Diagnosis and Psychopathology

Question 1

GAD

Answer 1

Generalized Anxiety Disorder is diagnosed in the presence of excessive anxiety and worry about several events or activities on most days for six months or longer. Cognitive-behavioral therapy is an empirically supported treatment for this disorder.

Question 2

Social Anxiety Disorder

Answer 2

Social Anxiety Disorder is characterized by marked fear of or anxiety about one or more social situations in which the individual may be exposed to the scrutiny of others. The preferred treatment is exposure with response prevention.

Question 3

Bipolar I Disorder

Answer 3

Bipolar I Disorder is characterized by the presence of at least one manic episode, which is a distinct period involving an abnormally and persistently elevated, expansive, or irritable mood and persistently increased activity or energy. Episodes last at least one week and cause marked impairment in functioning, require hospitalization, or include psychotic features. The treatment-of-choice is lithium or an antiseizure medication.

Question 4

Avoidant Personality Disorder

Answer 4

Avoidant Personality Disorder is characterized by a pervasive pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation.

Question 5

Somatic Symptom Disorder

Answer 5

Somatic Symptom Disorder is characterized by one or more somatic symptoms that cause distress or a significant disruption in daily life with excessive thoughts, feelings, or behaviors related to the symptoms.

Question 6

Specific Learning Disorder

Answer 6

Specific Learning Disorder involves difficulties related to academic skills as indicated by the presence of at least one characteristic symptom that persists for six months or more despite the provision of interventions targeting those difficulties. The person’s academic skills must be substantially below those expected for his/her age, interfere with academic or occupational performance or activities of daily living, have started during the school-age years, and not be better accounted for by another condition or disorder or other factor.

Question 7

Narcolepsy

Answer 7

Narcolepsy is characterized by attacks of an irresistible need to sleep with brief episodes of sleep that occur three or more times per week and have been present for at least three months.

Question 8

Histrionic Personality Disorder

Answer 8

Histrionic Personality Disorder is characterized by a pervasive pattern of emotionality and attention-seeking as manifested by at least five characteristic symptoms - e.g., discomfort when not the center of attention; inappropriately sexually seductive or provocative; rapidly shifting and shallow emotions; consistent use of physical appearance to gain attention; considers relationships to be more intimate than they are.

Question 9

Paraphilic Disorder

Answer 9

A Paraphilic Disorder is a paraphilia that causes distress or impairment to the individual or involves harm or risk of harm to others. Included in this category are Frotteuristic Disorder, Fetishistic Disorder, and Transvestic Disorder.

Question 10

Oppositional Defiant Disorder

Answer 10

The diagnosis of Oppositional Defiant Disorder requires are current pattern of an angry/irritable mood, argumentative/defiant behavior, or vindictiveness as manifested by four or more characteristic symptoms that occur during interactions with at least one individual who is not a sibling.

Question 11

Factitious Disorder

Answer 11

Factitious Disorder involves falsification of symptoms in oneself or another person that are associated with an identified deception and engagement in deceptive behavior even in the absence of an external reward.

Question 12

Agoraphobia

Answer 12

Agoraphobia is characterized by marked fear or anxiety about at least two of five situations: using public transportation, being in open spaces, being in enclosed spaces, standing in line or being in a crowd, and being outside the home alone. A person with this disorder fears or avoids these situations due to concern that escape might be difficult or help will not be available if he or she develops panic-like, incapacitating, or embarrassing symptoms.

Question 13

Posttraumatic Stress Disorder

Answer 13

The DSM-5 provides separate diagnostic criteria for PTSD for adults, adolescents, and children over age six and for children six years old and younger. The specific symptoms for the two age groups vary somewhat but represent the same diagnostic categories: exposure to a traumatic event, re-experiencing of the event, negative alterations in cognition and mood associated with the event, and marked alterations in arousal associated with the event. For both age groups, symptoms must last for more than one month.

Question 14

Childhood-Onset Fluency Disorder

Answer 14

Childhood-Onset Fluency Disorder (stuttering) involves an impairment in normal fluency and time patterning of speech that is inappropriate for the person’s age and includes frequent repetitions or prolongations of sounds and syllables, pauses within words, word substitutions, and/or monosyllabic whole-word repetitions. Treatment often includes habit reversal training.

