Psychopathology: DSM 5 Disorders Flashcards

Question 1

Q

Grief vs Major Depressive Episode

Answer

A

Grief
- feelings of emptiness and loss
MDE
- depressed mood
- inability to anticipate happiness

Question 2

Q

Premenstrual Dysphoric Disorder

Answer

A

Depressive Disorder
- five symptoms the week prior to period and improve withing a few days of period coming
- one or more these symptoms
  - affective lability (mood swings, sensitive)
  - irritability or anger
  - depressed mood
  - anxiety
- one or more of these symptoms
  - decreased interest
  - concentration difficulty
  - lethargy
  - appetite changes
  - sleep problems
  - physical symptoms
- present within the past year
- needs to be confirmed by prospecive daily ratings of at least 2 symptoms for 2 months
  - if this is not done–> provisional diagnosis

Question 3

Q

Manic Episode

Answer

A

one event in lifetime required for Bipolar 1
persistent elevated or irritable mood and increased goal-directed activity
- lasts at least 1 week
During mood disturbance at least 3 or 4 if only irritable
- increase self-esteem
- less need for sleep
- more talkative
- flight of ideas
- distractability
- increase in goal directed activity
- involvement in high risk activity
cause marked impairment in functioning
requires major life desturbance or hospitalization

Question 4

Q

Major Depressive Episode

Answer

A

common, but **not required for bipolar 1 **
present during same two-week period
One of the following
- depressed mood or loss of interest
4 or more of the following
- weight loss or gain
- sleep disturbances
- psychomotor agitation or retardation
- fatigue
- feelings of worthlisness
- lack of ability to concentrate
- thoughts of death (recurrent)
cause impairment in functioning

Question 5

Q

Anxiety

Answer

A

anticipation of future threat

Question 6

Q

Anxiety Disorder Due to Another Medical Condition

Answer

A

Panic Attacks or anxiety is predomincant in the clinical picture
findings that the disturbance is the direct pathophysiological consequence of another medical condition
not better explained by another mental disorder
not exclusively during delirium
NOT MEANT TO INCLUDE PRIMARY ANXIETY DISORDERS THAT ARISE IN THE CONTEXT OF CHRONIC MENTAL ILLNESS

Question 7

Q

Obsessive Compulsive and Related Disorders
- preoccupation with one or ore defects or flaws in physical appearance that or not observable to others
- performced repetitive behaviors or mental acts in response to concern
- clinically significant distress
- not better explained by concerns with body fat or weigh in an individual whose diagnositic symptoms meet criteria for an eat disorder
- specify if
  - with muscle dysmorphia
    - preoccupied with the idea that body is insufficiently muscular

Answer

A

Body Dysmorphic Disorder

Question 8

Q

Cultural syndromes:
- Clusters of invariant symptoms that tend to co-occur among individuals in specific cultural groups, communities, or contexts
Cultural idioms of distress:
- A way of talking about suffering among people in a cultural group
- Ex: For western clinicians, major depressive disorder (MDD) is considered a “syndrome,” or cluster of symptoms that appear to “hang together.” But it can also be considered an “idiom of distress,” in that Westerners commonly talk of feeling “depressed” in everyday life.
Cultural explanations of distress or perceived causes:
- Cultural explanation or perceived cause for etiology, sxs, illness, or distress

Answer

A

What were the DSM IV “culture-bound syndromes” replaced by

Question 9

Q

recurrent MDD
- temporal relationship
- full remissions
- last two years demonstrate relationship
- seasonal outnumber nonseasonal

Answer

A

Seasonal Pattern Depressive Specifier

Question 10

Q

applied to Bipolar I or II
at least 4 mood episodes in last 12 months
- meet criteria for manic, hypomanic, or MDE
episodes marked by partial or full remission for 2 months or one of opposite polarity

