DSM 5 TR Criteria

Question 1

Substance Use Specifier
in early remission

Answer 1

After full criteria previously met, none are met for at least 3 months but less than 12 months with exception of craving

Question 2

Substance Use Specifier
in sustained remission

Answer 2

After full criteria previously met, none met at any time during a period of 12 months or longer with exception of craving

Question 3

Substance Use Specifier
in a controlled environment

Answer 3

access is restricted
(in jail or rehab)

Question 4

Substance Use Severity Specifier - Mild

Answer 4

2-3 symptoms

Question 5

Substance Use Severity Specifier - Moderate

Answer 5

4-5 symptoms

Question 6

Substance Use Severity Specifier - Severe

Answer 6

6 + symptoms

Question 7

Tolerance

Answer 7

• Need for markedly increased amounts to achieve desired effect
• A markedly diminished effect with continued use of the same amount of alcohol

Question 8

Withdrawal

Answer 8

• The characteristic withdrawal syndrome for x substance
• Substance taken to relieve or avoid withdrawal symptoms

Question 9

Substance Use Disorder Criteria

Answer 9

A. Problematic pattern of x use causing clinically significant impairment or distress, as manifested by at least 2 symptoms within a 12 mo. pd.
- Taken in larger amounts and for longer than intended
- Persistent desire/unsuccessful efforts to cut down
- Great deal of time spent in activities needed to maintain use
- Craving - strong desire to use
- Recurrent alcohol use resulting in a failure to fulfill role obligations
- Continued use despite recurrent social/interpersonal problems caused/exacerbated by the effects of substance
Important activities given up/reduced bc of use
- Recurrent use in hazardous situations
- Use continued despite knowledge of having physical/psychological problems likely caused/exacerbated by substance

Question 10

Key Concerns for Substance Use Disorders

Answer 10

• People with substance use problems might not be motivated to treatment
• Health issues - people being treated for substance use disorders need to seek a medical consultation before beginning any kind of treatment
• Could be a way to cope with stress or other mental illnesses
• Could lead to higher risk of suicidality or homicidality
• Depending on the drug, may need to rule out other mental health disorder (i.e. meth usage vs. psychosis)
• Withdrawal and relapse

Question 11

Methods/Assessment of Substance Use Disorder

Answer 11

• Retrospective self-reports; use of substances over a specified period of time
• Unstructured clinical interview: family, personal, developmental history of use, DSM criterion, drug being used, pattern of use and symptoms
• Review of Records
• Mental status exam
• Personality measures have questions regarding substance use
• Substance Abuse Subtle Screening Inventory (SASSI - 3)
• SCID-5 for Substance Use Disorders
• MMPI (particularly BXD (behavioral/externalizing), RC4(antisocial behavior), JCP (Juvenile Conduct Problems), SUB (substance use), AGG (Aggression), DISC-r (Disconstraint) scales)
• PAI
• Self-report measures like the Substance Abuse Subtle Screening Inventory (SASSI - 3), Michigan Alcoholism Screening Test (MAST), the Drug Abuse Screening Test (DAST)

Question 12

Treatment Recommendations for Substance Use Disorder

Answer 12

• Motivational Interviewing to assess readiness to change and to determine what goals a client would be willing to set for themselves
• CBT
• Case management
• Intensive outpatient treatment (most effective)
• A 12-Step Program such as Alcoholics Anonymous or Narcotics Anonymous
• Inpatient/Residential
• Individual and group counseling
• Medication assisted treatment

Question 13

ASD Specifiers

Answer 13

With or without intellectual disability
With or without language impairment

Question 14

Cluster A Personality Disorders

Answer 14

Paranoid
Schizod
Schizotypal

Question 15

Cluster B

Answer 15

Borderline
Antisocial
Histrionic
Narcissistic

Question 16

Cluster C

Answer 16

Dependent
Obsessive-Compulsive
Avoidant