Psychopathology

Question 1

Social Anxiety Disorder

Answer 1

1. Marked fear/anxiety about one or more social situations in which the individual is exposed to possible scrutiny by others
2. Fears/acts in a way or to show anxiety symptoms that will be negatively evaluated (e.g., embarrassing)
3. Social situations almost always provokes fear/anxiety
4. Social situations are endured with intense fear/anxiety
5. Fear is out of proportion to actual threat
6. Persistent, lasting for 6 months or more
7. Causes clinically significant distress
8. Not primarily attributable to substance/medical
   **Specify if Performance Only

Question 2

OCD

Answer 2

A. Presence of obsessions, compulsions, or both
1. Obsessions defined by: 1) recurrent and persistent thoughts/urges/images that are intrusive and unwanted 2) Individual attempts to ignore or suppress thoughts/urges/images or neutralize them with some other thought/action (ie., compulsion)
2. Compulsions defined by: 1) repetitive behaviors or mental acts that individual is driven to perform in response to an obsession 2) aimed at preventing anxiety/distress

Question 3

Reactive Attachment Disorder

Answer 3

A. Consistent patterns of inhibited, emotionally withdrawn behavior toward adult caregivers, manifested by both:
1. Minimally seeks comfort when distress
2. Minimally responds to comfort when distressed

B. Persistent social and emotional disturbance characterized by:
1. Minimal social and emotional responsiveness
2. Limited positive affect
3. Episodes of unexplained irritability, sadness, or fearfulness

C. Child has had pattern of extremes of insufficient care as evidenced by:
1. Social neglect or deprivation in form of persistent lack of having basic emotional needs for comfort, stimulation, and affection
2. Repeated changes of primary caregivers
3. Rearing in unusual settings that severely limit opportunities to form selective attachments

Question 4

MDD

Answer 4

Need at least 5+ symptoms
1) Depressed mood or anhedonia
2) At least four other symptoms including the following:
- Significant weight loss/gain
- Insomnia/hypersomnia
- Psychomotor agitation or retardation
- Fatigue/loss of energy
- Feelings of worthlessness/guilt
- Diminished ability to think or concentrate/indecisiveness
- Suicidal ideation/attempt

Question 5

Persistent Depressive Disorder (Dysthymia)

Answer 5

1) Depressed mood most of the day, more days than not, for at least 2 years
2) During the 2 years, not without symptoms for >2 months at a time
3) Depressed mood
4) 2+ of the following
- Poor appetite/overeating
- Insomnia/hypersomnia
- Low energy/fatigue
- Low self-esteem
- Poor concentration or difficulty making decisions
- Feelings of hopelessness

Question 6

PTSD

Answer 6

A. Exposure to actual or threatened death, serious injury, or sexual violence in one of the following ways:
1. Directly experiencing the vent
2. Witnessing the event occurring to others
3. Learning that it occurred to close family member or close friend
4. Experiencing repeated or extreme exposure to aversive details of traumatic events (e.g., first responders)
B. Presence of intrusion symptoms:
1. Recurrent, involuntary, intrusive memories
2. Distressing dreams related to event
3. Dissociative reactions (e.g., flashbacks)
C. Persistent avoidance of stimuli associated with trauma evidenced by:
1. Avoidance of memories, thoughts, feelings
2. Avoidance of external reminders
D. Negative alterations in cognitions and mood evidenced by:
1. Inability to remember aspects of traumatic event
2. Persistent negative beliefs about self
3. Persistent distorted cognitions about cause/consequences of traumatic event
4. Persistent negative emotional state
5. Markedly diminished interest or participation in activities
6. Feelings of detachment or estrangement
7. Persistent inability to experience positive emotions
E. Marked alterations in arousal and reactivity associated with traumatic events
1. Irritable behavior and angry outbursts typically expressed as verbal/physical aggression
2. Reckless or self-destructive behavior
3. Hypervigilance
4. Exaggerated startle response
5. Problems with concentration
6. Sleep disturbance
F. Disturbance more than one month

