DSM5 diagnoses

Question 1

panic disorder

Answer 1

-2(+) unexpected panic attacks
-attacks must dev suddenly, an abrupt surge (not triggered by an event)

-reach peak very quickly (minutes)

-in addition, persistent concerns abt addl attacks, or worry abt consequence of attacks, or panic attack results in a significant alteration in behavior

Question 2

panic attacks

Answer 2

discrete periods of intense fear/discomfort that are accompanied by AL 4 of the following 13 symptoms:

1. Palpitations, pounding heart, or accelerated heart rate
2. Sweating
3. Trembling/shaking
4. Sensations of shortness of breath/smothering
5. Feeling of choking
6. Chest pain/discomfort
7. Nausea or abdominal distress
8. Feeling dizzy, unsteady, light headed, faint
9. Derealization (feeling of unreality) or depersonalization (being detached from oneself)
10. Fear of losing ctrl / going crazy
11. Fear of dying
12. Paresthesias (numbness or tingling sensations)
13. Chills or hot flashes

Question 3

differentiate: panic disorder from other anxiety disorders

Answer 3

-other anxiety disorders also characterized by panic attacks, but attacks in panic disorder are uncued + followed by an apprehension/worry about future attacks

Question 4

agoraphobia

Answer 4

feared situations actively avoided, req the presence of a companion, or are endured only w extreme anxiety

-is made regardless of whether panic disorder is present (someone can have both)

Question 5

specific phobia

Answer 5

-intense fears of a spec situation / object, enough to interfere w everyday activities
-cause marked distress + significantly disrupt daily lives

-diagnosis: must be marked + persistent fear of an object/situation; exposure to it must invariably produce anxiety rxn that’s excessive/unreasonable; symptoms interfere w everyday fnxining

Question 6

social anxiety disorder

Answer 6

A. Marked fear or anxiety about 1(+) social situations in which the indiv may be scrutinized by others. (eg conversations, meeting new people, eating/drinking, giving a speech) *

B. The individual fears that they will act in a way or show anxiety symptoms that will be negatively evaluated (i.e., humiliating
or embarrassing)

C. The social situations almost always provoke fear or anxiety.
-Note: In children, may be expressed by crying, tantrums, freezing, clinging, shrinking, 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 threat 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, or avoidance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.

H. The fear, anxiety, or avoidance is not attributable to the physiological effects of a substance (e.g., 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

J. If another medical condition (e.g., Parkinson’s disease, obesity, disfigurement from burns or injury) is present, the fear, anxiety, or avoidance is clearly unrelated or is excessive.

Question 7

Obsessive compulsive disorder

Answer 7

A. Presence of obsessions, compulsions, or both:
-obsessions: thoughts, images, or impulses that are recurrent + uncontrollable, cause marked distress
-common obsessions incl thoughts related to contamination, uncertainty, sexuality, violence
-compulsions: repetitive behaviors / cog acts performed in response to an obsession (or according to rigidly applied rules)
-behavioral compulsions: engaging in a behavior eg handwashing, checking, rigidly maintaining order + organization
-cognitive compulsions: counting numbers, praying, repeating wds + phrases

B. The obsessions or compulsions are time-consuming (e.g., take more than 1 hour per day) or cause clinically significant distress or
impairment in social, occupational, or other important areas of functioning.

C. symptoms not due to a substance / other med cond

D. disturbance not better explained by another mental disorder

Question 8

Generalized Anxiety Disorder

Answer 8

-fear is more pervasive across # of diff situations

A. excessive anxiety + worry (apprehension expectation) occurring more days than not for AL 6mos, abt a number of events/activities (eg work, school performance)

B. finds it difficult to ctrl the worry

C. the anxiety+worry are assoc w AL 3 of the following 6 symptoms (w AL some symptoms present more days than not for the past 6mos):
-Restlessness; feeling “keyed up” / “on edge’
-Being easily fatigued
-Difficulty concentrating / “mind going blank”
-Irritability
-Muscle tension
-sleep disturbance (difficulty falling/staying asleep, restless unsatisfying sleep

D. [ ] of anxiety / worry isn’t confined to another anxiety / Axis I disorder

Question 9

major depressive disorder

Answer 9

5+ of the following within a 2 week period and MUST have either 1) or 2):
1. Depressed mood*
2. Diminished interest or pleasure*
3. Change in weight/appetite
4. insomnia/hypersomnia
5. Psychomotor agitation/retardation
6. fatigue/loss of energy
7. Worthlessness or guilt
8. Difficulties concentrating/indecisiveness
9. Thoughts of death, suicidal ideation, or attempt

-These need to have a clinically significant impairment and not due to the direct physiological influence of a substance

