Exam 4-PSY 320 Flashcards
Psychosis
State involving a loss of contact with reality as well as an inability to differentiate between reality and one’s subjective state
Schizophrenia
Disorder consisting of unreal or disorganized thoughts and perceptions as well as verbal, cognitive, and behavioral deficits
Positive Symptoms
In schizophrenia, hallucinations, delusions, and disorganization in thoughts and behavior (also called Type 1 symptoms)
Delusions
Fixed beliefs with no basis in reality
Persecutory Delusions
False, persistent beliefs that one is being pursued by other people.
Delusions of Reference
False belief that external events, such as other people’s actions or natural disasters, relate some how to oneself
Grandiose Delusions
False, persistent beliefs that one has superior talents and traits
Delusions of Thought Insertion
Beliefs that one’s thoughts are being controlled by outside forces
Hallucinations
Perceptual experiences that are not real
Auditory Hallucination
Auditory perception of a phenomenon that is not real, such as hearing a voice when one is alone
Visual Hallucination
Visual perception of something that is not actually present
Tactile Hallucinations
Unreal perceptions that something is happening to the outside of one’s body – for example, that bugs are crawling up one’s back
Somatic Hallucinations
Unreal perceptions that something is happening inside one’s body – for example, that worms are eating one’s intestines
Formal Thought Disorder
State of highly disorganized thinking (also known as loosening of associations)
Catatonia
Group of disorganized behaviors that reflect an extreme lack of responsiveness to the outside world.
Negative Symptoms
In schizophrenia, deficits in functioning that indicate the absence of a capacity present in people without schizophrenia, such as affective flattening (also called Type II symptoms
Affective Flattening
Negative symptom of schizophrenia that consists of a severe reduction or the complete absence of affective responses to the environment
Alogia
Deficit in both the quantity of speech and the quality of its expression
Avolition
Inability to persist at common goal-directed activities
Prodromal Symptoms
In schizophrenia, milder symptoms prior to an acute phase of the disorder, during which behaviors are unusual and peculiar but not yet psychotic or completely disorganized
Residual Symptoms
In schizophrenia, milder symptoms following an acute phase of the disorder, during which behaviors are unusual and peculiar but not psychotic or completely disorganized.
Paranoid Schizophrenia
Syndrome marked by delusions and hallucinations that involve themes of persecution and grandiosity
Disorganized Schizophrenia
Syndrome marked by incoherence in cognition, speech, and behavior as well as flat or inappropriate affect
Catatonic Schizophrenia
Type of schizophrenia in which people know a variety of motor behaviors and ways of speaking that suggest almost complete unresponsiveness to their environment
Undifferentiated Schizophrenia
Diagnosis made when a person experiences schizophrenic symptoms, such as delusions, and hallucinations, but does not meet criteria for paranoid, disorganized, or catatonic schizophrenia
Residual Schizophrenia
Diagnosis made when a person has already experienced a single acute phase of schizophrenia but currently has milder and less debilitating symptoms
Schizoaffective Disorder
Disordr in which individuals simultaneously experience schizophrenic symptoms (i.e., delusions, hallucinations, disorganized speech and behavior, and/or negative symptoms) and mood symptoms meeting the criteria for a major depressive episode, a manic episode, or an episode of mixed mania/depression
Schizophreniform Disorder
Disorder in which individuals meet the primary criteria for schizophrenia but show symptoms lasting only 1 to 6 months.
