DSM 5 Flashcards
Bipolar I Disorder
Necessary to meet the following criteria for a manic episode.
MANIC EPISODE [HYPOMANIC CAN OCCUR]
AND MAJOR DEPRESSION
MANIC EPISODE
A- distinct period of abnormally, persistently elevated, expansive or irritable mood / energy.
B- lasts at least 1 WEEK and present most of the day, nearly every day
—> 3 or more of the following symptoms —>
—-inflated self esteem or grandiosity
—-decreased need for sleep
—-more talkative than usual or pressure to keep talking
—-flight of ideas; thoughts are racing (subjective)
—-distractibility
—-increase in goal directed activity
C- mood disturbance is sufficiently severe to cause marked impairment in social / occupational functioning
D- Episode not attributable to the physiological effects of substance
MAJOR DEPRESSIVE EPISODE
A- Five or more of the following symptoms have been present during the same 2-week period and represent a change from previous functioning. At least one of the symptoms is either 1) depressed mood or 2) loss of interest or pleasure
- depressed mood most of the day
-markedly diminished interest or pleasure in all or almost all activities
-significant weight loss or weight gain
-insomnia or hypersomnia every day nearly
-psychomotor agitation or retardation nearly every day
-fatigue or loss of energy nearly every day
-diminished ability to concentrate or think
B- Symptoms cause clinically significant distress or impairment in social, occupational, or other
C- Episode not attributable to to physiological effects of substance
Bipolar II Disorder
HYPOMANIC and MAJOR DEPRESSION
HYPOMANIC
A- a distinct period of abnormally and persistently elevated, expansive or irritable mood and increased activity or energy, lasting at least 4 CONSECUTIVE DAYS and present most of the day
B- during period of mood disturbance and increased energy and activity, three or more of the following symptoms have persisted
-inflated self-esteem or grandiosity
-decreased need for sleep
-more talkative than usual
-flight of ideas or subjective experience that thoughts are racing
-distractibility
-increase in goal orient activity at work or school
-excessive involvement in activities that have a high potential for painful consequences (buying sprees, sexual indiscretions)
MAJOR DEPRESSIVE EPISODE
5 or more of the following symptoms that have been present during the SAME 2-WEEK PERIOD. At least one of the symptoms is either 1) depressed mood or 2) loss of interest or pleasure
Cyclothymic Disorder
[Bipolar or Related Disorder]
A- for at least 2 years there have been numerous periods with hypomanic symptoms that do not meet the criteria of a hypomanic episode and numerous periods with depressive symptoms that do not meet the criteria of major depressive episode
B- During the above e 2-year period (1 year in children and adolescents) the hypomanic and depressive episodes have been present for at least half the time and individual hasn’t been without the symptoms for more than 2 months at a time
C- Criteria for major depressive, manic or hypomanic episode have never been met
D- Symptoms in criterion A are not better explained by schizoaffective disorder, schizophrenia, schizophreniform, delusional disorder or other specified or unspecified schizophrenia spectrum and other psychotic disorder
E- Symptoms are not attributable to substance
F- symptoms cause clinically significant distress or impairment in social occupational or other
Disruptive Mood Dysregulation Disorder
[Depressive Disorder]
A- Severe recurrent temper outbursts manifested verbally and/or behaviorally that are grossly out of proportion in intensity or duration to the situation
B- Temper outbursts are inconsistent with developmental level
C- Temper outbursts occur on average THREE OR MORE TIMES PER WEEK
D- Mood between temper outbursts is persistently irritable or angry most of the day, nearly every day, and observable by others
E- Criteria A-D have been present for 12 OR MORE MONTHS. Throughout that time, individual HAS NOT HAD A PERIOD LASTING 3 OR MORE CONSECUTIVE MONTHS without all of the symptoms
F- Criteria A and D are present in at least two of the three settings (at home, at school, with peers) and are severe in at least one
G- The DIAGNOSIS SHOULD NOT BE MADE for the first time BEFORE age of 6 years old OR AFTER 18 years old
H- By history or observation, the age at onset of criteria A-E is before 10 years
I- There has never been a distinct period lasting more than 1 day during which the full symptom criteria, except duration, for a manic or hypomanic episode have been met
J- The behaviors do not occur exclusively during an episode of major depressive disorder and not better explained by another mental disorder
Major Depressive Disorder
[Depressive Disorder]
A- Five or more of the following symptoms have been present during the SAME 2-WEEK PERIOD and represent a change from previous functioning. At least one symptom is 1) depressed mood or 2) loss of interest or pleasure
