DSM-5 TR Disorders

Question 1

What are the 3 Intellectual Disability criteria?

Answer 1

1) Intellectual deficit confirmed by assessment
2) Deficits in adaptive functioning that result in a failure of independence and social responsibility and impair functioning across multiple environments in 1+ ADL
3) Onset during developmental period

Question 2

What is the Intellectual Disability specifier?

Answer 2

Severity - Mild, moderate, severe, and profound based on adaptive functioning

Question 3

What are the early indicators for Intellectual Disability?

Answer 3

1) Motor delays
2) Poor eye contact during feeding
3) Lack of interest in environmental stimuli (e.g., voices, movement)

Question 4

What are the 3 domains of adaptive functioning for Intellectual Disabilities?

Answer 4

1) Conceptual (e.g., academics)
2) Social (e.g., making friends)
3) Practical (e.g., transportation)

Question 5

What are the 6 common Intellectual Disability etiologies?

Answer 5

1) 5% hereditary (Tay-Sachs, fragile X syndrome, PKU)
2) 5% acquired medical condition
3) 10% pregnancy and perinatal problems
4) 15-20% environmental factors (neglect)
5) 30% chromosomal and prenatal toxins (Down Syndrome, fetal alcohol disorder)
6) 30% unknown cause

Question 6

What are the 5 Intellectual Disability differentials?

Answer 6

1) Neurocognitive disorder
2) Communication disorders
3) SLD
4) ASD
5) Borderline intellectual functioning

Question 7

What are the Childhood-Onset Fluency Disorder criteria?

Answer 7

Disturbance in normal fluency and time patterning of speech

Question 8

What is the typical age of onset for Childhood-Onset Fluency Disorder?

Answer 8

Ages 2-7

Question 9

What is the prognosis for Childhood-Onset Fluency Disorder and what is a good predictor of the prognosis?

Answer 9

1) 65-85% of children recover
2) Severity at age 8 is a good predictor of prognosis

Question 10

What are the Childhood-Onset Fluency Disorder differentials?

Answer 10

Normal early childhood speech problems

Question 11

How is Childhood-Onset Fluency Disorder treated?

Answer 11

1) Young children: Reduce stress at home (limit criticism, reduce demands, increase coping skills)
2) Older individuals: Habit reversal training (awareness, relaxation, motivation, competing response, and generalization training)

Question 12

What are the 4 ASD criteria?

Answer 12

1) Deficits in social communication/interaction across contexts
2) Restricted, repetitive bx, interests, or activities by 2+ symptoms
3) Onset during developmental period
4) Impairs functioning

Question 13

What is the ASD specifier?

Answer 13

Severity:
1) Level 1 (support)
2) Level 2 (substantial support)
3) Level 3 (very substantial support)

Question 14

What are the 5 additional features of ASD?

Answer 14

1) Intellectual impairments
2) Language abnormalities
3) Uneven cognitive profiles
4) Motor deficits
5) Self injurious behavior

Question 15

What are the early warning signs of ASD and the prognosis?

Answer 15

1) Early signs: Abnormal social orienting and responsivity (social gaze, eye contact, joint attention) that are apparent by age 1
2) Only 1/3 adults achieve partial independence

Question 16

What are 3 factors associated with a better prognosis for ASD?

Answer 16

1) Verbal by age 5/6
2) IQ over 70
3) Later age of onset

Question 17

What are the 3 etiological factors for ASD?

Answer 17

1) Unusually rapid head growth during 1st year of life
2) Structural brain abnormalities (amygdala, cerebellum)
3) Abnormalities with serotonin, dopamine, and other neurotransmitters

Question 18

What are the 7 ASD differentials?

Answer 18

1) Rett syndrome
2) Selective mutism
3) Language disorder
4) ID
5) Stereotypic movement disorder
6) ADHD
7) Schizophrenia

Question 19

What are the 4 treatments for ASD?

Answer 19

1) Parent management training
2) Special education
3) Training in self-care and supported employment
4) Behavioral techniques - shaping and discrimination training

Question 20

What are the 5 ADHD criteria?

Answer 20

1) 6+ sxs for children and 5+ for ages 17+
2) Pattern of inattentive, hyperactive, or impulsive bx
3) Duration 6+ months
4) Symptoms 2+ context
5) Symptom onset prior to age 12

Question 21

How long do ADHD symptoms need to be present?

Answer 21

6+ months

Question 22

When do ADHD symptoms need to start?

Answer 22

Prior to age 12

Question 23

What are the 3 ADHD specifiers?

Answer 23

1) Predominantly inattentive,
2) Predominantly hyperactive/impulsive
3) Combined presentation

Question 24

What are the 5 additional features for ADHD?

Answer 24

1) Avg or above avg IQ but lower scores on IQ tests
2) Academic difficulties
3) Social problems
4) Low self-esteem
5) Poorer health, educational, and occupational outcomes

Question 25

What 7 disorders are individuals with ADHD at risk for?

Answer 25

1) Depression
2) Bipolar
3) Anxiety disorders
4) Antisocial behavior
5) CD
6) ODD
7) SLD

Question 26

What is the typical course and prognosis for ADHD (4)?

Answer 26

1) 65% - 80% of children continue to meet criteria as adolescents
2) 15% of children continue to meet criteria as young adults
3) 60% eventually meet criteria for partial remission
4) Symptoms vary over lifespan with gross motor activity declining/evolving over time

Question 27

What are the ADHD prevalence rates and differences by age and gender?

Answer 27

1) Prevalence 5% for children
2) Prevalence 2.5% for adults
2) More prevalent in males (2:1 children, 1.6:1 adults)
3) Combined more common in males, inattentive in females

Question 28

What are the etiological brain findings for ADHD?

Answer 28

Smaller and less active caudate nucleus, globus pallidus, and prefrontal cortex

Question 29

What are the 2 etiological theories for ADHD?

Answer 29

1) Barkley’s behavioral disinhibition hypothesis suggests ADHD is due to inability to fit bx to situational demands
2) Another theory suggests an inability to regulate attention

Question 30

What are the 9 differentials for ADHD?

Answer 30

1) ODD
2) CD
3) Intermittent explosive disorder
4) SLD
5) ID
6) ASD
7) Anxiety disorders
8) Mood disorders
9) Substance use disorders

Question 31

What are the typical ADHD treatments?

Answer 31

1) CNS stimulants reduce core symptoms 75% of cases
2) Parent/teacher management training

Question 32

What did the ADHD Mental Health Multimodal Treatment study find?

Answer 32

1) Medication only and combined treatment performed similarly at symptom reduction
2) Combined treatment was superior in other ways
3) But long-term the treatment groups were indistinguishable from the control groups

Question 33

What are the Cluster A Personality Disorders?

Answer 33

Cluster A (Odd & Eccentric) - Paranoid, Schizoid, Schizotypal

Question 34

What are the Cluster B Personality Disorders?

Answer 34

Cluster B (Dramatic, Emotional, Erratic) - Antisocial, Borderline, Histrionic, Narcissistic

Question 35

What are the Cluster C Personality Disorders?

Answer 35

Cluster C (Anxious & Fearful) - Avoidant, Dependent, OCPD

Question 36

What are the 8 Paranoid PD criteria?

Answer 36

Pervasive distrust and suspiciousness of malevolence as evidenced by 4+ sxs:
1) Suspects malevolence w/o proof
2) Unjustified doubts
3) Reluctance to confide in others
4) Misperceives benign events
5) Holds grudges
6) Misperceives attacks on character
7) Reactive anger
8) Suspects fidelity w/o justification

Question 37

What are the 7 Schizoid PD criteria?

Answer 37

Pervasive pattern of social detachment and restricted range of emotional expression in social settings and 4+ sxs:
1) Doesn’t desire/enjoy close relationships
2) Prefers solitary activities
3) Little interest in sex
4) Anhedonia
5) Lacks close friends besides relatives
6) Seems indifferent to others’ opinions
7) Emotionally cold/detached

Question 38

What are the 11 Schizotypal PD criteria?

Answer 38

Pervasive social and interpersonal deficits, discomfort or limited capacity for close relationships, and eccentric cognition, perception, or bx and 5+ sxs:
1) Ideas of reference
2) Odd beliefs
3) Odd perceptions
4) Odd thinking/speaking
5) Peculiar bx or appearance
6) Magical thinking
7) Bodily illusions
8) Suspicious or paranoid, odd affect
9) Lacks close friends other than relatives
10) Excessive social anxiety
11) Desire for close friends but has few and paradoxically prefers being alone

Question 39

What are Personality Disorders in general?

Answer 39

Patterns of inner experience and bx that:
1) Deviate from cultural norms
2) Are pervasive and inflexible
3) Are stable over time
4) Cause distress or impairment

Question 40

What are the 8 Antisocial PD criteria?

Answer 40

Disregard/violation of others’ rights and needs history of CD before 15 but cannot be diagnosed before 18 and 3+ symptoms:
1) Nonconformity to social norms or laws
2) Deceitfulness
3) Impulsivity
4) Irritability
5) Aggressiveness
6) Recklessness
7) Irresponsibility
8) Lack of remorse

Question 41

What are the 3 additional features of Antisocial PD?

Answer 41

1) Inflated self-esteem/grandiosity
2) Lack of empathy
3) Superficial charm

Question 42

What are the 2 universal diagnostic criteria for Personality Disorders?

Answer 42

1) Onset is in adolescence or early adulthood
2) People under 18 must have had symptoms for at least 1 year

• Except Antisocial PD which cannot be diagnosed until 18+

Question 43

What are the 9 Borderline PD critiera?