Brief Psychotic Disorder
Disorder characterized by the sudden on set of delusions, hallucinations, disorganized speech, and/or disorganized behavior that lasts only between 1 day and 1 month, after which the symptoms vanish completely
Delusional Disorder
Disorder characterized lasting at least 1 month regarding situations that occur in real life, such as being followed, poisoned, or deceived by a spouse or having a disease; people with this disorder do not show any other symptoms with schizophrenia
Shared Psychotic Disorder
Disorder in which individuals have a delusion that develops from a relationship with another person who already has delusions (also referred to as folie a deux)
Dopamine
Neurotransmitter in the brain, excess amounts of which have been thought to cause schizophrenia
Phenothiazines
Drugs that reduce the functional level of dopamine in the brain and tend to reduce the symptoms of schizophrenia
Neuroleptics
Drugs used to treat psychotic symptoms
Mesolimbic pathway
Subcortical part of the brain involved in cognition and emotion
Social Drift
Explanation for the association between schizophrenia and low social status that says that because schizophrenia symptoms interfere with a person’s ability to complete an education and hold a job, people with schizophrenia tend to drift downward in social class compared to their family of origin
Expressed Emotion
Family interaction style in which families are overinvolved with each other, are overprotective of the disturbed family member, voice self-sacrificing attitudes to the disturbed family member, and simultaneously are critical, hostile, and resentful of this member.
Chlorpromazine
Antipsychotic drug
Tardive Dyskinesia
Neurological disorder marked by involuntary movements of the tongue, face, moth, or jaw, resulting from taking neuroleptic drugs.
Atypical Antipsychotics
Drugs that seem to be even more effective in treating schizophrenia than phenothiazines without the same neurological side effects; they bind to a different type of dopamine receptor than other neuroleptic drugs
Assertive Community Treatment Programs
System of treatment that provides comprehensive services to people with schizophrenia, employing the expertise of medical professionals, social workers, and psychologists to meet the variety of patients’ needs 24 hours a day.
Anorexia Nervosa
Eating disorder in which people fail to maintain body weights that are normal for their age and height and have fears of becoming, fat, distorted body images, and amenorrhea
Amenorrhea
Cessation of the menses
Restricting Type of Anorexia Nervosa
Type of anorexia nervosa in which weight gain is prevented by refusal to eat
Binge/Purge type of Anorexia Nervosa
Type of anorexia nervosa in which periodic binging or purging behaviors occur along with behaviors that meet the criteria for anorexia nervosa
Bulimia Nervosa
Eating disorder in which people engage in bingeing and behave in ways to prevent weight gain from the beinges, such as self induced vomiting, excessive exercise, and abuse of purging drugs (such as laxatives)
Bingeing
Eating a large amount of food in one sitting
Purging type of bulimia nervosa
Type of bulimia nervosa in which bingeing is followed by the use of self-induced vomiting or purging medications to control weight gain
Nonpurging type of bulimia nervosa
Type of bulimia nervosa in which bingeing is followed by excessive exercise or fasting to control weight gain
Binge-eating Disorder
Eating disorder in which people compulsively overeat either continuously or on discrete binges but do not behave in ways to compensate for the overeating
Eating Disorder Not Otherwise Specified (EDNOS)
Diagnosis for individuals who have some symptoms of anorexia or bulimia nervosa but do not meet the full criteria
Obesity
Condition of being significantly overweight, defined by the Centers for Disease Control as a body mass index (BMI) of 30 or over, where BMI is calculated as weight in pounds multiplied by 703, then divided by the square of height in inches
Cognitive Disorders
Dementia, delirium, or amnesia characterized by impairments in cognition (such as deficits in memory, language, or planning) and caused by a medical condition or by substance intoxication or withdrawal
Dementia
Cognitive disorder in which a gradual and usually permanent decline of intellectual functioning occurs; can be caused by a medical condition, substance intoxication, or withdrawal
Aphasia
Impaired ability to initiate common voluntary behaviors
Echolalia
Communication abnormality in which an individual simply repeats back what he or she hears rather than generating his or her own speech
Palilalia
Continuous repetition of sounds and words
Apraxia
Impaired ability to initiate common voluntary behaviors
Agnosia
Impaired ability to recognize objects or people
Executive Functions
Functions of the brain that involve the ability to sustain concentration; use abstract reasoning and concept formation; anticipate, plan and program; initiate purposeful behavior; self-monitor; and shift from maladaptive patterns of behavior to more adaptive ones
