Intro To Psychopathology And Anxiety Flashcards
What is psychopathology?
Characteristics
• A mental disorder causing a disturbance in an individual’s cognition, emotion regulation, or behavior
• Associated with significant distress or impairment in social, occupational, or other important activities
What is the significance of DSM-5?
‒ “Authoritative” classification system of mental disorders
‒ Published by the American Psychiatric Assoc.
‒ Current edition: DSM-5-TR (Text Revision, 2022)
▪ Clarification of criteria; renamed disorders; 1 new disorder
▪ Updates to descriptive text, terminology
➢ International Classification of Diseases (ICD-11):
– A “companion” publication closely aligned with DSM
– Includes “Mental & Behavioral Disorders”
– Published by the WHO
What are the basic features of the DSM-5?
Basic Features of the DSM-5
➢ The DSM includes a checklist of diagnostic criteria for each psychiatric disorder
‒ Criteria often include frequency of behavior and a minimum duration of symptoms
‒ Symptoms must be clinically significant
‒ Symptoms are NOT substance-induced or due to another medical condition (otherwise, a different diagnosis is made)
Contrast. DSM 4 to DSM-5-TR
• BPM2 Exams:
– Diagnostic name changes
• Know both names
• Both names will not appear as answer choices in the same exam question
• NBME Step 1 and Step 2 exams:
– Unknown transition date to DSM-5-TR language
Describe the diagnostic criteria of the DSM 5
➢ The DSM includes a checklist of diagnostic criteria for each psychiatric disorder
• Criteria often include frequency of behavior and a minimum duration of symptoms
• Symptoms must be clinically significant
• Symptoms are NOT substance-induced or due to another medical condition (otherwise, a different diagnosis is made)
➢ Capture patient’s problems with fewest number of diagnoses
Describe the “provisional” diagnostic descriptor of the DSM
➢ “Provisional”: Used if one presumes that criteria are
(or will be) met for the disorder but either:
• Patient information is unavailable (and expected to be
confirmed upon inquiry) or
• Required symptoms are present, but the duration
criterion is NOT YET (but expected to be) met
➢“Provisional” goes after the name of the specific diagnosis that the person is presumed to have
, provisional
What’s the example of provisional descriptors of the DSM 5?
A 20-year-old woman appears to have bulimia nervosa, an Eating Disorder characterized by binge-eating and inappropriate compensation (e.g., purging). However, the frequency and duration of her “binging and purging” are unknown. Based on physical indicators, it is presumed that she does meet the frequency and duration criteria. Until this fact can be confirmed, what is her diagnosis?
Describe the Unspecified diagnostic disorders
➢ “Unspecified”: An “unspecified” disorder is diagnosed when a patient definitely does NOT meet criteria for a specific disorder but has significant symptoms within a given diagnostic category
➢ Insert the word “Unspecified” before the name of the diagnostic category (DSM-5 chapter title)
Unspecified
Give an example of unspecified descriptor
Example: A 30-year-old woman presents with symptoms suggestive of Major Depressive Disorder (MDD), which is a specific diagnosis that falls in the “Depressive Disorders” category of mental illness. After a thorough history is gathered, however, it is determined that she has an insufficient number of symptoms for the diagnosis of MDD or any other depressive disorder. However, her depressive symptoms are still noteworthy. What is her diagnosis?
What are the “prior history” and “in remission” descriptors of the DSM 5?
➢ “Prior History” and “In Remission”: Use these descriptors when a patient has been previously diagnosed with a disorder, but the symptoms are no longer present
- “Prior history” implies that the prior disorder will not recur
- “In remission” implies that the prior disorder is currently controlled but is likely to recur
What are the anxiety disorders?
ANXIETY DISORDERS • Panic disorder • Agoraphobia • Specific phobia • Social anxiety disorder • Generalized anxiety disorder • Separation anxiety disorder • Selective mutism
When is anxiety normal?
All share in common the theme of inappropriate anxiety*
➢ Anxiety is abnormal when it is:
• Elicited by inappropriate cues (or no cues)
• Excessive in intensity
• Excessive in duration
Note: The terms “fear” (response to imminent threat) and “anxiety” (response to anticipation of future threat) are used interchangeably in this course
What is the diagnostic criteria of panic disorder?
Diagnostic Criteria
➢ Recurrent and unexpected panic attacks (the exact # of attacks is not specified)
➢ The individual shows either:
• Fear of future panic attacks AND/OR
• A significant change in behavior related to the attacks (e.g., avoidance of exertion)
What are the symptoms of a Panic Attack?
Panic Attack: Intense fear with somatic or cognitive symptoms such as:
- Cardiac symptoms
- Sweating
- Trembling
- Shortness of breath
- Choking
- Chest pain
- Gastrointestinal symptoms
- Feeling faint
- Feeling detached
- Fear of losing control
- Fear of dying
- Tingling/numbness
- Chills/hot flushes
➢ Abrupt onset with episode peak within minutes
What are the diagnostic criteria of agarophobia?
Diagnostic Criteria ➢ >2 of these situations are feared/avoided: ‒ Using public transportation ‒ Being in open spaces ‒ Being in enclosed spaces ‒ Standing in line or being in a crowd ‒ Being outside of the home alone
➢ These situations are feared/avoided because of thoughts that escape might be difficult (or help might not be available) if incapacitating/embarrassing symptoms develop
