DSM Disorders- Differential Crriteria Flashcards
What is the most effective, evidence-based treatment for Bulimia Nervosa?
Cognitive-behavioral Therapy (CBT) – used to change underlying eating disorder cognitions & behaviors
Combined TX using pharmacotherapy + CBT = mazimum efficacy.
Stages Of Psychosexual Development (Freud)
Freud’s theory of psychosexual development proposes that = the id’s libido (sexual energy) centers on a different part of the body during each stage of development and the personality results from how conflicts are resolved at each stage
The 5 stages of development are:
- ) oral
- ) anal
- ) phallic
- ) Latency
- ) genital
DELIRIUM ? (diagnostic criteria)
A diagnosis of Delirium requires:
(a) a disturbance in attention & awareness that develops over a short period of time (usually hours to a few days),
Represents a change from baseline functioning,
Fluctuates in severity over the course of a day
and (b) an additional disturbance in cognition
(e.g., impaired memory, disorientation, impaired language, deficits in visuospatial ability, perceptual distortions).
SX NOT due to another Neurocognitive Disorder
+
DOES NOT occur during a severely reduced level of arousal (e.g., during a coma),
**SX = are a direct result of physiological consequence of:
(A) MEDICAL CONDITION
(B) SUBSTANCE INTOXICATION / WITHDRAWAL
and/or
(C) TOXIN EXPOSURE
Conduct Disorder
The diagnosis of Conduct Disorder requires:
– persistent behavior that violates basic rights of others
AND/OR
- age-appropriate social norms /rules
*Evidenced by a min of :
1) 3 SX within the past year (12 months)
+
2) at least 1 SX in the past 6 months.
SX are divided into 4 categories:
(1) aggression to people / animals
(2) destruction of property
(3) deceitfulness or theft
(4) a serious violation of rules.
SX = must cause significant impaired functioning
and
***CANNOT dx ADULTS (over age 18) who meet criteria for Antisocial Personality Disorder.
Graphic assessment techniques include:
(1) the genogram and (2) ecomap.
(1) the genogram = depicts family relationships over several generations + info on significant life events, family structure & roles, etc.
(2) ecomap = provides info on the strength and nature of relationships between family members and people, in the social environment.
Bipolar 1
Bipolar I Disorder requires:
– at least 1 manic episode that lasts for at least 1 week
–is present most of the day nearly every day
–and includes at least 3 characteristic symptoms
(e.g., inflated self-esteem / grandiosity;
decreased need for sleep; flight of ideas)
SX = marked impairment in social / work functioning
+ require hospitalization to avoid harm to self/others
OR or include psychotic features.
DX =may also include 1 or more episodes of hypomania or major depression.
Posttraumatic Stress Disorder (PTSD)
(SX = MORE THAN 1 MONTH)
**For individuals of all ages = SX must be present over 1 month + cause clinically significant distress / impaired functioning.
For adults/teens/children older than 6yr (aka 7yr old +),
PTSD requires:
(1) a) exposure to actual or threatened death (b) serious injury or
c) sexual violence;
(2) min 1 intrusion SX Re: event
(3) persistent avoidance of stimuli RE: event
(4) negative changes in cognition or mood RE: event
(5) marked change in arousal a reactivity RE: event
…………………………………………………………………………………………………………
*For children 6 yrs or younger (5yr or below)
PTSD Dx requires:
(1) exposure to actual or threatened death, serious injury, or sexual violence in at least one of the following ways; or learning the event occurred to a caregiver:
(2) min 1 intrusion SX Re: event
(c) persistent avoidance of stimuli / or negative changes in
thoughts/ mood > Re: event
(d) Altered arousal / reactivity > Re: event.
**For individuals of all ages = SX must be present over 1 month + cause clinically significant distress / impaired functioning.
Antisocial Personality Disorder
Antisocial Personality Disorder (diagnostic criteria):
(1) : a pattern of disregard & violation of others rights
(2) : SX present by age 15
(3): Includes min of 3 Sx
(*Sx e.g.,)
