Differential Diagnosis Flashcards
Definitions of Psychopathology
(Maddux & Winstead 2008)
- Statistically different/infrequent
- Maladaptive behavior
- Distress and Disability
- Social Deviance
- Harmful dysfunction
- DSM
DSM Definition of Mental Disorder
(DSM-5 2013)
- Clinically significant disturbance in cognition, emotion regulation, or behavior
- Dysfunction in psychological, biological, or developmental processes
- Usually associated with significant distress or disability
- Expected or culturally approved response to stress, socially deviant behavior, conflicts between individual and society NOT a disorder
Cultural definitions of pathology
(Nevid 1994)
-Definitions are different in various cultures
Basic Criteria for PD (DSM)
(DSM-5 2013)
- Enduring pattern of inner experience that deviates from culture (cognition, affect, interpersonal, impulse control)
- enduring pattern is inflexible and pervasive across range of situations
- enduring pattern leads to distress or impairment in social, work, or other areas
- enduring pattern is stable and of long duration beginning in adolescence or adulthood
- not better explained by another disorder
- not attributable to substance use or medical condition
Personality Clusters in DSM
(DSM-5 2013)
Cluster A: Odd or Eccentric, including Paranoid, Schizoid and Schizotypal
Cluster B: Dramatic/Emotional, including Antisocial, Borderline, Histrionic, Narcissistic
Cluster C: Anxious, including Avoidant, Dependent, Obsessive compulsive
Summary of pathology causes in Drive Model
(Pine 1990)
-Overwhelming drives or weak defenses cause illness
-Compromise formation is based on drive vs. defense and can cause neurotic symptoms
-Failure of compromise formation leads to neurosis
Guilt through internalized authority figures and aggressive drives causes neurosis
Cognitive model of pathology
- maladaptive/unrealistic beliefs can negatively impact behavior and emotions
- cognition and behaviors are the problem, not the cause of symptoms
- cognitions are learned and genetic, and continued through reinforcement
Difference between mood and affect
(Maddux & Winstead, 2008)
Mood is stable, pervasive, sustained emotion which colors experiences and perceptions
Affect is the fluctuating change in emotion moment to moment, a pattern of observable behaviors
Psychodynamic conceptualization of depression
Two types:
Introjective (Freud 1917) concerned with securing a positive self
Anaclitic (Spitz 1945) concerned with obtaining and maintaining close relationships
Diagnostic Criteria for Depressive Episode
(DSM-5, APA 2013)
- Depressed mood or anhedonia >2 weeks must be present
- 4 other symptoms from I’M SAD, WEPT:
- Inadequate self-esteem
- Mood, depressed
- Sleep
- Anhedonia
- Death thoughts/suicidal
- Weight change
- Energy loss/fatigue
- Psychomotor
- Thinking/concentration or indecisiveness
Diagnostic Criteria for Persistent Depressive Disorder
(DSM-5, APA 2013)
- Depressed mood >2 years
- Two or more symptoms of a depressive episode
- No remission in >2 months
Diagnostic Criteria for Disruptive Mood Dysregulation Disorder
(DMS-5, APA 2013)
- severe temper
- inconsistent for developmental level
- outbursts averaging 3+ times per week
- mood is persistently irritable/angry
- Present in at least 2 settings (home, school, or peers)
- diagnosis made between age 6 and 18
- onset before age 10
Prevalence rates for depressive disorders
(DSM-5, APA 2013)
- 20-25% lifetime prevalence for women. 9-13% for men
- Age of first episode usually 15-29 years old
Diagnostic Criteria for Generalized Anxiety Disorder
(DSM-5, APA 2013)
- excessive anxiety and worry for >6 months about a number of things
- difficult to control the worry
- three or more from Indiana (Jones) Fights Monsters, Rattlesnakes, Communists, and Swastikas:
- Irritability
- Fatigue
- Muscle tension
- Restlessness
- Concentration/mind blank
- Sleep disturbance
Diagnostic Criteria for Panic Disorder
(DSM-5, APA 2013) -four or more from Puh Panic Study Skills A B CCC DD FF -Palpitations -Paresthesias -Sweating -Shaking or trembling -Abdominal distress -Breath is short -Choking feeling -Chest pain -Chills or hot flushes -Dizzy -Derealization/depersonalization -Fear of losing control -Fear of dying Also with worry about additional attacks and/or significant behavior change
Diagnostic Criteria for Social Anxiety Disorder
(DSM-5, APA 2013)
- fear of social situations
- Fear that they will be negatively evaluated
- the situation almost always provokes fear
- The situation is avoided or endured with intense fear
- Fear is out of proportion for actual threat
- lasting >6 months
Diagnostic Criteria for Agoraphobia
(DSM-5, APA 2013)
- fear in 2 of the following:
- using public transit
- being in open spaces
- being in closed spaces
- standing in line or crowd
- being outside the home alone
- avoidance of situation due to fear that escape would be difficult or help would not be available
- situation almost always provokes fear
- active avoidance or requires the presence of a companion, or endured with great fear
- out of proportion to the actual danger
- lasting >6 months
Diagnostic Criteria for Obsessive Compulsive Disorder
(DSM-5, APA 2013) Obsessions (RISE) -recognition of thoughts (not thought insertion) -Intrusive and inappropriate -Suppression attempts -excessive beyond worries about life Compulsions (R&R) -repetitive behaviors or mental acts they feel driven to perform -Reducing distress is the goal
In addition, the person recognizes the behavior as unreasonable and is causes marked distress and is time consuming
Diagnostic Criteria for Post Traumatic Stress Disorder
(DSM-5, APA 2013) TIA CMA -Traumatic event -Intrusive symptoms -Avoidance -Cognition or Mood (2) -Arousal changes (2) > 1 month
Diagnostic Criteria for Acute Stress Disorder
(DSM-5, APA 2013) -traumatic event 9 or more symptoms from (I MAAD) -Intrusive symptoms -Mood -Avoidance -Arousal -Dissociation 3 days to 1 month
Diagnostic Criteria for Manic Episode
(DSM-5, APA 2013)
FART GAS
Flight of ideas Attention easily drawn Risky activities Talkative Grandiosity Activity, goal directed Sleep, decreased
lasting at least a week
