Midterm Exam Flashcards
1
Q
Involves identifying subjective conditions
A
Diagnosis
2
Q
How we assess will change based on:
A
Personal history, what we’ve learned, lenses we use, information we have
3
Q
Goal of diagnosis
A
Not to be right, but to be more reliable, document what we’re treating and why
4
Q
The root word of this means “mark of shame”
A
Stigma
5
Q
What is a mental disorder
A
Conditions that affect one’s emotions, thinking, and/or behavior and lead to distress or functional impairment
6
Q
Subjective conditions that can be identified
A
Mental disorder
7
Q
A biopsychosocial approach to understanding, identifying, and communicating human suffering using evidence-based and ethical practices.
A
Diagnosis in counseling
8
Q
Parts of the counseling process that is the focus of this class
A
Assessment and Diagnosis
9
Q
Part of the counseling process that never goes down to nothing
A
Assessment
10
Q
Starts the first session, is biopsychosocial in nature, focuses on current issues, seeks to understand history, signs and symptoms
A
Assessment
11
Q
Abbreviation: CL/PT
A
Client or Patient
12
Q
Abbreviation: DA
A
Diagnostic Assessment
13
Q
Abbreviation: Hx
A
History
14
Q
Abbreviation: SxS
A
Signs and Symptoms
15
Q
Something you can observe
A
Signs
16
Q
Something that is internal and needs to be reported by client
A
Symptoms
17
Q
Sign or Symptom ex: No eye contact, closed, tear as they speak about how hard life is
A
Sign
18
Q
Sign or Symptom ex: Client says “I don’t think anything is going to change, I feel hopeless. I have such low energy that I can’t get up for work.”
A
Symptom
19
Q
Abbreviation: ICD
A
International Classification of Diseases
20
Q
Official coding system to make diagnosis and to use for documentation and billing purposes
A
ICD
21
Q
Abbreviation: CPT
A
Current Procedural Terminology
22
Q
Coding system used to identify services rendered and is used for billing purposes
A
CPT; Current Procedural Terminology
23
Q
Both ICD and CPT codes need to be accepted before what?
A
Before treatment planning begins and to be reimbursed
24
Q
The extent to which two or more raters (or observers, coders, examiners) agree
A
Interrater reliability
25
Psychodiagnosis is rooted in the sub-field of what?
Abnormal Psychology
26
Focuses on the assessment, causes, and consequences of maladaptive behavior (and NOT treatment)
Abnormal Psychology
27
Type of behavior that describes personal vulnerability combined with environmental events leading to problem(s) in living, disability, impairment (social, occupational), distress
Maladaptive behavior
28
Statistically different from the norm
Deviant
29
What is deviant does not necessarily mean it is ________.
Maladaptive
30
Key terms of this include: Vulnerability, Lifetime Prevalence Rate, Incidence Rate, Etiology, Risk Factors
Abnormal Psychology
31
Abbreviation: LPR
Lifetime Prevalence Rate
32
__________ is in contrast to resiliency.
Vulnerability
33
The likelihood that someone will respond maladaptively in a certain situation
Vulnerability
34
Statistics reporting proportion of a population that will experience a characteristic at some point during their lifetime.
LPR; Lifetime Prevalence Rate
35
Rate that means: X disorder had a prevalence rate of X% in X timeframe
Incidence Rate
36
Cause or set of causes for a disease or condition
Etiology
37
More and more, our society is moving towards __________ etiology.
Biological (etiology)
38
T/F: There are reliable biological markers for mental conditions.
False
39
T/F: Biological markers of mental conditions are indicative of correlation vs causation.
True
40
Characteristics associated with higher likelihood of experiencing a disease or condition
Risk Factors
41
T/F: Risk factors of mental conditions are indicative of causation vs correlation.
False
42
T/F: The more risk factors a person has, the more likely someone is for experiencing a mental condition
True
43
T/F: You should assess for diagnosis with the highest LPR first.
