; Axis V: GAF
When a therapist applies
diagnoses for a person on
both Axis I and Axis II, what words should be used to emphasize the one that is the focus of treatment?
Principle Diagnosis (or Reason for Visit)

Routinely used defense mechanisms and maladaptive personality traits that are not pervasive enough to qualify for a personality disorder can be recorded on what axis?
Axis II
This diagnosis requires the
following three criteria: (1) Significantly sub-average intellectual functioning, (2) concurrent impairments or deficits in at least 2 areas of adaptive functioning, and (3) onset before age 18.
Mental Retardation
True or False: A therapist should not consider impairment caused by a client’s physical or environmental limitations when using the GAF scale (Axis V)?
True
What are the 4 degrees of mental retardation and their corresponding IQ scores, as defined by the DSM?
Mild (IQ = 50-55 to 70); Moderate (IQ = 35-40 to 50-55); Severe (IQ = 20-25 to 35-40); Profound (IQ = 20-25 or below)
The DSM-IV-TR takes a ________ approach to mental disorder diagnosis, classifying a person as either meeting or not meeting a disorder’s given criteria. This differs from a ________ approach, which quantifies a persons symptoms rather than classifying them.
Categorical; dimensional
People with this degree of
mental retardation are able to develop social and communication skills during childhood, acquire about a 6th grade level of academic skills, and are able to work and live independently as adults.
Mild Retardation (85% of all mentally retarded people)
What biological antecedent to mental retardation is caused by a lack of the enzyme necessary to oxidize phenylalanine (and amino acid in protein foods)?
Phenylketonuria (PKU)
This biological cause of mental retardation occurs due to a faulty distribution of chromosomes when the egg or sperm is formed, leaving the person with 47 rather than 46 chromosomes.
Down’s Syndrome (aka Trisomy-21)
________ retardation is often related to early deprivation of nurturance, deficiencies in health care, early deficiencies in social, cognitive, and other stimulation, and poverty.
Cultural-familial
What disorder is characterized
by delayed or abnormal functioning in: social interaction, language as used in social communication, or symbolic or imaginative play by age 3?
Autism Disorder
True or False: As people with Autism grow older, they may become more interested in developing relationships, which is usually absent in Autistic children?
True- though they usually do not understand the customs that regulate social interaction
With this level of mental retardation, people may require guidance and some supervision in social and occupational settings; they usually have no more than a 2nd grade academic level; and as adults, they can contribute to their own support by performing unskilled or semiskilled work under close supervision.
Moderate Retardation (10% of all mentally retarded people)
What is the term used to define a person’s tendency to repeat the words or phrases of others?
Echolalia
People with this degree of mental
retardation have poor motor skills and communication skills as a child, though may learn to talk and can be trained in simple hygiene tasks; and they are often able to perform simple tasks as a adults, often living in highly supervised settings (e.g., group homes, with family).
Severe Retardation (3-4% of all mentally retarded people)
What form of therapy has been shown to be fairly successful in treating people with Autism?
Behavioral therapy, particularly techniques such as shaping and operant conditioning, has helped people with Autism replace abnormal behaviors with more desirable ones
At this level of mental retardation, people demonstrate extreme limitations in motor and sensory function; require highly structured environments, usually assisted by a caregiver; and can sometimes perform simple tasks under close supervision in a sheltered workshop.
Profound Retardation (1-2% of all mentally retarded people)
People with ________ experience a significant loss of developed skills (language, social, adaptive behavior, bowel/bladder control, play, and/or motor) after 2 or more years of seemingly normal development.
Childhood Disintegrative
Disorder (similar social/communication
and behavior to those with Autism)
What are the significant
differences between a
person with Autism and a person with Asperger’s Disorder?
While both involve deficits in social interaction and behavior, people with Asperger’s show no impairment in language development, self-help skills, cognitive development, or interest in the environment
What are the 3 Learning Disorders described in the DSM?
Reading Disorder, Mathematics Disorder, and Disorder of Written Expression
True or False: Learning disorders cannot be caused by mental retardation, but mental retardation can be co-diagnosed with a learning disorder?
True
What condition involves inflammation of the middle ear accompanied by accumulation of liquid in the middle ear cleft and is said to cause cerebellar-vestibular dysfunction, which has been linked to the development of learning disorders?
Otitis Media with Effusion (OME)
This diagnosis would likely apply when a person's academic/occupational or social abilities are impeded by their inappropriate use of speech sounds.
Phonological Disorder
While considered “normal childhood dysfluency” when it occurs in young children, ________ is said to be aggravated by tension or anxiety in more mature individuals.
Stuttering
A young person whose scholastic achievement
is impeded by abnormal
clumsiness would likely receive a diagnosis of ________.
Motor Skills Disorder
True or False: Children
classified as ADHD tend
to become delinquent and antisocial young adults?
True- about 70% exhibit signs of ADHD throughout their lives

