Guide to HiTOP and DSM Flashcards
What we will see in these flashcards and how they work
- These flashcards are from the videos on DSM and HiTOP.
- First we see structure of HiTOP and DSM and then we go spectrum by spectrum of HiTOP and name criteria for each syndrome (disorder) from DSM that we need to know
- The criteria included are already the ones we need to know, there are no extra (if they are, they are in brackets so that we are aware of it but don’t need to know by heart)
- Some of the syndromes in the spectrum we don’t need to know so learn only the ones in bold
- The lecturer used the word syndrome for disorder so I wrote it like that but in DSM they say disorder, so just know that these are used interchangably
- Any extra info the lecturer mentioned when naming the criteria for each disorder, is in the footnote on the same flashcard
- At the top of the flashcard where the question (name of the syndrome you need to say the criteria for) is, we have: (# of video) - name of the spectrum the syndrome belongs to - subfactor (some of the spectra don’t have subfactors so then the spectrum’s name follows with the chapter #) - # of dsm chapter and name
What we need to know for the exam (from canvas page)
The DSM-5 chapter name to which they belong
The syndrome name.
The specific criteria indicated in the CIDS-DSM-Table
NB You need to know the meaning of the criteria rather than the literal description. Thus when a person speaks about not wanting to do hobbies, social interactions and homework anymore you need to be able to understand that this can refer to the symptom ‘loss of interest’ as part of a depressive episode.
NB You need to stay literal enough. For example ‘obsessive thinking’ is really something different from ‘ruminating’. This is something you’ll need to learn
The specifiers - again, only if they are included in the CIDS-DSM-Table.
And from the CIDS-DSM-Table you must also learn:
The spectra and subfactors of the HiTOP model and how the DSM-syndromes fit in the HiTOP model. (Again, this connection needs to be learnt only for DSM syndromes included in the CIDS-DSM-table).
Video 1
What is DSM about?
DSM provides a set of standard names for problems for which people seek help:
- Problems people express themselves
- Problems other people express about them: parent, spouse, teacher, coworker, etc.
- Problems inferred by a clinician
- Sorted into ‘syndromes’ (he tries to avoid the term ‘disorder’ if possible because syndrome refers to a set of symptoms that go together whereas disorder suggests that we know why symptoms come together which often we don’t)
What is the HiTOP?
Hierarchical Taxonomy of
Psychopathology
HiTOP dimensions
What are the six broad domains that people fall into for the problems they commonly present?
- Somatoform
- Internalizing
- Detachment
- Thought disorder
- Antagonistic externalizing
- Disinhibited externalizing
DSM-5-TR disorders can be grouped into these 6 dimensions
What is the structure of HiTOP?
- 6 spectra/dimensions
- subfactors
↪ the subfactors can be empirically distinguished, but when factor analysis is done, we see a common factor specifically related to for example fear or distress BUT they tend to correlate very highly with each other so people with fear often experience sexual problems - empirical syndromes and symptom components are even more fine-grained groupings of syndromes and these are connected to the DSM
Which syndromes are in DSM-5-TR but not in HiTOP?
- Autism spectrum
- Dissociation
- Sleep-wake problems (chapter 12)
- Elimination syndromes (chapter 11)
- Gender dysforia (chapter 14)
- Neurocognitive problems (e.g. dementia) (chapter 17)
The ones that are not in bold are not on the exam
Video 2
What is the structure of the DSM-5?
It has 3 sections
Section I: DSM basics
Section II: Diagnostic criteria and codes
- Structure of chapters material for PARTIAL exam
- Specific criteria for syndromes for PARTIAL exam
Section III: Emerging measures and models
We only need to know Section II
IMPORTANT! BOLD ONES WE NEED TO LEARN BY HEART
What is the structure (chapters) of the Section II
- Neurodevelopmental syndromes
- Schizophrenia Spectrum and Other Psychotic syndromes
- Bipolar and Related syndromes
- Depressive syndromes
- Anxiety syndromes
- Obsessive-Compulsive and Related syndromes
- Trauma- and Stressor-Related syndromes
- Dissociative syndromes
- Somatic Symptom and Related syndromes
- Feeding and Eating syndromes
- Elimination syndromes
- Sleep-Wake syndromes
- Sexual Dysfunctions
- Gender Dysphoria
- Disruptive, Impulse-Control, and Conduct syndromes
- Substance-Related and Addictive syndromes
- Neurocognitive syndromes
- Personality syndromes
- Paraphilic syndromes
- Other Mental syndromes and Additional Codes
- Other Conditions That May Be a Focus of Clinical Attention
Exam material: the ones in bold
Video 3 - Somatoform spectrum
In what chapter of DSM is somatoform spectrum and which syndromes does it cover? What is important to remember about this spectrum?
Chapter 9: Somatic symptom and related syndromes
- Somatic Symptom
- Illness Anxiety
- Conversion (Functional Neurological Symptom
Individuals who are primarily diagnosed with a disorder from a different chapter, have very often problems on this spectrum as well
Somatoform spectrum - ch9 somatic symptom and related syndromes
Somatic symptom syndrome
A. One or more somatic symptoms that are distressing or result in significant disruption of daily life.
B. Excessive thoughts, feelings, or behaviors related to the somatic symptoms or associated health concerns as manifested by at least one of the following:
- Disproportionate and persistent thoughts about the seriousness of one’s symptoms.
- Persistently high level of anxiety about health or symptoms.
- Excessive time and energy devoted to these symptoms or health concerns.
SOME ATTIC
Symptoms
One or more
Medically unexplained
Excessive
Anxiety
Thinking about
Time-consuming
Impairing
Chronic (months)
Avoid discussion about whether symptoms are strong enough etc, just establish that people have somatic symptoms by them telling us about them.