Question 7

Schizophrenia

Answer 7

1) At least 2 of the follow symptoms significant for one month: Delusions, Hallucinations, Disorganized Speech (one of these 3 required), Negative symptoms, Disorganized Behavior, Catatonia
2) Disturbance lasts 6+ months
3) Symptoms cause drop in functioning

Question 8

Bipolar I

Answer 8

1) One or more FULL manic episodes/mixed manic episodes
2) Minor or major depressive episodes often present
3) May have psychotic symptoms during manic or depressive episode
- Single manic episode (do not need to have a major depressive episode)

Question 9

Bipolar II

Answer 9

• Five or more of the following (at least one of which is 1 or 2)
  1) Depressed mood
  2) Diminished interest in activities
  3) Significant weight gain/loss
  4) Insomnia/hypersomnia
  5) Psychomotor agitation or retardation
  6) Fatigue/loss of energy
  7) Feelings of worthlessness/guilt
  8) Diminished ability to think or concentrate/indecisiveness
  9) Suicidal ideation/attempt
• Hypomanic episode (at least 4 days, not as severe as full manic)
• Major depressive episodes alternating with hypomanic episodes

Question 10

Somatic Symptom Disorder

Answer 10

1. Presence of one or more somatic symptoms that cause distress or impairment in daily living
2. Excessive thoughts, feelings, or behaviors related to somatic symptoms
   - disproportionate thoughts about seriousness of symptoms
   - persistent high levels of anxiety related to symptoms or health
   - devotes excessive amount of time to health
3. 6+ months

Specifiers:
- Predominant pain
- Persistent

Question 11

Adjustment Disorder

Answer 11

1. Development of emotional or behavioral problems in response to identifiable stressor occurring within 3 months of exposure to stressor
2. Symptoms and behaviors are clinically significant and out of proportion to the severity of the stressor

Do not persist longer than 6 months

Question 12

Substance Use Disorder

Question 13

Delusion

Answer 13

Fixed beliefs, not amenable to change even in the presence of contradictory information
- Can be bizarre (impossible) or non-bizarre (actually plausible)

Question 14

Types of Delusions
1) Persecutory (Paranoid)
2) Referential
3) Grandiose
4) Erotomaniac
5) Nihilistic
6) Somatic

Answer 14

1) Persecutory (Paranoid) - believes one will be harassed or harmed by someone else
2) Referential - believes that gestures, comments, environmental cues, etc. are directed at you or hold meaning
3) Grandiose - exceptional abilities, wealth, or fame
4) Erotomaniac - believes another individual is in love with them
5) Nihilistic - believes a major catastrophe will occur
6) Somatic - preoccupation with health/organs (e.g., “there’s a chip in my brain”)

Question 15

Hallucination

Answer 15

Perception-like experiences occurring without external stimuli, involuntary

Question 16

Brief Psychotic Disorder

Answer 16

1) Two or more of the following during a less than 1-month period: delusions, hallucinations, disorganized speech (must have one of these 3), grossly disorganized or catatonic behavior, negative symptoms
2) Episode lasts at least one day but less than 1 month

Question 17

Catatonia

Answer 17

Marked decrease in reactivity to environment (negative symptom of Schizophrenia)

Question 18

Prodome phase

Answer 18

Initial symptoms of an illness (e.g., negative symptoms in Schizophrenia)

Question 19

Schizoaffective Disorder

Answer 19

1) Meet full criteria for a mood episode (either mania or depression)
2) Exhibit symptoms of Schizophrenia during a period without mood episode for 2+ weeks
3) Mood episode must be present for a substantial period of the illness (majority of the total duration)

Question 20

Delusional Disorder

Answer 20

1) Presence of Delusions (specify type and if bizarre) for 1+ month
2) No other symptoms of Schizophrenia aside from hallucinations related to defined delusional system

Question 21

Schizophreniform

Answer 21

1) Two or more of the following during a 1-month period: delusions, hallucinations, disorganized speech (must have one of these 3), grossly disorganized or catatonic behavior, negative symptoms
2) Episode lasts 1-6 months

