PSY 600 Midterm Winter 2024

Question 1

What are two main criteria that are used to determine that a person’s behavior, emotions, or experiences constitute a mental disorder?

Answer 1

1. Statistically Atypical
   a. Nature of symptoms:
   hallucinations, suicidal.
   b. Number of symptoms or
   duration.
   c. Consequences
2. Maladaptive Behavior
   a. Significant subjective distress
   b. Significant impairment in
   functioning.
   c. Involves personal harm or risk of
   harm to others.

Question 2

What are 3 benefits of diagnostic labels?

Answer 2

1. Can help clinicians gain a better understanding of the client and an appropriate course of treatment can be applied.
2. Can facilitate communication between clinicians.
3. Helps families understand and recognize the symptoms of the diagnosed person.

Question 3

What are 3 concerns of diagnostic labels?

Answer 3

1. Can lead to negative effects such as stigmatization.
2. Clients may use diagnosis as an excuse for not changing maladaptive behaviors.
3. Misdiagnosis can mean implementing an incorrect treatment.

Question 4

Are DSM-5-TR: Other Conditions That May Be A Focus of Clinical Attention considered mental health disorders? Why?

Answer 4

The conditions and problems listed in this chapter are not mental disorders. There inclusion is meant to draw attention to the scope of additional issues that may be encountered in routine clinical practice and to provide a systematic listing that may be useful to clinicians in documenting these issues.

Question 5

Besides “Uncomplicated Bereavement” what are 2 other examples of diagnoses in the category of Other Conditions That May Be A Focus of Clinical Attention?

Answer 5

1. Parent-Child Relational Problem
2. Child Affected by Parental Relationship Distress
3. Relationship Distress With Spouse or Intimate Partner
4. Acculturation Difficulty
5. Phase of Life Problem
6. Educational Problems

Question 6

For an adjustment disorder diagnosis, how soon after a stressor do symptoms need to be begin?

Answer 6

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).

Question 7

What evidence suggests that symptoms are clinically significant?

Answer 7

As evidenced by one or both of the following:
1. Marked distress 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.
2. Significant impairment in social, occupational, or other important areas of functioning.

Question 8

When are Z codes used?

Answer 8

Z codes are used by clinicians to note stressful situations that might have a negative impact on mental health.

Question 9

A condition or problem may be coded when…

Answer 9

1) it is a reason for the current visit
2) it helps explain the need for a test, procedure, or treatment
3) it plays a role in the initiation exacerbation of a mental disorder
4) it constitutes a problem that should be considered in the overall management plan

Question 10

The symptoms of adjustment disorder persist within what time frames?

Answer 10

An adjustment disorder must resolve within 6 months of the termination of the stressor or its consequences.

Acute specifier is used to indicate persistence of symptoms for less than 6 months.

Persistent (Chronic) specifier is used to indicate persistence of symptoms for 6 months or longer.

Question 11

For a prolonged grief disorder diagnosis, at least one of what two symptoms characterizing the development of a persistent grief response must be present?

Answer 11

Since the death, the development of a persistent grief response characterized by one or both of the following symptoms:
1) intense yearning/longing for the deceased person
2) preoccupation with thoughts or memories of the deceased person

Question 12

For a prolonged grief disorder diagnosis how long must the symptom(s) be present? How long ago was the death?

Answer 12

The symptom(s) have occurred nearly every day for at least the last month.

The death, at least 12 months ago, of a person who was close to the bereaved individual (for children, at least 6 months ago).

Question 13

What is meant by the presenting problem?

Answer 13

The presenting problem is why your client is seeking treatment. This can reveal vital information, including client’s conflicts or stressors, level of insight or denial, and aspects of mental status such as mood, behavior, and thought processes.

Question 14

After the client describes the presenting concern (e.g., anxiety), why is it helpful to ask, “What does anxiety mean to you?” and/or “What do you experience when you are anxious?”

Answer 14

The answers can reveal culture-specific interpretations of the symptoms and experiences. Never assume your definition of the problem is the same as the client’s definition. Failure to consider the client’s conceptualization of their problem may result in non-adherence to treatment and/or termination of therapy.

Question 15

As non-medical therapists, why do we need to know a person’s medical/health state? Is it possible for medical conditions or substances/medications to mimic or trigger psychiatric symptoms?