Somatoform spectrum - ch9 somatic symptom and related syndromes
Illness anxiety syndrome
A. Preoccupation with having or acquiring a serious illness.
B. Somatic symptoms are not present or, if present, are only mild in intensity. If another medical condition is present or there is a high risk for developing a medical condition (e.g., strong family history is present), the preoccupation is clearly excessive or disproportionate.
C. There is a high level of anxiety about health, and the individual is easily alarmed about personal health status.
D. The individual performs excessive health-related behaviors (e.g., repeatedly checks his or her body for signs of illness) or exhibits maladaptive avoidance (e.g., avoids doctor appointments and hospitals).
The patient knows that it’s anxiety so it’s not a psychotic symptom of delusion of having a specific disease for example AIDS and no one can convince them otherwise. When they go to the doctor and they tell them that it’s not cancer, the patient will feel releaved but the anxiety returns after couple of days.
Somatoform spectrum - ch9 somatic symptom and related syndromes
What distinguishes Somatic symptom syndrom and illness anxiety syndrome?
In illness anxiety syndrome, the fear of having an illness is on the forefront, whereas in Somatic symptom syndrome, it’s about having the symptoms
Additionally, the somatic symptoms in illness anxiety syndrome are only mild, if any
SSD involves distressing physical symptoms with no clear medical cause, while IAD is marked by excessive worry about developing a serious illness
ch 9. somatic symptom and related syndromes
Conversion (functional neurological symptom syndrome)
Not part of the HiTOP
A. One or more symptoms of altered voluntary motor or sensory function.
B. Clinical findings provide evidence of incompatibility between the symptom
and recognized neurological or medical conditions.
Typically found out by neurologists who finds out that the pattern fits no known neurological symptoms.
Somatoform spectrum
Other disturbances in bodily functioning
Not on exams just need to know they exist
Chapter 11: Sleep-wake syndromes
Chapter 12: Elimination syndromes
Video 4 - internalizing spectrum (eating and sex)
What chapters of DSM does internalizing spectrum cover and what are the four subfactors?
Chapters:
- Chapter 13 Sexual Dysfunctions
- Chapter 10 Feeding and Eating Syndromes
- Chapter 5 Anxiety syndromes
- Chapter 6 Obsessive-Compulsive and Related Syndromes
- Chapter 4 Depressive Syndromes
- Chapter 7 Trauma- and Stressor-Related Syndromes
Subfactors:
- Sexual problems
- Eating pathology
- Fear
- Distress
Sexual dysfunctions we don’t have to know by heart, we just have to be aware of the disorders
Internalizing spectrum - sexual problems - ch sexual dysfunctions
What syndromes are in chapter 13 Sexual syndromes?
Not exam material
- Delayed Ejaculation
- Erectile Syndrome
- Female Orgasmic Syndrome
- Female (?) Sexual Interest/Arousal Syndrome
- Male (?) Hypoactive Sexual Desire syndrome
- Genito-Pelvic Pain/Penetration Syndrome
- Premature (Early) Ejaculation
Only arousal difficulties, low desire, orgasmic dysfunction, sexual pain are part of internalizing spectrum - sexual problems
Internalizing spectrum - Eating pathology - ch10 Feeding & eating syndr.
What syndromes does chapter 10 Feeding and eating syndromes cover?
- Pica
- Rumination syndrome
- Avoidant/Restrictive Food Intake syndrome
- Anorexia Nervosa
- Bulimia Nervosa
- Binge-Eating syndrome
Only 4, 5, 6 are on internalizing spectrum - eating pathology
Internalizing spectrum - Eating pathology - ch10 Feeding & eating syndr.
Anorexia Nervosa
A. Restriction of energy intake relative to requirements, leading to a significantly low body weight in the context of age, sex, developmental trajectory, and physical health. Significantly low weight is defined as a weight that is less than 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 a 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.
UNDERrexia
Underweight
Nervous to gain weight
Distorted perception
Exercise, purging
Restricting intake
Self-image is important part of this syndrome
Internalizing spectrum - Eating pathology - ch10 Feeding & eating syndr.
Bulimia Nervosa
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. 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.
Again, self-evaluation is important
Video 5 - internalizing spectrum (fear)
Which DSM chapters are covered in the subfactor fear of the internalizing spectrum? And what syndromes specifically are in each chapter?
Chapter 5: Anxiety syndromes
- Separation Anxiety syndrome
- Selective Mutism
- Specific Phobia
- Social Anxiety Syndromes
- Panic Syndrome
- Panic Attack Specifier
- Agoraphobia
- Generalized Anxiety Disorder (in distress subfactor)
Chapter 6: Obsessive-compulsive and related syndromes
- Obsessive-Compulsive syndrome
- Body Dysmorphic syndrome
- Hoarding syndrome
- Trichotillomania (Hair-Pulling syndrome)
- Excoriation (Skin-Picking) syndrome
Fear are about something specific; later discussed distress is more general
Internalizing spectrum - fear - ch5 anxiety syndromes
Specific phobia
A. Marked fear or anxiety about a specific object or situation (e.g., flying, heights, animals, receiving an injection, seeing blood)
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 for 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 explained by the symptoms of another mental syndrome, 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 obsessive-compulsive syndrome); reminders of traumatic events (as in posttraumatic stress syndrome); separation from home or attachment figures (as in separation anxiety syndrome); or social situations (as in social anxiety syndrome).)