Alzheimer’s disease
Progressive neurological disease that is the most common cause of dementia
Neurofibrillary Tangles
Twists or tangles of filaments within nerve cells, especially prominent in the cerebral cortex and hippocampus, common in the brains of Alzheimer’s disease patients
Plaques
Deposits of amyloid protein that accumulate in the extracellular spaces of the cerebral cortex, hippocampus, and other forebrain structures in people with Alzheimer’s disease
Beta-amyloid
Class of proteins that accumulates in the spaces between neurons in the brain, contributing to Alzheimer’s disease
Vascular Dementia
Second most common type of dementia, associated with symptoms of cerebrovascular disease (tissue damage in the brain due to blockage of blood flow)
Cerebrovascular disease
Disease that occurs when the blood supply to the brain is blocked, causing tissue damage to the brain
Stroke
Sudden damage to the brain due to blockage of blood flow or hemorrhaging
Delirium
Cognitive disorder including disorientation and memory loss that is acute and usually transient
Amnesia
Impairment in the ability to learn new information or to recall previously learned information or past events
Anterograde Amnesia
Deficit in the ability to learn new information
Retrograde Amnesia
Deficit in the ability to recall previously learned information or past events
Attention-Deficit Hyperactivity Disorder (ADHD)
Syndrome marked by deficits in controlling attention, inhibiting impulses, and organizing behavior to accomplish long-term goals
Conduct Disorder
Syndrome marked by chronic disregard for the rights of others, including specific behaviors such as stealing, lying, and engaging in acts of violence
Oppositional Defiant Disorder
Syndrome of chronic misbehavior in childhood marked by belligerence, irritability, and defiance, although not to the extent found in a diagnosis of conduct disorder
Separation Anxiety Disorder
Syndrome of childhood and adolescence marked by the presence of abnormal fear or worry over becoming separated from one’s caregiver(s) as well as clinging behaviors in the presence of the caregiver(s)
Behavioral Inhibition
Set of behavioral traits including shyness, fearfulness, irritability, cautiousness, and introversion; behaviorally inhibited children tend to avoid or withdraw from novel situations, are clingy with parents, and become excessively aroused when exposed to an unfamiliar situation
Elimination Disorders
Disorders in which a child shows frequent, uncontrolled urination or defecation far beyond the age at which children usually develop control over these functions
Enuresis
Diagnosis given to children at least age 5 who wet the bed or their close at least twice a week for three months
Bell and Pad method
Treatment for enuresis in which a pad placed under a sleeping child to detect traces of urine sets off a bell when urine is detected, awakening the child to condition him or her to wake up and use the bathroom before urinating
Encopresis
Diagnosis given to children who are at least age 4 and who defecate inappropriately at least once a month for three months
Reading disorder
Developmental Disorder involving deficits in reading ability
Mathematics Disorder
Developmental disorder involving deficits in the ability to learn mathematics
Disorder of written expressions
Developmental disorder involving deficits in the ability to write
Developmental Coordination Disorder
Disorder involving deficits to walk, run, or hold onto objects
Expressive Language Disorder
Disorder involving deficits in the ability to express oneself through language
Mixed Receptive-Expressive Language Disorder
Disorder involving deficits in the ability to express oneself through language and to understand the language of others
Phonological Disorder
Disorder involving the use of speech sounds inappropriate for one’s age or dialect
Stuttering
Significant problem in speech fluency, often including frequent repetitions of sounds or syllables
Mental retardation
Developmental disorder marked by significantly sub-average intellectual functioning, as well as deficits (relative to others) in life skill areas, such as communication, self-care, work, and interpersonal relationships
Fetal Alcohol Symptom (FAS)
Syndrome that occurs when a mother abuses alcohol during pregnancy, causing the baby to have lowered IQ, increased risk for mental retardation, distractibility, and difficulties with learning from experience
Pervasive Developmental Disorders
Disorders characterized by severe and persisting impairment in several areas of development
Autism
Childhood disorder marked by deficits in social interaction (such as a lack of interest in one’s family or other children), communication (such as failing to modulate one’s voice to signify emotional expression), and activities and interests (such as engaging in bizarre, repetitive behaviors)