Answer 15

Yes, we do need to know a person’s medical/health state. Knowledge of a clients’s current health status provides information on potential stressors they are facing. Some medical conditions can cause symptoms that mimic psychiatric conditions (e.g., hypothyroidism can mimic symptoms of depression).

Question 16

During an intake, is it appropriate to ask if the client has discussed their symptoms with a physician?

Answer 16

It is appropriate. If the client reports health problems, remember to ask about interventions, treatment, or involvement with other health care professionals. If a client presents with emotional or behavioral symptoms that may be associated with a medical condition, the clinician should refer the client for a medical evaluation.

Question 17

How does cultural identity impact a person’s understanding of the presenting problem?

Answer 17

Cultural identity can influence how a person perceives and interprets their symptoms. In some cultures, mental health issues may not be recognized as such and instead attributed to spiritual or supernatural causes.

Question 18

How does cultural identity impact a person’s ability to seek therapy?

Answer 18

Cultural beliefs and values can affect attitudes towards seeking help. Seeking help may be stigmatized, or there may be a preference for seeking help from family, community, or religious leaders.

Question 19

How does a person’s cultural identity impact the client-therapist relationship?

Answer 19

It can impact the dynamics of the therapeutic relationship. Cultural differences in communication styles, expectations about the therapist’s role, and beliefs about the nature of mental illness can all affect the relationship.

Question 20

The Cultural Formulation Interview takes a holistic and person-centered approach. What is meant by person-centered approach and what is this approach designed to do?

Answer 20

The CFI follows a person centered approach to elicit information from the individual about their own views and those of others in their social network. Focuses on individual experiences and the social context of the clinical problem, symptoms, or concerns.
It is designed to avoid stereotyping, each individual’s cultural knowledge affects how they interpret illness experience and guides how they seek help. There are no right or wrong answers.

Question 21

Define the term Cultural Concepts of Distress.

Answer 21

Refers to the ways that individuals experience, understand, and communicate suffering, behavioral problems, or troubling thoughts and emotions.

Question 22

What are some reasons that cultural concepts of distress are important to consider with psychiatric diagnosis and treatment?

Answer 22

(1) to enhance identification of individuals concerns and detection of psychopathology.
(2) to avoid misdiagnosis.
(3) to obtain useful clinical information
(4) to improve clinical rapport and engagement. “Speaking their language.”
(5) to improve therapeutic efficacy
(6) to guide clinical research
(7) to clarify cultural epidemiology

Question 23

Why is it important for clients and therapists to collaborate on goals?

Answer 23

If the client does not agree to the treatment plan then the treatment outcome will be unsuccessful.

Question 24

What variables should be taken into account when determining treatment objectives and goals?

Answer 24

Cost considerations, individual client variables such as readiness for change, client motivation, and expectations for treatment.

Question 25

Name four qualities of a client that can strengthen or weaken treatment outcomes and should be taken into account when determining treatment goals and objectives.

Answer 25

1. Degree of participation in treatment
2. Severity of the disorder
3. Willingness and ability to take action
4. Personality characteristics of the client

Question 26

In what way is a client’s motivation or readiness to change relevant to the treatment plan?

Answer 26

Client’s readiness to change has a significant impact on whether they take action.

Question 27

Motivational interviewing helps the therapist to…

Answer 27

…establish the conditions in which the client can choose to change and is often used at the beginning of the treatment.

Question 28

What are the five distinct stages of change in motivational interviewing?

Answer 28

1. Pre-contemplation
2. Contemplation
3. Preparation
4. Action
5. Maintenance

Question 29

How relevant is the therapeutic alliance to treatment outcome?

Answer 29

Meta-analysis of over 70 studies confirms the effect of the therapist in the alliance is a significant predictor of treatment outcome.
The role of the therapeutic alliance found that it accounted for 8% of the variance in treatment outcomes.
Therapeutic alliance is the best predictor of treatment outcome.

Question 30

What are some characteristics of individuals who adjust more easily to life stressors?

Answer 30

Strong support system
Positive attitude about life
Meaningful relationships
Overall functioning is good before the stressor
Advanced education
Stable relationship
Stable financially
Healthy coping is more likely to occur if there is only one stressor.

Question 31

What are some characteristics of individuals who are more susceptible to an adjustment disorder?

Answer 31

Subclinical symptoms of anxiety or depression mood
Ineffective coping styles
Multiple stressors

Question 32

What is the primary focus of treatment for adjustment disorder?