—1) depressed mood most of the day, nearly every day as indicated by either subjective report or by others
—2) diminished interest or pleasure in all or almost all activities, most of the day, nearly every day
—3) significant weight loss or weight gain
—4) insomnia or hypersomnia nearly every day
—5) Psychomotor agitation or retardation nearly every day
—6) fatigue or loss of energy nearly every day
—7) feelings of worthlessness or excessive or inappropriate guilt
—8) diminished ability to think or concentrate
—9) recurrent thoughts of death
B- symptoms cause clinically significant distress or impairment in social, occupational, or other areas
C- episode is not attributable to the physiological effects of a substance or to another medical condition
(Note: Criteria A-C represent a major depressive episode)
D- The occurrence of the major depressive episode is not better explained by schizoaffective disorder, schizophrenia, schizophreniform, delusional disorder, or other specified etc
E- There has never been a manic or hypomanic episode
Dysthymia (Persistent Depressive Disorder)
[Depressive Disorder]
(This disorder represents a consolidation of DSM-IV-defined chronic major depressive disorder and dysthymic disorder)
A- Depressed mood for most of the day, for more days than not, as indicated by either subjective account or observation by other FOR AT LEAST 2 YEARS (children and adolescents = 1 year)
B- Presence, while depressed, of two or more of the following:
—1) poor appetite or overeating
—2) insomnia or hypersomnia
—3) low energy or fatigue
—4) low self-esteem
—5) poor concentration or difficulty making decisions
—6) feelings of hopelessness
C- During the 2 year period (1 year for children/adolescents) of the disturbance, the individual has never been without symptoms in criteria A or B for more than 2 months at a time
D- Criteria for a major depressive disorder may be continuously present for 2 years
E- No manic or hypomanic episode and criteria have never been met for cyclothymic disorder
F- Not better explained by persistent schizophrenia disorders
G- Not attributable to substance
H- symptoms cause clinically significant distress or impairment in social, occupations, or other
Separation Anxiety Disorder
[Anxiety Disorder]
A- Developmentally inappropriate and excessive fear or anxiety concerning separation from those to whom the individual is attached, as evidenced by AT LEAST THREE OF THE FOLLOWING:
—1) recurrent excessive distress when anticipating or experiencing separation from home or from major attachment figures
—2) persistent and excessive worry about losing major attachment figures or about possible harm to them
—3) Persistent and excessive worry about experiencing an untoward event (getting lost, being kidnapped, having an accident)
—4) Persistent reluctance or refusal to go out, away from home, to school, to work, or elsewhere
—5) Persistent and excessive fear of or reluctance about being alone or without major attachment figures
—6) Persistent reluctance or refusal to sleep away from home o to go to sleep without being near a major attachment
—7) Repeated nightmares involving them of separation
—8) Repeated complaints of physical symptoms (headache, stomachache, nausea, vomiting) when separation from major attachment occurs
B- The fear, anxiety, or avoidance is persistent, lasting at least 4 weeks in children and adolescents and typically 6 months or more in adults
C- The disturbance causes clinically significant distress or impairment in social, academic, occupational, or other important areas
D- Not better explained by another mental disorder
Selective Mutism
[Anxiety Disorder]
A- Consistent failure to speak in specific social situations where there is an expectation of speaking
B- The disturbance interferes with education or occupations achievment
C- Duration of disturbance is AT LEAST ONE MONTH
D- Failure to speak is not attributable to lack of knowledge of, or comfort with, the spoken language
E- Disturbance is not better explained by a communication disorder
Specific Phobia
[Anxiety Disorder]
A- Marked fear or anxiety about a specific object or situation (ie flying, heights, animals, injections, seeing blood)
B- The phobic object or situation almost always provokes immediate fear or anxiety
C- The phobic object or situation is actively avoided or endured with intense fear or anxiety
D- The fear / anxiety is out of proportion to the actual danger posed by the specific object or situation
E- The fear anxiety or avoidance is persistent typically LASTING 6 MONTHS OR MORE
F- The fear, anxiety or avoidance causes clinically significant distress or impairment in social, occupational or other important areas of functioning
G - Not better explained by other disorders
Social Anxiety Disorder
[Anxiety Disorder]
A- Marked fear or anxiety about one more social situations which individual is exposed to possible scrutiny by others. Examples include social interactions, being observed, performing in front of others.