Rett’s Disorder
Pervasive developmental disorder in which children develop normally at first but later show permanent loss of basic skills in social interactions, language, and/or movement
Childhood disintegrative disorder
Pervasive developmental disorder in which children develop normally at first but later show permanent loss of basic skills in social interactions, language, and/or movement
Asperger’s disorder
Pervasive developmental disorder characterized by deficits in social skills and activities; similar to autism but does not include deficits in language or cognitive skills
Need for treatment
Legal criterion operationalized as a signed certificate by two physicians stating that a person requires treatment but will not agree to it voluntarily; formerly a sufficient cause to hospitalize the person involuntarily and force him or her to undergo treatment
Civil Commitment
Forcing a person into a mental health facility against his or her will
Grave Disability
Legal criterion for involuntary commitment that is met when a person is so incapacitated by a mental disorder that he or she cannot provide his or her own basic needs, such as food, clothing, or shelter, and his or her own survival is threatened as a result
Dangerousness to self
Legal criterion for involuntary commitment that is met when a person is imminently suicidal or a danger to him- or herself as judged by a mental health professional
Dangerousness to others
Legal criterion for involuntary commitment that is met when a person would pose a threat to other people if not incarcerated
Right to treatment
Fundamental right of involuntarily committed people to receive active treatment for their disorders rather than shelter alone
Right to refuse treatment
Right, not recognized by all states, of involuntarily committed people to refuse drugs or other treatment
Informed consent
Procedure (often legally required prior to treatment administration) in which a patient receives a full and understandable explanation of the treatment being offered and makes a decision about whether to accept or refuse the treatment
Incompetent to stand trial
Legal status of an individual who lacks a rational understanding of the charges against him or her, an understanding of the proceedings of his or her trial, or the ability to participate in his or her defense
Insanity
Legal term denoting a state of mental incapacitation during the time a crime was committed.
Insanity Defense
Defense used by people accused of a crime in which they state that they cannot be held responsible for their illegal acts because they were mentally incapacitated at the time of the act
M’Naghten Rule
Legal principle stating that, in order to claim a defense of insanity, accused persons must have been burdened by such a defect of reason, from disease of the mind, as not to know the nature and quality of the act they were doing or, if they did know it, as not to know what they were doing was wrong.
Irresistible Impulse rule
Legal principle stating that even a person who knowingly performs a wrongful act can be absolved for responsibility if he or she was driven by an irresistible impulse to perform the act or had a diminished capacity to resist performing the act.
Durham Rule
Legal principle stating that the presence of a mental disorder is sufficient to absolve an individual of responsibility for a crime
ALI rule
Legal principle stating that a person is not responsible for crime conduct if he or she lacks the capacity to appreciate the criminality (wrongfulness) of the act or to conform his or her conduct to the requirements of the law as a result of mental disease
Insanity Defense Reform Act
1984 law, affecting all federal courts and about half the state courts, that finds a person not guilty by reason of insanity if it is shown that, as a result of mental disease or mental retardation, the accused was unable to appreciate the wrongfulness of his or her conduct at the time of the offense.
American Psychiatric Association definition of insanity
Definition of insanity stating that people cannot be held responsible for their conduct if, at the time they commit crimes, as the result of mental disease or mental retardation they are unable to appreciate the wrongfulness of their conduct
Guilty but Mentally Ill (GBMI)
Verdict that requires a convicted criminal to serve the full sentence designated for his or her crime, with the expectation that he or she will also receive treatment for mental illness.
Delusional Disorder
A. The presence of one (or more) delusions with a duration of 1 month or longer
B. Criterion A for schizophrenia has never been met.
NOTE: Hallucinations, if present, are not prominent and are related to the delusional theme (e.g., the sensation of being infested with insects associated with delusions of infestation).
C. Apart from the impact of the delusion(s) or its ramifications, functioning is not markedly impaired, and behavior is not obviously bizarre or odd.