Answer 43

Pattern of unstable relationships, self-image, and affect paired with impulsivity across context. Must have 5+ sxs:
1) Frantic efforts to avoid abandonment
2) Relationships characterized by idealization and devaluation
3) Identity disturbance
4) Risky impulsivity in 2+ ways
5) Recurrent suicidality
6) Affective instability
7) Chronic feelings of emptiness
8) Anger dysregulation
9) Transient paranoia or dissociation

Question 44

When is Borderline PD usually diagnosed?

Answer 44

Ages 19-34

Question 45

When are Borderline PD symptoms most severe and how do they change over the life span?

Answer 45

1) Young adulthood
2) Substantial improvement by age 40 with 75% no longer meeting criteria

Question 46

What is the pattern of symptom improvement for Borderline PD?

Answer 46

Symptom improvement best to worst:
1) Impulsivity
2) Cognitive/interpersonal problems
3) Affect

Question 47

What is Stern’s Borderline PD etiological theory?

Answer 47

Stern related BPD to narcissism and disturbances in early mother-child attachment

Question 48

What is Mahler’s Borderline PD etiological theory?

Answer 48

Mahler attributed PDs to fixation at the rapprochement phase of separation-individuation resulting in need for separation paired with fear of abandonment

Question 49

What is Kernberg’s Borderline PD etiological theory?

Answer 49

Kernberg traced BPD to adverse, unpredictable caregiving that vacillate between rejection and smothering. This produces an insecure ego that tends to engage in “splitting” or the dichotomization of self and others into good vs bad

Question 50

What is Linehan’s Borderline PD etiological theory?

Answer 50

Linehan’s biosocial model says BPD is caused by emotion dysregulation and vulnerability paired with an invalidating environment

Question 51

What is the typical treatment for Borderline PD and what are its 2 components and 3 associated outcomes?

Answer 51

DBT and it reduces premature termination, hospitalizations, and parasuicidality. DBT involves:
1) CBT combined with Rogerian acceptance being necessary to change
2) Group skills training, individual outpatient therapy, and telephone coaching

Question 52

What are the 8 Histrionic PD criteria?

Answer 52

Intense emotionality and attention-seeking and 5+ sxs:
1) Discomfort not being the center of attention
2) Inappropriate seduction
3) Rapidly shifting/shallow emotions
4) Use of appearance to gain attention
5) Excessively impressionistic speech
6) Exaggerated expression of emotion
7) Easily influenced
8) Considers relationships to be more intimate than they are

Question 53

What are the 10 Narcissistic PD criteria?

Answer 53

Pervasive grandiosity, need for admiration, and lack of empathy and 5+ sxs:
1) Grandiosity
2) Preoccupation with grandiose fantasies
3) Belief in uniqueness and can only be understood by high-status people
4) Requires excessive admiration
5) Sense of entitlement
6) Interpersonally exploitative
7) Lacks empathy
8) Often envious
9) Believes others are envious of them
10) Arrogance

Question 54

For schizophrenia, what 3 factors are associated with a better prognosis?

Answer 54

1) Female gender
2) Later onset
3) More positive symptoms (which are more responsive to pharmacological treatment)

Question 55

What are the 3 levels of severity for Substance Use Disorders?

Answer 55

The 3 levels of severity are based on the number of symptoms:
1) Mild = 2 - 3 symptoms
2) Moderate = 4 - 5 symptoms
3) Severe = 6+ symptoms

Question 56

What are the 3 criteria for Specific Learning Disorder?

Answer 56

1) Difficulty with 1+ academic skill
2) Difficulty persists 6+ months
3) Targeted interventions do not help

Question 57

What 5 features are associated with a Specific Learning Disorder?

Answer 57

1) An average or better IQ
2) Delays in language development
3) Delays in motor development
4) Difficulty with attention and memory
5) Low self-esteem

Question 58

What 3 bx or outcomes are individuals with Specific Learning Disorder at-risk for?

Answer 58

1) Antisocial behavior
2) Arrests
3) Convictions

Question 59

What is SLD’s comorbidity rate with ADHD?

Answer 59

20 - 30%

Question 60

What is the typical course and prognosis for Specific Learning Disorder?

Answer 60

1) Persistent learning difficulties throughout lifespan
2) 33% of children with reading disorders develop psychosocial problems as adults

Question 61

What are the gender differences for Specific Learning Disorder?

Answer 61

A SLD is more common in males than in females (estimated ratio 2:1 to 3:1)

Question 62

What are the 3 etiologies for SLD?

Answer 62

1) Cerebellar-vestibular dysfunction (due to otitis media - ear infections)
2) Incomplete dominance and other hemispheric abnormalities
3) Exposure to toxins (especially lead)

Question 63

What is dyslexia?

Answer 63

1) A deficit in phonological processing
2) An etiology for SLD

Question 64

What are the 3 criteria for Tourette’s disorder?

Answer 64

1) Presence of 1+ vocal tic AND multiple motor tics
2) Tics persist for 1+ year
3) Tics began prior to age 18

Question 65

When is Provisional Tic Disorder diagnosed instead of Tourette’s or Persistent Motor/Vocal Tic Disorder?

Answer 65

Provisional Tic Disorder is diagnosed with there is 1+ motor OR vocal tic that began before age 18 but has been present for LESS than 1 year

Question 66

When is Persistent Motor or Vocal Tic Disorder diagnosed instead of Tourette’s?

Answer 66

Persistent Motor or Vocal Tic Disorder is diagnosed with there is only 1+ motor OR vocal tic that has been present for 1+ year and began prior to age 18.

Question 67

What are the 5 additional features of Tourette’s disorder?

Answer 67

1) Obsessions and compulsions (higher rates for biological relatives too)
2) Hyperactivity
3) Impulsivity
4) Distractibility
5) High rates of school problems

Question 68

What is the prognosis for Tourette’s disorder?

Answer 68

Frequency, severity, and disruptiveness of symptoms tend to decline with age

Question 69

What is the etiology of Tourette’s disorder?

Answer 69

1) Elevated levels of dopamine
2) Super sensitive dopamine receptors in the caudate nucleus

Question 70

How can Tourette’s and related disorders be treated (4 treatments)?

Answer 70

1) Antipsychotics (haloperidol, pimozide) are effective in 80% of cases
2) SSRIs can help alleviate the obsessive-compulsive symptoms
3) Clonidine (hypertension med) or desipramine (an antidepressant) can treat hyperactivity and inattention
4) Comprehensive behavioral intervention for tics (CBIT)

Question 71

What are the 3 diagnostic criteria for Delusional Disorder?

Answer 71

1) Presence of 1+ delusions
2) Delusion(s) last 1+ month
3) Psychosocial functioning is not markedly impaired or any impairment is directly related to the delusions (e.g., a person loses his job because he’s afraid to leave the house and repeatedly misses work)

Question 72

What are the 7 types of delusions?

Answer 72

1) Erotomanic (love)
2) Grandiose (importance)
3) Jealous (infidelity)
4) Persecutory (persecution)
5) Somatic (abnormal bodily functions or sensations)
6) Mixed
7) Unspecified

Question 73

What are the 2 specifiers for Delusional Disorder?

Answer 73

1) If delusions are bizarre
2) To describe the disorder’s course (first episode, currently in acute episode)

Question 74

What are the 3 diagnostic criteria for Schizophrenia?

Answer 74

1) Presence of 2+ active phase symptoms that last 1+ month with 1+ being delusions, hallucination, or disorganized speech (so you can’t just be blunted and disheveled)
2) Signs of the disorder for at least 6+ months
3) Causes distress or impairment

Question 75

What are the 5 active phase symptoms associated with Schizophrenia?

Answer 75

1) Delusions*
2) Hallucinations*
3) Disorganized speech*
4) Grossly disorganized behavior
5) Negative symptoms

Question 76

What are the 2 specifiers for Schizophrenia?

Answer 76

1) Course
2) Catatonia

Question 77

What are the 6 associated features of Schizophrenia?

Answer 77

1) Inappropriate affect (e.g., laughing for no reason)
2) Dysphoric mood
3) Disturbed sleep
4) Lack of interest in eating
5) Anosognosia
6) Substance Use Disorder (particularly Tobacco Use Disorder)

Question 78

What are the prevalence rates for Schizophrenia and differences by gender?

Answer 78

1) Lifetime prevalence of Schizophrenia ranges from 0.3 to 0.7%
2) Prevalence rate is slightly lower for females than for males

Question 79

What were the 3 results of the World Health Organization’s International Pilot Study of Schizophrenia?

Answer 79

The WHO study found that patients from developing countries compared to developed countries were more likely to exhibit:
1) An acute onset of symptoms
2) A shorter clinical course
3) Complete remission of symptoms

Question 80

What is the typical course and prognosis for Schizophrenia?

Answer 80

1) Onset of Schizophrenia is usually between the late teens and early 30s
2) Peak age of onset being in the early to mid-20s for males and the late 20s for females
3) Course is ordinarily chronic with complete remission being rare

Question 81

What 8 factors are associated with a better prognosis for Schizophrenia?

Answer 81

1) Good premorbid adjustment
2) An acute/later onset
3) Female gender
4) A precipitating event
5) A brief duration of active-phase symptoms
6) Insight into the illness
7) A family history of a mood disorder
8) No family history of Schizophrenia

Question 82

What is the concordance data for Schizophrenia?

Answer 82

1) High risk among first-degree biological relatives
2) Biological siblings 10%
3) Fraternal twins 17%
4) Child of 2 parents with schizophrenia 46%
5) Identical twins 48%

Question 83

What are the 8 etiologies for Schizophrenia?