Question 22

Separation Anxiety Disorder

Answer 22

3 or more symptoms:
- Recurrent excessive distress with separation from attachment figure
- Persistent excessive worry about losing/harm to attachment figure
- Persistent/excessive worry that an event will lead to separation
- Persistent reluctance/refusal to go out/away from home/to school/to work etc. for fear of separation
- Persistent/excessive fear/reluctance to be alone without attachment figure present
- Persistent reluctance/refusal to sleep without being near attachment figure
- Repeated nightmares involving separation
- Repeated complaints of physical symptoms with separation occurs/is anticipated
*must be developmentally inappropriate

Question 23

Selective Mutism

Answer 23

A. Consistent failure to speak in specific social situations in which there is an expectation for speaking, despite speaking in other situations
B. Disturbance interferes with educations/occupational achievement or with social communication
C. Duration at least 1 month (exclude first month of school)
D. Not due to lack of knowledge or comfort with spoken language
E. Not better explained by communication disorder, does not occur exclusively during course of ASD, schizophrenia, or another psychotic disorder

Question 24

Specific Phobia

Answer 24

A. Marked fear/anxiety about specific object/situation
B. Exposure to phobic stimulus almost invariably provokes an immediate anxiety/fear response
C. Phobic stimulus is actively avoided or endured with intense anxiety/fear
D. Fear/anxiety is disproportionate to actual danger (and to the sociocultural context)
E. Persistent - lasting > 6 months
F. Five subtypes
1. Animal
2. Natural Environment
3. Blood-injection-injury
4. Situational
5. Other

Question 25

Panic Attack

Answer 25

A. Discrete period of intense fear/discomfort that begins abruptly and reaches peak within 10 minutes
B. Includes at least 4 of the following:
1. Palpitations, pounding heart, increased HR
2. Sweating
3. Trembling/shaking
4. Sensations of shortness of breath
5. Feeling of choking
6. Chest pain/discomfort
7. Nausea/abdominal distress
8. Feeling dizzy, unsteady, lightheaded
9. Derealization
10. Fear of losing control/going crazy
11. Fear of dying
12. Parenthesias (numbness/tingling), chills or hot flashes

Question 26

Panic Disorder

Answer 26

A. Recurrent, unexpected panic attacks - abrupt surge or intense fear or intense discomfort that reaches a peak within minutes
B. At least one of the attacks followed by 1 month or more of one or both of the following
1. Persistent concern/worry about additional attacks or their consequences
2. Significant maladaptive change in behavior related to the attacks (e.g., avoidance)

Question 27

Agoraphobia

Answer 27

A. Fear of being in places or situations from which escape might be difficult (or embarrassing) or help may not be available if a panic attack occurred
B. Marked fear or anxiety for more that 6 months about 2 or more of the following:
1. Using public transportation
2. Being in open spaces
3. Being in enclosed spaces
4. Standing in line/being in a crowd
5. Being outside of the home alone

Question 28

Generalized Anxiety Disorder

Answer 28

A. Characterized by worry (repetitive thinking about a potential future threat, imagined catastrophes, uncertainties, and risks); spend excessive amount of time worrying and feeling anxious about variety of topics occurring for more days than not for at least 6 months about a number of events/activities
B. find it difficult to control the worry
C. Associated with three or more of the following:
1. Restlessness/feeling keyed up or on edge
2. Being easily fatigued
3. Difficulty concentrating or mind going blank
4. Irritability
5. Muscle Tension
6. Sleep disturbance

Question 29

Disruptive Mood Dysregulation Disorder

Answer 29

A. Severe recurrent temper outbursts manifested verbally/behaviorally that are grossly out of proportion in intensity/duration
B. Temper outbursts are inconsistent with development
C. Outbursts on average 3+ times per week
D. Mood between outbursts is persistently irritable/angry most of day & nearly every day
E. Criteria A-D present for 12+ months (without a period lasting 3+ months without all symptoms)
F. Criteria A-D present in at least 2 of 3 settings and are severe in at least one of these
G. Diagnose between 6-18 years of age
H. Age of onset before 10 years old
I. Rule out Bipolar
J. Rule out MDD episode
**Cannot coexist with ODD, intermittent explosive disorder, or bipolar

