Other Conditions that May Be a Focus of Clinical Attention Flashcards
20.1.
In what section is the diagnosis of malingering categorized in
the DSM-5?
A. Disruptive behavior disorders
B. Other conditions that may be a focus of clinical attention
C. Personality disorders
D. Psychotic disorder
E. Somatic symptom and related disorders
20.1. B. Other conditions that may be a focus of clinical
attention
Malingering, a deliberate falsifying of physical or psychological
symptoms to achieve a secondary gain (i.e., avoiding work, obtaining
financial compensation, avoiding criminal prosecution, etc.) is not
considered a mental health disorder, rather is listed in a section in
the DSM-5 called “Other conditions that may be a focus of clinical
attention.”
20.2.
Common potential causes of feigning symptoms as a part of
malingering include which of the following scenarios? (Choose
three correct answers)
A. Enjoyment of being in the sick role
B. Gaining free room and board at a hospital*
C. Getting worker’s compensation
D. Having severe depression
E. Inflicting pain upon minors by subjecting them to medical
tests
F. Obtaining drugs for abuse
20.2. B. Gaining free room and board at a hospital, C.
Getting worker’s compensation, and F. Obtaining drugs for
abuse
Malingering involves faking psychological or physical symptoms or
secondary gain. Common causes of faking symptoms include to
obtain drugs for abuse, or faking psychiatric symptoms to get free
room and board in a hospital if homeless. Other cause of malingering
includes faking injury to get money, or to get out of testifying in
court. When there is no clear secondary gain and enjoyment of the
sick role is noted, factitious disorder should be considered.
Munchausen disorder by proxy should be considered if the adult is
inflicting medical tests on a child and lying about their medical
symptoms
20.3.
Patients with conversion disorder as opposed to malingering
are more likely to display which of the following symptoms?
A. Avoidance of diagnostic evaluations
B. Behave as clingy and dependent
C. Possess a suspicious demeanor
D. Provide extremely detailed description of events leading to
their illness
E. Refuse opportunities for employment
20.3. B. Behave as clingy and dependent
Malingering should be differentiated between conversion disorder
with both, objective signs cannot account for their subjective
experience. Those with conversion disorder are often dependent,
clingy, friendly, and cooperative, compared to those with
malingering who are suspicious and aloof. While those with
conversion disorder want an answer and search for evaluations,
those with malingering avoid them. Malingerers often avoid
employment opportunities as well to circumvent their disability.
Those with conversion disorder often have vague descriptions of
their illness and inaccuracies and gaps in their history but those with
malingering often provide excessively detailed accounts of events
leading to their disability
20.4.
Which symptom is more typical of a major depressive
disorder rather than normal grief?
A. Difficulty carrying out daily activities for a few weeks
B. Guilt about not seeing the loved one enough
C. Hearing the voice of the loved one
D. Irritability and insomnia
E. Significant psychomotor retardation
20.4. E. Significant psychomotor retardation
Signs of normal bereavement can include sadness, irritability,
insomnia, tearfulness, and difficulty carrying out daily activities,
though if prolonged marked functional impairment, it is more
consistent with a major depressive disorder. Excessive guilt about
things (other than actions taken around the time of the loved one’s
death), along with thoughts of dying (other than wanting to be with
the loved one) are symptoms consistent with a major depressive
disorder. Significant psychomotor retardation and worthlessness,
along with hallucinations that don’t just involve the lost loved one,
can also point toward a diagnosis of a major depressive disorder,
rather than just grief
20.5.
Which neurologic abnormality is found in half of aggressive
criminals?
A. Abnormal EEGs
B. Brain tumors
C. Cerebral atrophy
D. Loss of grey matter in the brain
E. Migraines
20.5. A. Abnormal EEGs
Neurologic conditions are often associated with adult antisocial
behavior. Abnormal EEGs are commonly found in violent offenders,
with studies estimating around 50% of aggressive criminals have
abnormal EEG findings. Complex partial seizures should be ruled
out in those with antisocial behavior. In cases of epilepsy or
encephalitis, careful examination should be done to examine the
extent those disorders are contributing to the behavior
20.6.
Which is one of the most common symptoms noted in adult
antisocial behavior?
A. Drug abuse
B. Pathologic lying
C. Somatic complaints
D. Suicide attempts
E. Work problems
20.6. E. Work problems
Though all the symptoms noted above can be features of antisocial
behavior in adults, work problems are thought to be the most
prominent symptoms (around 85%) followed by marital, financial
dependency, and arrests, along with alcohol abuse. Less common
symptoms include somatic complaints (11%), drug abuse (15%),
suicide attempts (11%), and pathologic lying (16%).
20.7.
Though antisocial behavior often continues through a
person’s life, some evidence exists that which of the following
treatments might be helpful?
A. Acceptance and commitment therapy
B. Dialectical behavior therapy and phone coaching
C. Cognitive behavioral therapy
D. Group therapy and therapeutic communities
E. Interpersonal psychotherapy
20.7. D. Group therapy and therapeutic communities
Though often outcomes for treating adult antisocial behavior are
poor, in general, it is thought that behavior seems to decrease after
40 years old. Psychological therapy and medication treatment are
typically not very effective, though for incarcerated criminals in
institutional settings, some forms of group therapy have been shown
to help and therapeutic communities are also thought to be helpful.
20.8.
Which group of people appears to be more vulnerable to
negative experiences in dealing with phases of life problems?
A. Men
B. Minorities
C. People who utilize sublimation
D. Those of a higher socioeconomic status
E. Younger people
20.8. B. Minorities
Phases of life problems can occur at any age. Common problems
include divorce of parents, illness, having children, etc. Men appear
to handle these phases of life problems better externally, whereas
women, those of lower socioeconomic status, and minorities appear
most vulnerable to the negative experiences, resulting in anxiety and
depression. Positive attitudes, family relationships, mature
defense
mechanisms, with use of sublimation, creativity, and flexibility
appear to be protective factors against depression and anxiety from
these phases of life problems.
20.9.
Which parenting style is most likely to be associated with
children who are more aggressive, impulsive, and struggle
with achieving?
A. Attachment
B. Authoritarian
C. Authoritative
D. Helicopter
E. Permissive
20.9. E. Permissive
Permissive parenting, which can be described as minimally
restrictive and accepting, is associated with kids who are more
aggressive, impulsive, and tend to be low achievers. Authoritarian
parents can be described as cold and restrictive, and these children
tend to be withdrawn or conflicted. Parents should aim for an
authoritarian approach involving restriction as needed in a warm
and accepting way. These children are thought to be the most socially
well-adjusted and do better cognitively and are the highest achievers
20.10.
Studies support which of the following findings for
physician marriages compared to other occupational groups?
A. Conflicts and separation are less likely to occur
B. Psychiatrists have the highest rate of divorce
C. Surgeons are most likely to get married
D. They occur later in life, on average in their 30s
E. They have higher satisfaction rates
20.10. B. Psychiatrists have the highest rate of divorce
Physicians have the highest risk of divorce compared to other
occupation groups, with psychiatrists having the highest rates (50%),
followed by surgeons (33%), internist pediatricians, and
pathologists. Stress of work, including dealing with life–death
situations, long hours, malpractice risks, and increased risk of
depression and substance use are likely factors that contribute to the
high divorce rate.