Answer 83

1) Enlarged ventricles
2) Smaller hippocampus
3) Smaller amygdala
4) Smaller globus pallidus
5) Hypofrontality (e.g., lower prefrontal cortex activity)
6) Dopamine hypothesis (e.g., elevated dopamine or oversensitive dopamine receptors)
7) Imbalance of serotonin, glutamate, and GABA
8) Prenatal exposure to an influenza virus during winter

Question 84

What are the 5 differentials for Schizophrenia?

Answer 84

1) Amphetamines and cocaine
2) Schizoaffective Disorder
3) Major Depressive Disorder
4) Bipolar
5) Autism

In Schizophrenia, mood symptoms are brief, do not occur during the active phase, and do not meet the full criteria for a mood episode.

Question 85

How can you differentiate Mood Disorders with psychotic features from Schizoaffective Disorder?

Answer 85

Schizoaffective disorder would be diagnosed instead of a mood disorder if there was a period of 2+ weeks without prominent mood symptoms

Question 86

How can you differentiate Mood Disorders with psychotic features from Schizophrenia?

Answer 86

Schizophrenia is not diagnosed when the psychotic symptoms only occur during episodes of mood disturbances (e.g., depressive or manic episode)

Question 87

What are the 7 treatments for Schizophrenia?

Answer 87

1) Traditional antipsychotics (haloperidol, fluphenazine)
2) Atypical antipsychotics (clozapine, risperidone)
3) Individual CBT
4) Psychoeducation
5) Social skills training
6) Supported employment
7) Family-based interventions especially with high EE families (e.g., families who are hostile or overinvolved emotionally)

Question 88

What are the 2 diagnostic criteria for Schizophreniform Disorder?

Answer 88

1) Presence of 2+ active phase symptoms
2) Symptoms persist 1-6 months

*The criteria are essentially identical to those for Schizophrenia except that the disturbance is present for at least one month but less than six months and impairment may occur but is not required.

Question 89

What is the prognosis for Schizophreniform Disorder?

Answer 89

66% eventually meet criteria for Schizophrenia or Schizoaffective Disorder

Question 90

What are the 4 diagnostic criteria for Brief Psychotic Disorder?

Answer 90

1) Presence of 1+ symptoms (delusions, hallucinations, disorganized speech, or grossly disorganized or catatonic behavior) with 1+ being delusions, hallucinations, or disorganized speech
2) Symptoms persist 1-30 days
3) Eventual return to premorbid functioning
4) Onset usually follows exposure to an overwhelming stressor

Question 91

What are the 3 diagnostic criteria for Schizoaffective Disorder?

Answer 91

Concurrent symptoms of:
1) Schizophrenia
2) Major depression or mania
3) A period of 2+ weeks without prominent mood symptoms

Question 92

What are the 4 diagnostic criteria for Bipolar 1?

Answer 92

1) Occurrence of 1+ manic episode
2) Mania must last 1+ one week with sxs being present most of the day, nearly every day
3) Mania must include 3+ characteristic sxs – e.g., grandiosity, decreased need for sleep, excessive talkativeness, or flight of ideas
4) Dx requires impairment, hospitalization, or psychotic features

Question 93

What are the 3 specifiers for Bipolar 1?

Answer 93

1) Severity (mild, moderate, or severe) based on number of symptoms
2) Type of most recent episode (manic, hypomanic, depressed, or unspecified)
3) Pattern (e.g., rapid cycling, mood-congruent psychotic features, mood-incongruent psychotic features, peripartum onset, seasonal pattern)

Question 94

What are the 5 patterns for Bipolar 1?

Answer 94

1) Rapid cycling
2) Mood-congruent psychotic features
3) Mood-incongruent psychotic features
4) Peripartum onset
5) Seasonal pattern

Question 95

What are the 3 associated features of Bipolar Disorder?

Answer 95

1) Anxiety disorders
2) Substance use disorders
3) Lifetime risk for completed suicide is about 15x higher than the general population

Question 96

What are the prevalence rates for Bipolar 1 and differences by gender?

Answer 96

1) 12-month prevalence for Bipolar I Disorder in the United States is 0.6%
2) Lifetime male-to-female prevalence ratio is approximately 1.1 : 1

Question 97

What is the typical course for Bipolar 1?

Answer 97

1) Average age of first episode is 18 years old
2) 90% of individuals who have one episode experience additional episodes

Question 98

What is the general concordance pattern for Bipolar Disorder?

Answer 98

1) Identical twins - concordance rates ranging from .67 to 1.0
2) Fraternal twins - concordance rates of .20
3) Higher risk for first-degree relatives

• Genetic factors have been most consistently linked to the Bipolar Disorders

Question 99

What are the 3 best therapy options to treat Bipolar Disorder?

Answer 99

1) Cognitive-behavioral therapy (CBT)
2) Family-focused treatment (FFT)
3) Interpersonal and social rhythm therapy (IPSRT)

Question 100

What are the 3 basics about prescribing antidepressants for Bipolar 1?

Answer 100

1) Antidepressants may be prescribed to treat depressive symptoms
2) Antidepressant may trigger a manic episode when combined with a mood stabilizer
3) Triggering mania is more likely with TCAs compared to SSRIs

Question 101

What medication works best for Bipolar with rapid cycling or dysphoric mania?

Answer 101

Anticonvulsants like carbamazepine or divalproex sodium

Question 102

What medication works best for acute mania?

Answer 102

Antipsychotics like Olanzapine or Risperidone

Question 103

What is classic Bipolar 1 and what medication works best for it?

Answer 103

Classic Bipolar involves distinct episodes of mania and depression.

Lithium works best for classic Bipolar 1 and is effective in 60 - 90% of cases.

Question 104

What are the 2 diagnostic criteria for Bipolar 2?

Answer 104

1) Occurrence of 1+ hypomanic episodes that last 4+ consecutive days, and involve 3+ characteristic sxs of mania that don’t cause marked impairment or require hospitalization
2) Occurrence of 1+ major depressive episodes that last 2+ weeks, and involves 5+ characteristics of depression

Question 105

What are the 5 diagnostic criteria for Cyclothymic Disorder?

Answer 105

1) Numerous periods of hypomanic sxs that don’t meet criteria for a hypomanic episode
2) Numerous periods with depressive sxs that don’t meet criteria for a major depressive episode
3) Causes distress or impairment
4) Symptoms last for 2+ years in adults or 1+ year in youth
5) Symptoms cannot remit for greater than 2+ months at a time

Question 106

What are the 7 diagnostic criteria for Disruptive Mood Dysregulation Disorder?

Answer 106

1) Severe recurrent temper outbursts that are disproportionate to the situation and atypical for developmental level
2) A persistently irritable or angry mood between outbursts
3) Sxs have persisted for 12+ months
4) Sxs are present in 2+ settings
5) Outbursts occur on average 3+ times per week
6) Dx must be assigned between ages 6 - 18 years
7) Onset must occur before 10 years old

Question 107

What are the 4 diagnostic criteria for Major Depressive Disorder?

Answer 107

Presence of 5+ sxs nearly every day for at least 2+ weeks with 1+ depressed mood or a loss of interest or pleasure:
1) Changes in weight
2) Changes in appetite
3) Sleep disturbances
4) Psychomotor agitation or retardation
5) Fatigue or loss of energy
6) Feelings of worthlessness or excessive guilt
7) Diminished ability to think or concentrate
8) Recurrent suicidality
9) Causes distress or impairment

Question 108

What are the 3 specifiers for Major Depressive Disorder?

Answer 108

1) Severity (mild, moderate, severe)
2) Course (single episode or recurrent episode and in partial remission or in full remission)
3) Accompanying features (e.g., with psychotic features, with atypical features, with peripartum onset, with seasonal pattern)

Question 109

When do you use the specifier peripartum onset?

Answer 109

Peripartum onset is applied to MDD or the Bipolar Disorders when sxs occur during pregnancy or within 4 weeks postpartum

Question 110

What are the prevalence rates of the 3 peripartum conditions?

Answer 110

1) 10 - 20% experience peripartum depression
2) .1 to .2% develop postpartum psychosis
3) “Baby blues” occurs in 80% of people within 2 weeks of delivery and involve mild mood symptoms

Question 111

What 3 factors have been associated with Seasonal Affective Disorder?

Answer 111

1) Changes in the dark-light cycle that increases melatonin levels
2) A phase-delay in circadian rhythms
3) Serotonergic dysfunction

Question 112

What are the 3 peripartum onset Mood Disorder symptoms?

Answer 112

1) Anxiety
2) Preoccupation with the infant’s well-being
3) Delusional thoughts about the infant

Question 113

When do you use the seasonal pattern onset for Mood Disorders?

Answer 113

The seasonal pattern specifier is applied to MDD and the Bipolar Disorders when the onset of mood episodes are related to particular times of the year

Question 114

What are the 3 common symptoms associated with Mood Disorders with a seasonal pattern?

Answer 114

1) Hypersomnia
2) Increased appetite and weight gain
3) Craving for carbohydrates

Question 115

What are the 2 associated features of Major Depressive Disorder?

Answer 115

1) 40 - 60% of people experience sleep disturbances (disturbed sleep continuity, early morning awakenings, reduced deep sleep, earlier onset of REM sleep and increased REM early in night)
2) 60% lifetime comorbidity with anxiety, which is related to a poorer prognosis and greater risk for suicide

Question 116

What are the prevalence rates for Major Depressive Disorder and differences by age and gender?

