DSM Criteria & Symptoms Midterm 2 Flashcards
What are the DSM-5 Diagnostic Criteria for Substance-Use Disorder (SUD)?
A. A problematic pattern of substance use leading to clinically significant impairment or distress, as manifested by at least 2 of the following, occurring within a 12-month period (met by an adolescent or adult):
1. Substance is often taken in larger amounts or over a longer period than was intended
2. There is a persistent desire or unsuccessful effort to cut down or control substance use
3. A great deal of time is spent in activities necessary to obtain substance, use the substance, or recover from its effects
4. There is a craving or a strong desire or urge to use the substance
5. Recurrent substance use results in failure to fulfill major role obligations at work, school, or home (ex: repeated absences or poor work performance related to substance use, substance-related absences, suspensions, or expulsions from school, neglect of children or household)
6. Continued substance use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of the substance
7. Important social, occupational, or recreational activities are given up or reduced because of substance use
8. There is recurrent substance use in situations in which it is physically hazardous (ex: driving an automobile or operating a machine when impaired by substance use)
9. Substance use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by the substance
10. Tolerance, as defined by either or both:
a) A need for markedly increased amounts of substance to achieve intoxication or desired effect
b) Markedly diminished effect with continued use of the same amount of the substance
11. Withdrawal, as manifested by either:
a) The characteristic withdrawal syndrome for a substance
b) The same (or closely related) substance is taken to relieve or avoid withdrawal symptoms
What are the DSM-5 Specifiers for Substance-Use Disorder (SUD)?
- Specify if:
- In early remission: none of the criteria have been met for at least 3 months but for less than 12 months (except “craving” criterion) -> doesn’t mean you’ve been sober during this time, you just haven’t met criteria for SUD during this time
- In sustained remission: none of the criteria have been met at any time during a period of 12 months or longer (except “craving” criterion)
- Specify if:
- In a controlled environment: used if the individual is in an environment where access to substance is restricted
- Specify current severity:
- Mild: presence of 2-3 symptoms
- Moderate: presence of 4-5 symptoms
- Severe: presence of 6 or more symptoms
What are the 4 groupings of symptoms that capture the core features of the DSM-5 Substance-Use Disorder diagnosis?
○ Impaired control (Criteria 1 - 4)
○ Social impairment -> interpersonal problems (Criteria 5 - 7)
○ Risky use -> risk-taking behaviour or risky outcomes (Criteria 8 & 9)
○ Pharmacological criteria -> related to physical dependence (Criteria 10 & 11)
What was different about Substance-Use Disorder in the DSM-5?
- DSM-5 was the first to have a unified substance use disorder
- 11th symptom (withdrawal symptoms) was added in the DSM-5 -> important part of SUD and chronic symptom
What are the DSM-5 Diagnostic Criteria for Separation Anxiety Disorder (SAD)?
A. Developmentally inappropriate and excessive fear or anxiety concerning separation from those to whom the individual is attached, as evidenced by at least 3 of 8 behaviours
B. The fear, anxiety, or avoidance is persistent, lasting at least 4 weeks in children and adolescents and typically 6 months or more in adults
C. The disturbance causes clinically significant distress or impairment in social, academic, occupational, or other important areas of functioning
D. The disturbance is not better explained by another mental disorder, such as refusing to leave home because of excessive resistance to change in ASD, delusions or hallucinations concerning separation in psychotic disorders, refusal to go outside without a trusted companion in agoraphobia, worries about ill health or other harm befalling significant others in GAD, or concerns about having an illness in illness anxiety disorder
What are the 8 symptoms/behaviours of criterion A of Separation Anxiety Disorder?
- Recurrent excessive distress when anticipating or experiencing separation from home or from major attachment figures
- Persistent or excessive worry about losing major attachment figures or about possible harm to them, such as illness, injury, disasters, or death
- Persistent and excessive worry about experiencing an untoward event (ex: getting lost, being kidnapped, having an accident, becoming ill) that causes separation from a major attachment figure
- Persistent reluctance or refusal to go out, away from home, to school, to work, or elsewhere because of fear of separation
- Persistent and excessive fear of or reluctance about being alone or without major attachment figures at home or in other settings
- Persistent reluctance or refusal to sleep away from home or to go to sleep without being near a major attachment figure
- Repeated nightmares involving the theme of separation
- Repeated complaints of physical symptoms (ex: headaches, stomachaches, nausea, vomiting) when separation from major attachment figures occurs or is anticipated
What are the DSM-5 Diagnostic Criteria for Specific Phobia?
A) Marked fear or anxiety about a specific object or situation (ex: flying, heights, animals, receiving an injection, seeing blood)
Note: In children, the fear or anxiety may be expressed by crying, tantrums, freezing, or clinging
B) The phobic object or situation almost always provokes immediate fear or anxiety
C) The phobic object or situation is actively avoided or endured with intense fear or anxiety
D) The fear or anxiety is out of proportion to the actual danger posed by the specific object or situation and to the sociocultural context
E) The fear, anxiety, or avoidance is persistent, typically lasting 6 months or more
F) The fear, anxiety or avoidance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning
G) The disturbance is not better accounted for by another mental disorder, including fear, anxiety, and avoidance of situations associated with panic-like symptoms or other incapacitating symptoms (as in agoraphobia), objects or situations related to obsessions (as in OCD), reminders of traumatic events (as in PTSD), separation from home or attachment figures (as in SAD), or social situations (as in social anxiety disorder)
What are the specifiers for Specific Phobia?