B- The individual fears that they will act in a way or show anxiety symptoms that will be negatively evaluated
C- The social situations almost always provoke fear or anxiety
D- The social situations are avoided or endured with intense fear or anxiety
E- The fear or anxiety is out of proportion to the actual threat posed by the social siatuion and to the sociocultural context
F- The fear anxiety or avoidance is persistent, typically LASTING FOR 6 MONTHS OR MORE
G- Fear anxiety or avoidance causes clinically significant distress or impairment in social, occupational or other important areas
Panic Disorder
[Anxiety Disorder]
A- Recurrent unexpected panic attacks. A panic attack is an abrupt surge of intense fear or intense discomfort that reaches a peak within minutes, and during which time four (or more) of the following symptoms occur:
—1) Palpitations, pounding heart or accelerated HR
—2). Sweating
—3) trembling, or shaking
—4) Sensations of shortness of breath or smothering
—5) Feelings of choking
—6) Chest pain or discomfort
—7) Nausea or abdominal distress
—8) Feeling dizzy unsteady light headed or faint
—9) Chills or heat sensations
—10) Paresthesias
—11) Fear of losing control
—12) derealization (feelings of unreality)
B- At least one of the attacks has been followed by 1 months (or more) of one or both of the following:
—1) Persistent concern or worry about additional panic attacks or their consequences
—2) A significant maladaptive change in behavior related to the attacks
C- The disturbance is not attributable to the physiological effects of a substance
D- No better explained by another mental disorder
Agoraphobia
[Anxiety Disorders]
A- Marked fear or anxiety about two of the following five:
—1) Using public transportation
—2) Being in open spaces
—3) Being in enclosed spaces
—4) Standing in line or being in a crowd
—5) Being outside of the home alone
B- The individual fears or avoids these situations because of thoughts that escape might be difficult or help might not be available in the event of developing panic-like symptoms or other incapacitating or embarrassing symptoms
C- The agoraphobic situation almost always provokes fear or anxiety
D- The agoraphobic situations are actively avoided, require the presence of a companion, or are endured with intense fear or anxiety
E- The fear or anxiety is out of proportion to the actual danger posed
F- Persistent - LASTING 6 MONTHS OR MORE
G- Causes clinically significant distress or impairment in social, occupational, or other
H- If another medical condition is present, the fear/anxiety or avoidance is clearly excessive.
I- Not better explained by symptoms of another mental disorder
Generalized Anxiety Disorder
[Anxiety Disorders]
A- Excessive anxiety or worry occurring more days than not FOR AT LEAST SIX MONTHS, about a number of events or activities
B- Individual finds it difficult to control the worry
C- A & W are associated with three or more of the following six symptoms:
—1) Restlessness or feeling keyed up or on edge
—2) Being easily fatigued
—3) Difficulty concentrating
—4) Irritability
—5) Muscle tension
—6) Sleep disturbance
D- The A, W, or physical symptoms cause clinically significant distress or impairment in ..etc
E- Not attributable to the physiological effects of a substance
F- Not better explained by another M disorder
Obsessive-Compulsive Disorder
[Obsessive-Compulsive and Related Disorders]
A- Presence of obsessions, compulsions, or both
Obsessions are defined by 1) and 2):
—1) Recurrent and persistent thoughts urges or images that are experienced, at some time during the disturbance, as intrusive and unwanted, and that in most individual cause marked anxiety or distress
—2) The individual attempts to ignore or suppress such thoughts, urges, or images, or to neutralize them with some other thought or action
Compulsions are defined by 1) and 2):
