DSM-5 Flashcards
What are neurodevelopmental disorders (definition)
The disorders typicallymanifest early in development, often before the child enters grade school, andare characterized by developmental deficits that produce impairments of
personal,
social,
academic, or
occupational functioning.
what are the 8 types of neurodevelopmental disorders?
Intellectual disabilities
communication disorder
autism spectrum disorder
attention deficit/hyperactivity disorder
specific learning disorder
motor disorders
other specified neurodevelopmental tic disorder
unspecified neurodevelopmental tic disorder
Intellectual disability - criteria and severity
- deficits in intellectual functioning
- deficits in adaptive functioning
- onset during developmental period of both
Severity: mild, moderate, severe and profound
Anxiety Disorders and Obsessive-Compulsive and Related Disorders:
Diagnostic Criteria for Specific Phobia
Sx include:
-Intense fear/anxiety of an object or situation
-Avoidance or enduring with distress
-Disproportionate fear
-Persistent for 6+ months
-Significant distress/impairment
Diagnostic Criteria for Social Anxiety Disorder
Sx include:
-Intense fear/anxiety of 1+ social situations involving scrutiny by others
-Fear of negative evaluation
-Avoidance of situations or endures w/ fear
-Disproportionate fear
-Persistent for 6+ months
-Clinically significant distress/impair
Diagnostic Criteria for Panic Disorder
Sx include:
-Recurrent, unexpected attacks
-At least one attack followed by 1+ month concern having added attack, about consequences, and/or maladaptive change in behavior.
4+ additional Sx:
-Palpitations
-Sweating
-Trembling
-Choking feeling -Etc.
Diagnostic Criteria for Agoraphobia
how many situations sx of fear and time frame?
Sx -Fear of at least 2+ of 5 situations:
Public transport,
open space,
enclosed space,
in line or in a crowd,
outside home alone.
-Escape might be difficult
-Help unavailable in case of panic/ embarrassment
-Lasts at least 6+ months
Diagnostic Criteria for OCD
Recurrent obsessions/compulsions
-attempts to neutralise thoughts by actions
-Are time-consuming and/or impairing (1 hr or more)
-are etiher repetitive acts or mental acts
Specifiers include: -“with good, fair, or poor insight”
-“with absent insight/delusional beliefs”
-“with presence of tics”
Diagnostic Criteria for Body Dysmorphic Disorder
-Preoccupation with defect or flaw of appearance -Performed repetitive behaviors/mental acts due to flaw
Diagnostic Criteria for Hoarding Disorder
-Persistent difficulty discarding/parting with possessions
-Cluttered living area
-Symptoms cause distress or
impair functioning
Reactive Attachment Disorder
Inhibited/emotionally withdrawn behavior toward adult caregivers.
-Lack of seeking and/or responding to comfort when distressed
-Persistent social/emotional disturbance including 2+ of 3 Sx: -Minimal emotional/social response to others -Limited
positive affect -Episodes of irritability, sadness
disturbance evident before 5 yrs old
Disinhibited Social Engagement Disorder
child has Inappropriate interactions with strangers including 2+ Sx:
-Reduced/absent reticence with unfamiliar adults
-OVerly familiar behavior
-Diminished/absent checking with caregiver
-Willingness to accompany unfamiliar adult
Child has experienced patterns of extreme insufficient care
child has developmental age of at least 9 mths
EXCORIATION (SKIN PICKING) DISORDER
Recurrent skin picking resulting in skin lesions.
Repeated attempts to decrease or stop skin picking.
The skin picking causes clinically significant distress or impairment
Depersonalization/Derealization Disorder
Persistent or recurrent episodes of unreality, detachment- outside of oneself, or derealization: -Sense of unreality or detachment involving my surroundings
-Causes clinically significant distress/ impairment
-Reality testing remains intact
Dissociative Disorders and Somatic Symptom and Related
Illness Anxiety Disorder
Preoccupation with having or acquiring a serious illness
-Absence of somatic Sx or presence of mild somatic Sx
-High level of anxiety about health
-Excess health-related behaviors or Maladaptive avoidance of Dr., hospital, etc.
