Psych Diagnostic criteria

Question 1

Substance use disorder

Answer 1

12 month

2+

Question 2

Substance Intoxication

Answer 2

• Development of a reversible substance-specific syndrome due to recent ingestion of a substance
• Clinically-significant maladaptive behavioral or psychological changes that are due to the effect of the substance on the central nervous system and that develop during or shortly after use of the substance

Question 3

Substance Withdrawal

Answer 3

• Development of a substance-specific syndrome due to the cessation of or reduction in substance use that has been heavy and prolonged
• The substance-specific syndrome causes clinically significant distress or impairment in important areas of functioning

Question 4

Somatic Symptom Disorder

Answer 4

Persistent 6 months+

1+

Question 5

Illness Anxiety Disorder

Answer 5

6 months+
Types: Care-seeking
Care-avoidant

Question 6

Conversion Disorder

Answer 6

-Presence of symptom(s) that suggest altered motor or sensory functioning

Question 7

Factitious Disorder

Answer 7

• Imposed on Self:
 Feigning of physical or psychological symptoms or causing one’s injury or disease
 Presents self to be injured or sick
 Deception occurs, although no obvious external rewards are present
• Imposed on Another:
 Feigning of physical or psychological symptoms or causing one’s injury or disease
 Presents this other person as injured or sick
 Deception occurs, in absence of obvious external rewards
• Driven by desire to receive medical care

Question 8

Malingering

Answer 8

• Intentional production of symptoms for external gain (e.g., money, respite from work, shelter)
• Symptoms cannot be explained by objective medical findings

Question 9

Psychological Factors affecting other Medical Condition

Answer 9

• -Presence of medical condition
• Psychological or behavioral factors negatively impact this medical condition, affecting it in one of these ways:
 by affecting the condition’s course, evidenced by a close temporal relationship between the factor and worsening of medical condition or recovery from it
 By interferring with aspects of treatment of condition
 As presenting health risks
 By precipitating or exacerbating symptoms or resulting in requiring medical assistance

Question 10

Female Sexual Interest/Arousal Disorder

Answer 10

6 months+
reduction or absence of 3+

• Sexual interest/arousal is lacking or significantly reduced, as shown by reduction or absence of at least 3 of below:
• Interest in sexual relations
• Sexual thoughts/fantasies
• Initiation of sexual behavior or receptivity to partner’s initiation
• Pleasure or excitement while sexual in nearly all encounters (e.g., 75 to 100%)
• genital or nongenital sensations while sexual in nearly all encounters (e.g., 75 to 100%)
• Arousal/interest in response to sexual cues
• Cause significant distress
• Not better explained by another condition

Question 11

Male Hypoactive Sexual Desire Disorder

Answer 11

6 months+

• Persistent or recurrent absence or deficiency of sexual thoughts/fantasies and desire for sexual activity
• Results in distress
• Not better accounted for by another condition

Question 12

Erectile Disorder

Answer 12

6 months+
• Need at least one of the following, occurring nearly all of the time (75-100%) of occasions in which sexually active.
– Marked difficulty attaining an erection
– Marked difficulty maintaining an erection until sexual activity is completed
– Marked reduction in erectile rigidity
• Results in significant distress
• Not better accounted for by another condition

Question 13

Female Orgasmic Disorder

Answer 13

6 months+

• One of following must be present and occurs nearly all of the time (75-100%) of occasions in which sexually active.
– Significant delay in experiencing orgasm, or in the frequency of orgasm, or absence of orgasm
– Significant reduction in intensity of sensations associated with orgasm
• Results in distress
• Not due to another condition

Question 14

Premature Ejaculation

Answer 14

6 months+
75-100% of the time during sex

• Persistent/recurrent experience of ejaculation that occurs within 1 minute following vaginal penetration and before the person wishes to ejaculate
• Results in distress
• Not better accounted for by another condition