Question 10

manic episode

Answer 10

A. abnormally + persistently elevated, expansive, or irritable mood AND increased energy or goal-directed activity (min 1 week)

B. 3 or more of:
-Inflated self-esteem or grandiosity
-Decreased need for sleep
-More talkative than usual or pressure to keep talking
-Flight of ideas - having a hard time [ ] on one thing; mind wandering without “finishing” first set of ideas
-Distractibility
-Increase in goal-directed activity or psychomotor agitation
-Excessive involvement in risky pleasurable activities (eg sexual behavior, substance abuse, etc)

-in order to meet criteria for manic episode, the mood disturbance needs to be sufficiently severe to cause marked impairment in occupational fnxing/in usual activities/or relationships w others, or to necessitate hospitalization to prevent harm to self or others, or there are psychotic features
- needs to be IMPAIRMENT
- not due to the direct physiological effects of a substance

Question 11

hypomanic episode

Answer 11

same list of 7 symptoms of manic episode BUT:
-minimum duration is shorter (4 days);
-the episode is NOT severe enough to cause marked impairment in social/occupational fnxining, or to necessitate hospitalization, and there are NO psychotic features
-not due to the direct physiological effects of a substance

-some indivs can experience manic/hypomanic + depressive symptoms at the same time; this is called a “mixed” state

Question 12

bipolar i disorder

Answer 12

-history of one or more manic episodes, WITH OR WITHOUT major depressive episode

-depressive episode is not req for diagnosis

Question 13

bipolar ii disorder

Answer 13

-history of one or more manic episodes, WITH one or more major depressive episodes

Question 14

persistent depressive disorder

Answer 14

A. depressed mood most of the day, more days than not

B. while depressed, 2 or ore of:
-poor appetite/overeating
-insomnia/hypersomnia
-lower energy/fatigue
-low self-esteem
-poor concentration/indecisiveness
-hopelessness

-duration at least 2 years (1 for children/adolescents)
-during this ^ period, indiv has never been without criteria A or B for 2+ months at a time

Question 15

premenstrual dysphoric disorder

Answer 15

in majority of menstrual cycles, 5+ symptoms present in the week before the menses + improve within a few days of onset of menses; symptoms significantly interfere w fnxining (linked to distress/impairment)

-one or more of the following: marked affective instability, irritability, depressed mood, anxiety AND

-one or more of the following: decreased interest in usual activities, difficulty concentrating, fatigue, changes in sleep/appetite, physical symptoms (breast tenderness, joint/muscle pain, bloating)

Question 16

schizophrenia

Answer 16

A. 2+ of the following, for a significant period of time during a 1mo period; AL one of these should incl 1-3 (positive symptoms)
1. delusions*
2. hallucinations*
3. Disorganized speech*
4. Grossly disorganized/catatonic behavior
5. Negative symptoms (ie diminished emotional expression, avolition)

B. for a significant period of time since onset, lvl of fnxing (eg work, self care, social relationships) is markedly below what was achieved before the onset

C. continuous signs of the disturbance persist for AL 6 months (must incl AL 1 month of symptoms from criteria A)

Question 17

intellectual disability

Answer 17

A. Deficits in intellectual fnx (eg reasoning, problem solving, planning, abstract thinking, judgment, academic learning/learning from experience), confirmed by both clinical assessment + individualized, standardized intelligence testing

B. Accompanied by significant limitations in adaptive behavior: behaviors necessary to fnx independently, adequately, appropriately in everyday life
-communication (eg expressive, receptive, written language)
-daily living skills (eg eating, dressing, personal hygiene, domestic/community living skills)
-social skills (eg interpersonal relationships, coping, leisure skills)
-motor skills (eg movement coordination, ability to manipulate objects using fingers/hands)

C. Onset during developmental period

Question 18

autism spectrum disorder

Answer 18

A. Persistent deficits in social communication + social intxn across multiple contexts, as manifested by:
-Deficits in social-emotional reciprocity – eg failure to meet people in terms of their interests/feelings; failure to initiate/respond to social intxns
-Deficits in nonverbal communicative behaviors used for social intxn – eg gesturing, facial expression
-Deficits in dev’g, maintaining, understanding relationships

B. Restricted, repetitive patterns of behavior, interests, activities (eg rocking, spinning; intense interests in one area), as manifested by AL 2 of the following:
-stereotyped/repetitive motor movements, use of objects, speech
-insistence on sameness
-highly restricted interests
-hyper/hyporeactiviy to sensory input

Question 19

attention deficit/hyperactivity disorder

Answer 19

A. 6(+) symptoms (5 for adulthood) that have persisted for AL 6mos – need to est that symptoms aren’t consistent w developmental lvl