Onset of symptoms must be before what age, and for what duration, in order to assign an ADHD diagnosis?
7 y/o and for a duration of at least 6 months; also, symptoms must be present in 2 or more settings
What are common comorbid problems
experienced by children
and adolescents diagnosed with ADHD?
50% meet criteria for Conduct
Disorder, 25% have emotional disorder, 20% have Learning Disorder, and others experience social maladjustment, motor incoordination, and visual/audio impairments
What personality
characteristics have
been noted to develop as a result of untreated ADHD?
Narcissism and passive-aggressive traits (usually subside once ADHD is treated)

ADHD has been linked to
abnormalities in the ________ by research that found
diminished glucose metabolism and decreased blood flow in
this region, as well as pathways
connecting this region to the caudate nucleus.
Prefrontal cortex
The core feature of this disorder is a progressive pattern of developmental regression that begins before age 4 and is characterized by decelerated head growth, loss of hand skills, lack of bodily coordination, severe deficiencies in overall language development, psychomotor retardation, and lacking social interest.
Rett’s Disorder (only been found in females)
True or False: There is no genetic link regarding ADHD?
False- about 57% of children whose parents have ADHD are later diagnosed, while twin studies have revealed a .80 average heritability for hyperactivity/impulsivity
This idea suggests that the core of ADHD is not attention deficits but rather a lack of ability to adjust activity levels to fit the requirements of different settings.
Behavioral disinhibition hypothesis (Barkley)
What are some of the undesirable side effects of methylphenidate (Ritalin), which is often used to treat ADHD?
Somatic symptoms (decreased appetite, insomnia, stomach aches); movement abnormalities (motor and vocal tics, stereotyped movements); obsessive-compulsive symptoms (though more common with dextroamphetamine); growth suppression (hence “drug holidays”)
A child or adolescent who persistently violates social rules and norms, such as acting aggressively toward animals, destroying property, or stealing, is likely to receive what diagnosis?
Conduct Disorder
Regarding Conduct Disorder, what differentiates “Childhood Onset” from “Adolescent Onset?”
Childhood Onset diagnosed when symptoms present prior to age 10; Adolescent Onset when symptoms occur at age 10 or later
To diagnose Conduct Disorder, the person has to display ________ or more signs for at least ________ months, with at least one sign present in the past ________ months.
3; 12; 6