Question 15

Genito-Pelvic Pain/Penetration Disorder

Answer 15

6 months+

• Presence of persistent/recurrent problems with one or more of following:
– Vaginal penetration during intercourse
– Significant vulvovaginal or pelvic pain associated with sexual intercourse or attempts at intercourse
– Significant tensing/tightening of pelvic floor muscle when sexual intercourse is attempted.
• Results in distress
• Not better accounted for by another condition

Question 16

Paraphilic Disorders

Answer 16

• for minimum of 6 months, recurrent and intense sexual arousal (evidenced by fantasies, urges, behavior) associated with the following, and in which person has acted upon the urge or there is resultant distress and impairment in social, work-related, or other significant areas of functioning
– exposing one’s genitals to an unsuspecting individual— exhibitionist disorder.
– Spying on an unsuspecting person disrobing, unclothed, or involved in sexual activity–voyeuristic disorder
– rubbing or touching a non-consenting individual— frotteuristic disorder
– use of non-living objects or a highly focused interest in a non-genital part of the body– fetishistic disorder
– From dressing in attire of the opposite sex (cross-dressing) — transvestic disorder
– with being humiliated, engaging in bondage, or a being in a circumstance made to suffer– sexual masochism disorder
– Inflicting psychological or physical harm on another person, and has done so with a non-consenting individual or causes distress or impairment– sexual sadism disorder
– for minimum of 6 months, recurrent and intense sexual fantasies, urges, or behavior which involves engaging in sexual activity with a prepubescent child/children (generally age 13 or younger) –
and the individual experiences significant distress or interpersonal difficulty related to the urges/fantasies or has acted upon them- pedophilic disorder

Question 17

Histrionic Personality Disorder

Answer 17

A pervasive pattern of excessive emotionality and attention seeking, beginning in early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:

1. Is uncomfortable in situations in which he or she is not the center of attention.
2. Interaction with others is often characterized by inappropriate sexually seductive or provocative behavior.
3. Displays rapidly shifting and shallow expression of emotions.
4. Consistently uses physical appearance to draw attention to self.
5. Has a style of speech that is excessively impressionistic and lacking in detail.
6. Shows self-dramatization, theatricality, and exaggerated expression of emotion.
7. Is suggestible (i.e., easily influenced by others or circumstances).
8. Considers relationships to be more intimate than they actually are.

Question 18

Narcissistic Personality Disorder

Answer 18

A pervasive pattern of grandiosity (in fantasy or behavior), need for admiration, and lack of empathy, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:

1. Has a grandiose sense of self-importance (e.g., exaggerates achievements and talents, expects to be recognized as superior without commensurate achievements).
2. Is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love.
3. Believes that he or she is “special” and unique and can only be understood by, or should associate with, other special or high-status people (or institutions).
4. Requires excessive admiration.
5. Has a sense of entitlement (i.e., unreasonable expectations of especially favorable treatment or automatic compliance with his or her expectations).
6. Is interpersonally exploitative (i.e., takes advantage of others to achieve his or her own ends).
7. Lacks empathy: is unwilling to recognize or identify with the feelings and needs of others.
8. Is often envious of others or believes that others are envious of him or her.
9. Shows arrogant, haughty behaviors or attitudes.

Question 19

Borderline Personality Disorder

Answer 19

A pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:

1. Frantic efforts to avoid real or imagined abandonment. (Note: Do not include suicidal or self-mutilating behavior covered in Criterion 5).
2. A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation.
3. Identity disturbance: markedly and persistently unstable self-image or sense of self.
4. Impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating). (Note: Do not include suicidal or self-mutilating behavior covered in Criterion 5.)
5. Recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior.
6. Affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days).
7. Chronic feelings of emptiness.
8. Inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights).
9. Transient, stress-related paranoid ideation or severe dissociative symptoms.