-Preoccupation is present for 6+ months
Dissociative Disorders and Somatic Symptom and Related Disorders:
Conversion Disorder
1+ Sx:Disturbances in voluntary motor, sensory functions
-Sx suggestive of serious neuro disorder (paralysis)
-Incompatible Sx and neuro or med conditions
-Sx cause distress/impairment
Anorexia Nervosa
Restriction of food intake -> low body weight -Intense fear of weight gain or behavior that interferes w/
weight gain -Disturbed experience of own body weight/shape or lack of seriousness of own low weight
RUMINATION DISORDER
Repeated regurgitation of food over a period of at least 1 month. Regurgitated food may be re-chewed, re-swallowed, or spit out.
The repeated regurgitation is not attributable to an associated gastrointestinal or other medical condition (e.g., gastroesophageal reflux, pyloric stenosis).
The eating disturbance does not occur exclusively during the course of anorexia nervosa, bulimia nervosa, binge-eating disorder, or avoidant/restrictive food intake disorder.
AVOIDANT/RESTRICTIVE FOOD INTAKE DISORDER
An eating or feeding disturbance (e.g., apparent lack of interest in eating or food; avoidance based on the sensory characteristics of food; concern about aversive consequences of eating) as manifested by persistent failure to meet appropriate nutritional and/or energy needs associated with one (or more) of the following:
Significant weight loss (or failure to achieve expected weight gain or faltering growth in children).
Significant nutritional deficiency.
Dependence on enteral feeding or oral nutritional supplements.
Marked interference with psychosocial functioning.
Elimination Disorders, and Sleep-Wake
Disorders:
Enuresis
-voiding of urine into bed or clothes 2+X/week for 3+ consecutive months
-At least 5 years old, developmentally
Insomnia Disorder
Dissatisfaction with sleep quality, quantity associated w/ one of 3 Sx:
-Difficulty initiating sleep
-Maintaining sleep
-Early-AM wakening & inability to go back to sleep
-At least 3X/week for 3+ months
-Inspite of opportunity for sleep -Distress
Disruptive, Impulse-Control, and Conduct Disorders and Substance-
Related and Addictive Disorders:
Oppositional Defiant Disorder
-Recurrent angry/irritable mood pattern -Argumentative/defiant or vindictiveness
-At least 4 Sx exhibited with non-sibling person(s)such as loss of temper, arguing with authorities, refusal to comply w/ authorities or rules, blaming others for own mistakes,
at least 6 mths
Disruptive, Impulse-Control, and Conduct Disorders and Substance-
Related and Addictive Disorders:
Intermittent Explosive Disorder
-Recurrent outbursts related to inability to stop aggressions, manifested by -verbal or physical aggression
2X/week for 3+ months - OR
-three outbursts that caused damage, &/or physical assault that injures during a 12-month period.
-At least 6 years old
Substance-Use
Disorders - how many sx in what time frame
-A cluster of cognitive, behavioral, physiological Sx indicating continued use of substsance despite
significant problems
-Two or more Sx during 12-mo period
-Sx in 4 groups: impaired control, social impairment, risky use, pharmacological criteria
Neurocognitive Disorders:
Mild Neurocognitive
Disorders/Characteristics
-Modest decline from previous level of function in 1+ cognitive domains -Does not interfere w/independence in everday activities -Does not occur only in presence of Delirium
Neurocognitive Disorders:
Neurocognitive Disorder Due to
Alzheimer’s Disease Diagnostic Criteria and Stages
-Criteria for Major or Minor Neurocognitive Disorder are met -Insidious onset of Sx is present -Gradual
progression of impairment in 1+ cognitive domains -Criteria for Alzheimer’s disease are met -All other
causes of Neurocognitive Disorders are R/O
What is paranoid personality disorder?
● pattern of distrust and suspiciousness such that others’ motives are interpreted as malevolent.
4+ Sx:
Suspects, others are exploiting, harming, or deceiving him or her.