—1) Repetitive behaviors (ie hand washing, ordering, checking) or mental acts (ie praying, counting, repeating words) that the individual feels driven to perform in response to an obsession
—2) The behavior for mental acts are aimed at preventing or reducing anxiety or distress, or preventing some dreaded event or situation; however these behaviors or mental acts are not connected in a realistic way with what they are designed to neutralize or prevent
B- The O or C are time-consuming (ie take more than 1 hour per day) or cause clinically significant distress or impairment in social..etc
C- The O-C symptoms are not attributable to the physiological effects of a substance or another medical condition
D- Disturbance is not better explained by the symptoms of another mental disorder
Body Dysmorphic Disorder
[Obsessive-Compulsive and Related Disorders]
A- Preoccupation with one or more perceived defects or flaws in physical appearance that are not observable or appear slight to others
B- At some point during the course of the disorder, the person has performed repetitive behaviors (ie mirror checking, excessive grooming, skin picking) or mental acts (comparing his/her appearance) in response to the appearance concerns
C- The preoccupation causes clinically significant distress and is an impairment in social..etc
D- The appearance preoccupation is not better explained by concerns with body fat or weight in an individual who symptoms meet diagnostic criteria for an eating disorder
Hoarding Disorder
[Obsessive-Compulsive and Related Disorders]
A- Persistent difficulty discarding or parting with possessions, regardless of their value
B- The difficult is due to a perceived need to save the items and to distress associated with discarding them
C- The difficult discarding possessions results in the accumulation of possessions that congest and clutter active living areas and substantially compromises their intended use. If living areas are uncluttered, it is only because of the interventions of third parties.
D- The hoarding causes clinically significant distress or impairment..etc
E- Not attributable to another mental condition
F- Not better explained by symptoms of another M disorder
Trichotillomania (hair-pulling disorder)
A- Recurrent pulling out of one’s hair, resulting in hair loss
B- Repeated attempts to decrease or stop hair pulling or stop hair pulling
C- The hair pulling causes clinically significant distress or impairment in social.. etc
D- The hair pulling or hair loss in not attributable to another medical condition
E- Not better explained by another mental disorder
Excoriation
[Obsessive-Compulsive and Related Disorders]
A- Recurring skin picking resulting in skin lesions
B- Repeated attempts to decrease or stop skin picking
C- The skin picking causes clinically significant distress or impairment in social.. etc
D- The skin picking is not attributable to the physiological effects of a substance or another medical condition
E- Not better explained by symptoms of another mental disorder
Reactive Attachment Disorder
[Trauma and Stressor Related Disorders]
A- A consistent pattern of inhibited, emotionally withdrawn behavior toward adult caregivers, manifested by both of the following:
—1) Child rarely or minimally seeks comfort when distressed
—2) Child rarely or minimally responds to comfort when distressed
B- A persistent social and emotional disturbance characterized by at least two of the following:
—1) Minimal social and emotional responsiveness to others
—2) Limited positive affect
—3) Episodes of unexplained irritability, sadness, or fearfulness that are evident even during a nonthreatening interactions with adult caregivers
C- The child has experienced a pattern of extremes of insufficient care as evidenced by at least one of the following:
—1) Social neglect or deprivation in the form of persistent lack of having basic emotional needs for comfort, stimulation, and affection met by caregiving adults.