Question 20

Antisocial Personality Disorder

Answer 20

A. A pervasive pattern of disregard for and violation of the rights of others, occurring since age 15 years, as indicated by three (or more) of the following:
1. Failure to conform to social norms with respect to lawful behaviors, as indicated by repeatedly performing acts that are grounds for arrest.
2. Deceitfulness, as indicated by repeated lying, use of aliases, or conning others for personal profit or pleasure.
3. Impulsivity or failure to plan ahead.
4. Irritability and aggressiveness, as indicated by repeated physical fights or assaults.
5. Reckless disregard for safety of self or others.
6. Consistent irresponsibility, as indicated by repeated failure to sustain consistent work behavior or honor financial obligations.
7. Lack of remorse, as indicated by being indifferent to or rationalizing having hurt, mistreated, or stolen from another.
B. The individual is at least age 18 years.
C. There is evidence of conduct disorder with onset before age 15 years.
D. The occurrence of antisocial behavior is not exclusively during the course of schizophrenia or bipolar disorder.

Question 21

Paranoid

Answer 21

4+

• Suspects (without basis) exploitation, harm, deceit
• Preoccupied with loyalty and trustworthiness of friends and family
• Reluctant to confide
• Assumes that benign remarks or events are hidden put-downs or threats
• Unforgiving of insults or injuries
• Oversensitive to character attack; quick to react angrily
• Unjustified suspicion of sexual infidelity

Question 22

Schizoid

Answer 22

4+

• Does not enjoy or want close relationships; little desire to form a family
• Prefers solitary activities
• Little interest in interpersonal sexual activity
• Lacks friends, confidants
• Indifferent to praise, criticism
• Little pleasure from activities
• Emotionally cold, detached; flat affect

Question 23

Schizotypal

Answer 23

5+

• Odd, eccentric, or peculiar behavior or appearance
• Odd Thinking and Speech (e.g., vague, circumstantial stream of thought)
• Ideas of Reference
• Odd beliefs/Magical Thinking
• Unusual Perceptual Experiences
• Suspiciousness; paranoid thoughts
• Inappropriate or constricted affect
• Lacks close friends or confidants
• Excessive social anxiety that does not diminish with familiarity; associated with paranoid fears, not negative self-judgment

Question 24

Avoidant

Answer 24

4+

• Avoids occupational activities that involve significant interpersonal contact due to fear of criticism, disapproval, or rejection
• Unwilling to get involved with others unless certain of being liked
• Restrained in intimate relationships due to fear of being shamed or ridiculed
• Preoccupied with criticism or rejection in social situations
• Inhibited in new social situations due to feelings of inadequacy
• Views self as socially inept, unappealing, or inferior
• Reluctant to take risks as they may be embarrassing

Question 25

Dependent

Answer 25

5+

• Difficulty making everyday decisions
• Needs others to assume responsibility for decisions
• Reluctant to disagree; fears loss of support
• Hesitates to take initiative due to poor self-confidence
• Tries hard for nurture, support from others. Will volunteer to do unpleasant things if it will win support
• Fears being unable to care for self; helpless, distressed when alone
• Urgently seeks another when one relationship ends
• Unrealistically fearful of being left alone to take care of him/her self

Question 26

Obsessive-Compulsive Personality Disorder

Answer 26

4+

• Such preoccupation with organization that the major point is lost
• Perfectionism that interferes with task completion.
• Devoted to work and productivity to the exclusion of leisure, family, and friends
• Overly conscientious, scrupulous, and inflexible about morality, ethics, or values
• Can’t discard worn-out or worthless items even when no sentimental value
• Reluctant to delegate tasks; or must perform exactly to own specifications
• Miserly style of spending money; hoards money for future catastrophes
• Pervasive rigidly and stubbornness

Question 27

Major vs Mild Neurocognitive Disorder

Answer 27

A. Evidence of significant/modest cognitive decline from a previous level of performance in one or more cognitive domains based on:
1. Concern of the individual, a knowledgeable informant, or the clinician that there has been a significant/mild decline in cognitive function; and
2. A substantial/modest impairment in cognitive performance, preferably documented by standardized neuropsychological testing or, in its absence, another quantified clinical assessment.
B. The cognitive deficits interfere/do not interfere with independence in everyday activities (i.e., at a minimum, requiring assistance with complex instrumental activities of daily living such as paying bills or managing medications).
C. The cognitive deficits do not occur exclusively in the context of a delirium.
D. The cognitive deficits are not better explained by another mental disorder (e.g., major depressive disorder, schizophrenia).