Answer 116

1) 12-month prevalence rate is 7%
2) Prevalence for individuals ages 18 to 29 is 3x higher than individuals 60+
3) Beginning in early adolescence, rates for females is 1.5 - 3 times the rate for males

Question 117

What is the typical course for Major Depressive Disorder?

Answer 117

1) Peak age of onset for MDD is mid-20s
2) Initial episodes may be precipitated by a severe psychosocial stressor
3) As the number of previous episodes increase, the risk for subsequent episodes is less related to stress than to the number of previous episodes

Question 118

What are the 3 age differences for symptoms of Major Depressive Disorder?

Answer 118

1) Children - Somatic complaints, irritability, and social withdrawal
2) Preadolescents - Aggressiveness and destructiveness
3) Older adults - Memory loss, distractibility, disorientation, and other cognitive symptoms (usually with faster onset compared to neurocognitive disorders)

Question 119

What are 2 cultural variations of Major Depressive Disorder?

Answer 119

1) Latinos may complain of of “nerves” and headaches
2) Asians often experience depression as weakness, tiredness, or an “imbalance”

Question 120

What is the general concordance pattern for Major Depressive Disorder (4)?

Answer 120

1) Identical twin concordance rate is .50
2) Fraternal twin concordance rate is .20
3) MDD is about 1.5 - 3.0 times more common among first-degree biological relatives
4) Risk is similar between one parent or two parents with MDD

Question 121

What are the 4 etiologies for Major Depressive Disorder?

Answer 121

1) Neuroticism is associated with MDD
2) Catecholamine hypothesis (MDD is caused by deficiency in norepinephrine)
3) Indolamine hypothesis (MDD is caused by low levels of serotonin or receptors)
4) MDD is associated with elevated levels of cortisol which causes atrophy of neurons in the hippocampus

Question 122

What is the indolamine hypothesis?

Answer 122

The indolamine hypothesis proposes that MDD is caused by norepinephrine deficits

Question 123

What is the catecholamine hypothesis?

Answer 123

The catecholamine hypothesis proposes that MDD is caused by low levels of serotonin or serotonin receptors

Question 124

What is Lewinsohn’s theory of depression?

Answer 124

Lewinsohn’s believed depression occurred because of a low rate of response-contingent reinforcement which resulted in the extinction of behaviors and reduced the likelihood of positive reinforcement in the future. This caused the classic symptoms like pessimism, low self-esteem, and social isolation.

Question 125

What was Seligman’s theory about depression?

Answer 125

Seligman thought depression was caused by exposure to uncontrollable negative events coupled with learned helplessness that was caused by a tendency to attribute those events to internal, stable, and global factors

Question 126

What was Rehm’s theory of depression?

Answer 126

Rehm proposed that depression is caused by problems self-monitoring, self-evaluation, and self-reinforcement. He thought depressed people:
1) Focus on negative events and immediate outcomes
2) Fail to make accurate internal attributions
3) Set stringent criteria for self-evaluation
4) Have low rates of self-reinforcement and high rates of self-punishment

Question 127

What was Beck’s theory of depression?

Answer 127

Beck thought depression was related to negative, illogical self-statements about oneself, the world, and the future.

Some argued that depressed people’s negative beliefs may actually reflect a more accurate awareness of reality though. For example, Lewinsohn et al. found that non-depressed individuals tended to overestimate their abilities.

Question 128

What are the 3 differentials for Major Depressive Disorder?

Answer 128

1) Psychotic disorders involve psychosis being present without mood sxs
2) Adjustment Disorder would only be made if criteria for MDD were not met
3) Uncomplicated Bereavement tends to involve waves of mood problems but a generally normal mood

Question 129

What type of depression are Tricyclics best for?

Answer 129

Vegetative depression

Question 130

What type of depression are SSRIs best for?

Answer 130

Melancholic or severe/suicidal depression

Question 131

What type of depression are MAOIs best for?

Answer 131

Atypical symptoms

Question 132

What type of depression are SNRIs best for?

Answer 132

Comparable to TCAs and SSRIs for vegetative, melancholic, or severe depression but with different side effects

Question 133

What type of depression is ECT best for?

Answer 133

Very severe endogenous depression w/ delusions or suicidal ideation

Question 134

What does research say about treatment for depression?

Answer 134

1) An NIMH study found cognitive therapy (CT), interpersonal therapy (IPT), and tricyclic imipramine were all effective and imipramine was particularly effective for severe symptoms.
2) An 18-month follow-up study showed only 30% of CT patients, 26% of IPT patients, 19% of imipramine patients, and 20% of placebo patients stayed symptom free.
3) Research confirms that combining CBT with medication is better than either alone and that CBT is associated with a lower risk for relapse compared to medication.

Question 135

What are the 9 diagnostic criteria for Persistent Depressive Disorder?

Answer 135

PDD is diagnosed when 2+ characteristic symptoms have been present for 2+ years in adults or 1+ year in youth and sxs have not remitted for more than 2 months:
1) Depressed or irritable mood
2) Poor appetite or overeating
3) Insomnia or hypersomnia
4) Low energy or fatigue
5) Low self-esteem
6) Poor concentration
7) Difficulty making decisions
8) Feelings of hopelessness
9) Causes distress or impairment

Question 136

What are the 14 diagnostic criteria for Premenstrual Dysphoric Disorder?

Answer 136

PDD is diagnosed when there are 5+ sxs during the week before a period, an improvement in sxs during the period, and an absence of sxs after the period:
1) Affective lability
2) Irritability or anger
3) Depressed mood
4) Self-deprecating thoughts
5) Anxiety or tension
6) Decreased interest in usual activities
7) Impaired concentration
8) Lethargy
9) Changes in appetite
10) Sleep disturbances
11) A sense of being overwhelmed or out of control
12) Physical symptoms (e.g., breast swelling, joint or muscle pain)
13) Causes distress or impairment
14) Cannot be better explained by something else

Question 137

How does age relate to suicide?

Answer 137

1) Historically, suicide rates were highest for individuals 65+
2) Currently, highest rates are for females ages 45 - 54 and males ages 75+

Question 138

How does gender relate to suicide?

Answer 138

1) Males are 4x more likely to complete suicide
2) Females are 2-3x more likely to attempt suicide

Question 139

How does race/ethnicity relate to suicide?

Answer 139

1) Suicide rates are generally highest for Whites at all age groups
2) Natives age 15 - 24 are 2.5x more likely to attempt suicide than other groups

Question 140

How does marital status relate to suicide?

Answer 140

1) Lowest rates are found for married individuals
2) Highest rates are found for divorced, separated, and widowed individuals
3) Single individuals are in the middle for suicide rates

Question 141

How do suicidal thoughts, behaviors, and warning signs relate to suicide?

Answer 141

1) 60 - 80% of individuals who complete suicide made 1+ past attempt
2) 80% of individuals gave definite warnings of their intentions (threats, writing/talking about death/suicide, seeking means, and making preparations)

Question 142

How does life stress and social factors relate to suicide (4)?

Answer 142

Suicide is often associated with:
1) Failure at work or school
2) Interpersonal rejection (particularly for adolescents)
3) Living alone
4) Absence of social support

Question 143

How do psychiatric disorders relate to suicide?

Answer 143

1) Most suicide victims have a mental disorder
2) Individuals with mood disorders are 15 - 20% more likely to die by suicide
3) Suicide is most likely to occur within 3 months after depression improves
4) In adolescents, risk increases when depression co-occurs with Conduct Disorder, Substance Use Disorder, or ADHD

Question 144

How does personality relate to suicide?

Answer 144

1) Hopelessness more than intensity of depression
2) Socially prescribed perfectionism
3) Self-oriented perfectionism combined with high stress

Question 145

How does neurobiology relate to suicide?

Answer 145

Low levels of serotonin and 5-HIAA (a serotonin metabolite) have been linked to an increased risk for suicide and violent suicide attempts

Question 146

How is anxiety differentiated from depression?

Answer 146

1) Anxiety is associated with a higher level of positive affect and autonomic arousal
2) Pure anxiety sxs: Apprehension, tension, trembling, excessive worry, and nightmares
2) Pure depressive sxs: Depressed mood, anhedonia, loss of interest in usual activities, suicidal ideation, and decreased libido

Question 147

What are the 3 diagnostic criteria for separation anxiety disorder?

Answer 147

Inappropriate and excessive fear related to separation from home or attachment figures as evidenced by 3+ characteristic symptoms for 4+ weeks in youth or 6+ months in adults:
1) Recurrent excessive distress when anticipating or experiencing separation
2) Persistent excessive fear of being alone
3) Repeated complaints of physical symptoms when anticipating or experiencing separation

Question 148

What 3 ages categories does school refusal typically occur and why?

Answer 148

1) Ages 5 to 7 due to separation anxiety
2) Ages 10 to 11 due to change of schools and possibly social phobia
3) Ages 14 to 16 due to disorders and has the poorest prognosis

Question 149

What is the etiology for separation anxiety disorder?

Answer 149

Children with Separation Anxiety Disorder often come from close, warm families and their symptoms are frequently precipitated by a major life stressor

Question 150

What are the 3 differentials for separation anxiety disorder?

Answer 150

1) Developmentally appropriate levels of separation anxiety
2) Disorders involving marked anxiety (e.g., Agoraphobia, Generalized Anxiety Disorder)
3) Disorders involving school refusal (e.g., Conduct Disorder, Social Anxiety Disorder)

Question 151

What are the 2 treatments for social anxiety disorder?

Answer 151

1) Systematic desensitization
2) Cognitive approaches

*A primary goal of treatment is an immediate return to school to avoid academic failure, social isolation, and other secondary impairments.

Question 152

What are the 4 diagnostic criteria for Specific Phobia?