Answer 32

Treatment for adjustment disorder is usually short, urgent, and focused on helping people cope more effectively with changing life circumstance.

Question 33

What are some promising therapeutic approaches for adjustment disorder?

Answer 33

Mindfulness based practices, cognitive therapy, career counseling, DBT, medication, family therapy, bibliography

Question 34

What is the prognosis for adjustment disorder?

Answer 34

The prognosis for adults, particularly women, with adjustment disorder is excellent. The prognosis for men, adolescents, and those with behavioral symptoms or comorbid disorders is not good.

Question 35

What 2 forms can the outbursts in disruptive mood dysregulation disorder (DMDD) take?
How frequently must they occur? What needs to be considered about the situation and development level?

Answer 35

Verbal or behavioral.
They must occur frequently (3 or more times a week) over at least 1 year in at least two settings (home and school), and they must be developmentally inappropriate.

Question 36

What is the person’s mood like between outbursts in disruptive mood dysregulation disorder (DMDD)?

Answer 36

Severe irritability consists of chronic, persistently irritable or angry mood that is present between the severe temper outbursts. Be present most of the day, nearly every day, and noticeable by others in child’s environment.

Question 37

What are common depression symptoms in the DSM-5 criteria of a major depressive episode?

Answer 37

1. Depressed mood
2. Loss of interest or pleasure
3. Significant weight loss or gain, decrease or increase in appetite nearly every day.
4. Insomnia or hypersomnia
5. Psychomotor agitation or retardation (observable by others)
6. Fatigue loss of energy
7. Feelings of worthlessness or excessive guilt
8. Diminished ability to think or concentrate
9. Recurrent thoughts of death, suicide attempt, plan

Question 38

How many symptoms are required in major depressive disorder?
How long must symptoms be present?

Answer 38

Five or more of the symptoms must have been present during the same 2 week period and represent a change from previous functioning. At least one of the symptoms is either depressed mood or loss of interest or pleasure.

Question 39

How do you distinguish typical grief from major depressive disorder?

Answer 39

Consider that in grief the predominant affect is feelings of emptiness and loss, while in MDE it is persistent depressed mood and the inability to anticipate happiness or pleasure. The pain of grief may be accompanied by positive emotions and humor that are uncharacteristic of the pervasive unhappiness and misery characteristic of an MDE. In grief self-esteem is preserved whereas in MDE feelings of worthlessness and self loathing are common. Grief focuses on the deceased and joining them. MDE thoughts focused on ending one’s life because of feelings of worthlessness etc.

Question 40

Persistent depressive disorder requires depressed mood and how many additional symptoms?
Over what period of time?

Answer 40

Presence, while depressed, of two or more of the following:
1. Poor appetite or overeating
2. Insomnia or hypersomnia
3. Low energy or fatigue
4. Low self-esteem
5. Poor concentration or difficulty making decisions
6. Feelings of hopelessness

During the 2 year period (1 year children) individual has never been without symptoms (depression + 1 or more) for more than 2 months at a time.

Question 41

Differentiate the specifiers for persistent depressive disorder.
1. With pure dysthymic syndrome
2. With persistent major depressive episode

Answer 41

1. Pure dysthymic syndrome: full criteria for a major depressive episode have not been met in at least the preceding 2 years.
2. Persistent major depressive episode: full criteria for a major depressive episode have been met throughout the preceding 2 year period.

Question 42

When is the diagnosis substance/medication-induced depressive disorder used?

Answer 42

The depressive symptoms must have developed during or soon after substance intoxication or withdrawal or after exposure to or withdrawal from a medication as evidenced by clinical history, physical examination, or lab findings.
Substance/medication must be capable of producing the depressive symptoms.

Question 43

When is the diagnosis depressive disorder due to another medical condition used?

Answer 43

Client presents depressed mood or loss of interest/pleasure and that is thought to be due to the physiological effects of another medical condition. Clinician must establish the presence of another medical condition and its relation to the mood disturbance.

Question 44

Specifiers for depressive disorders. With psychotic features:

Answer 44

Delusions and/or hallucinations are present at any time in the current major depressive episode.

Question 45

Specifiers for depressive disorders. With peripartum onset:

Answer 45

If onset of mood symptoms occurs during pregnancy or within 4 weeks of delivery.