Question 28

Insomnia Disorder

Answer 28

Features:
• predominant complaint is dissatisfaction with sleep quality or quantity, associated with 1 or more:
– Difficulty initiating
– Difficulty maintaining sleep
– Early morning awakening and unable to fall back to sleep
• Causes distress or impairment
• Occurs minimum of 3 nights/week
• Exists for minimum of 3 months
• Sleep problem exists even with opportunity for sleep

Question 29

Hypersomnolence Disorder

Answer 29

• Per self-report, presence of excessive sleepiness (hypersomnolence) even though there has been a sleep period of at least 7 hours, with at least one of the following:
– periods of sleep or lapses into sleep within same day
– Prolonged main sleep episode of 9+ hours/daily that is unrefreshing
– Problems becoming full awake after an abrupt awakening
• Occurs at least 3 times/week, for minimum 3 months
• Accompanied by distress or impairment in functioning
• Too much nocturnal sleep or sleepiness during daytime
• Diminished quality of wakefulness (problems awakening or staying awake)
• Sleep inertia —- known as sleep drunkenness—involves impaired performance and less vigilance after a sleep episode); may appear confused, combative upon awakening.

Question 30

Circadian Rhythm Sleep-Wake Disorders

Answer 30

•	persistent or recurrent pattern of disrupted sleep primarily due to an alteration of the circadian system or misalignment between the person’s circadian rhythm and sleep-wake requirements of the environment
–	Delayed sleep phase type
–	Advanced sleep phase type
–	Shift work 
–	Irregular sleep-wake type
–	Non-24-hour sleep-wake type

Question 31

Nightmare Disorder

Answer 31

• more common in childhood
• content of nightmare usually involves threats to security, survival, or self-esteem
• person quickly becomes alert upon awakening and has full recall of nightmare
• associated with REM sleep
• often occurs during times of stress

Question 32

Non-rapid Eye Movement Sleep Arousal Disorder: Sleep Terror

Answer 32

• sudden arousal from sleep with displays of intense fear, panicky scream; signs of increased autonomic arousal
• not assoc. with dreaming (occurs during delta sleep)
• difficult to soothe individual
• no recall for event
• usually begins in childhood and later resolves

Question 33

Non-rapid Eye Movement Sleep Arousal Disorder: Sleepwalking (somnambulism)

Answer 33

• Person may rise and walk about environment
• blank, staring facial expression
• No recall of event
• difficult to awaken or communicate with
• occurs during stage 3-4 sleep (first third of night)
• common in childhood; most outgrow in adolescence

Question 34

Rapid Eye Movement Sleep Behavior Disorder

Answer 34

Rapid Eye Movement Sleep Behavior Disorder

• Repeated episodes of arousal during sleep that are accompanied by vocalization and/or complex motor behaviors
• Behaviors occur during REM sleep; typical after 90 minutes of sleep onset, and during later parts of sleep episode
• Person awakens and is alert, not confused or disoriented
– Greater prevalence in males
– Associated with neurodegenerative disorder
– Course is progressive

Question 35

Autism Spectrum Disorder (ASD)

Answer 35

 Currently, or by history, must meet criteria A, B, C, and D
 A. Persistent deficits in social communication and social interaction across contexts, not accounted for by general developmental delays, and manifest by all 3 of the following:
› 1. Deficits in social-emotional reciprocity
› 2. Deficits in nonverbal communicative behaviors used for social interaction
› 3. Deficits in developing and maintaining relationships
 B. Restricted, repetitive patterns of behavior, interests, or activities as manifested by at least 2 of the following:
› 1. Stereotyped or repetitive speech, motor movements, or use of objects
› 2. Excessive adherence to routines, ritualized patterns of verbal or nonverbal behavior, or excessive resistance to change
› 3. Highly restricted, fixated interests that are abnormal in intensity or focus
› 4. Hyper-or hypo-reactivity to sensory input or unusual interest in sensory aspects of environment;
 C. Symptoms must be present in early childhood, but may not become fully manifest until social demands exceed limited capacities
 D. Symptoms limit and impair everyday functioning.
› AAP recommends formal screening
for ASDs at 18 & 24 months of age

