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EPPP 2014 > DSM5 > Flashcards

DSM5 Flashcards

0
Q

What is the difference between other specified disorder or unspecified disorder?

A

other SPECIFIED disorder = certainty about what criteria is missing
UNspecified disorder = not sure what is missing

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1
Q

What is the new term for “NOS”?

A

other specified disorder or unspecified disorder

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2
Q

What is the age of onset of Intellectual Disability?

A

“the early developmental period”

trying not to be too rigid on age of onset

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3
Q

How is severity of ID determined?

A

based on adaptive functioning in conceptual, social and practical domains AND IQ.

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4
Q

What are the diagnostic criteria for Autism Spectrum Disorder?

A

persistent deficits in social communication
restricted, repetitive patterns of behavior, interests and activities
symptoms present from early developmental period

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5
Q

What are better prognostic indicators for ASD?

A

communication skills by age 5 or 6, IQ over 70, later onset of Sx.

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6
Q

What is the change in age of onset for ADHD from DSM4 to DSM5?

A

onset before age 12 (was age 7)

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7
Q

How many symptoms does an individual under age 17 need for an ADHD diagnosis?

A

5

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8
Q

etiology of ADHD

A

lower-than-normal activity in frontal lobes and BASAL GANGLIA

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9
Q

Tx for ADHD

A

stimulant medications
behavioral management
neurofeedback (EEG biofeedback)

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10
Q

Diagnostic criteria for Specific Learning Disorder

A

difficulties with academics indicated by presence of AT LEAST ONE Sx for at least 6 MONTHS despite provision of appropriate interventions. (Sounds like RTI)

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11
Q

subtypes of SLD

A

with impairment in…
…reading
…written expression
…mathematics

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12
Q

What is the new name for Stuttering?

A

Childhood Onset Fluency Disorder

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13
Q

Tx for Childhood Onset Fluency Disorder?

A

habit reversal training (awareness training, competing response training, and social support)
reduce stress in the family

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14
Q

Diagnostic criteria for Tourette’s Disorder

A

multiple motor tics
one or more vocal tics
duration of at least one year
age of onset before age 18

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15
Q

Schizoprehia Spectrum Disorders duration

A

Schizophrenia = 60 days or more
Schizophreniform Disorder = 30 - 60 days
Brief Psychotic Disorder = 1 - 30 days

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16
Q

Schizophrenia Dx criteria

A

at least TWO active phase symptoms for at least ONE MONTH
with one Sx being delusions, hallucinations or disorganized speech, grossly disorganized or catatonic behavior, or negative Sx

continuous signs of disturbance for at least 6 MONTHS

level of functioning has been below level achieved prior to onset for significant portion of time

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17
Q

prognosis of Schizophrenia

A 
better prognosis = 
good premorbid adjustment
abrupt and LATER onset
precipitating stressor
female
insight into illness
no family history
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18
Q

etiology of Schizophrenia

A

heredity
excessive levels of dopamine
enlarged ventricles
hypofrontality

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19
Q

Schizophreniform Disorder criteria

A

2 or more active phase Sx
30 - 60 days duration
at least one being delusions, hallucinations, or disorganized speech

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20
Q

Brief Psychotic Disorder diagnostic criteria

A

one or more Sx
at least one being delusions, hallucinations, or disorg speech
duration: 1- 30 days

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21
Q

Schizoaffective Disorder diagnostic criteria

A

concurrent Sx of Schizophrenia and major depression or manic episode
EXCEPT for a period of at least 2 weeks without mood Sx

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22
Q

manic episode

A

abnormally and persistent elevated, expansive or irritable mood
goal-directed activity or energy
for AT LEAST ONE WEEK
with at least THREE Sx
sx cause impaired functioning, require hospitalization, and/or include psychotic features

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23
Q

hypomanic episode

A

same as manic except:

for at least FOUR DAYS
does not require hospitalization or impair functioning, no psychotic features