–fails to conform to social norms/lawful bhvr
–deceitfulness
–impulsivity
–reckless disregard for safety of self / others
–lack of remorse
*(4): CT MUST BE 18 years old
AND
**HX of CONDUCT DX before 15 yrs.
What diagnosis requires:
(1) pattern of disregard/violation of others rights
(2) SX must be present by age ________
(3) Inclues a minimum of _____ SX
[Symptoms:}
–(no conform to social normals/lawful behavior)
–(deceitful)
–(impulsive)
–(reckless disregard for safetly of self/other
–(lacks remorse)
(C) ***CT must be____ yrs (or older)
AND
NEEDS hx of CONDUCt Dx before _____ yrs
ANTISOCIAL PERSONALITY DISORDER:
(1) : a pattern of disregard & violation of others rights
(2) : SX present by age 15
(3): Includes min of 3 SYMPTOMS
(*Sx e.g.,)
–fails to conform to social norms/lawful bhvr
–deceitfulness
–impulsivity
–reckless disregard for safety of self / others
–lack of remorse
*(4): CT MUST BE 18 years old
AND
**HX of CONDUCT DX before 15 yrs.
Which diagnostic criteria applies to _________ Dx?
1) : CT must be 18yr +
2) SX present before 15yr
3) Includes min 3 SX
* (4): MUST have HX of CONDUCT DX before 15 yrs.
ANTISOCIAL PERSONALITY DISORDER:
(1) : a pattern of disregard & violation of others rights
(2) : SX present by age 15
(3): Includes min of 3 SYMPTOMS
(*Sx e.g.,)
–fails to conform to social norms/lawful bhvr
–deceitfulness
–impulsivity
–reckless disregard for safety of self / others
–lack of remorse
*(4): CT MUST BE 18 years old
AND
**HX of CONDUCT DX before 15 yrs.
_________________ Disorder criteria, involes?
(1): recurrent pattern of:
– (a) angry/irritable mood
– (b) argumentative/defiant behavior
– (c) or vindictiveness
(2): Min of 4 SX > shown in interactions w/min 1 person
(*cannot be siblling)
[Sx e.g.,}
– (a) Loses tempoer
– (b) Argues with Authority figures
– (c) Wont comply w/authority requests/rules
– (d) Blames others for his/her mistakes.
(3) SX = 6 month (min duration)
(4) Causes distress for CT/others in immediate social env
Oppositional Defiant Disorder:
(1): recurrent pattern of:
– (a) angry/irritable mood
– (b) argumentative/defiant behavior
– (c) or vindictiveness
(2): Min of 4 SX > shown in interactions w/min 1 person
(*cannot be siblling)
[Sx e.g.,}
– (a) Loses tempoer
– (b) Argues with Authority figures
– (c) Wont comply w/authority requests/rules
– (d) Blames others for his/her mistakes.
(3) SX = 6 month (min duration)
(4) Causes distress for CT/others in immediate social env
SX duration = 6 months > applies to which Disorders?
Oppositional Defiant disorder
Posttraumatic Stress Disorder
Schizophrenia
Opposition Defiant Disorder
SX duration = 1 week (7 days) > applies to which Disorders?
BiPolar 1 –(manic episode for a week min -7 days)
SX duration = 1 month (30 days) months > applies to which Disorders?
Acute Stress Disorder (less than 1 month)
Oppositional Defiant Disorder
VS
Conduct Disorder
Oppositional Defiant Disorder:
VS
Conduct Diordser = *(worst) –
SX present since age 15yr + in later life results in
= ANTISOCIAL PERSONALITY Dx
Intellectual Disability
Intellectual Disability is diagnosed in the presence of
(a) deficits in intellectual functions
(e. g.,
a) reasoning; (b) problem solving (c) abstract think
(b) deficits in adaptive functioning that result in a failure to meet community standards of personal independence and social responsibility and impair functioning across multiple environments in one or more activities of daily life; and (
(c) onset of intellectual + adaptive deficits duringdevelopmental period.
* 4degrees of severity (mild, moderate, severe, profound) > based on adaptive functng in concept-social-practical domains
Mental Status Exam
A mental status exam (MSE) uses:
– questions
– simple tasks = info on CTscurrent mental state
– Observation
(e.g., appearance, thought content, affect)
***USED to determine if CTs Sx needs referral to Dr/Psyc
Major Depressive Disorder
[SIDEGAPS
sad mood interest loss diet changes worthless/ poor concetration sleep changes
Major Depressive Disorder
[SIDEGAPS
A diagnosis of Major Depressive requires
(1) At least 5 Sx of a major depressive episode nearly
– (a) every day for at least two weeks, with
– (b) at least 1 Sx being depressed mood or loss of
interest / pleasure.