Question 46

Specifiers for depressive disorders.
With seasonal pattern:

Answer 46

Regular relationship between onset of major depressive episodes in major depressive disorder and a particular time of year.

Question 47

What is the first line of treatment for children with disruptive mood dysregulation disorder (DMDD)?
Are psychotropic medications recommended?

Answer 47

The first line of treatment for children should be psychotherapy and parent psycho education, unless symptoms are severe enough to warrant the risk of side effects inherent in the use of psychotropic medications.

Psychotropic medications are not recommended.

Question 48

What are some situations where the combination of medication and psychotherapy is recommended for depression?

Answer 48

Treatment recommendations will be determined based on the number and severity of symptoms, the age and functional ability of the person, and the presence of any co-occurring disorders.
When psychosis or suicidal thoughts or actions are present the combination of medication and psychotherapy is almost always recommended.

Question 49

What are 4 distinct evidence-supported treatments for depression?

Answer 49

1. Behavior activation therapy,
2. acceptance-based cognitive-behavioral therapy (ACT, MBCT)
3. cognitive behavioral analysis system of psychotherapy (CBASP),
4. interpersonal therapy (IPT).

Emotion-focused therapies.

Question 50

What are a couple ways that those with persistent depressive disorder can present more of a challenge to therapists than those with major depression?

Answer 50

Research has found greater disturbances in psychosocial functions in persons with PDD compared to those with other types of depression.

Problems in establishing relationships, therapeutic relationship, marital relationship, is a common functional consequence of dysthymia.

The cognitions of persons with PDD is stuck in gloominess. High levels of inability, lack of self-efficacy, and thoughts such as “why bother?,” or “what difference does it make?”

PDD is often considered to be a treatment resistant disorder with 40% of persons not responding to medication.

Question 51

For a manic episode, describe 4 DSM-5 symptoms, minimal duration, and level of impairment.

Answer 51

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 (any duration if hospitalization is necessary).

1. Inflated self-esteem, grandiosity
2. Decreased need for sleep
3. More talkative
4. Flight of ideas
5. Distractibility
6. Increase in goal-directed activity
7. Excessive involvement in activities of high consequence

Sufficiently severe to cause marked impairment in social or occupational functioning or to need hospitalization or psychotic features are present.

Question 52

Differentiate a hypomanic episode from a manic episode.

Answer 52

(Hypo means below)
Hypomanic episode is a less severe version of a manic episode that does not cause marked impairment in social or occupational functioning or hospitalization, no psychotic features. Lasts at least 4 consecutive days and present most of the day, nearly every day. (Manic lasts at least 1 week)

Question 53

Differentiate Bipolar I disorder and Bipolar II disorder.

Answer 53

Bipolar I: the alternation of full manic episodes and depressive episodes.

Bipolar II: alternation of hypomanic episodes and major depressive episodes.

Question 54

Can Bipolar I include a hypomanic epiosde over the course of the condition?

Answer 54

Hypomanic or depressive episodes often precede or follow a manic episode. (Not essential to diagnosis)

Question 55

Which episode (hypomanic or depressed) causes the most impairment for Bipolar II?

Answer 55

The impairment results from the major depressive episodes or from a persistent pattern of unpredictable mood changes and fluctuating, unreliable interpersonal or occupational functioning.
Persons with BPII may not view hypomanic episodes as disadvantageous.

Question 56

Can Bipolar II include a manic episode?

Answer 56

No.

Question 57

What kinds of symptoms are involved in the mood swings for cyclothymic disorder?

Answer 57

The diagnosis of cyclothymic disorder is given to adults who experience at least 2 years (children 1 year) of both hypomanic and depressive periods without ever fulfilling the criteria for an episode of mania, hypomania, or major depression.

Question 58

What is the essential feature of cyclothymic disorder?

Answer 58

The essential feature of cyclothymic disorder is a chronic, fluctuating mood disturbance involving numerous periods of hypomanic symptoms and periods of depressive symptoms that never meet the full criteria for mania, hypomania, or depressive.

Symptom free intervals last no longer than 2 months

Question 59

What is meant by rapid cycling for Bipolar I and Bipolar II?

Answer 59

Presence of at least four mood episodes in the previous 12 months that meet the criteria for manic, hypomanic, or major depressive episode in BP I or that meet the criteria for hypomanic or major depressive episode in BP II.

Note: Rapid cycling is associated with a worse prognosis.

Question 60

What is considered to be the foundation of treatment of bipolar disorders?