Specify if:
○ Animal (ex: spiders, insects, dogs)
○ Natural environment (ex: heights, storms, water)
○ Blood, injection, injury (ex: needles, invasive medical procedures)
○ Situational (ex: airplanes, elevators, enclosed places)
○ Other (ex: situations that may lead to choking or vomiting, in children, loud sounds or costumed characters)
What are the DSM-5 Diagnostic Criteria for Social Anxiety Disorder (Social Phobia)?
A) Marked fear or anxiety about one or more social situations in which the individual is exposed to possible scrutiny by others Ex: social interactions (ex: having a conversation, meeting unfamiliar people), being observed (ex: eating or drinking), or performing in front of others (ex: giving a speech)
* Note: In children, the anxiety must occur in peer settings and not just during interactions with adults
B) The individual fears that they will act in a way or show anxiety symptoms that will be negatively evaluated (will be humiliating or embarrassing, will lead to rejection or offend others)
C) The social situations almost always provoke fear or anxiety
* Note: In children, the fear or anxiety may be expressed by crying, tantrums, freezing, clinging, shrinking away, or failing to speak in social situations
D) The social situations are avoided or endured with intense fear or anxiety
E) The fear or anxiety is out of proportion to the actual danger posed by the social situation and to the sociocultural context
F) The fear, anxiety, or avoidance is persistent, typically lasting for 6 months or more
G) The fear, anxiety, and avoidance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning
H) The fear, anxiety, and avoidance is not attributable to the direct physiological effects of a substance (ex: a drug of abuse, a medication) or another medical condition
I) The fear, anxiety, or avoidance is not better explained by the symptoms of another mental disorder (ex: panic disorder, body dysmorphic disorder, or autism spectrum disorder)
J) If another medical condition (ex: Parkinson’s disease, obesity, disfigurement from burns or injury) is present, the fear, anxiety, or avoidance is clearly unrelated or is excessive
What’s the specifier for Social Anxiety Disorder?
- Specify if:
- Performance only: if fear is restricted to speaking or performing in public
What are the DSM-5 Diagnostic Criteria for Selective Mutism?
- Children fail to speak in specific social situations in which there is an expectation to speak (ex: school), even though they may speak loudly and frequently at home or in other settings
- Child’s disturbance interferes with educational or work achievement or with social communication
- Present for at least one month
- Not limited to a lack of knowledge or discomfort with the spoken language required in the social situation
- Not better explained by a communication disorder
- Does not occur only during the course of autism spectrum disorder, schizophrenia, or another psychotic disorder
What are the DSM-5 Diagnostic Criteria for Panic Disorder?
A) Recurrent unexpected panic attacks
B) At least one of the attacks has been followed by 1 month (or more) of one or both of the following:
- Persistent concern or worry about additional panic attacks or their consequences (ex: losing control, having a heart attack, “going crazy”)
- Significant maladaptive change in behavior related to the attacks (ex: behaviors designed to avoid having panic attacks, such as avoidance of exercise or unfamiliar situations)
C) The disturbance is not attributable to the physiological effects of a substance (ex: drug of abuse, medication) or another medical condition (ex: hyperthyroidism, cardiopulmonary disorders)
D) The disturbance is not better accounted for by another mental disorder
What are the DSM-5 Diagnostic Criteria for Agoraphobia?
A) Marked fear or anxiety about 2 (or more) of 5 situations
B) The individual fears or avoids these situations because of thoughts that escape might be difficult or help might not be available in the event of developing panic-like symptoms or other incapacitating or embarrassing symptoms (ex: fear of falling in the elderly; fear of incontinence)
C) The agoraphobic situations almost always provoke fear or anxiety
D) The agoraphobic situations are actively avoided, require the presence of a companion, or are endured with intense fear or anxiety
E) The fear or anxiety is out of proportion to the actual danger posed by the agoraphobic situations and to the sociocultural context
F) The fear, anxiety, or avoidance is persistent, typically lasting for 6 months or more
G) The fear, anxiety, or avoidance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning
H) If another medical condition (ex: inflammatory bowel disease, Parkinson’s disease) is present, the fear, anxiety, or avoidance is clearly excessive
I) The fear, anxiety, or avoidance is not better explained by the symptoms of another mental disorder
Note: agoraphobia is diagnosed irrespective of the presence of panic disorder. If an individual’s presentation meets criteria for panic disorder and agoraphobia, both diagnoses should be assigned
What are the 5 situations in Criterion A of the DSM-5 diagnostic criteria for Agoraphobia?
- Using public transportation (ex: automobiles, buses, trains, ships, planes)
- Being in open spaces (ex: parking lots, marketplaces, bridges)
- Being in enclosed spaces (ex: shops, theatres, cinemas)
- Standing in line or being in a crowd
- Being outside of the home alone
What are the DSM-5 Diagnostic Criteria for Generalized Anxiety Disorder?
A) Excessive anxiety and worry (apprehensive expectation) occurring more days than not for at least 6 months, about a number of events or activities (ex: work or school performance)
B) The individual finds it difficult to control the worry
C) The anxiety and worry are associated with 3 (or more) of 6 symptoms (with at least some symptoms present for more days than not for the past 6 months)
Note: Only one item is required for children
D) The anxiety, worry, or physical symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning
E) The disturbance is not due to the general physiological effects of a substance (ex: a drug of abuse, a medication) or another medical condition (ex: hyperthyroidism)
F) The disturbance is not better explained by another mental disorder