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24
Q

major depressive episode

A

5 or more Sx
at least one being depressed mood or loss of interest or pleasure
Sx last for AT LEAST TWO WEEKS
cause significant distress or impaired functioning

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25
Q

Sx of major depressive episode

A

insomnia or hypersomnia
fatigue
feelings of worthlessness
impaired ability to think or concentrate

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26
Q

Bipolar I

A

at least one manic episode
may or may not be preceded or followed by major depressive or hypomanic episodes
marked impairment in functioning or require hospitalization

MANIA but not necessarily with MDD episode

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27
Q

Bipolar II

A

at least one hypomanic episode + at least one MDD

Must include MDD episode

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28
Q

Cyclothymic Disorder

A

numerous periods of hypomanic + depressive symptoms

for AT LEAST TWO YEARS in adults, ONE YEAR in child/adolescents

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29
Q

Major Depressive Disorder

A

at least one MDD episode

need at least FIVE Sx with one being depressed mood

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30
Q

MDD specifiers

A

–with peripartum onset
onset during pregnancy or four weeks following delivery
10-20% have symptoms sufficiently severe for MDD Dx

– with seasonal pattern
hypersomnia, overeating, weight gain, carb craving
temporal pattern with time of year

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31
Q

Persistent Depressive Disorder

A

different from MDD
depressed mood for at least TWO YEARS in adults, ONE YEAR in child/adolescents
MDD is one episode

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32
Q

Beck’s cognitive triad model of depression

A

negative view of self, world, and future

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33
Q

best therapies for depression

A

CBT, interpersonal

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34
Q

highest rates of suicide

A

highest for Whites

except Native Americans ages 15-34 (rate 2.5 times higher than national average for that age group)

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35
Q

duration of Separation Anxiety Disorder

A

4 weeks in children/adolescents
6 months in adults
(Adults can have it too now due to no more kid section of DSM)

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36
Q

Social Anxiety Disorder (used to be social phobia)

A

intense fear/anxiety about social situations due to exposure to scrutiny by others
avoids situation or endures them with marked distress

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37
Q

Panic Disorder treatment

A

best treatment: exposure with response prevention

CBT

38
Q

Agoraphobia

A

fear/anxiety about 2 of 5 situations,, due to concern that escape might be difficult or help unavailable in case of panic-like or embarassing symptoms.

39
Q

best treatment for agoraphobia

A

in vivo exposure with response prevention

40
Q

GAD treatment

A

best: CBT
medications: SSRIs, benzos, anxiolytics

41
Q

OCD treatment

A

exposure with response prevention

clomipramine (tricyclic) or SSRI

42
Q

Reactive Attachment Disorder

A

inhibited, emotionally withdrawn behavior toward adult caregivers
history of extreme insufficient care

43
Q

Disinhibited Social Engagement Disorder

A

inappropriate and overly familiar verbal and physical behavior with unfamiliar adults
history of extreme insufficient care

44
Q

PTSD symptom categories

A

intrusion symptoms
avoidance of stimuli associated with event
negative alterations in cognition and mood
alterations in arousal

45
Q

PTSD treatment

A

CBT with exposure, cognitive restructuring, anxiety management
EMDR

46
Q

Somatic Symptom Disorder

A

presence of at lest one somatic symptom
causes distress or significant disruption of daily life
excessive thoughts, feelings, or behaviors related to symptoms

47
Q

Conversion Disorder diagnosis

A

disturbance in voluntary motor or sensory functioning suggesting serious neurological or medical condition BUT is incompatible with recognized medical conditions

causes distress or impaired functioning

48
Q

what is the “conversion V” on the MMPI2?