We don’t have to know F and G by heart just know that those two criteria are the same for social anxiety, agoraphobia, GAD; only G for panic disorder
Internalizing spectrum - fear - ch5 anxiety syndromes
Social Anxiety Syndrome
A. Marked fear or anxiety about one or more social situations in which the individual is exposed to possible scrutiny by others. Examples include social interactions (e.g., having a conversation, meeting unfamiliar people), being observed (e.g., eating or drinking), and performing in front of others (e.g., giving a speech).
B. The individual fears that he or she will act in a way or show anxiety symptoms that will be negatively evaluated (i.e., will be humiliating or embarrassing; will lead to rejection or offend others).
C. The social situations almost always provoke fear or anxiety.
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
ch5 anxiety syndromes
Panic attack specifier
Not part of the HiTOP
This specifier can be given with any
other DSM syndrome
An abrupt surge of intense fear or intense discomfort that reaches a peak within minutes, and during which time four (or more) of the following symptoms occur:
- Palpitations, pounding heart, or accelerated heart rate.
- Sweating.
- Trembling or shaking.
- Sensations of shortness of breath or smothering.
- Feelings of choking.
- Chest pain or discomfort.
- Nausea or abdominal distress.
- Feeling dizzy, unsteady, light-headed, or faint.
- Chilis or heat sensations.
- Paresthesias (numbness or tingling sensations).
- Derealization (feelings of unreality) or depersonalization (being detached from oneself).
- Fear of losing control or “going crazy.”
- Fear of dying.
Internalizing spectrum - fear - ch5 anxiety syndromes
Panic disorder
A. Recurrent unexpected panic attacks. A panic attack is an abrupt surge of intense fear or intense discomfort that reaches a peak within minutes, and during which time four (or more) of the following symptoms occur;
Note: The abrupt surge can occur from a calm state or an anxious state.
- Palpitations, pounding heart, or accelerated heart rate.
- Sweating.
- Trembling or shaking.
- Sensations of shortness of breath or smothering.
- Feelings of choking.
- Chest pain or discomfort.
- Nausea or abdominal distress.
- Feeling dizzy, unsteady, light-headed, or faint.
- Chills or heat sensations.
- Paresthesias (numbness or tingling sensations).
- Derealization (feelings of unreality) or depersonalization (being detached from oneself).
- Fear of losing control or “going crazy.”
- Fear of dying.
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 (e.g., losing control, having a heart attack, “going crazy”).
- A significant maladaptive change in behavior related to the attacks (e.g., behaviors designed to avoid having panic attacks, such as avoidance of exercise or unfamiliar situations).
SURP-rise!
Sudden
Unexpected
Recurrent
Panic attacks
Give rise to anxiety
Internalizing spectrum - fear - ch5 anxiety syndromes
Agoraphobia
A. Marked fear or anxiety about two (or more) of the following five situations:
- Using public transportation (e.g., automobiles, buses, trains, ships, planes).
- Being in open spaces (e.g., parking lots, marketplaces, bridges).
- Being in enclosed places (e.g., shops, theaters, cinemas).
- Standing in line or being in a crowd.
- Being outside of the home alone.
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 (e.g., 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.
B is especially important
Internalizing spectrum - fear - ch6 Obsessive-compulsive & related synd.
Obsessive Compulsive Syndrome
A. Presence of obsessions, compulsions, or both:
Obsessions are defined by (1) and (2):
- Recurrent and persistent thoughts, urges, or images that are experienced, at some time during the disturbance, as intrusive and unwanted, and that in most individuals cause marked anxiety or distress.
- The individual attempts to ignore or suppress such thoughts, urges, or images, or to neutralize them with
some other thought or action (i.e., by performing a compulsion).
Compulsions are defined by (1) and (2):
1. Repetitive behaviors (e.g., hand washing, ordering, checking) or mental acts (e.g., praying, counting, repeating words silently) that the individual feels driven to perform in response to an obsession or according to rules that must be applied rigidly.
2. The behaviors or mental acts are aimed at preventing or reducing anxiety or distress, or preventing some dreaded event or situation; however, these behaviors or mental acts are not connected in a realistic way with what they are designed to neutralize or prevent, or are clearly excessive.
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.
I MURDER???
Intrusive
Mind-based (realise it’s not coming from the physical world)
Unwanted
Resistent to attempts of making them go away
Distressing
Ego-dystonic (realise that those are not their actual wishes)
Recurrent
Obsessive thinking is different from ruminating or from voices in one’s head (hallucination)
Video 6 - internalizing spectrum (distress)
Which DSM chapters are covered in the subfactor distress of the internalizing spectrum? And what syndromes specifically are in each chapter (besides anxiety which was already mentioned)?
Chapter 5: Anxiety syndromes
- Generalized Anxiety syndrome
Chapter 4: Depressive syndromes
- Disruptive Mood Dysregulation syndrome
- Major Depressive syndrome
- Persistent Depressive syndrome (Dysthymia)
- Premenstrual Dysphoric syndrome
Chapter 7: trauma- and stressor-related syndromes
- Reactive Attachment syndrome
- Disinhibited Social Engagement syndrome
- Posttraumatic Stress syndrome
- Acute Stress syndrome
- Adjustment syndrome
Internalizing spectrum - distress - ch5 anxiety syndromes
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 (such as work or school performance).
B. The individual finds it difficult to control the worry.
C. The anxiety and worry are associated with three (or more) of the following six symptoms (with at least some symptoms having been present for more days than not for the past 6 months):
- Restlessness or feeling keyed up or on edge.
- Being easily fatigued.
- Difficulty concentrating or mind going blank.
- Irritability.
- Muscle tension.
- Sleep disturbance (difficulty falling or staying asleep, or restless, unsatisfying sleep).
EGADS, I’m so MISERAble!