What diagnosis best applies for a child or young adolescent who is very negative, argumentative, and defiant to adults (usually parents), rarely accepts responsibility for their actions, but tends not to get into much trouble outside of the home?
Oppositional Defiant Disorder
This disorder involves persistently eating non-nutritive substances such as paint, cloth, sand, grass, etc. for at least 1 month; it is typically associated with Mental Retardation.
Pica
What is the diagnosis of a child who, for at least one month following normal functioning, recurrently regurgitates and re-chews their food?
Rumination Disorder
 True or False: Learning disorders cannot be caused by mental retardation, but mental retardation can be co-diagnosed with a learning disorder? True  A person with \_\_\_\_\_\_\_\_ is able to read regularly spelled words, but unable to decipher words spelled irregularly (e.g., reads "fight" as "fit"); a person with \_\_\_\_\_\_\_\_ might produce responses that are related to the target word in meaning but not visually or phonologically (e.g., substitutes "down" for "up" or "hot" for "cold"), which is referred to as "semantic paralexia."
Surface dyslexia; deep dyslexia
What disorder is diagnosed for
a child who, before age 6, chronically fails to eat enough food for at least one month, which leads to weight loss or failure to gain weight? It is commonly referred to as ________.
Feeding Disorder of Infancy or Early Childhood; failure to thrive
A person presenting with symptoms similar to Tourette’s Disorder who experiences tics in only one domain (movements or vocal sounds) would be most appropriately diagnosed:
Chronic Motor
or Vocal Tic Disorder
Regarding elimination disorders, ________ and ________ refer to repeated involuntary or intentional elimination of feces and urine, respectively.
Encopresis; enuresis
After administering a battery of standardized tests of intelligence to a client, results reveal severe deficits in both receptive and expressive language development, while the client’s performance on nonverbal measures are considerably higher. What is the likely diagnosis?
Mixed Receptive-Expressive Language Disorder
Treatment of enuresis often includes ________, which involves placing a pad under the child that sounds an alarm as soon urine touches it and are associated with the highest long-term success rate.
Moisture alarms (aka bell-and-pad)
True or False: It is recommended that a child with school phobia be removed from the academic setting until his fear is appropriately resolved?
False- the consensus is that the child should be returned to school
Usually caused by separation
anxiety, ________ refers to the experience of intense anxiety about going to school and is often an early sign of depression or another serious mental disorder.
School Phobia
What disorder is characterized by a chronic failure to talk in certain situations (e.g., school) for at least 1 month, despite competently and easily talking in other situations (e.g., home)?
Selective Mutism
Often associated with Mental Retardation, ________ is characterized by repetitive motor behaviors that are not functional, such as head banging or body-rocking, and cause physical harm or significantly interfere with normal activities.
Stereotypic Movement Disorder
A child who has a short nose, narrow upper lip, small chin, and flat mid-face, and who experiences developmental delays, failure to thrive, and is usually mild to moderately mentally retarded characterizes what non-DSM condition?
Fetal Alcohol Syndrome (caused by chronic consumption of alcohol by mother during pregnancy)
The 3 types of ADHD include ________, which is
characterized by 6 or more symptoms of inattention and 6 or more symptoms of hyperactivity-impulsiveness; ________, which is diagnoses when a person has 6 or more symptoms of inattention but fewer than 6 symptoms of hyperactivity-impulsiveness; and ________, which is characterized by 6 or more symptoms of hyperactivity-impulsiveness but fewer than 6 symptoms of inattention.
Combined; Predominantly Inattentive; Predominantly Hyperactivity-Impulsive
What is the 3rd most
frequent cause of
death for infants
between 1 month and 1 year old?
Sudden Infant Death Syndrome (SIDS)
What are the subtypes of Personality Change Due to a General Medical Condition?
Labile, Disinhibited, Aggressive, Apathetic, Paranoid, Other, Unspecified, and Combined
What is the most likely diagnosis for a person who becomes catatonic as a direct result of cerebrovascular disease?
Catatonic Disorder Due to a General Medical Condition
This diagnosis is given when a
reversible syndrome develops in a person due to recently terminating or reducing the use of a substance after using it in large quantities over a long period of time.
Substance Withdrawal
A client who discloses a history of extensive LSD use, though no longer uses, reports that he occasionally re-experiences hallucinations similar to those he experienced when using the LSD. What is the most appropriate diagnosis?
Hallucinogen
Persisting Perception Disorder
Describe the typical onset and duration of delirium.
Onset is usually rapid and duration is brief, typically less than 1 month
What four groups have research has found to be most at-risk for developing delirium?
Older people (60+ y/o); people with decreased cerebral reserve (e.g., prior CNS injury or impaired cognition); post-cardiotomy patients; people going through drug withdrawal
What percent of people over age 85 have dementia?
20%
What is the term used when an elderly person’s
experience of depression impairs their cognitive ability, but is unrelated to a general medical condition or substance use?
Pseudo-dementia
What is the only way to confirm with certainty that a person has Alzheimer’s Disease?
Postmortem brain autopsy or biopsy
A person who presents with significant problems in memory and/or other cognitive disturbances following a cerebrovascular disease (e.g., stroke or infarction) would receive what diagnosis?
Vascular Dementia
What is another term for what the DSM calls Dementia Due to HIV Disease?
AIDS Dementia Complex
When a person’s dementia is caused by the persisting effects of substance use, rather than the direct effects of intoxication or withdrawal, the most appropriate diagnosis is what?
Substance-Induced Persisting Dementia (with the responsible substance indicated)
Significant impairment in one’s ability to learn new information is referred to as ________ amnesia, while marked diminishment in one’s ability to recall learned information or events is called ________ amnesia.
Anterograde; retrograde
Alcohol-Induced Persisting Amnestic Disorder due to thiamine and other vitamin B deficiencies is know as ________.
Korsakoff’s Syndrome
When a person’s amnesia is due to a medical condition, such as hypoxia, seizures, or head trauma, the correct diagnosis is:
Amnestic Disorder
Due to a General
Medical Condition (with specific condition indicated)
What drug produces severe nausea when taken in conjunction with alcohol and is used to assist in the treatment of alcoholism?
Antabuse
In people diagnosed with Conduct Disorder, those with ________ Onset have a worse prognosis and are more likely to receive a later diagnosis of Antisocial Personality Disorder, while problematic behavior of those with ________ Onset is usually a product of their relationships with delinquent peers.
Childhood; Adolescent
True or False: A person cannot receive diagnosed with both Substance Abuse and Substance Dependence?
True- if a person meets the criteria for Dependence, Abuse is not diagnosed
Research has shown that alcoholics who are administered the WAIS perform relatively normal on _______ subtests, while their ________ subtest scores are often poorer than expected, especially on visual-spatial measures.
Verbal; performance
Occurring during alcohol withdrawal, ________ involve typical signs of delirium, in addition to hallucinations, delusions, autonomic hyperactivity, and agitation; they are often associated with a co-occurring medical condition (e.g., liver failure).
Delirium tremens
Withdrawal and Intoxication by what 2 substances share the same diagnostic criteria in the DSM?
Cocaine and amphetamine
What substance does not lead
to physical dependence, has no significant withdrawal symptoms, and has no evidence of causing any long-term negative or toxic effects to it’s users (based on governmental studies)?
Cannabis (Marijuana)
What term is used to describe the phenomenon that a person’s substance use relapse leads to feelings of guilt and failure, which in turn lead to more relapses?
Abstinence Violation Effect (AVE)
In any substance abuse treatment,
the first and most important step involves what?
Getting the person
to acknowledge that they have a problem, as denial is common
What 2 forms of treatment,
when done in tandem, have the highest benefit for people in treatment for nicotine dependence (e.g., looking to quit smoking)?
Nicotine replacement therapy (gum, patch) and behavioral intervention (stimulus control, aversive techniques)
This Tic Disorder has its onset before age 18 and is characterized by involuntary jerky movements, vocal sounds (grunts, clicks), and sometimes coprolalia (uttering obscene words); people with this diagnosis often have attention and hyperactivity problems.
Tourette’s Disorder
The symptoms of what disorder
affect content of thought, form of thought, perception, affect, sense of self, volition, interpersonal functioning, and/or psychomotor behavior, and literally means “splitting of the mind?”
Schizophrenia
A person diagnosed with Schizophrenia ________ Type might present with loose associations, incoherence, flat or inappropriate affect, and regressed behavior that is largely uninhibited (e.g., laugh w/ out reason, incongruous facial gestures).
Disorganized
What type of Schizophrenia is characterized by psychomotor motor disturbance, including posturing, mutism, rigidity, motoric immobility, extreme negativism, and/or extreme excitement?
Catatonic Type
A person who present with symptoms of Schizophrenia though do not clearly qualify as disorganized, catatonic, or paranoid types would be classified as what type?
Undifferentiated Type
A client who speaks candidly
and lucidly about a nonexistent world, is preoccupied with voices telling her “the world is ending,” and whose speech, overt behavior, and affect are largely appropriate best fits what type of Schizophrenia?
Paranoid Type
A client who has had an episode of Schizophrenia and continues to
display less severe negative and/or
positive symptoms (e.g., flat affect,
odd beliefs), though no prominent positive psychotic symptoms are
present would be classified as what type?
Residual Type