Is preoccupied with unjustified doubts about the loyalty or trustworthiness of friends or associates.
Is reluctant to confide in others because of unwarranted fear that the information will be used maliciously against him or her.
Reads hidden demeaning or threatening meanings into benign remarks or events.
Persistently bears grudges (i.e., is unforgiving of insults, injuries, or slights).
Perceives attacks on his or her character or reputation that are not apparent to others and is quick to react angrily or to counterattack.
Has recurrent suspicions, without justification, regarding fidelity of spouse or sexual partner.
What is schizoid personality disorder?
pattern of detachment from social relationships and a restricted range of emotional expression. Begins early adulthood
four (or more) of the following:
Neither desires nor enjoys close relationships, including being part of a family.
Almost always chooses solitary activities.
Has little, if any, interest in having sexual experiences with another person.
Takes pleasure in few, if any, activities.
Lacks close friends or confidants other than first-degree relatives.
Appears indifferent to the praise or criticism of others.
Shows emotional coldness, detachment, or flattened affectivity.
What is schizotypal personality disorder?
The signs of schizotypal personality disorder include three major components: pattern of acute discomfort in close relationships, cognitive or perceptual distortions, and eccentricities of behavior.
five (or more) of the following:
Ideas of reference (excluding delusions of reference).
Odd beliefs or magical thinking : in children and adolescents, bizarre fantasies or preoccupations).
Unusual perceptual experiences, including bodily illusions. Odd thinking and speech
Suspiciousness or paranoid ideation.
Inappropriate or constricted affect.
Behavior or appearance that is odd, eccentric, or peculiar.
Lack of close friends or confidants
Excessive social anxiety that does not diminish with familiarity and tends to be associated with paranoid fears rather than negative judgments about self.
What is antisocial personality disorder?
● pattern of disregard for, and violation of, the rights of others.
occurring since age 15 years, as indicated by three (or more) of the following:
Failure to conform to social norms with respect to lawful behaviors,
Deceitfulness, a
Impulsivity or failure to plan ahead.
Irritability and aggressiveness,
Reckless disregard for safety of self or others.
Consistent irresponsibility, ie work / finances
Lack of remorse
The individual is at least age 18 years.
There is evidence of conduct disorder with onset before age 15 years.
What is borderline personality disorder?
pattern of instability in interpersonal relationships, self-image, and affects, and marked impulsivity
beginning early adulthood and present in a variety of contexts,
as indicated by five (or more) of the following:
Frantic efforts to avoid real or imagined abandonment.
A pattern of unstable and intense interpersonal relationships
Identity disturbance: markedly and persistently unstable self-image or sense of self.
Impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating). (Note: Do not include suicidal or selfmutilating behavior covered in Criterion 5.)
Recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior.
Affective instability
Chronic feelings of emptiness.
Inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights).
Transient, stress-related paranoid ideation or severe dissociative symptoms
What is histrionic personality disorder?
● pattern of excessive emotionality and attention seeking.
beginning early adulthood / 5+ Sx:
uncomfortable in situations in which not the center of attention.
Interaction with others is often characterized by inappropriate sexually seductive or provocative behavior.
Displays rapidly shifting and shallow expression of emotions.
Consistently uses physical appearance to draw attention to self.
Has a style of speech that is excessively impressionistic and lacking in detail.
Shows self-dramatization, theatricality, and exaggerated expression of emotion.
Is suggestible (i.e., easily influenced by others or circumstances).
Considers relationships to be more intimate than they actually are.
What is narcissistic personality disorder?
● pattern of grandiosity, need for admiration, and lack of empathy.
beginning early adulthood / five (or more) of the following:
Has a grandiose sense of self-importance
Is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love.
Believes that he or she is “special” and unique and can only be understood by, or should associate with, other special or high-status people (or institutions).
Requires excessive admiration.
Has a sense of entitlement
Is interpersonally exploitative (i.e., takes advantage of others to achieve his or her own ends).
Lacks empathy: is unwilling to recognize or identify with the feelings and needs of others.