Question 30

Dissociation

Answer 30

Disruption/discontinuity in normal integration of consciousness, memory, identity, emotion, perception, body representation, motor control, and behavior

Question 31

Depersonalization

Answer 31

Characterized by a feeling of unreality or detachment from, or unfamiliar with one’s whole self or from aspects of the self (e.g., “I am no one”)

May result in out-of-body, observing and participating self

Question 32

Derealization

Answer 32

Feeling of unreality or detachment from or unfamiliar with the world

Feeling in a fog/dream; surroundings experiences as artificial, colorless, lifeless; subjective visual distortions/blurriness/heightened acuity

Question 33

Dissociative Amnesia

Answer 33

A. Inability to recall important autobiographical information (usually of a traumatic or stressful nature), inconsistent with normal forgetting
B. Symptoms cause clinically significant distress/impairment
C. Disturbance not attributable to substance/neurological/medical condition
D. Not better explained by DID, PTSD, acute stress, somatic symptom, or Neurocognitive

Subtypes:
- Localized: events during a specific time period
- Selective: can recall some events during a specific time period
- Generalized: very rare, complete loss of memory/life history
- Continuous: forget each new event as it occurs
- Systematized: loses memory for specific category of info (e.g., family)

Question 34

Depersonalization/Derealization Disorder

Answer 34

A. Persistent depersonalization, Derealization or both
B. Reality testing remains intact

Question 35

Dissociative Identity Disorder

Answer 35

A. Disruption of identity marked by two or more distinct personality states; discontinuity in sense of self and agency, alterations in affect, behavior, consciousness, memory, perception, cognition, sensory-motor
B. Recurrent gaps in recall of everyday events, personal information, and/or traumatic events inconsistent with ordinary forgetting
C. Symptoms causes clinically significant distress/impairment
D. Not a normal part of cultural/religious practice

Question 36

Pica

Answer 36

A. Persistent eating of non-nutritive, non-food substances over a period of at least 1 month
B. Eating of non-food substances is not developmentally appropriate
C. Not part of culture
D. Not explained by other medical condition/mental disorder (including pregnancy)

Question 37

Rumination Disorder

Answer 37

A. Repeated regurgitation of food over at least 1 month (food may be re-chewed, re-swallowed, or spit out)
B. Not attributable to medical condition
C. Does not occur exclusively during the course of another eating disorder

Question 38

Avoidance/Restrictive Food Intake Disorder

Answer 38

A. Eating/feeding disturbance as seen by persistent failure to meet appropriate nutritional and/or energy needs associated with 1+ of the following:
1. Significant weight loss
2. Significant nutritional deficiency
3. Dependence on enteral feeding/oral nutritional supplements
4. Marked interference with psychosocial functioning

Question 39

Anorexia Nervosa

Answer 39

A. Restrictive of intake relative to requirements needed to maintain body weight
B. Intense fear of gaining weight or becoming “fat” or persistent behavior that interferes with weight gain even though at a significantly low weight
C. Disturbance in how weight or shape is experienced / Undue influence of body weight/shape on self-evaluation / Denial of seriousness of low body weight

Specify:
- Restricting type: During last 3 months, individual has not engaged in binging/purging, weight loss accomplished through dieting/fasting/excessive exercise
- Binge-eating/purging type: During last 3 months, engaged in recurrently episodes of binge eating or purging

Severity determined by BMI

Question 40

Bulimia Nervosa

Answer 40

A. Recurrent episodes of binge eating characterized by both:
1. Eating in discrete period of time, amount of food is definitely larger than what most people would eat
2. Sense of lack of control over eating during episode
B. Recurrent inappropriate compensatory behaviors to prevent weight gain (e.g., vomiting, laxatives, diuretics, fasting, excessive exercise)
C. Binge eating and inappropriate compensatory behaviors average at least 2x/week for 3+ months
D. Self-evaluation is unduly influenced by body shape/weight
E. Disturbance does not occur exclusively during episodes of anorexia