Excessive
Generalized
Anxiety
Daily (or most days)
Six months
Muscle tension
Irritability
Sleep disturbance
Energy
Restlessness
Attention
Included in distress because it’s not about specific fear but about worrying and ruminating in general and most of the time.
Often comorbid with MDD and Persistent depressive syndrome
Internalizing spectrum - distress - ch4 depressive syndromes
Major depressive syndrome
A. Five (or more) of the following symptoms have been present during the same 2-week period and represent a change from previous functioning: at least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure.
Note: Do not include symptoms that are clearly attributable to another medical condition.
- Depressed mood most of the day, nearly every day, as indicated by either subjective report (e.g., feels sad, empty, hopeless) or observation made by others (e.g., appears tearful).
- Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day (as indicated by either subjective account or observation).
- Significant weight loss when not dieting or weight gain (e.g., a change of more than 5% of body weight in a month), or decrease or increase in appetite nearly every day.
- Insomnia or hypersomnia nearly every day.
- Psychomotor agitation or retardation nearly every day (observable by others, not merely subjective feelings of restlessness or being slowed down).
- Fatigue or loss of energy nearly every day.
- Feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day (not merely self-reproach or guilt about being sick).
- Diminished ability to think or concentrate, or indecisiveness, nearly every day (either by subjective account or as observed by others).
- Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide.
(B. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
C. The episode is not attributable to the physiological effects of a substance or to another medical condition.
Note: Criteria A-C represent a major depressive episode.
D. The occurrence of the major depressive episode is not better explained by schizoaffective disorder, schizophrenia, schizophreniform disorder, delusional disorder, or other specified and unspecified schizophrenia spectrum and other psychotic disorders.
E. There has never been a manic episode or a hypomanie episode)
SIGECAPS:
depressed mood +
Sleep disorder (increase/decrease)
Interest (diminished)
Guilt (worthlessness, hopelessness, regret)
Energy (poor/low)
Concentration (poor)
Appetite disorder (increase/decrease)
Psychomotor (retardation/agitation)
Suicidality
IMPORTANT! This disorder contains a depressive episode - DE is never a syndrome on its own, it’s a part of a syndrome
We only need to know criterion A by heart but we need to know the difference between an episode and MDD
Internalizing spectrum - distress - ch4 depressive syndromes
Persistent depressive syndrome
A. Depressed mood for most of the day, for more days than not, as indicated by either subjective account or observation by others, for at least 2 years.
B. Presence, while depressed, of two (or more) of the following:
- Poor appetite or overeating.
- Insomnia or hypersomnia.
- Low energy or fatigue.
- Low self-esteem.
- Poor concentration or difficulty making decisions.
- Feelings of hopelessness.
we also need to know 4 specifier for type of persistence
Specify if (for most recent 2 years of persistent depressive disorder):
- With pure dysthymic syndrome: Full criteria for a major depressive episode have not been met in at least the preceding 2 years.
- With persistent major depressive episode: Full criteria for a major depressive episode have been met throughout the preceding 2-year period.
- With intermittent major depressive episodes, with current episode: Full criteria for a major depressive episode are currently met, but there have been periods of at least 8 weeks in at least the preceding 2 years with symptoms below the threshold for a full major depressive episode.
- With intermittent major depressive episodes, without current episode: Full criteria for a major depressive episode are not currently met, but there has been one or more major depressive episodes in at least the preceding 2 years.
Internalizing spectrum - distress -ch7 trauma and stressor-related synd.
Post-traumatic stress disorder
A. Exposure to actual or threatened death, serious injury, or sexual violence in one (or more) of the following ways:
- Directly experiencing the traumatic event(s).
- Witnessing, in person, the event(s) as it occurred to others.
- Learning that the traumatic event(s) occurred to a close family member or close friend. In cases of actual or threatened death of a family member or friend, the event(s) must have been violent or accidental.
- Experiencing repeated or extreme exposure to aversive details of the traumatic event(s) (e.g., first responders collecting human remains: police officers repeatedly exposed to details of child abuse).
B. Presence of one (or more) of the following intrusion symptoms associated with the traumatic event(s), beginning after the traumatic event(s) occured
C. Persistent avoidance of stimuli associated with the traumatic event(s), beginning after the traumatic event(s) occurred
D. Negative alterations in cognitions and mood associated with the traumatic event(s), beginning or worsening after the traumatic event(s) occurred
E. Marked alterations in arousal and reactivity associated with the traumatic event(s), beginning or worsening after the traumatic event(s) occurred
F. Duration of the disturbance (Criteria B, C, D, and E) is more than 1 month.
We need to know the criteria groups (e.g. B intrusions), not the details of each group (so I didn’t include them because it’s sooo long)
ch7 trauma and stressor-related syndromea
Acute stress syndrome
Not part of the HiTOP
A. Exposure to actual or threatened death, serious injury, or sexual violence
B. Presence of nine (or more) of the following symptoms from any of the five categories of intrusion, negative mood, dissociative symptoms, avoidance, and arousal, beginning or worsening after the traumatic event(s) occurred
(you need not know the specific symptoms for each of these criteria).
C. Duration of the disturbance (symptoms in Criterion B) is 3 days to 1 month after trauma exposure.
ch7 trauma and stressor-related syndromes
Adjustment disorder
Not part of the HiTOP
A. The development of emotional or behavioral symptoms in response to an identifiable stressor(s) occurring within 3 months of the onset of the stressor(s).
B. These symptoms or behaviors are clinically significant, as evidenced by one or both of the following:
- Marked distress that is out of proportion to the severity or intensity of the stressor, taking into account the
external context and the cultural factors that might influence symptom severity and presentation. - Significant impairment in social, occupational, or other important areas of functioning.
