DSM Flashcards

Question

Factitious Diosrder vs. Malingering

Answer 1

Factitious Disorder - fake, not real, intentionally producing symptoms, can be physical or psychological symptoms. Just to be in sick role vs. Malingering - there is an external incentive - get out of work, criminal case; not a mental disorder but a v code

Answer 2

fear of being in a place where escape may be difficult or embarrassing or help won't be available; or a situationally predisposed panic attack

Answer 3

bound - cued by a specific stimulus or situation (usually in social or specific phobia) predisposed - do not always occur after person is exposed to the trigger

Answer 4

obsession - recurrent and persistent thoughts, impulses or images that are experienced at some time as intrusive and inappropriate and that cause marked anxiety or distress delusion - false but firmly sustained beliefs

Answer 5

3. The research on this issue is, not surprisingly, far from consistent. However, it has found that maintenance therapy is often required to prevent relapse. a. Incorrect Although some studies have found cognitive therapy to have some advantage over other techniques for reducing relapse, others have not. Therefore, the phrase "clearly superior" eliminates this as the correct response. b. Incorrect Interpersonal therapy has not been found to be “clearly superior” to other treatments in terms of preventing relapse. c. CORRECT Most experts agree that continued maintenance treatment is the best way to reduce the risk for relapse; and, at this point, antidepressants have been the target of most of the research on maintenance therapy. d. Incorrect Relapse is not ameliorated by combining psychosocial and drug therapies during the initial treatment.

Answer 6

9. This question describes feelings of detachment or estrangement from oneself. a. Incorrect Dissociation refers to a “disruption in the usually integrated functions of consciousness, memory, identity, or perception of the environment” (DSM-IV-TR, p. 822). Although depersonalization disorder is a type of dissociative disorder, depersonalization is a better response to this question. b. CORRECT Depersonalization refers to “an alteration in the perception or experience of the self so that one feels detached from, and as if one is an outside observer of, one’s mental processes or body” (DSM-IV-TR, p. 822). When depersonalization co-occurs with intact reality testing and significant distress or impaired functioning, a diagnosis of depersonalization disorder may be appropriate. c. Incorrect Delusions are false but firmly sustained beliefs based on incorrect inferences about external reality. Depersonalization could achieve delusional proportions, but that is not implied by the question. d. Incorrect Dissociative fugue is a dissociative disorder involving sudden, unexpected travel away from home with an inability to recall some or all of one's past.

Answer 7

10. Several symptoms help distinguish pseudodementia (memory and cognitive impairments associated with depression in older adults) from true dementia. a. Incorrect In pseudodementia, symptom onset is usually sudden; in dementia, it is typically insidious (gradual and subtle). b. Incorrect Increased severity of symptoms in the evening is characteristic of some forms of dementia but is uncommon in pseudodementia. c. Incorrect A patient with pseudodementia is likely to complain about and exaggerate his/her cognitive problems; a patient with dementia often denies problems in the early stage of the disorder and is unaware of them in the later stages. d. CORRECT A lack of cooperation during testing is more characteristic of patients with pseudodementia (depression) than of those with dementia. Patients with dementia are more likely to be cooperative (but inaccurate in their responses).

Answer 8

26. Maria seems to be experiencing fluctuating periods of depression and “normal” mood and functioning. a. Incorrect The diagnosis of bipolar I disorder requires the presence of at least one manic or one mixed episode. b. Incorrect A diagnosis of cyclothymic disorder requires the presence of hypomania and depression for at least two years. c. Incorrect The “atypical features” specifier is appropriate when the individual exhibits mood reactivity and at least two other characteristic symptoms (e.g., increased appetite and weight gain, hypersomnia). d. CORRECT Maria's symptoms suggest she is experiencing recurrent episodes of major depression. There is no evidence that she has experienced manic or mixed episodes, which would be required for a diagnosis of bipolar I disorder, or episodes of hypomania and depression, which are characteristic of cyclothymic disorder.

Answer 9

29. Sleep terror episodes are associated with sleep terror disorder and involve “abrupt awakenings from sleep usually beginning with a panicky scream or cry” (DSM-IV-TR, p. 634). a. Incorrect Sleep terrors usually begin during stage 3 or 4 NREM sleep. b. CORRECT As noted above, a sleep terror episode typically begins with a panicky scream or cry. c. Incorrect The individual usually does not have a detailed memory of a dream upon awakening but may have amnesia for the episode or may recall only fragmentary images of a dream. d. Incorrect Awakening from sleep with rhythmic, stereotyped motor activity is characteristic of nocturnal paroxysmal dystonia, which is diagnosed as a parasomnia NOS.

Answer 10

Approaches to treating anorexia vary, even among cognitive therapists. However, by definition, cognitive therapy entails addressing the cognitions that underlie or support a disorder. a. CORRECT Of the strategies given in the answers, this one is most similar to Garner and Bemis’s (1982) approach, which is based on Beck’s cognitive therapy. According to Garner and Bemis, an initial step in treatment is to foster doubt in the client about his or her assumption that it is worth the time and effort to deny one's appetite in order to stay thin. This is followed by addressing the validity of the anorectic's beliefs regarding the consequences of becoming fat and the conviction that thinness is a primary determinant of self-worth and personal value.