A. persistent pattern of inattn and/or hyperactivity-impulsivity that interferes w fnxing/devt, as characterized by 1) and/or 2):
1. Inattention: eg often has difficulty sustaining [ ] in tasks / play activities, fails to pay close attn/makes careless mistakes, often doesn’t seem to listen when spoken to directly, has difficulty organizing tasks/activities
2. Hyperactivity: eg is often “on the go” or often acts as if “driven by a motor”
Impulsivity: eg often blurts out answers before Qs have been completed, fidgets, leaves seat when remaining seated is expected, difficulty waiting their turn, interrupts/intrudes others

B. symptoms prior to 12yrs
C. symptoms present in 2(+) settings
D. symptoms interfere w / reduce the quality of social, academic, or occupational fnxing
E. symptoms are not better explained by another mental disorder

-combined presentation: if both Criterion A1 and A2 are met for the past 6mos

Question 20

specific learning disorder

Answer 20

A. difficulties learning + using academic skills despite the provision of interventions that target those difficulties, as indicated by the presence of AL one of the following:
1. inaccurate/slow/effortful word reading
2. difficulty understanding meaning of what’s read
3. difficulties spelling
4. difficulties w written expression
5. difficulties mastering number sense
6. difficulties w mathematical reasoning

B. affected academic skills are substantially + quantifiably below those expected for the indiv’s age

C. begin during school age years but may not fully manifest until demanding skills exceed indiv’s limited capacities

Question 21

oppositional defiant disorder

Answer 21

A. pattern of negativistic, hostile, defiant behavior lasting AL 6mos, 4+ of:
-often loses temper
-is touchy / easily annoyed
-often argues w authority figures (for children, argues w adults)
-often actively defies / refuses to comply w adults’ requests or rules
-often deliberately annoys people
-often blames others for mistakes / misbehaviors
-is often angry + resentful
-has been vindictive / spiteful AL twice in the last 6mos

B. disturbance in behavior is associated with distress in others in their immediate social context / negativly impacts social/educational/work/etc

Question 22

conduct disorder

Answer 22

-repetitive + persistent pattern of behavior in which the basic rights of others or major age-appropriate societal norms of rules are violated

-3+ in the last 12mos, and AL 1 in the last 6mos:
-aggression to people/animals
-destruction of property
-deceitfulness or theft
-serious violations of rules (eg run away from home, truant in school)
-often initiates phys fights
-has used a weapon that can cause serious phys harm to others
-has stolen while confronting a victim
-has forced someone into sexual activity
-deliberately destroyed others’ property

Question 23

separation anxiety disorder

Answer 23

AL 3 of the following for AL 4wks:
-recurrent distress upon separation from a parent
-worry that an event will lead to harm to the parent
-persistent + excessive worry abt experiencing an untoward event (eg getting lost) that causes separation from a major attachment figure
-reluctance to go places without the parent in proximity
-reluctance to sleep away from the parent
-nightmares about separation
-complaints about physical symptoms when separation is anticipated

-persistent, lasting AL 4wks in children / 6(+)mos in adults

Question 24

paranoid personality disorder

Answer 24

pervasive suspiciousness abt others’ motives + tendency to interpret what others say/do as personally meaningful in a negative way (primary features)
-typically humorless + eccentric, seen as hostile, jealous, preoccupied w power / control
-some suggest may be a subtype of schizophrenia / “cousin”
→ main diff is severity

-criteria A:
-pervasive distrust
-suspiciousness of others
-reluctant to confide in others bc of unwarranted fear that the info will be used maliciously against them
-persistently bears grudges (ie is unforgiving of insults, injuries, or slights)

Question 25

antisocial personality disorder

Answer 25

pervasive pattern of disregard for + violation of the rights of others, occurring since age 15 (and evidence of conduct disorder in childhood), as indicated by 3(+) of the following:
-nonconformity: failure to conform to social norms w respect to lawful behaviors, as indc by repeatedly performing acts that are ground for arrest
-deceitfulness: repeated lying, use of aliases, or conning others for personal profit/pleasure
-impulsivity
-aggressiveness: repeated phys fights/assaults
-recklessness: disregard for safety of self/others
-irresponsibility: repeated failure to sustain consistent work behavior / honor financial obligations; takes pleasure in few if any activities
-lack of remorse: being indifferent to / rationalizing having hurt, mistreated, stolen from another

Question 26

borderline personality disorder

Answer 26

instability across various domains of personality functioning, specifically:
-Fluctuations in/difficulty regulating emotions
-Unstable sense of identity
-Instability in social relationships
-Impulsive behavior