C. The stress-related disturbance does not meet the criteria for another mental disorder and is not merely an exacerbation of a preexisting mental disorder.
(D. The symptoms do not represent normal bereavement.
E. Once the stressor or its consequences have terminated, the symptoms do not persist for more than an additional 6 months.)
[note: this is assessed at step 5 of the step-wise approach, because it is a residual category, like
‘mental disorder not otherwise specified’. So we never diagnose it together with another disorder. Because this is something we diagnose when all the other categories are not fitting]
Video 7 - ch 8 dissociation
Which syndromes are included in DSM chapter 8 - dissociative syndromes
The whole chapter is not part of the HiTOP
- Dissociative Identity syndrome
- Dissociative Amnesia
- Depersonalization/Derealization syndrome
Linked to the internalizing spectrum because very often occuring in trauma and stressor related syndromes.
If the dissociation is the main symptom then the diagnosis is one of the syndromes in this chapter
Ch 8 - dissociative syndromes
Dissociative identity syndrome
Not part of the HiTOP
A. Disruption of identity characterized by two or more distinct personality states, which may be described in some cultures as an experience of possession. The disruption in identity involves marked discontinuity in sense of self and sense of agency, accompanied by related alterations in affect, behavior, consciousness, memory, perception, cognition, and/or sensory- motor functioning. These signs and symptoms may be observed by others or reported by the individual.
B. Recurrent gaps in the recall of everyday events, important personal information, and/or traumatic events that are inconsistent with ordinary forgetting.
In healthy individuals, they behave differently and may have varying personalities in different situations but there is a connection between those and they are continous but for individuals with dissociation there is no continuum
Ch 8 - dissociative syndromes
Dissociative amnesia
Not part of the HiTOP
A. An inability to recall important autobiographical information, usually of a traumatic or stressful nature, that is inconsistent with ordinary forgetting.
Ch 8 - dissociative syndromes
Depersonalization/derealization
Not part of the HiTOP
A. The presence of persistent or recurrent experiences of depersonalization, derealization, or both:
- Depersonalization: Experiences of unreality, detachment, or being an outside observer with respect to one’s thoughts, feelings, sensations, body, or actions (e.g., perceptual alterations, distorted sense of time, unreal or absent self, emotional and/or physical numbing).
- Derealization: Experiences of unreality or detachment with respect to surroundings (e.g., individuals or objects are experienced as unreal, dreamlike, foggy, lifeless, or visually distorted).
B. During the depersonalization or derealization experiences, reality testing remains intact.
It’s not a hallucination or delusion
Video 8 - Thought problems spectrum
Which DSM chapter is covered in the thought problems spectrum? And what syndromes specifically are in this chapter?
Chapter 2. Schizophrenia spectrum and other psychotic disorders
- Delusional Syndrome
- Brief Psychotic Syndrome
- Schizophreniform: Psychotic syndrome, low/medium severity
- Schizophrenia: Psychotic syndrome, medium/high severity
- Schizoaffective: Psychotic syndrome with mood episodes (subfactor mania)
Exclusion criteria psychotic syndrome: you only need to know that the psychotic syndromes in DSM-5 are mutually exclusive, i.e. one can only have one of them).
He said that the schizoterms are problematic so he is trying to avoid them
Thought problems spectrum - ch2 psychotic disorders
Delusional disorder
A. The presence of one (or more) delusions with a duration of 1 month or longer.
Delusion = thought about the world that is clearly not true (1 or 2 people; if more than group which then it’s not delusion)
Thought problems spectrum - ch2 psychotic disorders
Brief psychotic disorder
A. Presence of one (or more) of the following symptoms: 1) Delusions, 2) Hallucinations, 3) Disorganized speech, 4) grossly disorganized or catatonic behavior. (i.e. the same as criterion A for the others, except negative symptoms). At least one of these must be 1, 2 or 3.
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.
Thought problems spectrum - ch2 psychotic disorders
Schizophreniform disorder
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):
- Delusions.
- Hallucinations.
- Disorganized speech (e.g., frequent derailment or incoherence).
- Grossly disorganized or catatonic behavior.
- 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.”
Thought problems spectrum - ch2 psychotic disorders
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 the time since the 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 more symptoms listed in Criterion A present in an attenuated form (e.g., odd beliefs, unusual perceptual experiences).
Thought problems spectrum - subfactor mania - ch2 psychotic disorders
Schizoaffective disorder
A. An 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 or hallucinations for 2 or more weeks in the absence of a major mood episode (depressive or manic) during the lifetime duration of the illness.
[note: otherwise it may be ‘depressive’ or ‘bipolair I’ with psychotic]
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.
[note: otherwise it may be an other psychotic disorder comorbid with a mood disorders]
In case of mood symptoms and psychotic symptoms there are multiple possibilties for diagnoses
Video 9 - mania - internalizing and thought disorder spectrum
Which DSM chapter covers the subfactor mania and which syndromes does it include?
Chapter 3: Bipolair and related syndromes
↪ Manic episode
↪ Hypomanic episode
↪ Depressive episode
- Bipolar I Disorder
- Bipolar II Disorder
- Cyclothymic Disorder
The episodes are part of Bipolar I and II. an episode is not itself a syndrome in DSM-5 but a criterion for a syndrome.
In mild cases the internalizing spectrum is stronger and in severe cases the thought disorder spectrum is stronger
mania - internalizing and thought disorder spectrum - ch3 bipolar syndr.
Manic episode
A. A distinct period of abnormally and persistently elevated, expansive, or irritable mood and abnormally and persistently increased activity or energy, lasting at least 1 week and present most of the day, nearly every day (or any duration if hospitalization is necessary).