D. If manic or major depressive episodes have occurred, these have been brief relative to the duration of the delusional periods.
E. The disturbance is not attributable to the physiological effects of a substance or another medical condition and is not better explained by another mental disorder, such as body dimorphic disorder or obsessive-compulsive disorder.
Specify whether:
Erotomanic type: This subtype applies when the central theme of the delusion is that another person is in love with the individual
Grandiose Type: This subtype applies when the central theme of the delusion is the conviction of having some great (but unrecognized) talent or insight or having made some important discovery.
Jealous Type: This subtype applies when the central theme of the individual’s delusion is that his or her spouse or love is unfaithful.
Persecutory type: This subtype applies when the central theme of the delusion involves the individual’s belief that he or she is being conspired against, cheated, spied on, followed, poisoned, or drugged, maliciously maligned, harassed, or obstructed in the pursuit of long-term goals.
Somatic type: This subtype applies when the central theme of the delusion involves bodily functions and sensations.
Mixed type: This subtype applies when no one delusional theme predominates.
Unspecified type: This subtype applies when the dominant delusional belief cannot be clearly determined or is not described in the specific types (e.g., referential delusions without a prominent persecutory or grandiose component).
Specify if:
With bizarre content: Delusions are deemed bizarre if they are clearly implausible, not understandable, and not derived from ordinary life experiences (e.g., an individual’s belief that a stranger has removed his or her internal organs and replaced them with someone else’s organs without leaving any wounds or scars).
Schizophrenia
A. Two (or more) of the following, each present for a significant portion of time during a 1-month period (or less if successfully treated). At least one of these must be (1), (2), or (3):
1. Delusions
2. Hallucinations
3. Disorganized speech (e.g., frequent derailment or incoherence).
4. Grossly disorganized or catatonic behavior.
5. Negative symptoms (i.e., diminished emotional expression or avolition)
B. For a significant portion of thetime since onset of the disturbance, level of functioning in one or more major areas, such as work, interpersonal relations, or self-care, is markedly below the level achieved prior to the onset (or when the onset is in childhood or adolescence, there is failure to achieve expected level of interpersonal, academic, or occupational functioning).
C. Continuous signs of the disturbance persist for at least 6 months. This 6-month period must include at least 1 month of symptoms (or less if successfully treated) that meet Criterion A (i.e., active-phase symptoms) and may include periods of prodromal or residual symptoms. During these prodromal or residual periods, the signs of the disturbance may be manifested by only negative symptoms or by two or attenuated form (e.g., odd beliefs, unusual perceptual experiences).
D. Schizoaffective disorder and depressive or bipolar disorder with psychotic features have been ruled out because either 1) no major depressive episodes have occurred concurrently with the active-phase symptoms, or 2) if mood episodes have occurred during active-phase symptoms, they have been present for a minority of the total duration of the active and residual periods of the illness.
Schizophreniform Disorder
A. Two (or more) of the following, each present for a significant portion of the time during a 1-month period (or less if successfully treated). At least one of these must be (1), (2), or (3):
1. Delusions
2. Hallucinations
3. Disorganized speech (e.g., frequent derailment or incoherence).
4. Grossly disorganized or catatonic behavior
5. Negative symptoms (i.e., diminished emotional expression or avolition).
B. An episode of the disorder lasts at least 1 month but less than 6 months. When the diagnosis must be made without waiting for recovery, it should be qualified as “provisional”
C. Schizoaffective disorder and depressive or bipolar disorder with psychotic features have been ruled out because either 1) no major depressive or manic episodes have occurred concurrently with the active-phase symptoms, or 2) if mood episodes have occurred during active-phase symptoms, they have been present for a minority of the total duration of the active and residual periods of the illness.
Schizoaffective Disorder
A. An unreal uninterrupted period of illness during which there is a major mood episode (major depressive or manic) concurrent with Criterion A of schizophrenia.
NOTE: The major depressive episode must include Criterion A1: Depressed mood
B. Delusions of hallucinations for 2 or more weeks in the absence of a major mood episode (depressive or manic) during the lifetime duration of the illness.