A

elevated scales 1 and 3, depressed scale 2
1 - somatic (high)
2 - depression (low)
3 - hysteria (high)

49
Q

Factitious Disorder Imposed on Self or Another

A

FALSIFICATION of symptoms in oneself or another
engages in deception even in ABSENCE OF EXTERNAL REWARD

Malingering = same, but FOR an external reward

50
Q

Frotteuristic Disorder

A

rubbing on nonconsenting adult

history of acting on urges or experiencing significant distress or impaired functioning

51
Q

Transvestic Disorder

A

cross-dressing for purpose of sexual arousal

cause distress or impaired functioning

52
Q

Substance Use Disorder

A

continue to use despite significant substance-related problems.
4 Sx categories:
impaired control
social impairment
risky use
pharmacological criteria (tolerance and withdrawal)

53
Q

Sx of Alcohol Withdrawal

A 
autonomic hyperactivity
hand tremor
insomnia
nausea, vomiting
transient hallucinations
anxiety
psychomotor agitation
generalized tonic-clonic seizures
54
Q

Alcohol-Induced Major Neurocognitive Disorder 2 types

A

nonamnestic-confabulatory

amnestic-confabulatory (aka Korsakoff’s Syndrome) – includes both retro and anterograde amnesias

55
Q

Marlatt’s relapse prevention therapy (RPT)

A

identifies circumstances that increase risk of relapse:

situations that elicit strong emotions, alcohol-related cues

56
Q

Personality Disorders characterized by:

A

stable, enduring pattern of inner experience and behavior
deviates from expectation of person’s culture
is pervasive
began in early adulthood
causes significant distress or impairment

57
Q

Cluster A: Odd-Eccentric Behaviors

A

Paranoid: distrusting and suspicious

Schizoid: indifference to interpersonal relationships + restricted range of emotion. They chose NOT TO HAVE CONTACT WITH OTHERS.

Schizotypal: interpersonal deficits + eccentricities in cognition, perception, and behavior. They are ODD but WANT CONNECTION with others.

58
Q

What is the difference between Schizoid and Schizotypal?

A

Schizoid does not want contact with others.

Schizotypal is odd, but WANTS contact with others.

(SchizoTYPAL is the type that wants connection.)

59
Q

Cluster B Personality Disorders: Dramatic, Emotional or Erratic

A

Antisocial: disregard for and violation of rights of others; lack of empathy, inflated sense of self, superficial charm.

Borderline: impulsive, unstable personal relationships and self-image.

Histrionic: excessive emotionality and attention-seeking.

Narcissistic: grandiosity, need for admiration, lack of empathy.

60
Q

Cluster C Personality Disorders: Anxiety or Fearfulness

A

Avoidant: social inhibition, feelings of inadequacy, hypersensitive to negative evaluation. (fearful of humilitation by social contact)

Dependent: need to be taken care of, submissive/clingy behavior, fear of separation. (get into unhealthy reciprocal relationships)

Obsessive-Compulsive: preoccupied with orderliness, perfectionism, interpersonal control. DOES NOT HAVE COMPULSIONS LIKE OCD.
overly consciensious, dedicated to work, makes others feel poorly.

61
Q

Biological siblings are ___ times more likely to develop Sxhizophrenia than the general population.

A

10

62
Q

The highest rates of suicide for individuals ages 15-34 are for

A

Native Americans

63
Q

Differential diagnosis between PTSD and Acute Stress Disorder?

A

PTSD = only after one month of symptom duration

Acute Stress Disorder = symptoms for less than one month (2 days - 4 weeks)

64
Q

criteria for two types of Neurocognitive Disorder

A 
major = more than-2.0 SD
mild = -1 to -2.0 SD

neuropsych measure in complex attention, learning and memory, perceptual-motor, social cognition

65
Q

changes to Substance Use & Dependence

A
  • merged into one disorder w/spectrum of severity
  • 2-3 Sx = mild
    4-5 Sx = moderate
    6 or more = severe
  • legal problems REMOVED
  • cravings ADDED
66
Q

Depersonalization Disorder changed to…

A

Depersonalization/Derealization Disorder

67
Q

Is Dissociative Fugue a separate disorder or a specifier?

A

now a specifier

68
Q

How did Dissociative Identity Disorder Criteria A change?

A

expanded to include functional neurological symptoms
identity transitions can be observed by others or self
gaps in memory can be every day events not just the trauma

69
Q

Somatization Disorder and Undifferentiated Somatoform Disorder are now merged into ______.

