LPC - Disorders Flashcards
John is 15 years old and presents with a history dating back approximately 12 months in which he experiences periods of anhedonia, hypersomnia, and feelings of worthlessness, followed by periods of feeling rested after only a few hours and obsessive on-line gaming to the exclusion of all else. The periods frequently alternate. John does not have a significant history of drugs or alcohol, and he prefers sobriety to altered states. John’s diagnosis is most consistent with:
Correct answer: Cyclothymic Disorder
-Hypomanic and periods of depression.
Explanation: John’s hypomanic and depressive symptoms have been present for a year, which is consistent with the duration requirement for children and adolescents with Cyclothymic Disorder. His symptoms do NOT meet full criteria for hypomanic and major depressive episodes, which would be indicative of Bipolar II Disorder.
Josh lost his best friend in an auto accident in which the two were returning from a summer long adventure prior to starting college. Josh’s friend fell asleep at the wheel, the car crossed the median, and hit an oncoming vehicle, killing him instantly and leaving Josh with some injuries. A month has passed and Josh presents in your office. He reports feelings of grief and loss hitting in waves, in addition to depressed mood, inability to feel interest in any activity he previously enjoyed, difficulty concentrating, thoughts of death, feelings of worthlessness, and a desire to sleep all of the time. Josh’s mother reports that he appears to be moving through molasses. The best diagnosis for Josh is:
Correct answer: Major Depressive Disorder, severe
Explanation: While Josh’s symptoms started after his auto accident, his symptoms meet criteria for MDD, and the diagnosis of MDD, severe because of the number of depressive symptoms and because the dominance of the mood as depressed and anhedonic. With grief, the usual course is intense sadness when thinking about the loss, with periods of remitted mood.
Bipolar I Disorder, current episode manic, severe, with mood-congruent psychotic features
Correct answer: Bipolar I Disorder, current episode manic, severe, with mood-congruent psychotic features
Explanation: Mark is experiencing psychotic features (speaking with someone who is deceased), is grandiose (asking to be referred to by a title), has goal-directed behaviors, and is active with little sleep, all consistent with a manic episode. Hypomanic episodes do NOT have psychotic features. He is irritable, consistent with anger at the man with whom he seems to be angry (part of the psychotic behavior), making the psychotic features mood-congruent.
Barry has episodes of panic in which he struggles to catch his breath, his heart pounds in his chest, his hands tingle, and he feels as if he is going to die. These episodes last as long as 20 minutes, and two have resulted in a trip to the emergency room. Barry is terrified he will have another attack at the office, so he will not attend meetings unless he is convinced he can escape unnoticed. Barry can no longer go shopping because he had an attack at the mall. Barry’s symptoms are most consistent with:
Correct answer: Panic Disorder
Explanation: Panic Disorder is characterized by panic attacks and constant worry about an additional attack or significant changes to prevent another attack.
Social Communication Disorder
Social (Pragmatic) Communication Disorder is evident when the individual is restricted in his or her effective and efficient capacity to communicate due to deficits in assessing the social context. Deficits impair the individual’s ability to engage effectively in social interactions, impairing performance in important life areas.
Paranoid Personality Disorder
Paranoid Personality Disorder have a longstanding pattern and belief system characterized by a certainty that others’ motives are at minimum suspect, and possibly malevolent, even with no evidence or experience to document such beliefs. These individuals usually have difficulty with relationships because of their level of suspiciousness, often coming across as hostile, secretive, or lacking in feelings.
Obsessive-Compulsive Disorder
Individuals diagnosed with Obsessive-Compulsive Disorder are characterized by unwarranted fears and thoughts (obsessions) that lead to repetitive behaviors (compulsions). The individual may have either obsessions or compulsions, or both. Everyone will double-check themselves from time to time, such as making certain the coffee pot is turned off or that the door is locked before departing from home. However, individuals who suffer from OCD feel they must check things over and over or have to perform specific rituals or engage a routine, or they have thoughts they cannot stop.-3
Schizotypal Personality Disorder
Schizotypal Personality Disorder can be diagnosed by the presence of five or more of the following symptoms: magical thinking, bodily illusions, ideas of reference, odd thinking and speech, suspiciousness, inappropriate affect, oddities in behavior and appearance, few close friends, and social anxiety.
Social Communication Disorder
Social (Pragmatic) Communication Disorder is evident when the individual is restricted in his or her effective and efficient capacity to communicate due to deficits in assessing the social context. Deficits impair the individual’s ability to engage effectively in social interactions, impairing performance in important life areas.
Social Anxiety Disorder
The primary distinction of Social Anxiety Disorder (Social Phobia) is the fear of being embarrassed, humiliated, or judged by another. Social situations of all types (e.g., dealing with a cashier, meeting people, eating in a restaurant, public speaking) trigger the anxiety or fear response, and the individual avoids such circumstances if possible.
Persistent Depressive Disorder (Dysthymia); Alcohol Use Disorder, Moderate
Persistent Depressive Disorder may have poor concentration, but the issue is tied to mood, and the other characteristics (e.g., fatigue, low energy) are inconsistent with the balance of ADHD symptomology.
The essential feature of Persistent Depressive Disorder (Dysthymia) is a chronically depressed mood that occurs for most days for at least a two-year period. At least two symptoms must be present. They include but are not limited to poor appetite or overeating, insomnia or hypersomnia, low energy, and feelings of hopelessness. To establish the diagnosis, during the two-year period, the individual must not be without symptoms for longer than two months at a time. Alcohol Use Disorder refers to the pattern of alcohol use that leads an individual to experience significant impairment in physical, psychological, social, and/or interpersonal areas of functioning. A minimum of two significant symptom manifestations are present. Severity is based on the number of symptoms that the individual displays, with mild being 2-3, moderate being 4-5, and severe being 6 and above.
Cyclothymic Disorder
Cyclothymic Disorder is characterized by a period of time (a minimum of two years for adults or one year for minors) in which the individual experiences ongoing periods of symptoms related to hypomania and periods of symptoms related to depression, but neither set meet criteria for a hypomanic episode or a depressive episode.
Schizoid Personality Disorder
Schizoid Personality Disorder is marked by disinterest in interpersonal relationships and a narrow range of emotions in a social setting. These qualities are illustrated in at least four of the following symptoms: lack of close relationships, choosing solitary activities, disinterest in sexual relationships, deriving pleasure from few activities, lack of close friends, indifference to praise or criticism, and emotional aloofness.
Delusional Disorder
Delusional Disorder occurs when an individual experiences a delusion for a minimum of 30 days, but outside of that delusion, the individual is largely asymptomatic. Outside of the delusion, the individual does not experience impaired functioning.
Primary Hypersomnia
Primary Hypersomnia typically develops before one’s forties and often continues throughout life. It involves sleeping for more hours per day than normal without an underlying medical or psychological cause.