C. Symptoms that meet criteria for a major mood episode are present for the majority of the total duration of the active and residual portions of the illness.
Specify whether:
Bipolar type: This subtype applies if a manic episode is part of the presentation. Major depressive episodes may also occur.
Depressive type: This subtype applies if only major depressive episodes are part of the presentation.
Brief Psychotic Disorder
A. Presence of one (or more) of the following symptoms: At least one of these must be (1), (2), or (3):
1. Delusions
2. Hallucinations
3. Disorganized speech (e.g., frequent derailment or incoherence).
4. Grossly disorganized or catatonic behavior
NOTE: Do not include a symptom if it is a culturally sanctioned response.
B. Duration of an episode of the disturbance is at least 1 day but less than 1 month, with eventual full return to premorbid level of functioning.
C. The disturbance is not better explained by major depressive or bipolar disorder with psychotic features or another psychotic disorder such as schizophrenia or catatonia, and is not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication) or another medical condition.
Specify if:
With marked stressor(s) (brief reactive psychosis): If symptoms occur in response to event that, singly or together, would be markedly stressful to almost anyone in similar circumstances in the individual’s culture.
Without marked stressor(s): If symptoms do not occur in response to events that, singly or together, would be markedly stressful to almost anyone in similar circumstances in the individual’s culture.
With postpartum onset: If onset is during pregnancy or within 4 weeks postpartum.
Anorexia Nervosa
A. Restriction of energy intake relative to requirements, leading to a significantly low body weight in the context of age, sex, and developmental trajectory, and physical health. Significantly low weight is defined as a weight that is less that minimally normal or, for children and adolescents, less than that minimally expected.
B. Intense fear of gaining weight or of becoming fat, or persistent behavior that interferes with weight gain, even though at significantly low weight.
C. Disturbance in the way in which one’s body weight or shape is experienced, undue influence of body weight or shape on self-evaluation, or persistent lack of recognition of the seriousness of the current low body weight.
Specify whether:
Restricting type: During the last 3 months, the individual has not engaged in recurrent episodes of binge eating or purging behavior (i.e., self-induced vomiting or the misuse of laxatives, diuretics, or enemas). This subtype describes presentations in which weight loss is accomplished primarily through dieting, fasting, and/or excessive exercise.
Binge-eating/purging type: During the last three months the individual has engaged in recurrent episodes of binge eating or purging behavior (i.e., self-induced vomiting or the misuse of laxatives, diuretics, or enemas).
Bulimia Nervosa
A. Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following:
1. Eating, in a discrete period of time (e.g., within any 2-hour period), an amount of food that is definitely larger than what most individuals would eat in a similar period of time under similar circumstances).
2. A sense of lack of control over eating during the episode (e.g., a feeling that one cannot stop eating or control what or how much one is eating).
B. Recurrent inappropriate compensatory behaviors in order to prevent weight gain, such as self-induced vomiting; misuse of laxatives, diuretics, or other medications; fasting; or excessive exercise.
C. the binge eating and inappropriate compensatory behaviors both occur, on average, at least once a week for 3 months.
D. Self-evaluation is unduly influenced by body shape and weight
E. The disturbance does not occur exclusively during episodes of anorexia nervosa.
Binge Eating Disorder
A. Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following:
- Eating, in a discrete period of time (e.g., within any 2-hour period), an amount of food that is definitely larger than what most individuals would eat in a similar period of time under similar circumstances).
- A sense of lack of control over eating during the episode (e.g., a feeling that one cannot stop eating or control what or how much one is eating).
B. The binge-eating episodes are associated with three (or more) of the following:
- Eating much more rapidly than normal.
- Eating until feeling uncomfortably full.
- Eating large amounts of food when not feeling physically hungry.
- Eating alone because of feeling embarrassed by how much one is eating.
- Feeling disgusted with oneself, depressed, or very guilty afterward.