Answer 152

1) Intense disproportionate fear of or anxiety about a specific object or situation
2) Avoidance or endurance of object or situation with distress
3) Fear persists for 6+ months
4) Causes distress or impairment

Question 153

What are the 5 specifiers for Specific Phobia?

Answer 153

1) Animal
2) Natural environment
3) Blood-injection-injury
4) Situational
5) Other

Question 154

What are the 2 etiologies for Specific Phobia and other Anxiety disorders?

Answer 154

1) Abnormal levels of serotonin, norepinephrine, and GABA
2) Two-factor theory attributes phobias to avoidance conditioning (cycle of avoidance)

Question 155

What are the 3 treatments for Specific Phobia?

Answer 155

1) Exposure with response prevention (especially in vivo exposure)
2) For blood-injection-injury, exposure is most effective when it is combined with applied tension, which involves repeatedly tensing and releasing the body’s large muscle groups to increase blood pressure
3) Cognitive self-control is useful for children’s fear of the dark (relaxation, pleasant visualization, positive self-statements, and parental reinforcement)

Question 156

What are the 5 diagnostic criteria for Social Anxiety Disorder?

Answer 156

1) Intense fear of or anxiety about social situations potentially involving scrutiny
2) Fear exhibiting symptoms and being negatively evaluated for them
3) Avoidance or endurance of situations with distress
4) Fear persists 6+ months
5) Causes distress or impairment

Question 157

What are the 2 etiological theories of Social Anxiety Disorder?

Answer 157

1) Behavioral inhibition, a temperament characterized by social avoidance and fear of the unfamiliar
2) Information processing biases (e.g., tendency to attend selectively to threatening information and overestimate the likelihood for negative outcomes in social situations)

Question 158

What are the 4 treatments for Social Anxiety Disorder?

Answer 158

1) Exposure with response prevention
2) Social skills training
3) Cognitive restructuring
4) SSRI, SNRI, or beta-blockers

Question 159

How long do symptoms need to be present to diagnose Panic Disorder?

Answer 159

1+ month of persistent concern about additional attacks, their consequences, or maladaptive changes in behaviors

Question 160

What are the 3 medical differentials for Panic Disorder?

Answer 160

1) Hyperthyroidism
2) Hypoglycemia
3) Cardiac arrhythmia

Question 161

What are the prevalence rates for Panic Disorder and differences by gender?

Answer 161

1) The 12-month prevalence for Panic Disorder is about 2 to 3% for adolescents and adults
2) Females are 2x as likely as males to receive the diagnosis

Question 162

Why are prepubertal children rarely diagnosed with Panic Disorder?

Answer 162

Due to cognitive limitations that do not allow them to make catastrophic interpretations of their bodily symptoms

Question 163

What 4 types of drugs are used to treat Panic Disorder and what are the rates of relapse?

Answer 163

1) Imipramine and other TCAs
2) SSRIs
3) SNRIs
4) Benzodiazepines
5) 30 - 70% relapse rate

Question 164

What are the 4 diagnostic criteria for Agoraphobia?

Answer 164

1) Fear or anxiety about 2+ situations: public transportation, open spaces, enclosed spaces, standing in line, crowds, and being outside the home alone
2) Fears is due to concern that escape might be difficult or help will be unavailable
3) Avoidance, required presence of a companion, or endurance with distress
4) Symptoms persistent 6+ months

Question 165

How is agoraphobia distinguished from Specific Phobia (situational type)?

Answer 165

Specific Phobia is the more likely when anxiety involves only 1 situation and is related to something other than concern about experiencing panic-like, incapacitating, or embarrassing symptoms

Question 166

How is agoraphobia distinguished from Social Anxiety Disorder?

Answer 166

Social Anxiety Disorder is the likely diagnosis when the individual’s anxiety is related to being scrutinized by others and increases in the presence of a companion

Question 167

What are the 2 types of treatments for Agoraphobia?

Answer 167

1) In vivo exposure with response prevention (graded)
2) In vivo exposure with response prevention (ungraded)

*Some evidence suggests both treatments have similar short-term effects but that intensive exposure has better long-term effects

Question 168

What are the 4 diagnostic criteria for Generalized Anxiety Disorder?

Answer 168

1) Excessive anxiety and worry about multiple things that are difficult to control
2) Persists 6+ months
3) For adults, 3+ sxs are needed and for youth, 1+ sxs: Restlessness, keyed up, easy fatigue, difficulty concentrating, irritability, tense, disturbed sleep
4) Causes distress or impairment

Question 169

What is the most basic primary feature of Anxiety Disorders

Answer 169

50% are diagnosed with another disorder

Question 170

What disorder is associated with the highest comorbidity rate?

Answer 170

GAD is associated with the highest comorbidity rates (90%)

Question 171

What are the top comorbidities with Anxiety Disorders?

Answer 171

1) MDD
2) Persistent DD
3) Substance Use Disorder
4) Specific Phobia
5) Social Anxiety Disorder

Question 172

What are the 3 age differences for Generalized Anxiety Disorder?

Answer 172

1) Youth worry about school/sports or natural disasters
2) Young adults worry about work, family, finances, and the future
3) Older adults worry about personal health and minor or routine matters

Question 173

What is the differential for Generalized Anxiety Disorder?

Answer 173

Nonpathological anxiety is determined by:
1) Feelings of control
2) Number of domains of worry
3) Fewer somatic symptoms

Question 174

What are the 4 treatments for Generalized Anxiety Disorder?

Answer 174

1) CBT
2) SSRIs or SNRIs
3) Anxiolytics - buspirone (Buspar)
4) Benzodiazepine

Question 175

What are the 2 diagnostic criteria for OCD?

Answer 175

Obsessive-Compulsive Disorder (OCD) is characterized by recurrent obsessions and/or compulsions that are time-consuming or cause impairment/distress.
1) Obsessions are persistent thoughts, impulses, or images that are intrusive
2) Compulsions are repetitious behaviors or mental acts that the person feels driven to perform in order to reduce distress or prevent a dreaded situation from happening

Question 176

What are the 2 specifiers for OCD?

Answer 176

1) Level of insight (good, fair, poor, absent)
2) Presence of tics

Question 177

What is the prevalence rate of OCD and what are the differences by gender?

Answer 177

1) OCD has a12-month prevalence in the United States of about 1.2%
2) Equally common in adult males and females
3) Earlier age of onset for males so greater prevalence in adolescent males than females

Question 178

What are the 4 etiological theories of OCD?

Answer 178

1) Low levels of serotonin
2) Hyperactive right caudate nucleus (which converts sensory input into cognitions and actions)
3) Hyperactive orbitofrontal cortex
4) Hyperactive cingulate cortex (which involve emotional reactions)

Question 179

What is the differential for OCD?

Answer 179

OCPD - while both disorders involve rituals, they are performed to reduce anxiety in OCD but are related to perfectionism in OCPD.

Question 180

What are the 3 treatments for OCD?

Answer 180

1) Exposure with response prevention (particularly thought stopping or other interventions targeting the obsessions)
2) Tricyclic clomipramine
3) SSRI

Question 181

What are the 6 diagnostic criteria for Reactive Attachment Disorder?

Answer 181

1) Consistent pattern of inhibited and emotionally withdrawn behavior toward caregivers that includes 2+ sxs (minimal socio-emotional responsiveness, limited positive affect, unexplained irritability, sadness, or fearfulness with caregivers)
2) History of extremely insufficient care
3) Onset must be evident before age 5
4) Developmental age of 9+ months

Question 182

What are the 4 diagnostic criteria for Disinhibited Social Engagement Disorder?

Answer 182

1) Inappropriate interactions with unfamiliar adults as evidenced by 2+ sxs
2) History of extremely insufficient care
3) Onset must be evident before age 5
4) Developmental age of 9+ months

Question 183

What are the 7 diagnostic criteria for PTSD in individuals older than 6 years old?

Answer 183

1) Exposure to actual or threatened death, serious injury, or sexual violence
2) Presence of 1+ intrusive symptom
3) Presence of avoidance of stimuli associated with the event
4) Negative changes in mood or cognition
5) Marked change in arousal and reactivity
6) Symptoms must persist 1+ month
7) Causes distress or impairment

*Criteria for children 6 and younger only require avoidance OR negative changes in mood/cognition

Question 184

What are the 3 treatments for PTSD

Answer 184

1) Comprehensive CBT (exposure, cognitive restructuring, and anxiety management)
2) SSRI
3) EMDR

*Cognitive incident stress debriefing (CISD) involves providing treatment (a single lengthy session) within 72 hours of the event regardless of symptoms and is contraindicated

Question 185

What are the 4 diagnostic criteria for Acute Stress Disorder?

Answer 185

1) Exposure to trauma
2) 9+ sxs from any of the 5 PTSD categories (i.e., intrusion, negative mood, dissociative symptoms, avoidance symptoms, arousal symptoms)
3) Persists 3 days - 1 month
4) Causes distress or impairment

Question 186

What are the 4 diagnostic criteria for Adjustment Disorders?

Answer 186

1) Development of sxs in response to 1+ identifiable stressors within 3 months of the onset of the stressor(s)
2) Causes distress or impairment
3) Sxs must remit within 6 months after termination of the stressor or its consequences
4) Must not be diagnosed when symptoms represent normal bereavement.

Question 187

What are the 6 specifiers for Adjustment Disorders?

Answer 187

Description of the predominant symptoms:
1) With depressed mood
2) With anxiety
3) With mixed anxiety and depressed mood
4) With disturbance of conduct
5) With mixed disturbance of emotions and conduct
6) Unspecified

Question 188

What is the primary feature of Dissociative Disorders?