Answer 60

Mood stabilizers and other medications approved by the FDA form the foundation of evidence-based practice for bipolar disorder.

Mood stabilizers work best during acute phase to treat manic, hypomanic, or mixed episodes.

No antidepressants were found to be effective in the treatment of bipolar depression.

Question 61

What is the role of mood stabilizing medication and psychotherapy for bipolar disorders?

Answer 61

Combination treatment, psychotherapy and medication, has been found to be more beneficial than medication alone.

Question 62

What psychotherapies have empirical support as adjuncts to medications in treating those with bipolar disorder?

Answer 62

1. Family focused therapy
2. Interpersonal and social rhythm therapy
3. Cognitive behavior therapy with a mindfulness component has also been shown to improve many symptoms of bipolar disorder.

Question 63

What is the focus of social rhythm therapy?

Answer 63

Focuses on the circadian rhythms in an effort to help the client develop a sleep-wake cycle that enhances their moods and provides them with enough sleep.

People become more able to predict what might trigger a future episode and take steps to avoid it.

Being proactive and maintaining a healthy and balanced lifestyle has been found to shorten the length of time that people with BP spend in the depressive phase.

Question 64

In family focused therapy, how can family education affect the prognosis of a person with bipolar disorder?

Answer 64

FFT was found to decrease rehospitalization rates and increase time between relapse when compared to individual therapy.

Question 65

How is paranoid personality disorder different from delusional disorder, persecutory type or schizophrenia with paranoid delusions?

Answer 65

Paranoid personality disorder is different from those because those disorders are all characterized by a period of persistent psychotic symptoms (delusions and hallucinations).

Question 66

What are some key terms for borderline personality disorder?

Answer 66

Instability, impulsivity, frantic, intense, identity disturbance, suicidal, emptiness, anger

Question 67

What are some key terms for histrionic personality disorder?

Answer 67

Attention-seeking, inappropriate, sexual, provocative, self-dramatization, suggestible, shallow expression of emotions

Question 68

What are some key terms of avoidant personality disorder?

Answer 68

Feelings of inadequacy, hypersensitive to negative evaluation, fearful, preoccupied with being criticized, negative self view

Question 69

What are some key terms of dependent personality disorder?

Answer 69

Submissive, dependent, clingy, fears of separation

Question 70

What are key terms for obsessive compulsive disorder?

Answer 70

Orderliness, perfectionism, control, detailed

Question 71

Why do people with avoidant personality disorder withdraw and become socially isolated?
How does this compare to the reason for social isolation in schizoid personality?

Answer 71

People with avoidant personality disorder often withdraw and become socially isolated due to their fear of rejection and humiliation. They are hypertensive to criticism and have a high need for emotional reassurance. Despite wanting a relationship, their fear prevents them from forming or maintaining one.

Individuals with schizoid personality disorder are not necessarily afraid of rejection or humiliation. Instead they genuinely prefer solitude and are content being alone. They do not have a strong desire for a social relationship.

Both disorders can lead to isolation, the reason behind the isolation differs.

Question 72

What are two challenges in working with a client with histrionic personality disorder?

Answer 72

1. People with this disorder seek constant emotional reassurance that they are loved. They need to be loved by everybody, including therapist.
2. Limit setting and confrontation may be taken as rejection by the person, so set in advance clear short-term goals that are meaningful to client and can be used to redirect the client.

*Reinforce small gains. This reduces likelihood of client turning to dramatization or premature termination because their needs are not being met.

Question 73

What should a therapist do first with clients with borderline personality disorder?

Answer 73

Because of the self-destructive and potentially lethal behavior of these clients, therapists must quickly establish rapport while at the same time assessing the potential risk for self-harm and suicide.

A safety plan should be developed. Even though the client may not need the plan at the moment, suicidal ideation and behavior can occur at any time.

Question 74

What are two ways to continue working with clients with borderline personality disorder after addressing immediate concerns?

Answer 74

1. Clients must be helped to identify emotions and link them to their behavior.
2. Learning to self-soothe, finding positive ways to reduce disturbing negative affect instead of resorting to self-harming behaviors, and overcoming a tendency towards emotional reasoning will be a focus of therapy.

Question 75

What are the opposing mistakes therapists can make when treating a person with borderline personality disorder?