Question 15

Bipolar II Disorder

Answer 15

Bipolar II Disorder is characterized by the presence of at least one hypomanic episode and at least one major depressive episode. A hypomanic episode lasts for at least four days and is similar to a manic episode but does not cause marked impairment or require hospitalization. A major depressive episode lasts at least two weeks and includes five or more characteristic symptoms, one of which must be depressed mood or loss of interest or pleasure.

Question 16

Intellectual Disability

Answer 16

Three criteria must be met for a DSM-5 diagnosis of Intellectual Disability - deficits in intellectual functioning, deficits in adaptive functioning, and an onset of symptoms during the developmental period. Degree of severity (mild, moderate, severe, and profound) is based on adaptive functioning in conceptual, social, and practical domains.

Question 17

DSM-5

Answer 17

The DSM-5 was published in 2013 and is the most recent version of the Diagnostic and Statistical Manual of Mental Disorders. It provides a nonaxial assessment system in which all mental and medical diagnoses are listed together with the primary diagnosis listed first; and it uses a categorical approach that views psychiatric disorders as separate entities and describes each disorder in terms of criteria sets that specify the defining and minimum features for each diagnosis.

Question 18

Major Depressive Disorder

Answer 18

Major Depressive Disorder is characterized by the presence of at least one major depressive episode that lasts for at least two weeks and consists of five or more characteristic symptoms, one of which must be a depressed mood or loss of interest or pleasure. Treatment usually includes an antidepressant and/or cognitive behavioral therapy or interpersonal therapy

Question 19

Depersonalization/Derealization Disorder

Answer 19

Depersonalization/Derealization Disorder is characterized by recurrent or persistent episodes of depersonalization or derealization. Reality testing remains intact during episodes, but symptoms cause significant distress or impaired functioning.

Question 20

Dialectical Behavior Therapy

Answer 20

Linehan’s dialectical behavior therapy (DBT) is an empirically supported treatment for Borderline Personality Disorder. It is based on the assumption that BPD is due to pervasive emotion dysregulation, and it incorporates three strategies: (a) group skills training to develop mindfulness, emotion regulation, and interpersonal effectiveness; (b) individual outpatient psychotherapy to maintain motivation and strengthen newly acquired skills; and (c) telephone coaching to provide between-session support and promote skill generalization.

Question 21

Enuresis

Answer 21

Enuresis is characterized by repeated voiding of urine into the bed or clothes at least twice a week for three consecutive months. Urination is usually involuntary but can be intentional. This disorder is diagnosed only when the individual is at least five years old or the equivalent developmental level. The urine alarm (bell-and-pad) is the most common treatment.

Question 22

Hypertension

Answer 22

There are two types of hypertension (high blood pressure): Primary (essential) hypertension is most common and is diagnosed when the cause is unknown, while secondary hypertension is known to be secondary to another disorder or condition.

Question 23

Erectile Disorder

Answer 23

Erectile Disorder is characterized by at least one of three symptoms during all or almost all occasions of sexual activity: marked difficulty obtaining an erection during sexual activity; marked difficulty maintaining an erection until completion of sexual activity; marked decrease in erectile rigidity.

Question 24

Transactional Model of Stress

Answer 24

Lazarus and Folkman’s (1984) research led to the conclusion that how people respond to a potentially stressful event depends on their cognitive appraisal of that event. Their transactional model distinguishes between three types of cognitive appraisal: primary appraisal, secondary appraisal, and reappraisal.

Question 25

Dissociative Amnesia

Answer 25

Dissociative Amnesia is characterized by an inability to recall important autobiographical information that can’t be explained by ordinary forgetfulness and causes significant distress or impaired functioning. Amnesia can take one of several forms, but localized and selective amnesia are most common.

Question 26

Tourette’s Disorder

Answer 26

Tourette’s Disorder involves the presence of at least one vocal tic and multiple motor tics that may appear simultaneously or at different times, may wax and wane in frequency, have persisted for one year or more, and began before age 18.