Answer 188

A disruption of and/or discontinuity in the normal integration of consciousness, memory, identity, emotion, perception, body representation, motor control, and behavior

Question 189

What are the 5 types of amnesias associated with Dissociative Amnesia?

Answer 189

1) Localized amnesia
2) Selective amnesia
3) Generalized amnesia
4) Continuous amnesia
5) Systematized amnesia

Question 190

What is the specifier for Dissociative Amnesia?

Answer 190

With or without dissociative fugue (apparently purposeful travel with an inability to recall some or all of one’s past)

Question 191

What is the primary feature of Somatic Symptom Disorder?

Answer 191

Presence of 1+ somatic symptoms that cause distress or impairment and excessive thoughts, feelings, or behaviors related to the symptoms

Question 192

What are the 3 primary feature of Illness Anxiety Disorder?

Answer 192

1) A preoccupation with having a serious illness in the absence of serious symptoms
2) A high level of anxiety about one’s health
3) Performance of excessive health-related behaviors or maladaptive avoidance of doctors, hospitals, etc.

Question 193

What is the primary feature of Conversion Disorder?

Answer 193

Disturbances in voluntary motor or sensory functioning that suggest a serious condition with evidence of an incompatibility between the symptoms and recognized neurological or medical conditions

Question 194

What are the 2 types of Factitious Disorder and what do they entail?

Answer 194

Factious disorder involves falsifying physical or psychological symptoms via feigning, exaggeration, simulation, or induction in the absence of external rewards
1) Factitious Disorder Imposed on Self
2) Individuals with Factitious Disorder Imposed on Another

Question 195

What is Malingering?

Answer 195

Malingering is characterized by the intentional production of physical or psychological symptoms for the purpose of obtaining an external reward

Question 196

When should Malingering be suspected?

Answer 196

Malingering should be considered when the person seeks:
1) A medical evaluation for legal reasons
2) There is a marked discrepancy between symptoms and objective findings
3) The person does not cooperate with an evaluation or treatment
4) The person has Antisocial Personality Disorder

Question 197

What are the 4 diagnostic criteria for Anorexia Nervosa?

Answer 197

1) A restriction of energy intake that leads to a significantly low body weight
2) An intense fear of gaining weight or becoming fat
3) Behavior that interferes with weight gain
4) Body dysmorphia or a lack of recognition of the seriousness of their low weight

Question 198

What are the 3 specifiers for Anorexia Nervosa?

Answer 198

1) Type (restricting or binge-eating/purging)
2) Course (in partial remission or full remission)
3) Severity (mild, moderate, severe, or extreme) based on BMI

Question 199

What are the 5 potential consequences associated with purging behavior?

Answer 199

1) Anemia
2) Impaired renal functioning
3) Cardiac abnormalities
4) Dental problems
5) Osteoporosis

Question 200

How do Anorexia Nervosa and Anxiety Disorders relate?

Answer 200

1) Over half of individuals with Anorexia also have an anxiety disorder
2) Anxiety disorders often precede the onset of Anorexia
3) Social Phobia and OCD are particularly common

Question 201

What 3 disorders are associated with Anorexia Nervosa?

Answer 201

1) Social Phobia
2) OCD
3) Depression

Question 202

What 6 symptoms are associated with starvation and Anorexia Nervosa?

Answer 202

1) Constipation
2) Cold intolerance
3) Abdominal pain
4) Lethargy
5) Bradycardia
6) Amenorrhea

Question 203

What are the 5 etiologies for Anorexia Nervosa?

Answer 203

1) Perfectionism with unrealistic expectations
2) High levels of family conflict
3) Parents who are overprotective, rigid, and excessively concerned with thinness
4) Mothers who are depressed or domineering
5) Fathers who are physically or emotionally absent

Question 204

How do food and neurotransmitters interplay in Anorexia Nervosa?

Answer 204

Food restriction lowers elevated serotonin which may underlie the restlessness, anxiety, and obsessive thinking seen with Anorexia. Consequently, a drug that increases serotonin is not useful for people with Anorexia when they are still underweight and restricting. But it can help prevent relapse once the person has reached normal weight.

Question 205

What are 3 treatments for Anorexia Nervosa?

Answer 205

1) Contingency management (reinforcement for maintaining minimum weight)
2) CBT that modifies dysfunctional beliefs about weight and food
3) Separated family therapy for high EE families (to prevent relapse)

• First priority is always to get the individual to gain weight in order to avoid or reduce medical complications

Question 206

What are the 5 diagnostic criteria for Bulimia Nervosa?

Answer 206

1) Recurrent binging with a sense of a lack of control
2) Compensatory behavior
3) Self-evaluation that is unduly influenced by body shape and weight
4) Binges and purges 1+ time per week
5) Symptoms persist 3+ months

Question 207

What are the 2 specifiers for Bulimia Nervosa?

Answer 207

1) Course (in partial remission or full remission)
2) Severity (mild, moderate, severe, or extreme) based on compensatory behavior

Question 208

What are 7 associated features of Bulimia Nervosa?

Answer 208

1) Preceding comorbid Anxiety Disorder
2) Depression
3) Electrolyte disturbances
4) Metabolic alkalosis or acidosis
5 Dental problems
6) Menstrual abnormalities
7) Cardiac arrhythmia and arrest

Question 209

What are the 2 etiologies for Bulimia Nervosa?

Answer 209

1) Low levels of endogenous opioid beta-endorphin
2) Low levels of serotonin

Question 210

What are the 4 treatments for Bulimia Nervosa?

Answer 210

1) Nutritional counseling
2) CBT (self-monitoring, stimulus control, cognitive restructuring, problem-solving, and distraction)
3) Imipramine (tricyclic)
4) Fluoxetine (SSRI)

*Primary goal is to gain control over eating and modify dysfunctional beliefs

Question 211

What are the 4 diagnostic criteria for Enuresis?

Answer 211

1) Intentional or involuntary inappropriate voiding of urine
2) Accidents 2+ times per week
3) Accidents for 3+ months
4) Individual must be 5+ years old

*Occurs most often during non-REM sleep (stages 3 & 4)

Question 212

What are the 4 treatments for Enuresis?

Answer 212

1) The bell-and-pad is effective in 80% of cases but 33% relapse within 6 months
2) Behavioral rehearsal or overcorrection
3) Imipramine is effective in 85% of cases but relapse is high
4) Desmopressin (antidiuretic) works in the short-term but not the long term

Question 213

What are the 3 diagnostic criteria for Encopresis?

Answer 213

1) Intentional or involuntary inappropriate pooping 1+ time per month
2) Persistent accidents for 3+ months
3) Individual must be 4+ years old

Question 214

What are the 4 diagnostic criteria for Insomnia?

Answer 214

1) Distressing or impairing sleep quality or quantity despite sufficient opportunities
2) 3+ times per week
3) 3+ months
4) 1+ sxs (difficulty initiating, maintaining, or returning to sleep)

Question 215

What are the 2 treatments for Insomnia?

Answer 215

1) Barbiturates
2) CBT that involves sleep-hygiene education, stimulus control, relaxation training, correction of maladaptive thoughts/beliefs

Question 216

What are the 4 diagnostic criteria for Narcolepsy?

Answer 216

1) Attacks of an irrepressible need to sleep
2) Sleep attacks occur 3+ times per week
3) Symptoms persist 3+ months
4) Either cataplexy (loss of muscle tone), a hypocretin deficiency, or REM latency less than 15 minutes

Question 217

What are the 4 diagnostic criteria for Non-REM Sleep Arousal Disorders?

Answer 217

1) Recurrent episodes of incomplete awakening that usually occur during Stage 3 or 4 sleep
2) Either sleepwalking and/or sleep terrors
3) Limited or no recall of an episode
4) Causes distress or impairment

Question 218

What are the 4 diagnostic criteria for Nightmare Disorder?

Answer 218

1) Repeated occurrences of extremely dysphoric and well-remembered dreams
2) Occur during REM sleep
3) Fearful or anxious upon awakening
4) Causes distress or impairment

Question 219

What are the 4 diagnostic criteria for Erectile Disorder?

Answer 219

1) Presence of 1+ erectile symptoms - obtaining, maintaining, rigidity
2) Symptoms during almost all sexual activity
3) Symptoms persist 6+ months
4) Causes distress

Question 220

What are the 3 treatments for Erectile Disorder?

Answer 220

1) Referral for medical eval - absence of erections during REM sleep suggests an organic etiology
2) If psychological, CBT is preferred treatment
3) Sildenafil citrate (Viagra)

Question 221

What are the 3 diagnostic criteria for Genito-Pelvic Pain/Penetration Disorder?

Answer 221

1) Presence of 1+ characteristic symptom: Pain, anxiety, or tension before, during, or as a result of vaginal penetration during intercourse
2) Symptoms persist 6+ months
3) Causes distress

Question 222

What are the 2 specifiers for Genito-Pelvic Pain/Penetration Disorder?

Answer 222

1) Onset (lifelong or acquired)
2) Severity (mild, moderate, or severe)

Question 223

What are the 4 diagnostic criteria for Premature Ejaculation?

Answer 223

1) Ejaculation during partnered sex within 1 minute or before desired
2) Symptoms during almost all sexual activity
3) Symptoms persist 6+ months
4) Causes distress

Question 224

What are the 3 specifiers for Premature Ejaculation?

Answer 224

1) Onset (lifelong or acquired)
2) Extent (generalized or situational)
3) Severity (mild, moderate, or severe)

Question 225

What are the 4 diagnostic criteria for Gender Dysphoria in children?