Is often envious of others or believes that others are envious of him or her.
Shows arrogant, haughty behaviors or attitudes.
What is avoidant personality disorder
● pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation.
early adulthood and present in a variety of contexts, as indicated by four (or more) of the following:
Avoids occupational activities that involve significant interpersonal contact because of fears of criticism, disapproval, or rejection.
Is unwilling to get involved with people unless certain of being liked.
Shows restraint within intimate relationships because of the fear of being shamed or ridiculed.
Is preoccupied with being criticized or rejected in social situations.
Is inhibited in new interpersonal situations because of feelings of inadequacy.
Views self as socially inept, personally unappealing, or inferior to others.
Is unusually reluctant to take personal risks or to engage in any new activities because they may prove embarrassing
What is dependent personality disorder
how many sx to be diagnosed?
● pattern of submissive and clinging behavior related to an excessive need to be taken care of.
five (or more) of the following:
Has difficulty making everyday decisions without an excessive amount of advice and reassurance from others.
Needs others to assume responsibility for most major areas of his or her life.
Has difficulty expressing disagreement with others because of fear of loss of support or approval. (Note: Do not include realistic fears of retribution.)
Has difficulty initiating projects or doing things on his or her own (because of a lack of self-confidence in judgment or abilities rather than a lack of motivation or energy).
Goes to excessive lengths to obtain nurturance and support from others, to the point of volunteering to do things that are unpleasant.
Feels uncomfortable or helpless when alone because of exaggerated fears of being unable to care for himself or herself.
Urgently seeks another relationship as a source of care and support when a close relationship ends.
Is unrealistically preoccupied with fears of being left to take care of himself or herself.
Seeing a child 14 yrs and they come with mum and they tell you story about her getting increasing anxious in the last 12 months, episodes with heart palpitations, sweating, feels faint, stomach, shaking. These get much worse when she has to speak in public. Started when she had peer difficulties. Feels this when she speaks to people and is anxious about returning to school.
Most likely diagnosis
1. Panic disorder
2. Panic disorder with agoraphobia
3. Social anxiety disorder
4. Adjustment disorder
5. Selective mutism
- Social anxiety disorder
Object of her fear is people / social. Not panic disorder as she’s not scared about having a panic attack. It’s fear of social.
When looking at anxiety, always look at what the feared situation is.
Referral from gp 25 yr old woman who has had a few admissions to ed. Scared of having a heart attack, and physical examination doesn’t show any physical illness. She has all symptoms (breath, heart, sweaty,). Doesn’t know where it’s coming from. Scared it’s heart attack and going to die. Withdrawing activities. Avoiding situations / not going out much. Only goes out with partner.
1. Panic disorder
2. Panic disorder and agoraphobia
3. Soc anxiety
4. Borderline pd
5. Histrionic pd
- Panic disorder and agoraphobia
With agoraphobia, panic comes first, then agoraphobia. Remember the answer is often in the questions. Why would the question state avoidance if AD didn’t want you to consider ag.
Seeing 45 yr old client and she is expressing a series of rapidly changing and poorly articulated and unrealistivc plans. Speaks quick, loses train of thought and hard to follow what she’s saying.
1. Adhd
2. Delusional disorder
3. Hypomania
4. Depression with psychotic features
5. Borderline anxiety
- Hypomania
It’s not delusional disorder as that is someone having one rigid belief that’s not true. Ie harry styles is in love with them.
Someone presents with same presentation as above, excited about lots of ideas, doesn’t need to sleep much, has amazing plans, working a lot, doesn’t need to sleep, loses training of thought.
1. Adhd
2. Delusional disorder
3. Hypomania
4. Bipolar 2
5. Bipolar 1
- Hypomania
For a manic episode you need to have IMPAIRMENT IN FUNCTIONING. Most people with a manic episode ends up in hospital. Someone with a manic episode goes a bit psychotic.
Stick With what you know from this question – for bipolar 2 you need depressive episode and this isn’t mentioned in the question. Therefore based on this question all you can conclude atm is hypomania.