Question 27

Delirium

Answer 27

Delirium is characterized by a disturbance inattention and awareness and at least one additional disturbance in cognition with evidence that symptoms are the physiological consequence of a medical condition, substance intoxication or withdrawal, or exposure to a toxin.

Question 28

Borderline Personality Disorder

Answer 28

The diagnosis of Borderline Personality Disorder requires the presence of a pervasive pattern of instability of interpersonal relationships, self-image, and affect plus marked impulsivity.

Question 29

Separation Anxiety Disorder

Answer 29

A diagnosis of Separation Anxiety Disorder requires the presence of developmentally inappropriate and excessive fear or anxiety related to separation from home or attachment figures.

Question 30

Specific Phobia

Answer 30

Specific Phobia involves marked fear of or anxiety about a specific object or situation. The object or situation nearly always causes fear or anxiety, and the individual either avoids it or endures it with marked distress. Exposure with response prevention is an empirically supported treatment for Specific Phobia.

Question 31

Persistent Depressive Disorder

Answer 31

Persistent Depressive Disorder is characterized by a depressed mood on most days for at least two years in adults or one year in children and adolescents.

Question 32

Attention-Deficit/Hyperactivity Disorder

Answer 32

The diagnosis of ADHD requires the presence of at least six symptoms of inattention and/or six symptoms of hyperactivity-impulsivity. Symptoms must have had an onset prior to 12 years of age, be present in at least two settings, and interfere with functioning. About 15% of children with ADHD continue to meet the diagnostic criteria for the disorder as adults and another 60% continue to have some symptoms that have adverse effects on health, relationships, and other aspects of functioning.

Question 33

Cyclothymic Disorder

Answer 33

Cyclothymic Disorder involves multiple hypomanic episodes and multiple episodes of depressive symptoms that do not meet the criteria for a major depressive episode. Symptoms must last for at least two years in adults and one year in children and adolescents.

Question 34

Illness Anxiety Disorder

Answer 34

Illness Anxiety Disorder involves a preoccupation with having a serious illness with no or mild somatic symptoms, a high level of anxiety about health, and performance of excessive health-related behaviors or maladaptive avoidance of medical care.

Question 35

Substance-Induced Disorders

Answer 35

The Substance-Induced Disorders include Substance Intoxication, Substance Withdrawal, and Substance/Medication-Induced Mental Disorders. The symptoms of the Substance/Medication-Induced Disorders depend on the type of substance or medication but all share several features - e.g., they involve a significant symptomatic presentation of a mental disorder and evidence from a history, a physical exam, or laboratory results confirms that the disorder developed during or within one month of substance intoxication or withdrawal or taking a medication and the substance or medication is known to be capable of producing the mental disorder.

Question 36

Malingering

Answer 36

Malingering is included in the DSM-5 with Other Conditions That May Be a Focus of Clinical Attention. It involves the intentional production of physical or psychological symptoms to obtain an external reward.

Question 37

Schizotypal Personality Disorder

Answer 37

The essential feature of Schizotypal Personality Disorder is the presence of pervasive social and interpersonal deficits marked by acute discomfort with and reduced capacity for close relationships and cognitive or perceptual distortions and behavioral eccentricities.

Question 38

Relapse Prevention Therapy

Answer 38

Marlatt and Gordon’s relapse prevention therapy is a treatment for alcohol and drug addiction and focuses on helping clients identify circumstances that increase the risk for a lapse and use strategies that prevent future lapses. It is based on the assumption that an addiction is an over learned habit pattern.

Question 39

Outline for Cultural Formulation

Answer 39

The DSM-5’s Outline for Cultural Formulation provides a framework for assessing cultural features of a client’s presenting problems in terms of the following categories: the cultural identity of the individual; the individual’s cultural conceptualization of distress; psychosocial stressors and cultural features that affect the individual’s vulnerability and resilience; cultural features that affect the relationship between the client and therapist; and overall cultural assessment.

Question 40

Delusional Disorder

Answer 40

A diagnosis of Delusional Disorder requires the presence of one or more delusions that last at least one month. The DSM-5 distinguishes between seven subtypes: erotomanic, grandiose, jealous, persecutory, somatic, mixed, and unspecified.