Answer 225

Marked incongruence between assigned gender and experienced gender as evidenced by distress and all 6 of the characteristic sxs for 6+ months:
1-4) A strong preference for cross-gender clothing, roles, playmates, and toys/activities
5) A strong rejection of assigned gender’s toys, games, and activities
6) A strong desire for sex characteristics of other gender

Question 226

What are the 2 treatments for Premature Ejaculation?

Answer 226

1) Sex therapy - Sensate focus and the start-stop and squeeze techniques
2) SSRIs due to low serotonin being linked to premature ejaculation

Question 227

What are the 4 diagnostic criteria for Gender Dysphoria for adolescents and adults?

Answer 227

Marked incongruence between one’s assigned and experienced gender as evidenced by distress and 2+ sxs for 6+ months:
1) A marked incongruence between sex characteristics and experienced gender
2) A strong desire to be rid of one’s sex characteristics
3) A strong desire for the sex characteristics of the opposite gender
4) A strong desire to be of the opposite gender
5) A strong desire to be treated as the opposite gender
6) A strong conviction that one has the feelings and reactions of the opposite gender

Question 228

What is the course and prognosis for Gender Dysphoria (4)?

Answer 228

1) Onset is usually between the ages of 2 to 4 years
2) Persistence for natal males range from 2.2 to 30%
3) Persistence for natal females range from 12 to 50%.
4) Most who persist are sexually attracted to individuals of their natal gender (so they are straight)

Question 229

What is the primary characteristic of Paraphilic Disorders and what are the 7 Paraphilics Disorders?

Answer 229

Abnormal sexual interest that is distressing or impairing and could harm self or others.
1) Voyeuristic Disorder (watching others)
2) Exhibitionistic Disorder (being watched)
3) Sadism Disorder (causing pain)
4) Pedophilic Disorder
5) Fetishistic Disorder
6) Frotteuristic Disorder (touching nonconsenting adults)
7) Transvestic Disorder (cross dressing)

Question 230

What are the 5 diagnostic criteria for Oppositional Defiant Disorder?

Answer 230

1) Persistently irritable, argumentative, defiant, or vindictive bx
2) 4+ sxs (often loses temper, argues with authorities, noncompliant, blames others)
3) 1+ person who is not a sibling
4) Persists 6+ months
5) Causes distress for self or others

Question 231

What are the 7 diagnostic criteria for Intermittent Explosive Disorder?

Answer 231

1) Disproportionate outbursts due to inability to control aggression
2) 2+ times per week
3) 3+ months or 3 outbursts in 12 months that have damaged property or caused injuries
4) Not premeditated
5) Not for tangible outcomes
6) Causes distress, impairment, or significant consequences
7) Must be age 6+

Question 232

What are the 5 diagnostic criteria for Conduct Disorder?

Answer 232

1) Persistent violation of other’s rights, social norms, or rules
2) 3+ sxs within 12 months (aggression, destruction of property, theft, deceitfulness, violations of rules
3) 1+ sxs must occur within 6 months
4) Causes impairment
5) Cannot be assigned to individuals over age 18 who meet criteria for Antisocial Personality Disorder

Question 233

What are the differences in prevalence and symptomology by gender for Conduct Disorder?

Answer 233

1) Conduct disorder is more common in males than in females
2) In females, symptoms often include lying, truancy, running away, relational aggression, and substance use
2) Males are likely to exhibit both physical and relational aggression

Question 234

What are the 3 specifiers for Conduct Disorder?

Answer 234

1) Onset (childhood-onset if sxs emerge before age 10, adolescent-onset, and unspecified onset)
2) If limited prosocial emotions (lack of remorse or guilt, callous/lack of empathy, unconcerned about performance, and shallow or deficient affect)
3) Severity (mild, moderate, or severe) based on the number of conduct problems

Question 235

What is Moffitt’s theory of life-course-persistent Antisocial Personality Disorder (5)?

Answer 235

1) Began as early as age 3
2) Involved increasingly serious transgressions
3) Neurological impairments (deficits in verbal skills, executive functioning, and memory)
4) Difficult temperament
5) Adverse environment

Question 236

What is Moffitt’s theory of adolescence-limited Antisocial Personality Disorder?

Answer 236

Moffitt thought the adolescence-limited type was a temporary form of antisocial behavior that reflected a “maturity gap” and antisocial acts were usually committed with peers and were inconsistent across situations

Question 237

What is the childhood-onset type of Antisocial Personality Disorder associated with?

Answer 237

1) Greater aggressiveness
2) Eventual diagnosis of Antisocial Personality Disorder and/or a Substance-Related Disorder

Question 238

What are the 3 differentials for Conduct Disorder?

Answer 238

1) ADHD
2) ODD
3) Child or Adolescent Antisocial Behavior (an Other Conditions That May be a Focus of Clinical Attention)

Question 239

What are the 2 treatments for Conduct Disorder?

Answer 239

Interventions are most effective when they target preadolescents (rather than adolescents) and when they include a family intervention. Two options include:
1) Parent management training
2) Multisystemic treatment that targets the individual, family, school, and community and combines behavioral, cognitive, family systems, and case-management strategies

Question 240

What are the 4 diagnostic criteria for Substance Use Disorder?

Answer 240

A SUD is diagnosed when an individual continues using a substance despite significant problems for 12+ months as manifested by 2+ problems (e.g., impaired control, social impairment, risky use, withdrawal, or tolerance)

*SUD is not applicable to caffeine

Question 241

How long do substance use problems need to be present for a diagnosis of Substance Use Disorder?

Answer 241

12+ months

Question 242

What are the 4 problem areas associated with Substance Use Disorders?

Answer 242

1) Impaired control
2) Social impairment
3) Risky use
4) Pharmacological criteria – tolerance or withdrawal

Question 243

What are the 2 specifiers for Substance Use Disorder?

Answer 243

1) Remission status
2) Severity (mild, moderate, or severe) based on the number of symptoms

Question 244

What are the 3 etiological theories for Substance Use Disorder?

Answer 244

1) Conger’s tension-reduction hypothesis
2) Marlatt and Gordon overlearning hypothesis
3) Biopsychosocial models

Question 245

What was Marlatt and Gordon’s etiological theory of Substance Use Disorder?

Answer 245

Marlatt and Gordon describe addiction as an overlearned, maladaptive habit pattern

Question 246

What was Conger’s etiological hypothesis of Substance Use Disorder?

Answer 246

Conger’s tension-reduction hypothesis contends that alcohol reduces anxiety, fear, and other states of tension, which eventually leads to addiction via negative reinforcement

Question 247

What was Marlatt and Gordon’s treatment for Substance Use Disorder called and what did it involve?

Answer 247

Relapse Prevention Therapy (RPT)
1) Identifying risks for relapse
2) Identifying behavioral and cognitive strategies to prevent or respond to lapses

Question 248

What are the 5 treatment barriers for Tobacco Use Disorder?

Answer 248

1) Reinforcing effects (e.g., relaxation, decreased anger, increased alertness)
2) Withdrawal symptoms
3) Fear of failure
4) Fear of gaining weight (average gain in first few months is 5 or 6 pounds)
5) Long-lasting cravings for nicotine

Question 249

What 9 factors are associated with successful smoking cessation?

Answer 249

1) Male
2) Age 35 and older
3) Have a college education
4) Live in a smoke-free home
5) Have a non-smoking policy at work,
6) Be married or living with a non-smoking partner
7) Later starting age
8) Low level of nicotine dependence
9) History of abstaining longer than 5 days

Question 250

What are the 3 elements associated with long-term tobacco abstinence?

Answer 250

1) Nicotine replacement therapy
2) Multicomponent behavioral therapy (skills training, relapse prevention, stimulus control, rapid smoking)
3) Support and assistance from a clinician

Question 251

What are the 3 types of Substance-Induced Disorders?

Answer 251

1) Substance Intoxication
2) Substance Withdrawal
3) Substance/Medication-Induced Mental Disorders

Question 252

What are the 6 shared diagnostic criteria for Substance/Medication Induced Mental Disorders?

Answer 252

1) Mental health symptoms
2) Evidence that sxs could be caused by a substance
3) Evidence that sxs developed with 1 month of exposure or withdrawal
4) Sxs cannot be better explained by something else
5) Sxs don’t only occur during delirium
6) Sxs cause distress or impairment

Question 253

What are the 7 characteristics of Alcohol Intoxication?

Answer 253

1) Maladaptive behavioral and psychological changes (e.g., inappropriate behaviors, impaired judgment, mood lability)
2) Slurred speech
3) Poor coordination
4) Unsteady gait
5) Nystagmus
6) Impaired attention or memory
7) Stupor or coma

*Same symptoms as Sedative, Hypnotic, or Anxiolytic Intoxication

Question 254

What are the 8 characteristics of Alcohol Withdrawal?

Answer 254

1) Autonomic hyperactivity (e.g., sweating, tachycardia)
2) Hand tremor
3) Psychomotor agitation
4) Nausea or vomiting
5) Anxiety
6) Insomnia
7) Illusions or hallucinations
8) Generalized tonic-clonic seizures

Question 255

What are the 4 characteristics of Alcohol Withdrawal Delirium?

Answer 255

1) Delirium (disturbances in attention, awareness, and cognition)
2) Autonomic hyperactivity
3) Vivid hallucinations, delusions
4) Agitation

Question 256

What is Alcohol-Induced Major Neurocognitive Disorder in general and what are the two types?