True
44
Patron Saint of Mental Illness
St. Dymphna
45
Mental illness was originally viewed as what?
Punishment from the Gods, supernatural, unseeable forces
46
Surgical procedure where a hole was created in the skull by removing a circular piece of bone
Trephination
47
T/F: In the Middle Ages, there was very little distinction between deviation and maladaptive behavior.
True
48
Where did the first "Public Hospital for Persons of Insane and Disordered Minds" open in 1773?
Colonial Williamsburg, VA
49
During this time period, anatomy was documented, hospitals were reformed, and "moral treatment" was developed
1800s
50
In the 1800s, this entailed daily visits from staff, proper diet, letting clients out for physical activity, attempting to separate mild from severe
Moral treatment
51
The current theory of maladaptive behavior is __________.
Biopsychosocial
52
We focus on ________-_________ interventions.
psycho-social
53
The ___________ of mental conditions is complex, ever-changing, and ultimately unknowable.
Etiology
54
In the U.S., the percentage of adults who suffer from a diagnosable mental disorder each year.
26%
55
Of the top 10 leading illnesses, what 4 are mental disorders?
Anxiety disorders, Depressive disorders, Bipolar disorders, Psychotic disorders
56
In the U.S., what is the annual incidence rate for Anxiety disorders
13.3%
57
In the U.S., what is the annual incidence rate for Depressive disorders
9.5%
58
In the U.S., what is the annual incidence rate for Bipolar disorders
1.2%
59
In the U.S., what is the annual incidence rate for Psychotic disorders
1.2%
60
In the U.S., the LPR of developing a mental disorder of any kind is approximately X%
46%
61
In the U.S., the LPR of Anxiety Disorders
28%
62
In the U.S., the LPR of Impulse-Control Disorders
24%
63
In the U.S., the LPR of Mood Disorders
20%
64
In the U.S., the LPR of Substance-Related Disorders
15-20%
65
ICD was developed by whom?
World Health Organization (WHO) as part of the United Nations
66
Current ICD edition
11
67
What is the main goal of the ICD?
To track mortality (death) and morbidity (current illnesses) data globally
68
Number of members of WHO who have agreed to the current version of ICD
194
69
By international treaty, every country needs to use ICD to track what?
Causes of death
70
Permission to use a modified version of ICD is granted to track what?
Current illnesses
71
Modified version of ICD used in the U.S.
ICD-10-CM (Clinical Modification)
72
ICD-10-CM was developed by whom?
HHS (Department of Health and Human Services)
73
Section F (or F-codes) includes what 3 categories used in diagnosis?
Mental, Behavioral, and Neurodevelopmental
74
HIPPA Law mandates that all healthcare providers must use the ICD-CM to diagnose what?
Morbidity (current illness)
75
When is the ICD-CM updated every year?
October
76
CPT (Current Procedural Terminology) was developed by whom?
American Medical Association
77
ICD tracks Dx for all symptoms of _____, ______, and _______ internationally.
Illness, injury, and death (including mental disorders)
78
DSM codes are developed by whom?
The American Psychiatric Association
79
Both the DSM and ICD-CM are what type of system?
Categorical diagnostic system
80
Person who advocated for using person-first language (i.e. a person with a MD vs a MD person)
Fred Frese
81
T/F: The DSM and ICD-CM attempt to imply specific disorder causes as well as legal decisions
False
82
This federal law requires all healthcare providers to use ICD-CM codes, which describe why a healthcare service was required/billed
Health Insurance Portability and Accountability Act of 1996
83
T/F: DSM codes are used for billing/tracking purposes in America and in other countries
False
84
Terms used for mental illness before the 1800s
"Idiocy" or "insanity"
85
Year ICD-1 was introduced in the U.S.