What type of speech is a common symptom of psychosis
characterized by responses
that do not relate to questions
asked, or one paragraph, sentence, or phrase is not
logically connected to those that occur before or after?
Loosening of Associations (Loose Associations)
What diagnosis is most appropriate for a child who experiences excessive anxiety, lasting for at least 4 weeks, in response to separation from home or a significant figure of attachment (parent) and is often accompanied by somatic complaints (nausea, dizziness)?
Separation
Anxiety Disorder

A child with this disorder presents with extremely disturbed and developmentally inappropriate relatedness; the Inhibited Type fails to initiate or respond in age-expected manners to social interactions, while the Disinhibited Type is socially indiscriminate (e.g., easily affectionate with strangers).
Reactive
Attachment Disorder

A child diagnosed with ________ may present similarly as depressed adults, though often mask their feelings with delinquency, phobias, underachievement, psychosomatic complaints, hyperactivity, or aggression; it is often associated with family abuse or neglect.
Childhood Depression
A person presents for therapy after family members noticed significantly increased paranoia following a car accident where the person sustained a head injury. Collateral information suggests the paranoia presented only after the accident. What is the most likely primary diagnosis?
Personality Change Due to a General Medical Condition
What is diagnosed when maladaptive behavioral or psychological changes occur during or shortly after using or being exposed to a substance (e.g., alcohol, caffeine, opioids), and the changes are due to the physiological effects of the substance on the central nervous system?
Substance Intoxication
A person with ________ experiences a reduced
level of awareness and understanding of the environment, impaired ability to focus, maintain, or switch attention (disturbances of consciousness), as well as memory impairment, disorientation, or language difficulties (cognitive disturbances); sometimes illusions or hallucinations (perceptual disturbance) occur instead of cognitive disturbances.
Delirium
A client is relatively alert, though her memory has significantly declined and she has been experiencing increased difficulty recognizing objects, organizing her thoughts, and understanding abstract concepts. These problems have seriously impeded her normal functioning. What is her most likely diagnosis?
Dementia