Answer 256

Decline in 1+ cognitive domain causing impairment. It comes in 2 types:
1) Nonamnestic-confabulatory type
2) Amnestic-confabulatory type (Korsakoff Syndrome)

Question 257

What is Korsakoff Syndrome and what are the 3 primary symptoms?

Answer 257

Korsakoff Syndrome is usually due to a thiamine deficiency and involves anterograde amnesia, retrograde amnesia, and confabulation

Question 258

What are the 2 characteristics of Alcohol-Induced Sleep Disorder?

Answer 258

1) Intoxication tends to produce immediate sedation, increased deep sleep, and reduced REM sleep. This is followed by a rebound effect with decreased deep sleep and increased REM sleep.
2) Withdrawal tends to disturb sleep continuity and cause vivid dreams

Question 259

What are the 11 characteristics of Stimulant Intoxication*?

Answer 259

1) Maladaptive behavioral and psychological changes (e.g., euphoria, aggression, hyperfocus, racing thoughts)
2) Fast or irregular heart rate
3) Pupillary dilation
4) High blood pressure
5) Sweating or chills
6) Weight loss
7) Psychomotor agitation
8) Fast breathing
9) Confusion
10) Psychosis
11) Impaired judgements

*Cardiovascular collapse (deadly low blood pressure) due to overdose

Question 260

What are the 7 characteristics of Stimulant Withdrawal?

Answer 260

1) Fatigue/lethargy
2) Vivid, unpleasant dreams
3) Sleep disturbances
4) Increased appetite
5) Psychomotor agitation or retardation
6) Depression
7) Anxiety

Question 261

What are the 10 characteristics of Opioid Intoxication?

Answer 261

The opioids include heroin, morphine, codeine, methadone, oxycodone, and fentanyl.
1) Euphoria followed by apathy or dysphoria
2) Psychomotor retardation
3) Impaired judgment
4) Pupillary constriction
5) Extreme drowsiness
6) Coma
7) Slurred speech
8) Impaired attention or memory
9) Depressed breathing or heart rate
10) Changes in weight or appetite

Question 262

What are the 11 characteristics of Opioid Withdrawal?

Answer 262

1) Dysphoria
2) Nausea or vomiting
3) Muscle aches
4) Lacrimation or rhinorrhea
5) Pupillary dilation
6) Piloerection
7) Sweating
8) Diarrhea
9) Yawning
10) Fever
11) Insomnia

*Think flu symptoms

Question 263

What are the 14 characteristics of Inhalant Intoxication?

Answer 263

1) Maladaptive behavioral and psychological
2) Dizziness
3) Nystagmus
4) Poor coordination
5) Slurred speech
6) Unsteady gait
7) Lethargy
8) Depressed reflexes
9) Psychomotor retardation
10) Tremor
11) Generalized muscle weakness
12) Blurred vision
13) Stupor or coma
14) Euphoria

Question 264

What are the 7 characteristics of Tobacco Withdrawal?

Answer 264

1) Irritability or anger
2) Anxiety
3) Impaired concentration
4) Increased appetite
5) Restlessness
6) Depressed mood
7) Insomnia

Question 265

What are the 5 characteristics of delirium?

Answer 265

1) A disturbance in attention and awareness that develops quickly (hours to a few days)
2) Fluctuations in severity (often worsening later in the day)
3) 1+ additional disturbance in cognition
4) Symptoms must not be due to another Neurocognitive Disorder or a severely reduced level of arousal (e.g., coma)
5) Evidence that sxs are the direct physiological consequence of a medical condition, substance, etc.

Question 266

What 9 risk factors are associated with delirium?

Answer 266

1) Being old or young
2) Decreased cerebral reserve (e.g., dementia or HIV+ patients)
3) Post-operations
4) Burn injuries
5) Drug dependence and withdrawal (especially alcohol or benzos)
6) Systemic infections
7) Metabolic disorders
8) Electrolyte imbalances
9) Head trauma

Question 267

What are the 3 treatments for delirium?

Answer 267

1) Treatment of the underlying cause
2) Reduction of agitated behaviors via environmental manipulation and psychosocial interventions
3) Antipsychotic drugs (e.g., Haloperidol)

Question 268

What is Mild Neurocognitive Disorder?

Answer 268

A Mild Neurocognitive Disorder is a modest decline in 1+ cognitive domains that:
1) Does NOT cause impairment that cannot be overcome by effort or compensatory strategies
2) Does not occur only in the context of Delirium

Question 269

What are the 10 known etiologies for Major and Mild Neurocognitive Disorders?

Answer 269

1) Frontotemporal lobe degeneration
2) Vascular disease
3) HIV infection
4) Prion disease
5) Traumatic brain injury
6) Substance/medication use
7) Lewy body disease
8) Alzheimer’s disease
9) Parkinson’s disease
10) Huntington’s disease

Question 270

When is Neurocognitive Disorder diagnosed due to Alzheimer’s Disease (4 criteria)?

Answer 270

1) Criteria for a Neurocognitive Disorder are met
2) Criteria for probable or possible Alzheimer’s disease are met
3) Insidious onset
4) Gradual impairment

Question 271

When is a Neurocognitive Disorder Due to Alzheimer’s Disease (Probable) diagnosed (4 criteria)?

Answer 271

Neurocognitive Disorder Due to Alzheimer’s Disease (Probable) is diagnosed when there is evidence of:
1) A causative genetic mutation
2) Clear evidence of a decline in memory and 1+ other cognitive domain
3) Steadily progressive and gradual decline without extended plateaus
4) No evidence of a mixed etiology

*When there is no causative genetic mutation identified, “possible” is diagnosed

Question 272

How can you confirm Alzheimer’s disease (3 signs)?

Answer 272

Neuron loss, amyloid plaques and neurofibrillary tangles in the medial temporal structures (entorhinal cortex, hippocampus, and amygdala)

*Alzheimer’s disease can only be confirmed by a brain biopsy

Question 273

What is the most common cause of dementia and what is the likely course of onset?

Answer 273

1) Alzheimer’s disease accounts for 60 - 90% of all case of dementia
2) Late onset (80s+) is more common than early onset

Question 274

What are the 3 stages of Alzheimer’s Disease?

Answer 274

1) Stage 1 (1 to 3 years)
2) Stage 2 (2 to 10 years)
3) Stage 3 (8 to 12 years)

Question 275

What are the 6 characteristics of stage 1 Alzheimer’s Disease?

Answer 275

Stage 1 (1 to 3 years) involves:
1) Anterograde amnesia (especially for declarative memories)
2) Deficits in visuospatial skills (wandering)
3) Indifference
4) Irritability
5) Sadness
6) Anomia

Question 276

What are the 7 characteristics of stage 2 Alzheimer’s Disease?

Answer 276

Stage 2 (2 to 10 years) involves:
1) Increasing retrograde amnesia
2) Flat or labile mood
3) Restlessness and agitation
4) Delusions
5) Fluent aphasia (Wernicke’s aphasia)
6) Acalculia
7) Ideomotor apraxia (inability to translate an idea into movement)

Question 277

What are the 4 characteristics of stage 3 Alzheimer’s Disease?

Answer 277

Stage 3 (8 to 12 years) involves:
1) Severely deteriorated intellectual functioning
2) Apathy
3) Limb rigidity
4) Incontinence

Question 278

What are the 9 etiological factors associated with Alzheimer’s Disease?

Answer 278

1) Genetics
2) Early-onset familial type is linked to chromosomes 1, 14, and 21
3) Late-onset is linked to the ApoE4 gene on chromosome 19
4) Acetylcholine (ACh) deficits
5) Lower levels of formal education
6) Adult onset (type 2) diabetes
7) Depression
8) Traumatic brain injury
9) Down syndrome

Question 279

What are the 7 treatments for Alzheimer’s Disease?

Answer 279

1) Group therapy - reality orientation and reminiscence
2) Behavioral techniques
3) Antipsychotic drugs to reduce agitation
4) Antidepressant drugs to alleviate depression
5) Environmental manipulation
6) Cholinesterase inhibitors to reduce breakdown of ACh
7) Remaining at home with family

Question 280

What are the 4 cholinesterase inhibitors and what do they do?

Answer 280

Cholinesterase inhibitors to reduce breakdown of ACh and include:
1) Tacrine
2) Donepezil
3) Galantamine
4) Rivastigmine

Question 281

When is Vascular Neurocognitive Disorder diagnosed (3 criteria)?

Answer 281

1) Criteria for a Neurocognitive Disorder are met
2) Sxs are consistent with a vascular etiology
3) History of cerebrovascular disease

Question 282

What are the 4 common courses for Vascular Neurocognitive Disorder?

Answer 282

1) Partial recovery
2) A stepwise decline
3) Progressive course with fluctuations in severity
4) Plateaus that vary in duration

Question 283

What are the 6 symptoms of Neurocognitive Disorder Due to HIV Infection?

Answer 283

1) Impaired concentration and difficulty learning new information
2) Slowed psychomotor speed
3) Apathy and depression
4) Tremor
5) Clumsiness
6) Saccadic eye movements

Question 284

What are the 6 stages of Neurocognitive Disorder Due to HIV Infection?

Answer 284

1) Stage 0 (Normal): Mental/motor functions are normal
2) Stage 0.5 (Subclinical): Mild/minimal sxs without impairment
3) Stage 1 (Mild): Unequivocal functional, intellectual, or motor impairment but intact performance of most tasks
4) Stage 2 (Moderate): Cannot work but ambulatory and can do basic self-care
5) Stage 3 (Severe): Major cognitive deficits (no complex convos) or motor disability (cannot walk independently)
6) Stage 4 (End Stage): Nearly vegetative and functioning is rudimentary (mute, paralyzed, incontinent)