1898
86
Year DSM-I published and number of Dx
1952; 106 Dx
87
Year DSM-II published and number of Dx
1968; 182 Dx
88
DSM-1 and -II were based on what principles
Psychoanalytic
89
Year DSM-III published and number of Dx
1980; 265
90
Starting with this version of the DSM, Dx were atheoretical
DSM-III
91
Year DSM-III-R published and number of Dx
1987; 292
92
Year ICD-10 was published worldwide
1994
93
Year DSM-IV published and number of Dx
1994; 365
94
Year DSM-IV-TR published
2000
95
Year DSM-5 published
2013
96
This version of the DSM was published in 2022 with no major updates and still based on ICD-CM-10
DSM-5-TR
97
Year ICD-11 was published worldwide
2022
98
Number of categories in the DSM
21
99
1st step/question of assessment
Does this person meet the definition of a mental disorder at all?
100
Pre-Req for any F-Code
Person meets the definition of a Mental Disorder
101
T/F: Whatever the disfunction, it must not be culturally expected or accepted in their culture; locally maladaptive
True
102
A syndrome (collection of signs (observed) and symptoms (internal, reported)) characterized by clinically significant (disfunction (significant distress or disability) directly linked to the syndrome and must be able to be documented) disturbance in an individual’s cognition, emotion regulation, or behavior that reflects a dysfunction in the psychological, biological, or developmental processes underlying mental functioning... associated with significant distress or disability in social, occupational, or other important activities.
Definition of a Mental Disorder
103
Codes used by clinicians to note stressful situations (social, economic and environmental) that might have a negative impact on mental health
Z-Codes
104
Codes related to diseases of the nervous syste
G-Codes
105
Always rule out these 2 things as reasons for syndrome
Medical conditions and Substances
106
Period of time most insurers will accept "unspecified"
2-3 sessions
107
This notation is used when you're 95% sure of a specific diagnosis
Provisional
108
These conditions must be met in order for symptoms to be considered a mental disorder
They cluster in a characteristic way and must cause clinically significant distress or impairment in social or occupational functioning
109
T/F: The DSM mental disorders are no more than descriptive syndromes and they are not necessarily discrete diseases.
True
110
T/F: Having separate categories in the DSM adds information and precision, but should not imply separate causalities or need for separate treatments.
True
111
This type of diagnostic process is more accurate and efficient for clients who present with milder or ambiguous symptoms, or have too short a history to provide basis for future prediction
Stepped Diagnosis
112
Always rule out these 2 MDs first
Bipolar and Depressive Disorders
113
4 categories of criteria that are used in determining abnormal human behavior
Distress; Impairment; Risk to Self or Others; Socially and Culturally Unacceptable Behavior
114
T/F: Socially deviant behavior (for example, political, religious, or sexual) and conflicts that are primarily between the individual and society are not mental disorders unless the deviance or conflict results from a dysfunction in the psychological, biological, or developmental processes underlying mental functioning.
True
115
This helps clinicians determine prognosis, treatment plans and potential treatment outcomes.
Diagnosis of a mental disorder
116
T/F: Diagnosis of a mental disorder is equivalent to needing treatment
False
117
This is a complex clinical decision that considers symptom severity, symptom prominence (or salience), individual’s distress or disability associated with symptom(s), risk and benefits of available treatments, etc.
Diagnosis of a mental disorder
118
T/F: Clinician should consider individuals to be heterogeneous even in regard to the defining features of the diagnosis and boundary cases will likely be diagnosed in a probabilistic fashion
True
119
This defines mutually exclusive and jointly exhaustive phenomenological subgroupings within a diagnosis
Subtypes
120
T/F: Subtypes and Specifiers provide more homogenous subgrouping of individuals
True
121
Social construct divides humanity into groups based on variety of superficial physical traits
Race
122
Culturally constructed group identity used to define people and communities
Ethnicity
123
Set of protocols that clinicians may use to obtain info during DA about impact of culture on key aspects of individual’s clinical presentation and care
Cultural Formulation Interview (CFI)
124
Among the most common and stereotyped (and stigmitized) groups of mental disorders
Substance-Related & Addictive D/O
125
T/F: In the DSM, the phrase “addiction” is not applied as a diagnostic term; more neutral term “substance use disorder” is what is applied
True
126
Dx that should be listed first if multiple
Reason for visit
127
Abbreviation: R/O
Rule Out
128
T/F: Genes do not cause addiction, but some are genetically predisposed to have a more intense or euphoric reaction to a substance
True
129
Unlike Alcohol Abuse Disorder, this variation includes a biological component
Dependence
130
Number of symptoms present for Substance Abuse label
2-3
131
Number of symptoms present for Substance Dependence label
4+
132
U.S. LPR of schizophrenia is what?