Severity determined by # episodes of compensatory bx per week

Question 41

Delirium

Answer 41

A. Disturbance in attention and awareness
B. Develops over short period of time (hours to a few days)
C. Additional disturbance in cognition (e.g., memory, disorientation, language, perception, etc.)
D. Not better explained by other disorder
E. Disturbance is a direct physiological consequence of another medical conditions, substance, or withdrawal

Question 42

Major Neurocognitive Disorder

Answer 42

A. Significant cognitive decline from a previous level of performance in one or more domains (complex attention, executive function, learning/memory, language, perceptual-motor, or social cognition) based on:
1. Concern of the individual, knowledgeable informant, or clinician that there has been a significant decline
2. Substantial impairment in cognitive performance (documented by assessment)
B. Cognitive deficits interfere with independence
C. Does not occur exclusively in the context of delirium
D. Not better explained by another mental disorder

Question 43

Mild Neurocognitive Disorder

Answer 43

A. Evidence of modest cognitive decline from a previous level of performance in one or more cognitive domains (attention, executive function, learning and memory, language, perceptual-motor, or social cognition) based on:
1. Concern that their has been a mild decline in cognitive function
2. Modest impairment in cognitive performance
B. Cognitive deficits do not interfere with capacity for independence in everyday activities (ADLs)

Question 44

Major/Mild Disorder due to Alzheimer’s

Answer 44

A. Criteria met for major/mild
B. Insidious (slow) onset and gradual progression of impairment in one or more cognitive domains
C. Criteria met for probable/possible Alzhiemer’s

Question 45

Probable Alzheimer’s Disease

Answer 45

Evidence of a causative Alzheimer’s disease genetic mutation from either genetic testing or family history

Question 46

Possible Alzheimer’s Disease

Answer 46

No evidence of causative Alzheimer’s disease genetic mutation, all of the following present:
1. Clear evidence of decline in memory and learning
2. Steadily progressive, gradual decline in cognition without extended plateaus
3. No evidence of mixed etiology

Question 47

Stages of Alzheimer’s

Answer 47

1. No impairment
2. Very mild cognitive decline (may be normal age-related changes or early signs)
3. Mild cognitive decline
   - Problems coming up with the right word
   - Trouble remembering names
   - Greater difficulty performing tasks in social/work settings, forgetting material that one has just read
   - Losing or misplacing things
   - Increasing trouble with planning/organizing
4. Moderate Cognitive decline
   - Forgetfulness of recent events
   - Impaired ability to perform mental arithmetic (serial 7s)
   - Greater difficulty performing complex tasks
   - Forgetfulness about one’s own personal history
   - Becoming moody/withdrawn
5. Moderately severe decline
   - Gaps in memory and thinking, need help with ADLs
   - Unable to recall own address/phone number
   - Confused about who they are or what day it is
   - Trouble with less challenging mental arithmetic
   - Need help choosing proper clothing
   - Still remembering significant details about self/fam
   - No assistance with eating/toileting
6. Severe cognitive decline
   - Memory worsens, personality changes, extensive help for ADLs
   - Lose awareness of recent experiences/surroundings
   - Difficulty with personal history
   - Trouble remembering names of intimate people
   - Need help dressing
   - Major changes in sleep patterns
   - Wander/become lost
7. Very severe cognitive decline
   - Lose ability to respond to environment, carry on conversation, control movement
   - Help with eating, toileting
   - May lose ability to smile, sit without support, hold head up
   - Abnormal reflexes, rigid muscles, impaired swallowing

Question 48

Fluent Aphasia (Wernicke’s)

Answer 48

Speech is fluent but generally incomprehensible

Compromised understanding of speech

Substitute incorrect words for correct ones (verbal paraphasia)

Lesion is generally in the superior gurus of the left temporal lobe

Question 49

Nonfluent aphasia (Broca’s)

Answer 49

Comprehension is better but speech is difficult and limited

Lesion is in the lower, posterior portion of the left frontal lobe

Question 50

Alexia

Answer 50

Lost abilities in reading

Question 51

Agraphia

Answer 51

Lost abilities in writing

Question 52

Acalculia

Answer 52

Difficulties with numbers

Question 53

Agnosias

Answer 53

Difficulty recognizing some class of external objects

Classified with regard to modality and verbal/nonverbal content

Question 54

Neglect (disorder of perception)