—2) Repeated changes of primary caregivers that limit opportunities to form stable attachments
—3) Rearing in unusual settings that severely limit opportunities to form selective attachments
D- The care in criterion C is presumed to be responsible for the disturbed behavior in Criterion A
E- The criteria are not met for autism spectrum disorder
F- The disturbance is EVIDENT BEFORE AGE 5 YEARS
G- The child has a developmental age of at least 9 months
Disinhibited Social Engagement Disorder
[Trauma dn Stressor Related Disorders]
A- A pattern of behavior in which a child actively approaches and interacts with unfamiliar adults and exhibits at least two of the following:
—1) Reduced or absent reticence in approaching and interacting with unfamiliar adults
—2) Overly familiar verbal or physical behavior (that is not consistent with culturally sanctioned and with age appropriate social boundaries)
—3) Diminished or absent checking back with a adult caregiver after venturing away, even in unfamiliar settings
—4) Willingness to go off with an unfamiliar adult with minimal or no hesitation
B- The behaviors in A are not limited to impulsivity (as in ADHD) but include socially disinhibited behavior
C- The child has experienced a pattern of extremes of insufficient care as evidenced by at least one of the following:
—1) Social neglect or deprivation in the form of persistent lack of having basic emotional needs for comfort, stimulation, and affection met by caregiving adults
—2) Repeated changes of primary caregivers that limit opportunities to form stable attachments
D- The care in Criterion C is presumed to be responsible for the disturbed behavior in Criterion A
E- The child has a developmental age of at least 9 months
Posttraumatic Stress Disorder
[Trauma and Stress-Related Disorders]
Applies to adults, adolescents, and children OLDER THAN 6 YEARS. For children 6 years and under, see corresponding criteria below*
DURATION IS MORE THAN 1 MONTHS
A- Exposure to actual or threatened death, serious injury, or sexual violence in one (or more) of the following ways:
—1) directly experiencing the traumatic event(s)
—2) Witnessing, in person, the events as it occurred to others
—3) Learning that the traumatic events occurred to a close family member or friend. In cases of actual or threatened death of family member or friend, the event(s) must have been violent or accidental
—4) Experiencing repeated or extreme exposure to aversive details of the traumatic event(s) (ie first responders collecting remains; police officers repeated exposed to details of child abuse).
B- Presence of one (or more) of the following intrusion symptoms associated with the T event(s) BEGINNING AFTER THE T EVENT(S) OCCURRED:
—1) Recurrent, involuntary and intrusive distressing memories of the T events
—2) Recurrent distressing dreams in which the content and/or affect of the dream are related to the traumatic events
—3) Dissociative reactions (ie flashbacks) in which the individual feels o acts as if the T events were recurring. (Such reactions may occur on a continuum, with the most extreme expression being a complete loss of awareness of present surroundings)
—4) Intense or prolonged psychological distress at exposure to internal or external cues that symbolize or remember an aspect of T evnets
—5) Marked physiological reactions to internal or external cues that symbolize or resemble an aspect of T events
C- Persistent avoidance of stimuli associated with the T events, beginning after the T events occurred, as evidenced by one or both of the following:
—1) Avoidance of or efforts to avoid distressing memories, thoughts, or feelings about or closely associated with the traumatic events
—2) Avoidance of or efforts to avoid external reminders (people, places, conversations, activities, objects, situations) that arouse distressing memories, thoughts or feelings about the T events.
D- Negative alterations in cognitions and mood associated with the T events, beginning or worsening after the T events occurred as evidenced by two or more of the following:
—1) Inability to remember an important aspect of the T events (typically due to dissociative amnesia and not to other factors such as heady injury, alcohol, drugs)
—2) Persistent and exaggerated negative beliefs or expectations about oneself, others, or the world (ie “I am bad,” “No one can be trusted,” “the world is completely dangerous,” “my whole nervous system is permanently ruined”)
—3) Persistent, distorted cognitions about the cause or consequences of the traumatic event(s) that lead to the individual to blame themself or others
—4) Persistent negative emotional state (ie fear, horror, anger, guilt, shame)
—5) Marked diminished interest or participation in significant activites
—6) Feelings of detachment or estrangement of others
—7) Persistent inability to experience positive emotions (ie inability to experience happiness, satisfaction, or loving feelings)
E- Marked alterations in arousal and reactivity associated with the T events, beginning or worsening after the T events occurred, as evidenced by two or more of the following:
—1) Irritable behavior and angry outbursts (with little or no provocation) typically expressed as verbal or physical aggression toward people or objects
—2) Reckless or self-destructive behavior
—3) Hypervigilance
—4) Exaggerated startle response
—5) Problems with concentration
—6) Sleep disturbance
G- Disturbance causes clinically significant distress or impairment in social.. etc
H- The disturbance is not attributable to the physiological effects of a substance
PTSD for Children 6 Years or younger
[Trauma and Stress-Related Disorders]
DURATION OF DISTURBANCE IS MORE THAN 1 MONTH
A- Same as PTSD for adults in the following ways:
—1) Directly experiencing traumatic events
—2) Witnessing, in person, the event as it occurred to others, especially primary caregivers
—3) Learning that the traumatic events occurred to a parent or caregiving figure
B- Presence of one or more of the following intrusion symptoms associated with the T events, beginning after the T events occurred:
—1) Recurrent, involuntary and intrusive distressing memories of the T events
—2) Recurrent distressing dreams in which the content and/or affect of the dream are related to the T event
—3) Dissociative reactions (flashbacks) in which the child feels or acts as if the T events were recurring).