1%
133
U.S. LPR for all psychotic disorders is what?
2%
134
T/F: For Schizophrenia, prevalence rates are generally equal between men and women, but onset is earlier for women.
False, onset is earlier for men
135
Risk factors include: Urban residence, life stressors, high-expressed emotional environments (critical or overbearing), low SES/social support, psychoactive drug use, family Hx of related illnesses
Schizophrenia
136
Percentage of clients with schizophrenia who complete suicide
10-15%
137
Percentage of clients with schizophrenia who attempt suicide
40%
138
Percentage of clients with schizophrenia who have thoughts of suicide
70-80%
139
This fraction of the homeless population is thought to have a psychotic disorder
1/3
140
T/F: With schizophrenia, preteen onset is common, though after 40s is rare
False, preteen onset is also rare
141
Antipsychotics try to reduce these two chemicals
dopamine and serotonin
142
The environmental hypothesis for causation in schizophrenia is a _________ family environment.
High-Expressed Emotional (criticism, hostility and emotional over-involvement)
143
Factors for good prognosis in Schizophrenia
Good insight; average onset; acute onset (rapid); good premorbid functioning; good social support
144
Genetic vulnerability or predisposition for an illness or medical condition
Diathesis
145
This model is a psychological theory that suggests that schizophrenia is caused by a combination of genetic vulnerability (diathesis) and environmental stressors. According to this model, individuals who are genetically predisposed to schizophrenia will only develop the condition if they are exposed to environmental stressors.
Diathesis-Stress Model
146
Schizophrenia Spectrum and Other Psychotic Disorders are defined by abnormalities in these 5 domains:
Delusions; Hallucinations; Disorganized Thinking; Grossly Disorganized or Abnormal Motor Behavior; Negative Symptoms
147
Most common delusion type: Belief that one is going to be harmed or harassed by an individual or group
Persecutory
148
Delusion Type: Belief that certain gestures, comments, environmental cues are directed at oneself
Referential
149
Delusion Type: When an individual believes that he or she has exceptional abilities, wealth, or fame
Grandiose
150
Delusion Type: Belief that someone is in love with them
Erotomanic
151
Delusion Type: Conviction that a major catastrophe will occur
Nihilistic
152
Delusion Type: Preoccupations regarding health and organ function
Somatic
153
Most common hallucination type
Auditory
154
Hallucinations must occur during what?
Clear sensorium
155
Disorganized thinking is typically inferred through what?
The individual's speech
156
T/F: In Schizophrenia, disorganized thinking must be severe enough that it impairs effective communication
True
157
Period in schizophrenia where symptoms start to show up
Prodromal
158
Period in schizophrenia where symptoms are most noticeable
Active Stage
159
Last stage of schizophrenia, symptoms are waning
Residual
160
State of being symptomatic or unhealthy for a disease or condition
Morbidity
161
These symptoms account for substantial portion of the morbidity associated with schizophrenia but are less prominent in other psychotic disorders
Negative Symptoms
162
Term meaning a decrease in motivated self-initiated purposeful activities
Avolition
163
Term meaning a diminished speech output, lack of fluency of speech, speaking slower
Alogia
164
Term meaning a decreased ability to experience pleasure
Anhedonia
165
Term meaning an apparent lack of interest in social interactions
Asociality
166
Most common countertransference reactions when treating a client with schizophrenia
Fear; next are nurturance/pity/sympathy
167
The number one risk that comes with better insight in schizophrenia is what?