Answer 54

Patient may neglect entire right or left side

E.g., vision - neglect entire side of visual world

Question 55

Apraxia

Answer 55

Impairment of purposive moment occurring in the absence of paralysis, weakness, or unsteadiness

Question 56

Vascular dementia

Answer 56

Several vascular risk factors including hypertension and a series of strokes

End result is substantial deterioration (not uniform but stepwise and patchy) of different areas of the brain

Question 57

Frontotemporal dementia

Answer 57

Executive dysfunction

Relatively better memory and visuoconstructional abilities than Alzheimer’s patients

Often have behavioral disturbances or language dysfunction

Question 58

Anterograde Amnesia

Answer 58

Inability to form new memories from time of onset of the illness

Question 59

Retrograde amnesia

Answer 59

Inability to recall events that took place before the onset of illness

** Korsakoff’s syndrome

Question 60

Intellectual Disability

Answer 60

BOTH
A. Deficits in intellectual functions
1. reasoning, problem solving, abstraction, academics
2. Confirmed by both clinical assessment and standardized testing
B. Deficits in adaptive functioning: failure to meet developmental and sociocultural standards for independence and social responsibility

C. Onset during developmental period

Question 61

Global Developmental Delay

Answer 61

Children < 5 who fail to meet expected developmental milestones in several areas of intellectual functioning

*applies when child is not able to undergo systemic assessments

Question 62

Language Disorder

Answer 62

Persistent difficulties in acquisition and use of language across modalities due to deficits in comprehension or production including:
1. Reduced vocabulary
2. Limited sentence structure
3. Impairments in discourse

Quantifiable below age expectations

Onset in early developmental period

Question 63

Speech Sound Disorder

Answer 63

A. Persistent difficulty with speech sound production that interferes with speech intelligibility or prevents verbal communication
B. Disturbance limits effective communication
C. Onset of symptoms in early developmental period

Question 64

Childhood Onset Fluency Disorder (Stuttering)

Answer 64

A. Disturbances in normal fluency and time patterning of speech that are inappropriate for age/language skills and persist over time. Include 1+ of following
1. Sound/syllable repetition
2. Sound prolongations of consonants/vowels
3. Broken words
4. Audible or silent blocking
5. Circumlocutions (word substitutions)
6. Pronounce with excess physical tension
7. Monosyllabic whole word rep
B. Disturbance causes anxiety about speaking or limitations in effective communication
C. Onset of symptoms is in the early developmental period

Question 65

Social (Pragmatic) Communication Disorder

Answer 65

A. Persistent difficulties in social use of verbal/nonverbal communication as shown by:
1. Deficits using communication for social purposes
2. Impaired ability to adapt communication to match context or listener needs
3. Difficulties following rules for conversation and story-telling (e.g., taking turns)
4. Difficulty understanding what is not explicitly stated (e.g., metaphor, sarcasm)

Question 66

Autism Spectrum Disorders

Answer 66

A. Persistent deficits in social communication/interaction across multiple contexts
1. Deficits in social-emotional reciprocity
2. Deficits in nonverbal communicative behavior used for social interaction (e.g., eye contact)
3. Deficits in developing, maintaining, and understanding relationships
B. Restricted, repetitive patterns of behavior, interests, or activities by 2+ of following:
1. Stereotyped/repetitive motor movements
2. Insistence on sameness, inflexible adherence to routines or ritualized patterns of verbal/nonverbal behavior
3. Highly restricted, fixated interests
4. Hyper- or hypo-activity to sensory input or unusual interests in sensory aspects of environment
C. Symptoms present in early developmental period
D. Symptoms cause clinically significant impairment