Question 41

Anorexia Nervosa

Answer 41

Anorexia Nervosa is characterized by a restriction of energy intake that causes a significantly low body weight; an intense fear of gaining weight or becoming fat or persistent behavior that interferes with weight gain; and a disturbance in the experience of one’s body weight or shape or lack of recognition of the seriousness of one’s low body weight.

Question 42

Autism Spectrum Disorder

Answer 42

Autism Spectrum Disorder is characterized by (a) persistent deficits in social communication and interaction across multiple context; (b) restricted, repetitive patterns of behavior, interests, and activities; (c) the presence of symptoms during the early developmental period; and (d) impaired functioning as the result of symptoms. The best prognosis is associated with the development of functional language by age 5, an IQ over 70, a later onset of symptoms, and an absence of comorbid mental disorders.

Question 43

Gender Dysphoria

Answer 43

Gender Dysphoria in Children, the diagnostic criteria are a marked incongruence between assigned gender at birth and experienced or expressed gender as evidenced by a strong desire to be the opposite sex and at least five symptoms - e.g., strong preference for wearing clothes of the other gender; strong preference for cross-gender roles during play; strong preference for toys and activities typically used or engaged in by the other gender; strong preference for playmates of the opposite gender; strong desire for primary and/or secondary sex characteristics of one’s experienced gender. For Gender Dysphoria in Adolescents and Adults, the marked incongruence between assigned gender and experienced or expressed gender must be manifested by at least two symptoms - e.g., marked incongruence between one’s primary and/or secondary sex characteristics and one’s experienced or expressed gender; strong desire for the primary and/or secondary sex characteristics of the opposite gender; strong desire to be of the opposite gender; strong conviction that one has the feelings and reactions that are characteristic of the opposite gender. For both disorders, symptoms must have a duration of at least six months and cause clinically significant distress or impaired functioning.

Question 44

Premature Ejaculation

Answer 44

Premature Ejaculation involves a persistent or recurrent pattern of ejaculation during partnered sexual activity within about one minute of vaginal penetration or before the person desires it. Of the various Sexual Dysfunctions, sex therapy has been found to be the most effective for this disorder.

Question 45

Acute Stress Disorder

Answer 45

Acute Stress Disorder involves the development of symptoms following exposure to actual or threatened death, severe injury, or sexual violation with symptoms representing five categories: intrusion, negative mood, dissociation, avoidance, and arousal. Symptoms must have a duration of three days to one month and cause significant distress or impaired functioning.

Question 46

General Adaptation Syndrome

Answer 46

Selye concluded that people respond to all types of prolonged stress in a similar way. He named this response the general adaptation syndrome (GAS) and proposed that it involves three stages: alarm, resistance, and exhaustion.

Question 47

Adjustment Disorders

Answer 47

The Adjustment Disorders involve the development of emotional or behavioral symptoms in response to one or more psychosocial stressors within three months of the onset of the stressors. Once the stressors or their consequences have terminated, symptoms must remit within six months.

Question 48

Conduct Disorder

Answer 48

Conduct Disorder is characterized by a persistent pattern of behavior that involves violation of the basic rights of others or age-appropriate societal norms or rules as manifested by symptoms that represent four categories: aggression to people and animals, destruction of property, deceitfulness or theft, and serious violation of rules.

Question 49

Schizoaffective Disorder

Answer 49

Schizoaffective Disorder involves an uninterrupted period of illness during which, at some time, there are concurrent psychotic symptoms and symptoms of a major depressive or manic episode with a period of two weeks or more in which psychotic symptoms are present without prominent mood symptoms.

Question 50

Vascular Neurocognitive Disorder

Answer 50

A diagnosis of Vascular Neurocognitive Disorder is assigned when the criteria for Major or Mild Neurocognitive Disorder are met, symptoms are consistent with a vascular etiology, and there is evidence of cerebrovascular disease from the individual’s history, a physical exam, and/or neuroimaging.

Question 51

Obsessive-Compulsive Personality Disorder

Answer 51

Obsessive-Compulsive Personality Disorder involves a pervasive pattern of preoccupation with orderliness, perfectionism, and mental and interpersonal control that limit flexibility, openness, and efficiency.