B. During the period of mood disturbance and increased energy or activity, three (or more) of the following symptoms (four if the mood is only irritable) are present to a significant degree and represent a noticeable change from usual behavior:
- Inflated self-esteem or grandiosity.
- Decreased need for sleep (e.g., feels rested after only 3 hours of sleep).
- More talkative than usual or pressure to keep talking.
- Flight of ideas or subjective experience that thoughts are racing.
- Distractibility (i.e., attention too easily drawn to unimportant or irrelevant external stimuli), as reported or observed.
- Increase in goal-directed activity (either socially, at work or school, or sexually) or psychomotor agitation (i.e., puroseless non-goal-directed activity).
- Excessive involvement in activities that have a high potential for painful consequences (e.g., engaging in unrestrained buying sprees, sexual indiscretions, or foolish business investments).
C. The mood disturbance is sufficiently severe to cause marked impairment in social or occupational functioning or to necessitate hospitalization to prevent harm to self or others, or there are psychotic features.
DIGFAST:
Euphoria/irritability +
Distractibility
Indiscretion (excessive involvement in pleasurable activities)
Grandiosity
Flight of ideas
Activity increase
Sleep deficit (decreased need for sleep)
Talkativeness (pressured speech)
C distinguishes manic from hypomanic episode
mania - internalizing and thought disorder spectrum - ch3 bipolar syndr.
Hypomanic episode
A. A distinct period of abnormally and persistently elevated, expansive, or irritable mood and abnormally and persistently increased activity or energy, lasting at least 4 consecutive days and present most of the day, nearly every day
B. During the period of mood disturbance and increased energy or activity, three (or more) of the following symptoms (four if the mood is only irritable) are present to a significant degree and represent a noticeable change from usual behavior:
- Inflated self-esteem or grandiosity.
- Decreased need for sleep (e.g., feels rested after only 3 hours of sleep).
- More talkative than usual or pressure to keep talking.
- Flight of ideas or subjective experience that thoughts are racing.
- Distractibility (i.e., attention too easily drawn to unimportant or irrelevant external stimuli), as reported or observed.
- Increase in goal-directed activity (either socially, at work or school, or sexually) or psychomotor agitation (i.e., puroseless non-goal-directed activity).
- Excessive involvement in activities that have a high potential for painful consequences (e.g., engaging in unrestrained buying sprees, sexual indiscretions, or foolish business investments).
C. The episode is associated with an unequivocal change in functioning that is uncharacteristic of the individual when not symptomatic.
D. The disturbance in mood and the change in functioning are observable by others.
mania - internalizing and thought disorder spectrum - ch3 bipolar syndr.
Depressive episode
A. Five (or more) of the following symptoms have been present during the same 2-week period and represent a change from previous functioning; at least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure.
- Depressed mood most of the day, nearly every day, as indicated by either subjective report (e.g., feels sad, empty, or hopeless) or observation made by others (e.g., appears tearful).
- Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day (as indicated by either subjective account or observation).
- Significant weight loss when not dieting or weight gain (e.g., a change of more than 5% of body weight in a month), or decrease or increase in appetite nearly every day.
- Insomnia or hypersomnia nearly every day.
- Psychomotor agitation or retardation nearly every day (observable by others; not merely subjective feelings of restlessness or being slowed down).
- Fatigue or loss of energy nearly every day.
- Feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day (not merely self-reproach or guilt about being sick).
- Diminished ability to think or concentrate, or indecisiveness, nearly every day (either by subjective account or as observed by others).
- Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide.
mania - internalizing and thought disorder spectrum - ch3 bipolar syndr.
Bipolar I
A. Criteria have been met for at least one manic episode
this disorder contains a manic episode. Not necessarily a depressive episode.
mania - internalizing and thought disorder spectrum - ch3 bipolar syndr.
Bipolar II
A. Criteria have been met for at least one hypomanic episode and at least one major depressive episode
(B. There has never been a manic episode.)
This disorder contains both a hypomanic and a depressive episode.
We only need to know A but B clarifies the difference between Bipolar I and II
Thought disorder spectrum - ch3 bipolar & ch4 depressive
Specifier ‘with psychotic features’
A specifier that can be given with Bipolar I or Depressive syndromes
Bipolar I:
With psychotic features: Delusions and/or hallucinations are present at any time in the current manic or major depressive episode in Bipolar I or in current major depressive episode in Bipolar II:
Depressive:
With psychotic features: Delusions and/or hallucinations are present at any time in the current major depressive episode:
And then this is same for both bipolar and depressive, you specify whether:
- With mood-congruent psychotic features: The content of all delusions and hallucinations is consistent with the typical depressive themes of personal inadequacy, guilt, disease, death, nihilism, or deserved punishment.
- With mood-incongruent psychotic features: The content of the delusions or hallucinations does not involve typical depressive themes of personal inadequacy, guilt, disease, death, nihilism, or deserved punishment, or the content is a mixture of mood-incongruent and mood-congruent themes.
We must know when to give this specifier, not further details but I included them just to be aware of them
Video 10 - Detachment
What is part of the detachment spectrum?
No specific chapter in dsm
Anhedonia - inability to experience pleasure, joy, and enjoy life
- Often related to detachment from one’s emotions and from other (affective interpersonal detachment)
In DSM: Dysthymia (MDD), and then personality disorders (which we don’t need to know for this exam)
Video 10-disinhibited and antagonistic externalizing - antisocial behav.
Which DSM chapters cover the disinhibited and antagonistic externalizing spectrum and which syndromes does each include?