Question 67

Attention Deficit Hyperactivity Disorder

Answer 67

1. Presence of 6+ inattentive and/or hyperactive impulsive symptoms for 6+ months (5+ symptoms for adults and older adolescents)
   * hyperactivity does not have to be present for a diagnosis
   A. Inattention symptoms
   - fails to give close attention to details or make careless mistakes
   - difficulty sustaining attention in tasks or play
   - Often does not seem to listen when spoken to directly
   - Often does not follow through on instructions and fails to finish work
   - Often has difficulty organizing tasks/activities
   - Often avoids, dislikes, or is reluctant to engage in tasks and activities
   - Often loses necessary things
   - Often easily distracted by extraneous stimuli
   - Often forgetful in daily activities
   B. Hyperactivity and impulsivity symptoms
   - Often fidgets with or taps hands or feet or squirms
   - leaves seat when should remain seated
   - Runs about or climbs inappropriately
   - Often unable to play or engage in leisure activities quietly
   - Often “on the go” acting as if “driven by a motor”
   - Talks excessively
   - Blurts out answers before question is finished
   - Difficulty waiting for a turn
   - Interrupts or intrudes on others
2. Onset before 12 years old
3. Symptoms are present in at least two settings (social, academic, work)
4. Symptoms interfere with functioning

Question 68

Specific Learning Disorders

Answer 68

A. Difficulties learning and using academic skills, indicated by presence of at least one of the following that have persisted for 6+ months
1. Inaccurate or slow and effortful word reading
2. Difficulty understanding meaning of what is read
3. Difficulties with spelling
4. Difficulties with written expression
5. Difficulties mastering number sense/difficulties with math reasoning

B. Academic skills substantially and quantifiable below those expected for age (confirmed by assessment)

C. Begin in school-age years

Question 69

Cluster A Personality Disorders

Answer 69

Paranoid
Schizoid
Schizotypal

Question 70

Cluster B Personality Disorders

Answer 70

Antisocial
Borderline
Histrionic
Narcissistic

Question 71

Cluster C Personality Disorders

Answer 71

Avoidant
Dependent
Obsessive-compulsive

Question 72

Paranoid Personality Disorder

Answer 72

A. Pervasive distrust and suspiciousness of others such that their motives are interpreted as malevolent. Indicated by 4+ of following:
1. Suspects others are exploiting/harming
2. Preoccupied with unjustified doubts about the loyalty or trustworthiness of friends
3. Reluctant to confide in others because of unwarranted fear that info will be used against them
4. Reads hidden demeaning/threatening meanings into benign remarks/events
5. Persistently bears grudges
6. Perceives attacks on character that are not apparent to others
7. Has recurrent suspicions without justification regarding fidelity of spouse/partner

Question 73

Schizoid Personality Disorder

Answer 73

A. Pervasive pattern of detachment from social relationships and restricted range of expression of emotions in interpersonal settings indicated by 4+ of the following:
1. Neither desires nor enjoys close relationships
2. Almost always chooses solitary activities
3. Little interest in sexual experiences
4. Takes pleasure in few activities
5. Lacks close friends
6. Appears indifferent to praise/criticism
7. Shows emotional coldness/detachment/flattened affectivity

Question 74

Schizotypal Personality Disorder

Answer 74

A. Pervasive pattern of social and interpersonal deficits marked by acute discomfort/reduced capacity for close relationships by cognitive/perceptual distortions and eccentricities of behavior (still desire relationship) marked by 5+ of the following:
1. Ideas of reference
2. Odd beliefs or magical thinking that influences behavior inconsistent with subcultural norms
3. Unusual perceptual experiences, including bodily illusions
4. Odd thinking/speech
5. Suspiciousness or paranoid ideation
6. Inappropriate or constricted affect
7. Behavior or appearance that is odd, eccentric, peculiar
8. Lack of close friends or confidants
9. Excessive social anxiety that does not diminish with familiarity and tends to be associated with paranoid fears

Question 75

Antisocial Personality

Answer 75

A. Pervasive pattern of disregard for and violation of rights of others, indicated by 3+ of following:
1. Failure to conform to social norms with respect to lawful bx, repeatedly performing acts that are grounds for arrest
2. Deceitfulness
3. Impulsivity/failure to plan ahead
4. Irritability and aggressiveness
5. Reckless disregard for safety of self or others
6. Consistent irresponsibility, repeated failure to sustain consistent work
7. Lack of remorse, indifferent to or rationalizing having hurt/mistreated/stolen from another