Remember to answer the question on the presentation / symptoms that you’re presented with.
Working with a 32 yr old woman who has difficulties finding a job, hasn’t worked 3-4 yrs, stays home, doesn’t go out, frequent thoughts of inappropriate sexual behaviours. Finds thoughts disturbing and avoids situations. When goes out tries to control sexual thoughts by reciting bible. Which describes her attempts to manage sexual thoughts.
1. Delusions
2. Worries
3. Obsessions
4. Compulsions
5. Ruminations
- Compulsions
Get referred 48 yr old woman / admission to ED following suicide attempt / not a very good historian / child hood abuse / overdoes 4 times past 10 years / after breakup of relationships / history of unstable employment and interpersonal difficulties:
Most likely diagnosis for this lady?
BPD
Guy presents after having lots of studies by gastroend… stomach pain, no medical reasons, he worries about range of different things, finance, health, work, relationships. Know’s his worries are too much but can’t control them. Tense, can’t sleep. Most likely diagnosis:
1. illness anxiety disorder
2. panic
3. GAD
4. OCD
5. insomnia
- GAD
Doing assessment on young man. He tells you he has been drinking over the last 2 years for long periods, he tried to reduce but cannot and has missed deadlines at work, otherwise he’s employed , married and functioning ok in most areas of life. Recognises he has been drinking more than would like to. How do you characterise persons prob
1. Severe
2. Mild
3. Moderate
4. No probs as everyone drinks like that
5. Significant global impairment.
- Moderate
how many symptoms are considered mild, moderate and severe for substance use.
2-3 symptoms = mild
4-5 symptoms = moderate
6+ symptoms = severe
This is across all substances.
Board is going to give list of symptoms and ask is this mild, moderate or severe.
What is the mental status examination?
It’s a behavioural observation.
Working at school and teacher of 10 year old boy disruptive, socially isolated, has difficulties staying in his seat, what would be the best information to understand:
- Self report measure
- Cognitive assessment
- School observation
- Previous school reports
- Talking to boys peers.
- School observation
When people are talking about behaviour best first thing to do is observation.
how do you record observations
When doing obs need to choose target behaviours and observe them. Observations need to be able to be replicated. You are looking for a base line to compare intervention with. Has the intervention helped?
* Choose target behaviours
* Set up a way to measure
* Small number of behaviours
* Keep track of intensity / frequency / duration
what is the defining characteristic of ODD
The defining characteristic is a fight against being controlled
ODD child/teen fights against authority figures such as parents and teachers, they lose their temper, argue, resist rules and discipline, refuse to comply with directions, have low frustration tolerance
what is the defining characteristic of conduct disorder
Conduct disorder is used to describe an older child or adolescent who has moved into a pattern of violating the rights of others: intimidation or aggression toward people or animals, stealing or the deliberate destruction of property.
The DSM-5, a diagnostic handbook used by mental health professionals, describes these individuals as having “a callous and unemotional interpersonal style.” It means a lack of empathy—not
understanding or caring about how their behavior may physically or emotionally hurt others
what is the key difference between ODD and conduct disorder
role of control. Kids who are oppositional or defiant will fight against being controlled.
Kids who have begun to move—or have already moved—into
conduct disorder will fight not only against being controlled, but will attempt to control others as well
what are cluster B personality disorders
characterized by dramatic, overly emotional or unpredictable thinking or behavior.
“wild”
borderline
antisocial
histrionic
narcissistic
what are cluster C personality disorders
characterized by anxious, fearful thinking or behavior
“worried”
avoidant
dependent
obsessive-compulsive
what does it mean if someone is in the 96th percentile
This means that the student had a test score greater than or equal to 96% of the reference population. Conversely, only 4% of students scored equal to or higher than the individual tested.
what range of scores are problematic for impression managmenet in the 16pf assessment
below 5th percentile and above 95th percentile
Q - A 45-year-old woman is referred to a psychologist for treatment of spider phobia. The psychologist decides to use a form of exposure therapy. Which of the following exposure methods is likely to be most effective?