Answer 75

Being too available and therefore fostering dependence and unreasonable expectations or not being available enough triggering concerns about abandonment and escalating self-harming behaviors.

Question 76

What are 2 supported treatments for borderline personality disorder?

Answer 76

1. Dialectical behavior therapy (DBT)
2. Schema-focused CBT
3. Systems Training for Emotional Predictability and Problem Solving
4. Mentalization-based psychotherapy
5. Transference-focused psychotherapy
6. Dynamic supportive therapy

Question 77

How does a person with dependent personality disorder view the therapist?

Answer 77

They will view the therapist as a “magical helper” whom they can rely on, and whom they will work hard to please.

Question 78

What is the overall goal of treatment for a person with dependent personality disorder?

Answer 78

Rarely will the goal of therapy be to increase assertiveness or independence, rather the overall goal will be to improve the client’s self-reliance and autonomy in a safe context so that newly found skills can be transferred into other settings outside of therapy.

Question 79

What are some suggestions for therapists working with clients with delusions?

Answer 79

Cognitive behavior therapy, social skills training, and psych education are important to help clients with delusional disorder reduce social isolation and stress, normalize social behaviors, and modify core beliefs.

Therapists who decide to use CBT should use interventions that target specific reasoning processes that underpin the maintenance of the client’s delusional belief system.

Question 80

When do the symptoms of schizophrenia tend to emerge?
For men?
For women?

Answer 80

Delusions, hallucinations, and other psychotic symptoms tend to emerge in early adulthood, with the first full blown psychotic episode occurring in the early to mid-20s for men and the late 20s for females. Males generally have more negative symptoms and longer duration of the disorder that lead to worse outcomes.

Question 81

Genetic risk factors contribute to schizophrenia. What are 2 other factors?

Answer 81

1. Environmental factors: being born in winter months, living in an urban setting, low socioeconomic status, complications of birth, and advanced paternal age.
2. Cannabis use and chronic abuse of psychostimulants can cause dopamine dysregulation that may lead to the development of schizophrenia.
3. Being a first generation immigrant is also related to the development of schizophrenia but this relationship disappears in the second generation.
4. Childhood trauma, particularly sexual abuse.
5. Familial component. With first degree relatives being 12 times more likely than the general population to develop the disorder.

Question 82

Which drugs can contribute to schizophrenia symptoms?

Answer 82

Cannabis or psychostimulants

Question 83

After creating a positive alliance, what is suggested when working with a client’s delusions and hallucinations?
What is cautioned against?

Answer 83

Gentle reality testing will help clients begin to address delusional beliefs. Do not support or join in a client’s delusional system. Help person recognize delusions and hallucinations as tricks of the mind. Visual disturbances as misrepresentation by the brain of a visual phenomenon.

Confrontation or argumentation is likely to cause a rupture in the therapeutic alliance.

Question 84

What are 4 psychosocial interventions that have strong research support for the treatment of schizophrenia?

Answer 84

After stabilization in medication has occurred the following psychosocial interventions can be an important part of maintenance and relapse prevention.
1. Skills training
2. CBT
3. Dual Diagnosis- treat schizophrenia and substance use
4. Group therapy
5. Family focused interventions
6. Long-term management

Question 85

What are some factors that contribute to a better prognosis of schizophrenia?

Answer 85

1. Stay on their medications
2. Some level of peer support and employment
3. Actively involved in therapy to manage stress and depression
4. Participating in interesting or pleasurable activities
5. Family support
6. Avoid substance abuse

Question 86

Why are education and counseling important treatment components for families?

Answer 86

Education and counseling of families reduce relapse rates and rates of re-hospitalization. Medication compliance rates are improved.

Question 87

What are delusions?

Answer 87

Fixed beliefs that are not amendable to change in light of conflicting evidence.

Question 88

What are the 6 types of psychotic delusions?

Answer 88

1. Persecutory delusions: harmed, harassed, by an individual or group (most common)
2. Referential delusions: certain gestures, comments, environmental cues are directed at person.
3. Grandiose delusions: has exceptional wealth, fame, or abilities.
4. Erotomanic delusions: believes falsely that another person is in love with them.
5. Nihilistic delusions: catastrophe will occur.
6. Somatic delusions: regard health and organ function.

Question 89

What is the difference between bizarre and nonbizarre delusions?

Answer 89

Bizarre: impossible (I can fly)
Nonbizzare: possible, not plausible (the FBI bugged my phone)

Question 90

What is a hallucination?
Most common?
Other types?