Question 76

Borderline Personality Disorder

Answer 76

Pervasive pattern of instability of interpersonal relationships, self-image, affect, and marked impulsivity, marked by 5+ of following:
1. Frantic efforts to avoid real or imagined abandonment
2. Pattern of unstable and intense interpersonal relationships characterized by alternating extremes of idealization and devaluation
3. Identity disturbance, unstable self-image/sense of self
4. Impulsivity in at least two areas (spending, sex, substance abuse, reckless driving, binge-eating)
5. Recurrent suicidal behavior, gestures, or threats or self-mutilating behavior
6. Affective instability due to marked reactivity of mood
7. Chronic feelings of emptiness
8. Inappropriate anger or difficulty controlling anger
9. Transient, stress-related paranoid ideation or dissociative symptoms

Question 77

Histrionic Personality Disorder

Answer 77

Pervasive pattern of excessive emotionality and attention seeking indicated by 5+:
1. Uncomfortable in situations in which their not the center of attention
2. Interaction with others 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. Style of speech that is excessively impressionistic and lacking detail
6. Shows self-dramatization, theatricality, exaggerated expression
7. Is suggestible (easily influenced by others)
8. Considers relationships to be more intimate than they are

Question 78

Narcissistic Personality Disorder

Answer 78

Pervasive pattern of grandiosity (in fantasy or bx), need for admiration, lack of empathy, indicated by 5+:
1. Grandiose sense of self-importance (e.g., exaggerates achievements and talents, expects recognition)
2. Preoccupied with fantasies of unlimited success, power, brilliance, beauty, ideal love
3. Believes that they are “special” and unique and can only be understood by other high-status people
4. Requires excessive admiration
5. Sense of entitlement
6. Interpersonally exploitative
7. Lacks empathy, unwilling to recognize or identity the feelings of others
8. Often envious of others or believes that others are envious
9. Shows arrogant, haughty behaviors/attitudes

Question 79

Avoidant Personality Disorder

Answer 79

Pervasive pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation indicated by 4+:
1. Avoids occupational activities that involve significant interpersonal contact because of fear of criticism, disapproval, or rejection
2. Unwilling to get involved with people unless certain of being liked
3. Show restraint with intimate relationships because of fear of being shamed or ridiculed
4. Preoccupied with being criticized or rejected
5. Inhibited by new interpersonal situations because of feelings of inadequacy
6. Views self as socially inept, personally unappealing , or inferior
7. Unusually reluctant to take personal risks or engage in new activities because they may be embarrassing

Question 80

Dependent Personality Disorder

Answer 80

Pervasive and excessive need to be take care of that leads to submissive and clinging behavior and fears separation, marked by 5+:
1. Difficulty making everyday decisions without excessive amount of advice and reassurance
2. Needs others to assume responsibility for most major areas of life
3. Difficulty expressing disagreement with others because of fear of loss of support or approval
4. Difficulty initiating projects or doings things on their own
5. Goes excessive lengths to obtain nurturance and support from others to the point of volunteering to do unpleasant things
6. Feels uncomfortable or helpless when alone because of exaggerated fears of being unable to care for self
7. Urgently seeks another relationship as source of care when a close relationship ends
8. Unrealistically preoccupied with fears of being left to take care of self

Question 81

Obsessive Compulsive Personality Disorder

Answer 81

Pervasive pattern of preoccupation with orderliness, perfectionism, and mental/interpersonal control at the expense of flexibility, openness, and efficiency. Marked by 4+:
1. Preoccupied with details, rules, lists, order, organization, or schedules to the extent that the major point of the activity is lost
2. Shows perfectionism that interferes with task completion
3. Is excessively devoted to work and productivity to the exclusion of leisure activities and friendships
4. Is over conscientious, scrupulous, and inflexible about matters of morality, ethics, or values
5. Unable to discard worn-out or worthless objects even when they have no sentimental value
6. Reluctant to delegate tasks or work with others unless they submit to exactly their way of doing things
7. Adopts a miserly spending style toward both self and others
8. Rigidity and stubbornness