Question 36

Social Communication Disorder

Answer 36

 A. Persistent difficulties in the social use of verbal and nonverbal communication as manifest by deficits in all of the following:
› 1) Using communication for social purposes, such as greeting and sharing information, in a manner that is appropriate for the social context;
› 2) Changing communication to match context or the needs of the listener, such as speaking differently in a classroom than on a playground, communicating differently to a child than to an adult, and avoiding use of overly formal language.;
› 3) Following rules for conversation and storytelling, such as taking turns in conversation, rephrasing when misunderstood, and knowing how to use verbal and nonverbal signals to regulate interaction;
› 4) Understanding what is not explicitly stated (e.g. inferencing) and nonliteral or ambiguous meanings of language, for example, idioms, jokes, metaphors and multiple meanings that depend on the context for interpretation.
 B. Deficits result in functional limitations in effective communication, social participation, social relationships, academic achievement, or occupational performance.
 C. Onset in the early developmental period (but deficits may not become fully manifest until social communication demands exceed limited capacities).
 D. Deficits are not better explained by low abilities in the domains of word structure and grammar, or by intellectual disability, global developmental delay, Autism Spectrum Disorder, or another mental or neurologic disorder.

Question 37

Intellectual Disability

Answer 37

Criteria must be met in all 3 categories:
 1. Deficit in intellectual functioning: Reasoning; Problem solving; Planning; Abstract thinking; Judgment; Academic learning (ability to learn in school via traditional teaching methods); Experiential learning (the ability to learn through experience, trial and error, and observation).
Mental abilities are measured by IQ tests. A score of approximately 2 standard deviations below average represents a significant cognitive deficit. The tests used to measure IQ must be standardized and culturally appropriate. This is typically an IQ score of 70 or below.
 2. Deficits or impairments in adaptive functioning:
This includes skills needed to live in an independent and responsible manner. Measured using standardized, culturally appropriate tests.
Various skills are needed for daily living:
-Communication
-Social skills
-Personal independence at home or in community settings: Refers to the ability to take care of yourself (bathing, dressing, feeding). It also includes the ability to safely complete day-to-day tasks without guidance (cooking, cleaning, laundry). There are also routine activities performed in the community (shopping for groceries, and accessing public transportation).
 3. These limitations occur during the developmental period or evident during childhood/adolescence.
If these problems began after this developmental period, the correct diagnosis would be neurocognitive disorder (i.e.: a traumatic brain injury from a car accident could cause similar symptoms.
Intellectual Disability, mild: IQ score of 70-55(ish) or 2 standard deviations below the mean
Borderline Intellectual Function (low average function): 71-84

Degree	IQ	% of total cases	Need for support
Moderate	35-40 
to 
50-55	10%	Limited
Severe	20-25
to
35-40	3%-4%	Extensive
Profound	Less than
20-25	1%-2%	Constant

Question 38

Learning Disorders

Answer 38

Learning and using academic skills is substantially below expected levels for a child’s IQ, age, and education for at least 6 mos. beginning during school age years.
DSM 5 term is Specific Learning Disability
 With impairment in reading (dyslexia)
 With impairment in written expression
 With impairment in mathematics (dyscalculia)
 Each is listed as mild, mod, or severe

Question 39

Separation Anxiety Disorder

Answer 39

Must meet 3 of the following criteria:
 Recurrent, excessive anxiety or fear when separated or contemplating separation from home or from caregiver whom child has strong emotional attachment
 Significant, persistent fear of losing a caregiver to illness, disaster, or death
 Fear of being alone in the home or other settings
 Reluctance/Refusal to participate in activity that would require separation from parent/caregiver (leaving home, going to school)
 Fear of an event that would cause separation: kidnapping, accidents, illness
 Persistent nightmares about separation
 Difficulty sleeping without caregiver
 Somatic symptoms (headaches, stomachaches, nausea) when separation is anticipated
Fear is inappropriate and excessive for age and level of development (not the same as separation anxiety)
Symptoms range from mild (anticipatory anxiety) to severe (panic and marked anxiety about separation)
Symptoms must be present for at least 4 weeks