Answer 90

Perception like experiences that occur without an external stimulus. They are vivid and clear, with the full force and impact of normal perceptions and not under voluntary control.

Auditory hallucinations are the most common.

Hypnagogic (falling asleep) or hypnopompic (waking up) hallucinations are considered to be within the range of normal experience. These are not DSM-5 hallucinations.

Question 91

What are 2 other psychotic symptoms present in schizophrenia other than delusions and hallucinations?
Give an example of a positive and negative symptom.

Answer 91

Disorganized speech: switching topics, answers to questions are unrelated, incomprehensible

Grisly disorganized or abnormal motor behavior including catatonia: childlike silliness, unpredictable agitation, difficulty performing daily living activities.

Catatonic behavior: resistance to instruction, maintaining rigid or bizarre posture, lack of verbal or motor response, staring, grimacing, repeated movement, echoing of speech.

Negative symptom: diminished emotional expression and severe lack of motivation.

Positive symptom: hallucinations and delusions

Question 92

Number and duration of symptoms for delusional disorder?
What are two types of delusional disorders?

Answer 92

The presence of 1 or more delusions with a duration of 1 month or longer.

1. Grandiose type
2. Jealous type
3. Persecutory type

Question 93

What is erotomanic type?

Answer 93

This subtype applies when the central theme of the delusion is that another person is in love with the individual.

Question 94

How does delusional disorder differ from schizophrenia?

Answer 94

Delusional disorder can be distinguished from schizophrenia by the absence of other symptoms characteristic of schizophrenia (e.g., prominent auditory or visual hallucinations, disorganized speech, grossly disorganized or catatonic behavior, negative symptoms)

Question 95

How many symptoms are required for brief psychotic disorder?
Duration?

Answer 95

Presence of one or more of the following. At least one of these must be 1, 2, or 3:
1. Delusions
2. Hallucinations
3. Disorganized speech
4. Grossly disorganized or catatonic behavior

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.

Question 96

How is the duration of brief psychotic disorder different from that of schizophrenia or schizophreniform?

Answer 96

Schizophreniform: an episode of the disorder lasts at least 1 months but less than 6 months.

Schizophrenia: continuous signs of the disturbance persist for at least 6 months. Must include at least 1 month of symptoms.

Brief psychotic disorder: an episode of the disturbance is at least 1 day but less than one month.

Question 97

Number of symptoms of schizophreniform?
Duration?

Answer 97

Two or more of the following, each present for a significant portion of time during a 1 month period. At least one of these must be 1, 2, or 3

1. Delusions
2. Hallucinations
3. Disorganized speech
4. Grossly disorganized or catatonic behavior
5. Negative symptoms

An episode lasts at least 1 month but less than 6 months

Question 98

How does schizophreniform differ from schizophrenia?

Answer 98

Shorter duration. In schizophreniform the disturbance is present less than 6 months.

Question 99

How many symptoms over a 1 month period are needed to qualify for Criterian A of schizophrenia?

Answer 99

Two or more symptoms and at least one of these must be delusions, hallucinations, or disorganized speech.

Question 100

How long do continuous signs of schizophrenia need to persist?

Answer 100

For at least 6 months.

Question 101

Besides the active phase, what are the other 2 phases of schizophrenia?

Answer 101

Prodromal phase and residual phase

Question 102

What is the primary feature of schizoaffective disorder?

Answer 102

An uninterrupted period of illness during which there is a major mood episode (major depressive or manic) concurrent with Criterion A of schizophrenia.

Question 103

Do the schizophrenic symptoms and major mood episodes always co-occur in schizoaffective disorder?

Answer 103

No. Defining features include a major mood episode (depressed or manic mood) and at least a two week period of psychotic symptoms when a major mood episode is not present.

Question 104

What distinguishes schizoaffective disorder from major depression or bipolar with psychotic features?

Answer 104

Based on the presence of prominent delusions and/or hallucinations for at least 2 weeks in the absence of a major mood episode. In depressive or bipolar with psychotic features, the psychotic features only occur during the mood episodes.

Question 105

Can substances, medications, or medical conditions cause psychotic-like symptoms?

Answer 105

Yes. If there is evidence from the history, physical examination, or lab findings of symptoms developing during or soon after substance intoxication or withdrawal and/or the substance is capable of producing the symptoms.