C. Marked distress regarding binge eating is present
D. The binge eating occurs, on average, at least once a week for 3 months.
E. The binge eating is not associated with the recurrent use of inappropriate compensatory behavior as in bulimia nervosa and does not occur exclusively during the course of bulimia nervosa or anorexia nervosa.
Delirium
A. A disturbance in attention(i.e., reduced ability to direct, focus, sustain, and shift attention) and awareness (reduced orientation to the environment).
B. The disturbance develops over a short period of time (usually hours to a few days), represents a change from baseline attention and awareness, and tends to fluctuate in severity during the course of a day.
C. An additional disturbance in cognition (e.g., memory deficit, disorientation, language, visuospatial ability, or perception).
D. The disturbances in Criteria A and C are not better explained by another preexisting, established, or evolving neurocognitive disorder and do not occur in the context of a severely reduced level of arousal, such as coma.
E. There is evidence from the history, physical examination, or laboratory findings that the disturbance is a direct physiological consequence of another medical condition, substance intoxication, or withdrawal (i.e., due to a drug of abuse or to a medication), or exposure to a toxin, or is due to multiple etiologies.
Specify whether:
Substance intoxication delirium: This diagnosis should be made instead of substance intoxication when the symptoms in Criteria A and C predominate in the clinical picture and when they are sufficiently severe to warrant clinical attention.
Major Neurocognitive Disorder
A. Evidence of significant cognitive decline from a previous level of performance in one or more cognitive domains (complex attention, executive function, learning and memory, language, perceptual-motor, or social cognition) based on:
1. Concern of the individual, a knowledgeable informant, or the clinician that there has been a significant decline in cognitive function; and
2. A substantial impairment in cognitive performance, preferably documented by standardized neurophsychological testing or, in its absence, another quantified clinical assessment.
B. The cognitive deficits interfere with independence in everyday activities (i.e., at minimum, requiring assistance with complex instrumental activities of daily living such as paying bills or managing medications).
C. The cognitive deficits do not occur exclusively in the context of a delirium
D. The cognitive deficits are not better explained by another mental disorder (e.g., major depressive disorder, schizophrenia).
Specify whether due to:
Alzheimer’s disease
Frontotemporal lobar degeneration
Lewy body disease
Vascular disease
Traumatic brain injury
Substance/medication use
HIV infection
Prion disease
Parkinson’s disease
Huntington’s disease
Another medical condition
Multiple etiologies
Unspecified
Autism Spectrum Disorder
A. Persistent deficits in social communication and social interaction across multiple contexts, as manifested by the following, currently or by history (examples are illustrative, not exhaustive):
1. Deficits in social-emotional reciprocity, ranging, for example, from abnormal social approach and failure of normal back-and-forth conversation; to reduced sharing or interest, emotions, or affect; to failure to initiate or respond to social interactions.
2. Deficits in nonverbal communicative behaviors used for social interaction, ranging, for example from poorly integrated verbal and nonverbal communication; to abnormalities in eye contact and body language or deficits in understanding and use of gestures; to a total lack of facial expressions and nonverbal communication.
3. Deficits in developing, maintaining, and understanding relationships, ranging for example, form difficulties adjusting behavior to suit various social contexts; to difficulties in sharing imaginative play or in making friends; to absence of interest in peers.
B. Restricted, repetitive patterns of behavior, interests, or activities, as manifested by at last two of the following, currently or by history (examples are illustrative, not exhaustive):
1. Stereotyped or repetitive motor movements, use of objects, or speech (e.g., simple motor stereotypies, linging up toys or flipping objects, echolalia, idiosyncratic phrases).
2. Insistence on sameness, inflexible adherence to routines, or ritualized patterns of verbal or nonverbal behavior (e.g., extreme distress at small changes, difficulties with transitions, rigid thinking patterns, greeting rituals, need to take same route or at same food every day).
3. Highly restricted, fixated interests that are abnormal in intensity or focus (e.g., strong attachment to or preoccupation with unusual objects, excessively circumscribed or perservative interests).