In HiTOP, disinhibited externalizing and antagonistic externalizing are separate domains but they have a subfactor in common - antisocial behaviour
Chapter 15: Disruptive, Impulse-Control, and Conduct Syndromes
- Oppositional Defiant Syndrome (ODD)
- Intermittent Explosive Syndrome
- Conduct Syndrome (CD)
- Pyromania
- Kleptomania
Chapter 1: Neurodevelopmental syndromes
- Attention Deficit Hyperactivity Syndrome (ADHD)
These are in the subfactor antisocial behaviour
ch15 Disinhibited and antagonistic externalizing - antisocial behaviour
Oppositional Defiant Syndrome
A. A pattern of angry/irritable mood, argumentative/defiant behavior, or vindictiveness lasting at least 6 months as evidenced by at least four symptoms from any of the following categories, and exhibited during interaction with at least one individual who is not a sibling.
Angry/Irritable Mood
1. Often loses temper.
2. Is often touchy or easily annoyed.
3. Is often angry and resentful.
Argumentative/Defiant Behavior
4. Often argues with authority figures or, for children and adolescents, with adults.
5. Often actively defies or refuses to comply with requests from authority figures or with rules.
6. Often deliberately annoys others.
7. Often blames others for his or her mistakes or misbehavior.
Vindictiveness
8. Has been spiteful or vindictive at least twice within the past 6 months.
Doesn’t involve criminal behaviour - what differentiates it from conduct disorder
ch15 - Disinhibited antagonistic externalizing - antisocial behaviour
Conduct syndrome
A. A repetitive and persistent pattern of behavior in which the basic rights of others or major age-appropriate societal norms or rules are violated, as manifested by the presence of at least three of the following 15 criteria in the past 12 months from any of the categories below, with at least one criterion present in the past 6 months:
Aggression to People and Animals
1. Often bullies, threatens, or intimidates others.
2. Often initiates physical fights.
3. Has used a weapon that can cause serious physical harm to others (e.g., a bat, brick, broken bottle, knife, gun).
4. Has been physically cruel to people.
5. Has been physically cruel to animals.
6. Has stolen while confronting a victim (e.g., mugging, purse snatching, extortion, armed robbery).
7. Has forced someone into sexual activity.
Destruction of Property
8. Has deliberately engaged in fire setting with the intention of causing serious damage.
9. Has deliberately destroyed others’ property (other than by fire setting).
Deceitfulness or Theft
10. Has broken into someone else’s house, building, or car.
11. Often lies to obtain goods or favors or to avoid obligations (i.e., “cons” others).
12. Has stolen items of nontrivial value without confronting a victim (e.g., shoplifting, but without breaking and entering; forgery).
Serious Violations of Rules
13. Often stays out at night despite parental prohibitions, beginning before age 13 years.
14. Has run away from home overnight at least twice while living in the parental or parental surrogate home, or once without returning for a lengthy period.
15. Is often truant from school, beginning before age 13 years.
If adults - antisocial personality syndrome (where one of the criteria is that when they were childreb they would have met the criteria for conduct syndrome)
Disinhibited externalizing - ch1 neurodevelopmental
Attention Deficit Hyperactivity Syndrome (ADHD)
A persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development, as characterized by (1) and/or (2):
1 Inattention: Six (or more) of the following symptoms have persisted for at least 6 months to a degree that is inconsistent with developmental level and that negatively impacts directly on social and academic/occupational activities:
Note: The symptoms are not solely a manifestation of oppositional behavior, defiance, hostility, or failure to understand tasks or instructions. For older adolescents and adults (age 17 and older), at least five symptoms are required.
- Often fails to give close attention to details or makes careless mistakes in schoolwork, at work, or during other activities (e.g., overlooks or misses details, work is inaccurate).
- Often has difficulty sustaining attention in tasks or play activities (e.g., has difficulty remaining focused during lectures, conversations, or lengthy reading).
- Often does not seem to listen when spoken to directly (e.g., mind seems elsewhere, even in the absence of any obvious distraction).
- Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (e.g., starts tasks but quickly loses focus and is easily sidetracked).
- Often has difficulty organizing tasks and activities
- Often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort (e.g., schoolwork or homework; for older adolescents and adults, preparing reports, completing forms, reviewing lengthy papers).
- Often loses things necessary for tasks or activities (e.g., school materials, pencils, books, tools, wallets, keys, paperwork, eyeglasses, mobile telephones).
- Is often easily distracted by extraneous stimuli (for older adolescents and adults, may include unrelated thoughts).
- Is often forgetful in daily activities (e.g., doing chores, running errands; for older adolescents and adults, returning calls, paying bills, keeping appointments).
2 Hyperactivity and impulsivity: Six (or more) of the following symptoms have persisted for at least 6 months to a degree that is inconsistent with developmental level and that negatively impacts directly on social and academic/occupational activities:
The note is the same as in inattention
- Often fidgets with or taps hands or feet or squirms in seat.
- Often leaves seat in situations when remaining seated is expected (e.g., leaves his or her place in the classroom, in the office or other workplace, or in other situations that require remaining in place).
- Often runs about or climbs in situations where it is inappropriate. (Note: In adolescents or adults, may be limited to feeling restless.)
- Often unable to play or engage in leisure activities quietly.
- Is often “on the go,” acting as if “driven by a motor” (e.g., is unable to be or uncomfortable being still for extended time, as in restaurants, meetings; may be experienced by others as being restless or difficult to keep up with).
- Often talks excessively.
- Often blurts out an answer before a question has been completed (e.g., completes people’s sentences; cannot wait for turn in conversation).
- Often has difficulty waiting his or her turn (e.g., while waiting in line).
- Often interrupts or intrudes on others (e.g., butts into conversations, games, or activities; may start using other people’s things without asking or receiving permission; for adolescents and adults, may intrude into or take over what others are doing).