—4) Intense or prolonged psychological distress at exposure to internal or external cues that symbolize or resemble the T event
—5) Marked physiological reactions to reminders of T events
C- Persistent avoidance of stimuli
–Negative alterations in cognitions
D- Alterations in arousal and reactivity associated with T events, beginning or worsening after the T events occurred, evidenced by 2 or more of:
—1) irritable behavior
—2) Hypervigilance
—3) Exaggerated startle response
Acute Stress Disorder
[Trauma and Stress Related Disorder]
DURATION IS 3 DAYS TO 1 MONTH
A- Exposure to actual or threatened death, serious injury, or sexual violation in one or more of the following:
—1-4) same as PTSD
B- Presence of nine ore more of the following from ANY OF THE FIVE CATEGORIES OF
1) INTRUSION, 2) NEGATIVE MOOD, 3) DISSOCIATION, 4) AVOIDANCE, and 5) AROUSAL
—1) Intrusion: memories, dreams, dissociative reactions (flashbacks) intense or prolonged psychological distress
—2) Negative mood: persistent inability to experience positive emotions
—3) Dissociative symptoms: altered sense of reality, inability to remember an important aspect of the T event
—4) Avoidance: avoiding memories, thoughts, feelings, external reminders
—5) Arousal: Sleep disturbance, irritable behavior, angry outbursts, hypervigilance, problems with concentration, exaggerated startle response
C- Duration is 3 days to 1 month
D- Disturbance causes clinically significant distress..etc
E- Not attributable to another disorder
Adjustment Disorders
[Trauma and Stress-Related Disorders]
A- Development of emotional or behavioral symptoms in response to an identifiable stressor OCCURRING WITHIN 3 MONTHS OF THE ONSET OF THE STRESSOR
B- Symptoms or behaviors are clinically significant, as evidenced by ONE or BOTH of the following:
—1) Marked distress that is out of proportion to the severity or intensity of the stressor
—2) Significant impairment in social.. etc
C- Disturbance does not meet criteria of another disorder
D- Symptoms do not represent normal bereavement
E- Once the stressor or its consequences have terminated, THE SYMPTOMS DO NOT PERSIST FOR MORE THAN AN ADD’L 6 MONTHS
Dissociative Identity Disorder
[Trauma and Stress-Related Disorders]
A- Disruption of identity characterized by two or more distinct personality states, which may be described in some cultures as an experience of possession. Marked discontinuity in sense of self and agency with alterations in affect, behavior, consciousness, memory, perception, cognition, and/or sensory motor functioning.
B- Recurrent gaps in the recall of everyday events, important personal information, and/or traumatic events that are in consent with ordinary forgetting
C- Symptoms cause clinically significant distress or impairment in social..etc
D- Disturbance is not a normal part of a broadly accepted cultural or religious practice
E- Symptoms not attributable to the physiological affects of a substance
Dissociative Amnesia
[Dissociative Disorders]
A- Inability to recall important autobiographical information, usually of a traumatic or stressful nature that is inconsistent with ordinary forgetting
B- Symptoms cause clinically significant distress or impairment in social…etc
C- Disturbance isn’t attributable to substance
D- Not better explained by dissociative identity disorder
Depersonalization / Derealization Disorder
[Dissociative Disorders]
A- Presence of persistent or recurrent experiences of depersonalization or derealization or both:
—1) Depersonalization: Experiences of unreality, detachment or being an outside observer with respect to one’s thoughts, feelings, sensations, body or actions
—2) Derealization: Experiences of unreality or detachment with respect to surroundings (objects are experienced as unreal, dreamlike, foggy, lifeless, distorted)
B- During the depersonalization or derealization experience, reality testing remains intact
C- Symptoms cause clinically significant distress…etc
D-… etc
E-… etc