Question 40

Reactive Attachment Disorder

Answer 40

 A. A consistent pattern of inhibited, emotionally withdrawn behavior toward adult caregivers, manifested by both of the following:
 The child rarely or minimally seeks comfort when distressed.
 The child rarely or minimally responds to comfort when distressed.
 B. A persistent social or emotional disturbance characterized by at least two of the following:
 Minimal social and emotional responsiveness to others
 Limited positive affect
 Episodes of unexplained irritability, sadness, or fearfulness that are evident even during nonthreatening interactions with adult caregivers.
 C. The child has experienced a pattern of extremes of insufficient care as evidenced by at least one of the following:
 Social neglect or deprivation in the form of persistent lack of having basic emotional needs for comfort, stimulation and affection met by caring adults
 Repeated changes of primary caregivers that limit opportunities to form stable attachments (e.g., frequent changes in foster care)
 Rearing in unusual settings that severely limit opportunities to form selective attachments (e.g., institutions with high child to caregiver ratios)
 D. The care in Criterion C is presumed to be responsible for the disturbed behavior in Criterion A (e.g., the disturbances in Criterion A began following the lack of adequate care in Criterion C).
 E. The criteria are not met for autism spectrum disorder.
 F. The disturbance is evident before age 5 years.
 G. The child has a developmental age of at least nine months.
 Specify if Persistent: The disorder has been present for more than 12 months.
 Specify current severity: Reactive Attachment Disorder is specified as severe when a child exhibits all symptoms of the disorder, with each symptom manifesting at relatively high levels.
Related Features:
 Lack of conscience or empathy for others, manifesting in antisocial behavior
 Severe aggression
 Property destruction
 Lying
 Stealing
 Hiding food from the family’s kitchen or refrigerator
 Inappropriate sexual behavior
 Manipulative behavior
 Animal cruelty

Question 41

Enuresis

Answer 41

Definition:
Primary: failure to develop control over urination as evidenced by repeated voiding of urine into bed or clothes by at least 5 years of age
 a frequency of 2X/week for 3 consecutive months
 the frequency can be less given the presence of clinically significant distress or impairment in social, academic (occupational), or other important areas of functioning.
 The behavior is not due to the direct effect of a substance or a general medical condition.
Secondary: revert to wetting the bed or clothing after initially (for at least 6 months) developing control over micturition.

Question 42

Encopresis

Answer 42

 Repeated passage of feces into inappropriate places, whether involuntary or intentional, in children over 4.
 At least one event a month for at least 3 months.
 The behavior is not due exclusively to the direct physiological effects of a substance or a general medical condition except through a mechanism involving constipation.
 Primary VS Secondary
 Continuous type (primary): the child has never become toilet trained
 Discontinuous type (secondary): the child has initially been toilet trained and has subsequently become incontinent.
 Retentive (constipation & overflow incontinence) vs Non-Retentive
 Causes of retentive type: painful defecation, inadequate or punitive toilet training, fear of school bathroom, or toilet related fear
 characterized by a cycle of several days of retention, a painful expulsion, and another period of retention. While the fecal mass is growing, there may be leakage around the mass.
 Non-retentive encopresis applies to those children who simply do not control the expulsion of feces on a psychological, physiologic, or combined basis.