Disinhibited externalizing spectrum - substance abuse - ch 16
What disorders are in ch 16 - Substance related and addictive disorders?
Alcohol Use Syndrome
Alcohol Intoxication
Alcohol Withdrawal
Unspecified Alcohol-Related Disorder
And Caffeine, Cannabis, Different kinds of recreational drugs, certain medications, tobacco, gambling
We only need to learn the criteria for alcohol use syndrome - The criteria for the others are mostly the same and you don’t need to know the difference by heart
Disinhibited externalizing spectrum - substance abuse subfactor - ch 16
Alcohol Use Syndrome
A. A problematic pattern of alcohol use leading to clinically significant impairment or distress, as manifested by at least two of the following, occurring within a 12-month period:
- Alcohol is often taken in larger amounts or over a longer period than was intended.
- There is a persistent desire or unsuccessful efforts to cut down or control alcohol use.
- A great deal of time is spent in activities necessary to obtain alcohol, use alcohol, or recover from its effects.
- Craving, or a strong desire or urge to use alcohol.
- Recurrent alcohol use resulting in a failure to fulfill major role obligations at work, school, or home.
- Continued alcohol use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of alcohol.
- Important social, occupational, or recreational activities are given up or reduced because of alcohol use.
- Recurrent alcohol use in situations in which it is physically hazardous.
- Alcohol 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 alcohol.
- Tolerance, as defined by either of the following:
a. A need for markedly increased amounts of alcohol to achieve intoxication or desired effect.
b. A markedly diminished effect with continued use of the same amount of alcohol. - Withdrawal, as manifested by either of the following:
a. The characteristic withdrawal syndrome for alcohol (refer to Criteria A and B of the criteria set for alcohol withdrawal)
b. Alcohol (or a closely related substance, such as a benzodiazepine) is taken to relieve or avoid withdrawal symptoms.
Time 2 CUT DOWN PAL:
Time spent (2 or more)
Cravings
Unable to stop
Tolerance
Dangerous
Others affected
Withdrawal
Neglects responsibilities
Problem made worse
Activities stopped
Larger amounts or for longer
Disinhibited externalizing spectrum - substance abuse subfactor - ch 16
Alcohol withdrawal
I only include this here because in the criteria for alcohol use syndrome they mention to look at alcohol withdrawal criteria, but it’s not in our table specifically mentioned
A. Cessation of (or reduction in) alcohol use that has been heavy and prolonged.
B. Two (or more) of the following, developing within several hours to a few days after the cessation of (or reduction in) alcohol use described in Criterion A:
- Autonomic hyperactivity (e.g., sweating or pulse rate greater than 100 bpm).
- Increased hand tremor.
- Insomnia.
- Nausea or vomiting.
- Transient visual, tactile, or auditory hallucinations or illusions.
- Psychomotor agitation.
- Anxiety.
- Generalized tonic-clonic seizures.
Disinhibited externalizing spectrum - substance abuse subfactor - ch 16
What are other substance disorders?
[…] Use Syndrome
Criteria are very comparable and you do not need to learn these differences
[…] Intoxication
Criteria depend on the specific substance. You do not need to know these.
[…] Withdrawal
Criteria depend on the specific substance. You do not need to know these.
We need to know that intoxication and withdrawal are important, possible cause of psychopathology (as described in the differential diagnosis chapter 1)
Video 11 - other syndromes in DSM-5
Which other chapters are there that we haven’t mentioned?
Chapter 14: Gender dysforia
Chapter 17: Neurocognitive syndromes (just know that there are all types of dementia)
Chapter 19: Paraphilic disorder (pedophilic, masochism, sadism…) - we just need to know the general overview what the chapter includes, nothing to learn by heart
Chapter 22: Other Conditions That May Be a Focus of Clinical Attention
Ch 1 - neurodevelopmental syndromes
Autism Spectrum Syndrome
Not part of the HiTOP
A. Persistent deficits in social communication and social interaction across multiple contexts, as manifested by all of the following, currently or by history (examples are illustrative, not exhaustive; see text):
- Deficits in social-emotional reciprocity, ranging, for example, from abnormal social approach and failure of normal back-and-forth conversation; to reduced sharing of interests, emotions, or affect; to failure to initiate or respond to social interactions.
- 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.
- Deficits in developing, maintaining, and understanding relationships, ranging, for example, from 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 least two of the following, currently or by history (examples are illustrative, not exhaustive; see text):
1. Stereotyped or repetitive motor movements, use of objects, or speech (e.g., simple motor stereotypies, lining 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 eat 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 perseverative 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).
Specify current severity:
Severity is based on social communication impairments and restricted, repetitive patterns of behavior (next flashcard)
(C. Symptoms must be present in the early developmental period)
Only A, B by heart
Autism spectrum disorder - specifiers for severity
There are three levels: (we don’t need to know the descriptions of each level)
Level 1: ‘‘Requiring support’’
Level 2: ‘‘Requiring substantial support’’
Level 3: ‘‘Requiring very substantial support’’
The levels have different description for social communication and then for restrictive, repetitive behaviours
Other Conditions That May Be a Focus of Clinical Attention
Not part of HiTOP - also not on exams, just need to be aware
- Relational Problems
- Abuse and Neglect
- Educational and Occupational Problems
- Housing and Economic Problems
- Other Problems Related to the Social Environment
- Problems Related to Crime or Interaction With the Legal System
- Other Health Service Encounters for Counseling and Medical Advice
- Problems Related to Other Psychosocial, Personal, and Environmental Circumstances
- Other Circumstances of Personal History
Just be aware that these exist
Just attaching the picture of the HiTOP so that we can remember it