A

Somatic Symptom Disorder (and is now a spectrum disorder)

70
Q

What is Binge-Eating Disorder?

A

new, essentially Bulimia Nervosa without recurrent inappropriate compensatory behavior

71
Q

What are the new Breathing-Related Sleep Disorders?

A

Obstructive Sleep Apnea
Hypopnea (“underbreathing” or shallow breathing)
Central Sleep Apnea
Sleep-related Hypoventilation

72
Q

What are the 3 new symptom categories for ODD?

A

angry/irritable mood
argumentative/defiant behavior
vindictiveness

73
Q

What is the new modifier for Conduct Disorder, and what does it mean?

A

“with limited prosocial emotions” means more severe presentation

74
Q

What are the changes to SLD?

A

all one diagnosis now, with subtypes
6 months intervention with little or no gains
NO MORE discrepancy formula
Severity ratings: mild, moderate, severe

75
Q

What is the new specifier for Body Dysmorphic Disorder?

A

“with muscular dysmorphia”

76
Q

What are the changes to Acute Stress Disorder and PTSD?

A

trauma event must be explicit

criterion re: subjective reaction REMOVED

77
Q

What are the changes to PTSD?

A

now Sx in 2 clusters
diagnostic thresholds lowered for children and adolescents
separate criteria for child under age 6

78
Q

What happened to Hypochondriasis?

A

now Somatic Symptom Disorder
– OR –
Illness Anxiety Disorder

Pain Disorder = can be medically explained

79
Q

What are the changes to Autism?

A

now a single condition, with different levels of severity, across 2 domains: social communication, restricted, repetitive behaviors
Level 1 - requires support
Level 2 - requires substantial support
Level 3 - requires very substantial support

80
Q

What are the new specifiers for Autism?

A

with/without intellectual impairment
with/without language impairment
associated with known medical or genetic condition or environmental factor
associated with another neurodevelopmental, mental or behavioral disorder
with catatonia

81
Q

What are the changes to ADHD?

A

examples added to facilitate application across lifespan
cross situational requirement = strengthened “several Sx in each setting”
age of onset now changed to before 12
subtypes replaced with: “presentation specifiers”
adults = 5 Sx
children=6 Sx

82
Q

Delerium, Dementia & Amnestic and Other Cognitive disorders are now called ______.

A

Nuerocognitive Disorders

83
Q

Schizophrenia and Other Psychotic Disorders renamed ______.

A

Schizophrenic Spectrum and Other Psychotic Disorders

84
Q

Intellectual Disability severity is determined by….

A

adaptive functioning, NOT IQ

conceptual, social, practical

85
Q

What does ‘global delay’ mean?

A

ID under age 5 and cannot be assessed

86
Q

New name for Phonological Disorder?

A

Speech-Sound Disorder

87
Q

Social (pragmatic) Communication Disorder is new. Does it overlap with ASD?

A

no! It is own classification.

88
Q

differential Dx between situational type of Specific Phobia, Agoraphobia, and Social Anxiety Disorder?

A

Specific Phobia==> anxiety involves only ONE situation and related only to situation itself

Social Anxiety Disorder==> fear is related to being negatively evaluated by others; person is usually calm when left alone (not true for Agorophobia.)

Specific Phobia==> only involves one situation related to situation itself

89
Q

Anorexia may be attributed to ______ levels of ______.

A

high serotonin

fasting lowers serotonin

90
Q

Bulimia may be attributed to _____ levels of ______.

A

low serotonin

binging increases serotonin

91
Q

What are the 4 symptom groups for Substance Use Disorders?

A

impaired control
social impairment
risky use
tolerance and withdrawal (pharmacological criteria)

92
Q

What is the difference between Schizoid and Schizotypal Personality Disorder?

A

schizotypal = bizarre/eccentric; DISCOMFORT with personal relationships

schizoid = detached from personal relationships; restricted range of emotion in interpersonal settings

EPPP 2014 (7 decks)

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