Question 52

Neurocognitive Disorder Due To Alzheimer’s Disease

Answer 52

This diagnosis is assigned when the criteria for Major or Mild Neurocognitive Disorder are met, symptoms had an insidious onset and have caused a gradual progression of impairment in at least one cognitive domain for Mild Neurocognitive Disorder or at least two cognitive domains for Major Neurocognitive Disorder, and the criteria for probable or possible Alzheimer’s disease are met.

Question 53

Substance Use Disorders

Answer 53

The Substance Use Disorders are characterized by the presence of “cognitive, behavioral, and physiological symptoms indicating that the individual continues using the substance despite significant substance-related problems” (APA, 2013, p. 483). Symptoms represent four groups: impaired control, social impairment, risky use, and pharmacological criteria (tolerance and withdrawal).

Question 54

Schizoid Personality Disorder

Answer 54

Schizoid Personality Disorder is characterized by a pattern of detachment from interpersonal relationships and a restricted range of emotional expression in interpersonal settings.

Question 55

Antisocial Personality Disorder

Answer 55

Antisocial Personality Disorder involves a pervasive pattern of disregard for and violation of the rights of others since age 15 with a history of Conduct Disorder before age 15. This diagnosis cannot be assigned to individuals less than 18 years of age.

Question 56

Bulimia Nervosa

Answer 56

Bulimia Nervosa is characterized by recurrent episodes of binge eating that involve eating a larger amount of food than most people would eat in a similar period of time, with a sense of lack of control over eating; recurrent compensatory behaviors to prevent weight gain; and self-evaluation that is overly influenced by body weight and shape.

Question 57

Non-Rapid Eye Movement Sleep Arousal Disorders

Answer 57

The Non-Rapid Eye Movement Sleep Arousal Disorders are characterized by recurrent episodes of incomplete awakening that occur most often during Stage 3 or 4 sleep in the first third of a major sleep episode and that involve sleep walking or sleep terrors.

Question 58

Schizophreniform Disorder

Answer 58

Schizophreniform Disorder is diagnosed in the presence of two or more characteristic symptoms (delusions, hallucinations, disorganized speech, grossly disorganized or catatonic behavior) with at least one symptom being delusions, hallucinations, or disorganized speech. Symptoms have a duration of at least one month but less than six months.

Question 59

Schizophrenia

Answer 59

Schizophrenia is characterized by two or more active phase symptoms (delusions, hallucinations, disorganized speech, grossly disorganized behavior, negative symptoms) for at least one month, with at least one symptom being delusions, hallucinations, or disorganized speech. Continuous signs of the disorder must have been present for at least six months, and symptoms must cause impaired functioning. It is often treated with a traditional (first-generation) or newer (second-generation) antipsychotic. The beneficial effects of an antipsychotic are augmented when it is combined with cognitive-behavioral therapy, social skills training, and other interventions for the patient and his or her family.

Question 60

Panic Disorder

Answer 60

Panic Disorder involves recurrent unexpected panic attacks with at least one attack being followed by at least one month of persistent concern about having other attacks or about their consequences and/or a significant maladaptive behavior change that is related to the attacks. Cognitive-behavioral therapy and pharmacotherapy are the preferred treatments for Panic Disorder.

Question 61

Brief Psychotic Disorder

Answer 61

Brief Psychotic Disorder involves one or more characteristic symptoms (delusions, hallucinations, disorganized speech, grossly disorganized or catatonic behavior) with at least one symptom being delusions, hallucinations, or disorganized speech. Symptomshave a duration of one day to less than one month

Question 62

Insomnia Disorder

Answer 62

Insomnia Disorder is characterized by dissatisfaction with sleep quality or quantity due to difficulty maintaining or initiating sleep. The disturbance occurs three or more nights each week and has been present for three or more months.

Question 63

Obsessive-Compulsive Disorder

Answer 63

OCD is characterized by recurrent obsessions, compulsions, or both. Treatment usually includes a combination of medication and either exposure with ritual prevention or cognitive-behavioral therapy that integrates exposure with other techniques.