SX are depressed mood;
*(or, in kidss/teens, a depressed or irritable mood);
[e.g.,]
–(a) markedly diminished interest or pleasure in
most or all activities;
–(b) significant weight loss when not dieting or
weight gain or a decrease/increase in appetite;
–(c) insomnia or hypersomnia;
–(d) psychomotor agitation or retardation;
–(e) fatigue or loss of energy;
–(f) feelings of worthless or excessive guilt; –
–(h) diminished ability to think or concentrate;
–(i)recurrent thoughts of death, recurrent suicidal
ideation, or a suicide attempt.
**Symptoms cause clinically significant distress or impaired functioning.
...................................... ACRONYM [SIGEGAPS] sad mood interest loss diet changes esteem (low) appetite changes poor concetration Suicidal thoughts
DIAGNOSING: (D-E-M-R/P-R)
D:\_\_\_ E:\_\_\_ M:\_\_\_ R/P:\_\_\_ R:\_\_\_
DSM DIAGNOSING (using acronym D-E-M-R/P-R)
D = Disorders (all clinical Dx + conditions)
- DSM Dx
- "other" mental Dx
- Medication induced / adverse side effects
- V Codes
- Personality Dx
- Mental Retardation
E = Environmental + Psychosocial problems
(list of all problems that may impact Dx,Tx, Prognosis)
-ICD codes “F____”
M = Medical Conditions
(all conditions possibly relevant to understanding
/ management of Dx)
R/P = Rule Out / Provisional
(use when uncertain of Dx)
-Coded on insurance AS IF CT HAS THAT DX
R = Reasoning
(show why you chose Dx / what were the Sx)
DIFFERENTIAL DIAGNOSIS
steps
- Start = Figure out category of Dx/ conditions similar to
CT SX
- Rule Out:
(a) Drug/ Alcohol
(b) Medical Conditions > (refer=medical evaluation) - Determine CATEGORY
(make hierarchy of Dx – use decision trees)
In each Section (or “Category”) of DSM Disorders, it includes:
- Specific Disorders
- Substance / Medication-Induced
- Due to Another Medical Condition
- Other Specified
- Unspecified
(*within each diagnosis–the chapter includes: ICD-10 codes + Diagnostic criteria + Prevalence + Differential Diagnosis)
⟪NEURODEVELOPMENTAL DISORDERS⟫
(1st Ch. of Mental Disorders in DSM)
……………………………………………………………………..
✦What are the Categories of listed in the DSM under Neurodevelopmental Dx (6)?
+
✦Name each specific DSM disorder within each sub-category? (13)
……………………………………………………………………..
⟦AKA: Name the ‘Category’ listed under Neurodevelopmental Disorders + the specific diagnosis?⟧
⟦EXAMPLE⟧
⋞DSM≽Neurodevelopmental Dx
⦑Category⦒Communication Disorders
⩿Disorder⪀ Language Disorder
……………………………………………………………………..
⭐︎٭⚝✦⟐⟢⟠⋅⟡⋇⊘⊗⋄⧫⋆∙∘∗⊨
≫≪⩾⩽⪪⪫⟪⟫≼≽⦑⦒⫸⫷⦗⦘⟦⟧⊒⊑>< ⋞≽⩿⪀ ……………………………………………………………………..
⟪ NEURODEVELOPMENTAL DISORDERS ⟫
Neurodevelopmental: Sub-categories (6)
+
Specific Diagnosis
……………………………………………………………………………………
(I) INTELLECTUAL
1 • Intellectual Disability
2 • Global Developmental Delay
(II) COMMUNICATION
3 • Language dx
4 • Speech Sound dx
5 • Childhood-Onset Fluency
6 • Social (Pragmatic) Communication
(III) AUTISM SPECTRUM (7)
(IV) ADHD (8)
(V) SPECIFIC LEARNING DISORDER (9)
(VI) MOTOR DISORDERS
10 • Developmental Coordination dx
11 • Stereotypic Movement dx
⟢ (VI-a) TIC DISORDERS
12 • Tourette’s dx
13 • Persistent(chronic) Motor or Vocal Tic
⫷SCHIZOPHRENIA SPECTRUM
&
OTHER PSYCHOTIC DISORDERS⫸
……………………………………………………………………..
✦Name each DSM disorder listed under “schizophrenia spectrum & other psychotic disorders”? (7)
……………………………………………………………………..
DSM - SCHIZOPHRENIA SPECTRUM & OTHER PSYCHOTIC DISORDERS
……………………………………………………………………………………
1 • Schizotypal Peronality
2 • Delusional
3 • Brief Psychotic
4 • Schizophreniform
5 • Schizophrenia
6 • Schizoaffective [*bipolar vs depressive type]
7 • Catatonia