Suicide (demoralization; especially among)
168
Term meaning the experiencing of helplessness and hopelessness
Demoralization
169
Characteristics which are “added to” persons with psychosis that the typical person does not experience
Positive symptoms
170
Most common type of positive symptom in psychosis
Self-generated hallucinations
171
Characteristics which are normally present but are “taken away from” persons with psychosis
Negative symptoms
172
T/F: The DSM categorizes disorganized symptoms as positive.
True
173
Examples of this type of symptom in psychosis are alogia and amotivation
Negative Symptoms
174
Sensory experiences in the absence of any external stimuli
Hallucinations
175
All-encompassing, systemic, tightly-held beliefs related to a certain theme and are clearly false.
Delusions
176
Most common delusion theme
Persecutory
177
Second-most common delusion theme
Grandiose
178
Most common symptoms include: Hallucinations, Delusions, Social Withdrawal, Suspiciousness, Blunted Affect, Motor Retardation, Lake of insight
Psychosis
179
Type of psychotic disorder with diagnostic criteria that includes: 1+ positive/disorganized symptom(s) with duration of less than a month
Brief Psychotic D/O
180
Type of psychotic disorder with diagnostic criteria that includes: 1+ delusion with duration of 1 month or greater
Delusional D/O
181
Type of psychotic disorder with diagnostic criteria that includes: 2+ positive/negative symptoms with duration of 1-6 months
Schizophreniform D/O
182
Type of psychotic disorder with diagnostic criteria that includes: 2+ positive/negative symptoms with duration of greater than 6 months
Schizophrenia
183
Type of psychotic disorder that is the same as Schizophrenia with the addition of a mood disorder (depressive or manic) that is concurrent (occurring 50% or more of the time) with schizophrenic symptoms
Schizoaffective D/O
184
3 D/Os with childhood onset
ADHD, ODD, CD
185
1 possible definition includes: A neurological inefficiency in the area of the brain that controls impulses, and is the center of “executive functions”
ADHD
186
1 possible definition includes: A performance disorder, a problem of being able to produce or act upon desired behaviors
ADHD
187
1 possible definition includes: A psychological disorder involving reduced ability to control one’s thoughts and emotions
ADHD
188
1 possible definition includes: A biopsychosocial condition linking brain/body to toxins, environmental settings, psychological/social expectations and more
ADHD
189
ADHD LPR for the general population
3-7%
190
When is ADHD usually diagnosed?
When a child enters school
191
ADHD is diagnosed in what percentage of school-aged children?
4-12%
192
Male to female ratio for ADHD
3:1
193
Number of symptoms required to meet either Inattentive or Hyperactive ADHD presentations
6 (6 from each if both)
194
LPR of ODD
2-16%
195
T/F: In ODD, males may be more confrontational and have more persistent symptoms
True
196
T/F: In ODD, although prevalence rates for males and females are similar during middle adolescence, rates are higher for girls during pre-puberty and late adolescence
False, rates are higher for boys during pre-puberty and late adolescence
197
Defined as a recurrent pattern of “problem” behavior toward authority figures
ODD (Oppositional Defiant Disorder)
198
In this D/O, symptoms are more evident with peers or adults who know the individual well and may not be apparent during clinical interview/intake
ODD (Oppositional Defiant Disorder)
199
Individuals with this disorder usually do not see themselves the problem; they see others as placing unreasonable demands on them
ODD (Oppositional Defiant Disorder)
200
Disorder similar to ODD but is more egregious and dangerous
CD (Conduct Disorder)
201
LPR of CD
1-10%
202
Cluster of characteristics that can combine in individuals with CD
Sexual offenses, bed wetting, fire setting, cruelty to animals
203
ODD is a common precursor to this D/O and is rarely diagnosed after 16
CD
204
Adolescence is what age period
10-19
205