-characteristics incl: instability of interpersonal relationships, unstable sense of self, marked impulsivity
1. Frantic efforts to avoid real/imagined abandonment
Does not incl suicidal/self-harming behaviors
2. A pattern of unstable + intense interpersonal relationships characterized by alternating between extremes of idealization + devaluation
3. Identity disturbance: markedly + persistently unstable self-image or sense of self
4. Impulsivity in at least 2 areas that are potentially self-damaging (eg spending, sex, substance abuse, reckless driving, binge eating) (NOTE: do not incl suicidal/self-mutilating behavior)
5. Recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior
6. Affective instability due to a marked reactivity of mood (eg intense episodic dysphoria, irritability, or anxiety usu lasting a few hours + only rare more than a few days)
7. Chronic feelings of emptiness
8. Inappropriate, intense anger / difficulty controlling anger (eg freq displays of temper, constant anger, recurrent phys fights)
9. Transient, stress-related paranoid ideation or severe dissociative symptoms

Question 27

histrionic personality disorder

Answer 27

attention-seeking behaviors, overly dramatic, self-centered

-characteristics:
-attention seeking
-life of the party
-overly dramatic + emotional
-unable to tolerate not being able to be the center of attention
-“emotionally shallow”

Question 28

narcissistic personality disorder

Answer 28

narcissistic, grandiose, consider themselves to have unique + outstanding abilities

-characteristics:
-grandiose
-egocentric
-exaggerated sense of importance
-“me, me, me”
-can’t handle criticism*
→ *diff between someone egocentric and someone w NPD is that person w NPD doesn’t believe they’re the best – actually thinks they’re the worst, but wants others to believe they’re the best; try their best to convince others they are

Question 29

avoidant personality disorder

Answer 29

fundamental fear is of social rejection - social inhibition; feelings of inadequacy; hypersensitivity to negative evaluation; intense fears of criticism / disapproval / rejection
-symptoms + associated features:
-misinterpret social responses as critical
-problems occur in social + occupational fnxing
-low self esteem + hypersensitivity to rejection

Question 30

dependent personality disorder

Answer 30

afraid to rely on self to make decisions, constantly seek advice/reassurance, seek submissive role in relationships
-will seek an outside indiv to be close w to make those decisions for them
-avoid making decisions at all costs
-common in abusive relationships

Question 31

obsessive compulsive personality disorder

Answer 31

core features are inflexibility + strong desire for perfection; preoccupation w details, rules, lists, order, organization, or schedules
-differential diagnosis: easily distinguished
-OCD involves presence of true obsessions/compulsions to “neutralize” obsession
-indivs w OCPD will not engage in rituals

Question 32

anorexia nervosa

Answer 32

A. restriction of energy intake relative to reqs, leading to significantly low body weight

B. intense fear of gaining weight/becoming fat that interferes w weight gain

C. body image disturbance, shape / weight based self esteem, or denial of seriousness

-restricting type: not engaged in binging/purging behavior
-binge-eating/purging type: indiv has engaged in recurrent episodes of binging/purging behavior

Question 33

bulimia nervosa

Answer 33

A. recurrent binge eating episodes (characterized by large amount + lack of control)

B. recurrent inappropriate compensatory behaviors in order to prevent weight gain

C. binge eating / compensatory behaviors occur AL 1/wk for 3mos (on avg)

D. self eval is unduly infl by body shape/weight

-does not meet criteria for AN

Question 34

binge eating disorder

Answer 34

A. Recurrent binge eating

B. Assoc w min 3:
-eating much more rapidly than normal
-eating until uncomfortably full
-eating large amounts of food when not physically hungry
-eating alone bc embarrassed
-feeling disgusted w oneself, depressed, or v guilty afterward

C. Distress regarding binge eating
D. Binge eating occurs AL once/wk for 3mos
E. No compensatory behaviors

Question 35

other specified feeding or eating disorder

Answer 35

-OSFED encompasses EDs that don’t meet spec criteria of AN, BN, or BED; in other cases the features of an ED combine in a diff way than in one of the 3 disorders

1. Sub-threshold AN - all criteria except low weight
2. Sub-threshold BN - all criteria are met except frequency of binge/purge
3. Purging disorder - compensatory behavior in normal body weight indiv after eating small amts of food
4. Sub-threshold BED - all criteria are met except frequency of binging
5. Night eating syndrome - binge eating when waking up at night

Question 36

pica

Answer 36

persistent eating of nonnutritive, nonfood substances

Question 37

rumination

Answer 37

repeated regurgitation of food (may be re-chewed, re-swallowed, or spit out)

Question 38

differentiate BN and BED

Answer 38

-unlike bulimia, episodes of inappropriate compensatory behaviors to prevent weight gain don’t follow binge episodes