4. Hyper-or hyporeactivity to sensory input or unusual interest in sensory aspects of the environment (e.g., apparent indifference to pain/temperature, adverse response to specific sounds or textures, excessive smelling or touching of objects, visual fascination with lights or movement).
C. Symptoms must be present in the early developmental period (but may not become fully manifest until social demands exceed limited capacities, or may be masked by learned strategies in later life).
D. Symptoms cause clinically significant impairment in social, occupational, or other important areas of functioning.
E. These disturbances are not better explained by intellectual disability or global developmental delay.
Intellectual Developmental Disorder
Intellectual disability (intellectual developmental disorder) is a disorder with onset during the developmental period that includes both intellectual and adaptive functioning deficits in conceptual, social, and practical domains. The following three criteria must be met: A. Deficits in intellectual functions, such as reasoning, problem solving, planning abstract thinking, judgment, academic learning, and learning from experience, confirmed by both clinical assessments and individualized, standardized intelligence testing. B. Deficits in adaptive functioning that result in failure to meet developmental and sociocultural standards for personal independence and social responsibility. Without ongoing support the adaptive deficits limit functioning in one or more activities of daily life, such as communication, social participation, and independent living, across multiple environments, such as home, school, work, and community. C. Onset of intellectual and adaptive deficits during the developmental period.
TIC Disorders
NOTE: A tic is a sudden, rapid, recurrent, nonrhythmic motor movement or vocalization.
Tourette’s Disorder
Chronic Motor or Vocal Tic Disorder
Tourette’s Disorder
A. both multiple motor and one or more vocal tics have been present at some time during the illness, although not necessarily concurrent.
B. The tics may wax and wane in frequency but have persisted for more than 1 year since first tic onset.
C. Onset is before age 18 years.
D. The disturbance is not attributable to the physiological effects of a substance (e.g., cocaine) or another medical condition (e.g., Huntington’s disease, postviral encephalitis).
Chronic Motor or Vocal Tic Disorder
A. Single or multiple motor or vocal tics have been present during the illness, but not both motor and vocal.
B. The tics may wax and wane in frequency but have persisted for more than 1 year since tic onset.
C. Onset is before age 18 years.
D. The disturbance is not attributable to the physiological effects of a substance (e.g., cocaine) or another medical condition (e.g., Huntington’s disease, postviral encephalitis).
E. Criteria have never been met for Tourette’s disorder.
Stereotypical Movement Disorder
A. Repetitive, seemingly driven, and apparently purposeless motor behavior (e.g., hand shaking or waving, body rocking, head banging, self-biting, hitting own body).
B. The repetitive motor behavior interferes with social, academic, or other activities and may result in self-injury.
C. Onset is in the early developmental period.
D. The repetitive motor behavior in not attributable to the physiological effects of a substance or neurological condition and is not better explained by another neurodevelopmental or mental disorder (e.g., trichotillomania, (hair-pulling disorder), obsessive-compulsive disorder).
Separation Anxiety Disorder
A. Developmentally inappropriate and excessive fear or anxiety concerning separation from those to whom the individual is attached, as evidenced by at least three of the following:
1. Recurrent excessive distress when anticipating or experiencing separation from home or when major attachment figures.
2. Persistent and excessive worry about losing major attachment figures or about possible harm to them, such as illness, injury disasters, or death.
3. Persistent and excessive worry about experiencing an untoward event (e.g., getting lost, being kidnapped, having an accident, becoming ill) that causes separation from a major attachment figure.
4. Persistent reluctance or refusal to go out, away from home, to school, to work, or elsewhere because of fear of separation.
5. Persistent and excessive fear of or reluctance about being alone or without major attachment figures at home or in other settings.
6. Persistent reluctance or refusal to sleep away from home or to go to sleep without being near a major attachment figure.
7. Repeated nightmares involving the theme of separation.
8. Repeated complaints of physical symptoms (e.g., headaches, stomachaches, nausea, vomiting) when separation form major attachment figure occurs or is anticipated.
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