1. Graduated exposure and habituation to live spiders.
2. Graduated exposure and habituation to plastic spiders
3. Exposure and habituation using pictures of spiders.
4. Exposure and habituation of the response to live and plastic spiders
5. Graduated exposure and habituation using spiders and other insects.
- Graduated exposure and habituation to live spiders.
Q – Client has a driving phobia. Were in a car accident, were at fault, cannot sit in drivers seat without getting very anxious so cannot drive. What is the most effective treatment for this client?
1) Cognitive restructuring
2) Narrative therapy
3) Graded exposure
4) Imaginal exposure
5) Motivational interviewing
Answer
3 – graded starting with imaginal then in vivo
Q - Work in counselling department, client upset and find risk is really high. Assessment is that should go to hospital straight away but client says no. What do you do?
1) Call parent
2) Call friend
3) Take to hospital in car
4) Talk to senior staff and ask for advice
5) Let him go
4) Talk to senior staff and ask for advice
Q - What is the best way to observe a child?
1) Record as many features of the bx as possible, multiple environment
2) Record frequency, intensity, duration of a small number
3) Make sure client is not aware bx is being observed
4) Compare child’s bx to another childs bx in same environment
5) Tell teacher to do observation as they know child the best
Answer
2 – want to make sure observation can be replicated (choose target behaviours, if have too many cannot replicate) want to make sure whether behaviour reduces or not with intervention
1. Choose target behaviours 2. Seta up a way of measuring them 3. Keep track of intensity, freq, duration of them
Someone presents with same presentation as above, excited about lots of ideas, doesn’t need to sleep much, has amazing plans, working a lot, doesn’t need to sleep, loses training of thought.
1. Adhd
2. Delusional disorder
3. Hypomania
4. Bipolar 2
5. Bipolar 1
- Hypomania
For a manic episode you need to have IMPAIRMENT IN FUNCTIONING. Most people with a manic episode ends up in hospital. Someone with a manic episode goes a bit psychotic.
Stick With what you know from this question – for bipolar 2 you need depressive episode and this isn’t mentioned in the question. Therefore based on this question all you can conclude atm is hypomania.
Remember to answer the question on the presentation / symptoms that you’re presented with.
You see client for 1st time. 43 yr old man. Relationship problems, financial difficulties, made money, lost money, difficulty getting out of bed because of low mood, aggressive to partner, relationship issues, he’s taking lithium prescription from psych but doesn’t know what it’s for.
What is the most likely diagnosis for this person?
1. Bipolar
2. Mdd
3. Adhd
4. Adjustment disorder
5. Ptsd
- Bipolar
Anything with lithium is for bipolar. In exam they will say something like ‘lithium ….ate”. anytime they mention lithium they are talking about bipolar
Next client is in waiting room and you see him pacing, looking around, talking to himself, been to toilet many times, can’t understand what he’s talking about, flat affect, can’t understand speech, cant’ follow train of thought, he says he doesn’t get out of room much, prefers to stay there and play games, dangerous to be outside, people want to get him, no motivation, hasn’t enrolled in uni and isn’t working. 20 yrs . most likely explanation of his condition:
1. Social anxiety disorder.
2. Antisocial pd
3. Asd
4. Substance
5. schizophrenia
- schizophrenia
when the board wants you to think about schizophrenia they will give you symptoms of both positive and negative symptoms. These people are globally impaired.
Loss of motivation, flat affect, staying in bed, staying in rooms
Positive: hallucinations , delusions, disorganised speech etc.
Seeing someone husbands own small hotel, she cleans bed linen and worries about getting hiv from bed linen and worried about giving hiv to kids. Washes everything hands, clothes with bleach. Tells you that she know’s her concerns could be unrealistic but needs to do this.
Most likely disorder is?
OCD
talking to mum of 8 yr old and tells you teacher complained about son / disruptive and destructive behaviour / doesn’t complete school work / child can be aggressive to sister / ignores instructions / looses belongings / impulsive behaviour / forgetful.