Question 43

Attention Deficit Hyperactivity Disorder

Answer 43

Inattention

(a) often fails to give close attention to details or makes careless mistakes in schoolwork, work, or other activities
(b) often has difficulty sustaining attention in tasks or play activities
(c) often does not seem to listen when spoken to directly
(d) often does not follow through on instructions and fails to finish school work, chores, or duties in the workplace (not due to oppositional behavior or failure to understand instructions)
(e) often has difficulty organizing tasks and activities
(f) often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort (such as schoolwork or homework)
(g) often loses things necessary for tasks or activities (e.g., toys, school assignments, pencils, books, or tools)
(h) is often easily distracted by extraneous stimuli
(i) is often forgetful in daily activities

Hyperactivity -Impulsivity
(a) often fidgets with hands or feet or squirms in seat
(b) often leaves seat in classroom or in other situations in which remaining seated is expected
(c) often runs about or climbs excessively in situations in which it is inappropriate (in adolescents or adults, may be limited to subjective feelings of restlessness)
(d) often has difficulty playing or engaging in leisure activities quietly
(e) is often “on the go” or often acts as if “driven by a motor”
(f) often talks excessively
(g) often blurts out answers before questions have been completed
(h) often has difficulty awaiting turn
(i) often interrupts or intrudes on others (e.g., butts into conversations or games)
 6 or more of the previously noted symptoms persisting for 6 months or longer qualifies for a diagnosis of ADHD in either the inattentive category or hyperactivity-impulsive category.
 If both inattentive and hyperactive-impulsive symptoms are present, then a combined type diagnosis is given.
 Symptoms need to have been present before the age of 12.
 Some impairment from the symptoms is present in two or more settings, such as school or home.
 There must be clear and significant evidence of a social, academic, or occupational impairment.
 The symptoms are not better accounted for by another mental disorder.

Question 44

Oppositional Defiant Disorder

Answer 44

 Includes at least 4 symptoms from any of these categories: angry and irritable mood; argumentative and defiant behavior; or vindictiveness
 Occurs with at least one individual who is not a sibling
 Occurs on its own, rather than as part of the course of another mental health problem, such as a substance use disorder, depression or bipolar disorder
 On most days for at least six months
 Angry and irritable mood:
 Often loses temper
 Is often touchy or easily annoyed by others
 Is often angry and resentful
 Argumentative and defiant behavior:
 Often argues with adults or people in authority
 Often actively defies or refuses to comply with adults’ requests or rules
 Often deliberately annoys people
 Often blames others for his or her mistakes or misbehavior
 Vindictiveness:
 Is often spiteful or vindictive
 Mild: Symptoms confined to 1 setting
 Moderate: Symptoms presents in 2 settings
 Severe: Symptoms present in 3 or more settings

Question 45

Conduct Disorder

Answer 45

Repetitive and persistent pattern of behavior in which either the rights of others or major age-appropriate societal rules or norms are violated as manifested by the presence of 3 or more of the following criteria in the past twelve months:
Aggression to People & Animals:
 Often bullies, threatens, or intimidates others.
 Often initiates physical fights.
 Has used a weapon that can cause serious physical harm to others (e.g., a bat, brick, broken bottle, knife, gun).
 Has been physically cruel to people.
 Has been physically cruel to animals.
 Has stolen while confronting a victim (e.g., mugging, purse snatching, extortion, armed robbery).
 Has forced someone into sexual activity.
Destruction of Property:
 Has deliberately engaged in fire setting with the intention of causing serious damage.
 Has deliberately destroyed others property (other than by fire setting).
Deceitfulness or Theft:
 Has broken into someone else’s house, building, or car.
 Often lies to obtain goods or favors or to avoid obligations (i.e., “cons” others).
 Has stolen items of nontrivial value without confronting a victim (e.g., shoplifting, but without breaking and entering; forgery).
Serious Violation of Rules:
 Often stays out at night despite parental prohibitions, beginning before age 13 years.
 Has run away from home overnight at least twice while living in parental or parental surrogate home (or once without returning for a lengthy period).
 If often truant from school, beginning before age 13 years.
Specifiers:
 Childhood onset, Adolescent onset, Unspecified
 With Limited Prosocial Emotions (2 for 12 mos):
 Lack of remorse or guilt
 Callous-lack of empathy
 Unconcerned about performance
 Shallow or deficient affect
Increased risk for antisocial personality disorder