1. Specific learning
2. Adhd
3. Asd
4. Oppositional defiant
5. Conduct disoarder
- Adhd.
For diagnosis of oppositional defiant needs to be always angry, arguing, revengeful.
Board may try to confuse you by saying things ‘can be aggressive’, breaks things. Etc. that’s not enough for ODD
GO THROUGH DIFFERENCES BETWEEN CONDUCT , OPPOSITIONAL AND ADHD
ADHD has to be in at least 2 settings.
Doing assessment, seeing 8 yr old and mum thinks doing well in maths, struggling with reading writing, teacher says struggles with change, organise belongings by shape and colour. Struggles socially and prefers to play alone. Considering ASD
1. Preoccupation order and routine (need 2 out of 4 in diagnosis)
2. Fear neg eval
3. Low adaptive functioning
4. Repetitive behaviour interest
5. Behaviour impulsivity / hyperactivity
- Repetitive behaviour interest
For a diagnosis of ASD you need social communications / interactions and repetitive patterns of interest / behaviour.
how many symptoms need to be present to categorise substance use disorder as:
Mild?
Moderate?
Severe?
Mild: 2-3 symptoms
Moderate: 4-5 symptoms
Severe: 6+ symptoms
This is across all substances.
Board is going to give list of symptoms and ask is this mild, moderate or severe.
What is the mental status examination?
It’s a behavioural observation.
Working at school and teacher of 10 year old boy disruptive, socially isolated, has difficulties staying in his seat, what would be the best information to understand:
1. Self report measure
2. Cognitive assessment
3. School observation
4. Previous school reports
5. Talking to boys peers.
- School observation
When people are talking about behaviour best first thing to do is observation.
What is social (pragmatic) communication disorder
- Persistent difficulties in the social use of verbal and nonverbal communication as manifested by all of the following:
a. Deficits in using communication for social purposes,
b. Impairment of the ability to change communication to match context or the needs of the listener, such as speaking differently in a classroom than on a playground,
c. Difficulties following rules for conversation and storytelling, such as taking turns in conversation, .
d. Difficulties understanding what is not explicitly stated (e.g., making inferences) and nonliteral or ambiguous meanings of language (e.g., idioms, humor, metaphors, multiple meanings that depend on the context for interpretation). - The deficits result in functional limitations in effective communication, social participation,social relationships, academic achievement, or occupational performance, individually or in combination.
- The onset of the symptoms is in the early developmental period (but deficits may not become fully manifest until social communication demands exceed limited capacities).
- The symptoms are not attributable to another medical or neurological condition or to lowabilities in the domains of word structure and grammar, and are not better explained by autism spectrum disorder, intellectual disability (intellectual developmental disorder), global developmental delay, or another mental disorder.
ASD criteria
-Persistent deficits in social communication/ interaction across multiple contexts -Restricted, repetitive
patterns of behavior -Symptoms during the early developmental period Impairments in social, occupational,
other areas as a result of symptoms
Attention-Deficit/Hyperactivity Disorder (ADHD)and Course/Prognosis
-Symptoms persist for 6 or more months -Onset prior to 12 years of age -Present in at least 2 settings -
Interference w/ social, academic, occupation -At least 6 inattention &/or hyper/impulse symptoms
Specific
Learning Disorder
-At least one symptom for at least 6 months despite help to target the difficulty -Inaccurate, slow/effortful
reading -Trouble understanding readings -Spelling -Writing -Number sense, facts, or calculation -Math
reasoning -Low academic skills
Tourette’s
Disorder
-Included with Movement Disorders -A sudden ,rapid, recurrent, nonrhythmic motor
movement/vocalization -Other tics include Persistent Motor or Vocal Tic and Provisional Tic Disorder -
Tourette’s = 1+ vocal & 2+ motor tics -1+ years since before age 18
of Sx? Time frame?
Delusional Disorder
1+ delusions lasting at least 1 month; Impairment is related exclusively to the delusions; Erotomanic
Grandiose Jealous Persecutory Somatic Mixed Unspecified Bizarre First episode, multiple episodes, acute
episode
Schizophreniform Disorder
time frame?
Identical to schizophrenia except: -Symptoms present for 1+ months up to <6 months -2/3 of people meet
diagnostic criteria for Dx of Schizophrenia or Schizoaffective Disorder
of Sx? Timeframe?
Brief Psychotic Disorder
1+ of the following four symptoms: Delusions Hallucinations Disorganized speech Gross
disorganized/catatonic behavior -Symptoms for 1+ day up to <1 month -Returns to premorbid functioning -
Triggered by stress
Schizoaffective Disorder
Uninterrupted period of illness Concurrent symptoms of Schizophrenia and major depressive/manic
episode 2+ weeks without prominent mood symptoms
of Sx? Timeframe?
Bipolar I Disorder
1+ manic episodes -Distinct period of abnormal & persistent elevated, expansive, irritable mood & increased
goal-directed activity/energy -Lasts 1+ week -Present most of day, nearly every day -Sx cause marked
impairment in social, occupation
Bipolar II Disorder
1+ hypomanic episode & 1 major depressive episode -Hypomania must last for 4+ days -Major depression
lasts 2+ weeks, with 5+ Sx, one must be depressed mood or loss of interest in almost all activities
Cyclothymic Disorder
-Numerous periods with hypomanic symptoms and depressive symptoms, neither of which meet criteria for
a hypomanic episode or major depressive episode. -Sx cause significant distress/impaired function -Sx last
2+ years, 1+ years in children/adolescents
of Sx? Timeframe?
Persistent Depressive Disorder
-Depressed mood (children = irritable) -Most days for 2+ years (1+ years for kids) Two+ Sx: -Change in
appetite -Change in sleep -Fatigue -Low self-esteem -Poor concentration, difficulty w/ decisions -
Hopelessness -Not Sx-free for 2+ months
of Sx? Timeframe for kids and adults?
Separation Anxiety Disorder
At least 3 Sx: -Recurrent, excess distress regarding separation -Persistent fear of being alone -Repeated complaints of physical Sx -Lasts 4+ weeks for kids, 6+ months for adults
Acute
Stress Disorder
-Exposure to actual or threatened death, injury, etc., in 1+ of 4 ways: -Direct experience of event -
Witnessing event in-person -Learning event occurred to close person -Repeated/extreme exposure to
aversive details of event - Duration 3 days to 1 mo
Adjustment Disorder
-Emotional/behavioral Sx develop due to 1+ identifiable stressors within 3 months of onset of stressor(s) -Sx
must remit within 6 months after stressor ceases -Specifiers include: w/ depressed mood, w/ anxiety, w/
mixed anxiety & depressed mood, etc.
Narcolepsy
-Attacks of need to sleep, lapses into sleep/ naps -Occurs 3+ X/week for 3+ months -Involves either
cataplexy (loss of muscle tone) -or hypocretin deficiency -or rapid eye movement latency < or = 15 minutes -
Hypnogogic or hypnopompic hallucinations
Oppositional
Defiant Disorder
-Recurrent angry/irritable mood pattern -Argumentative/defiant or vindictiveness -At least 4 Sx exhibited
with non-sibling person(s)such as loss of temper, arguing with authorities, refusal to comply w/ authorities
or rules, blaming others for own mista
Intermittent
Explosive Disorder
-Recurrent outbursts related to inability to stop aggressions, manifested by -verbal or physical aggression
2X/week for 3+ months -three outbursts that caused damage, &/or physical assault that injures during a 12-
month period. -At least 6 years develo
Conduct
Disorder
-Violation of basic rightrs of others or rules -At least 3 Sx during past 12 months & 1+ Sx in past 6 months -
Sx in 4 categories: aggression to people/animals, destruction, deceit or theft, serious violation of rules. -If
over 18, cannot meet Dx of APD
Age and Onset for Reactive
Attachment Disorder
-Sx must be present before age 5 years -Child must have a developmental age of 9+ months