Answer

A

Rapid Cycling Specifier for Bipolar or Related Disorders

Question 11

Q

Psychological Factors Affecting Other Medical Conditions

Answer

A

Somatic Symptom and Related Disorders
- Diagnostic Criteria
  - medical symptom or condition is present
  - psycholigcal or behavioral factors adversely affect the med condition in one or more:
    - factors have influenced the course as shown by a close temporal association between psych factors and development and delayed recovery
    - interfere with treatment
    - constitute well-established health risks for individual
    - influence the underlying pathophysiology which exacerbates symptoms to necessitate med attentions
  - not better explained by another med condition
  - Specify
    - mild: increases med risk
    - moderate: aggrevates
    - severe: results in hospitalization
    - extreme: results in severe, life-threatening risk
- Prevalence
  - unclear
  - more common than somatic symptom disorder
- Onset
  - can occur across the lifespan
    - can be characteristic of life stages
- Gender
- Differentials
  - mental disorder due to another medical condition
  - adjustment disorder
  - somatic symptom disorder
  - illness anxiety disorder
- Comorbidity
  - requires relavent psychological or behavioral syndrome or trait

Question 12

Q

Factitious Disorder

Answer

A

Somatic Symptom and Related Disorders
- Diagnostic Criteria
  - falsification of physical signs or symptoms, or induction of injury or dease, associated with identified deception
  - presents themself as ill, injured, or impaired
  - deceptive behavior is evident even in the absence of obvious external rewards
  - specify
    - single episode
    - recurrent episodes
- Prevalence
  - unknown, but probably 1%
  - single episodes are less common
- Onset
  - usually during early adulthood, often after hospitalization
- Gender
- Differentials
  - somatic symptom disorder
  - malingering
  - conversion disorder
  - borderline personality disorder
  - medical condition not associated with intentional symptom falsification
- Comorbidity

Question 13

Q

Catatonia (more indepth)

Answer

A

can occur in several disorders, including neurodevelopmental, psychotic, bipolar, depressive, and other mental disorders
can also be catanonic disorder due to another medical condition

Question 14

Q

Schizophreniform Disorder

DSM Criteria

Answer

A

Schizophrenia and Other Psychotic Disorders
- Diagnostic Criteria
  - 2 or more of the following, each present for a significant portion of the time during 1 month. At least 1 must be present 1,2, or 3
    - Delusions
    - Hallucinations
    - Disorganized speech
    - Grossly disorganized or catatonic behavior
    - negative symptoms
  - Episode lasts at least 1 month, but less than 6 months
    - when the diagnosis must be made without waiting for recovery, it should be qualified as provisional
  - schizoaffective, depressive, bipolar with psychotic features have been rule out
    - no major depressive or manic have occurred
    - mood episodes have occured during active-phase symptoms, thahve have been present for a minority of duration of the active and residual preiods of the illness
- Specifiers
  - good prognostic features
  - without good prognostic features
  - with catatonia
  - severity
- Onset
  - between late teens and mid 30s
- Prevalence
  - five fold less than schizophrenia
  - higher with the specifier of with good prognostic features
- Differentials
  - other mental disorders and medical conditions
  - brief psychotic disorders
- Comorbid

Question 15

Q

Narcissistic Personality Disorder

Answer

A

A pattern of gradiosity, need for admiration, and a lack of empathy

Question 16

Q

Personality Disorders Cluster B

Answer

A

Disorders
- antisocial
- borderline
- histrionic
- narcissistic
Characteristics
- dramatic
- emotional eratic
Prevalence
- 6%

Question 17

Q

Dissociative Amnesia DSM Diagnostic Criteria

Answer

A

Diagnostic Criteria
- inability to recall autobiographical info, usually of a traumatic or stressful nature, inconsistent with ordinary forgetting
  - localized (specific period of time) or selective (can recall some, but not all of one’s life history) or generalized (one’s life history)
- not attributable to a substance or medical or neurological conditions
- not explained by dissociative identity disorder, PTSD, acute stress disorder, somatic symptom disorder, or major or mild neurocognitive disorder
- Specify if with or without fugue
  - fugue: purposeful travel or bewildered wandering
Prevalence
- 1.8%
  - 1% for men and 2.6% for women
Development and Course
- it is usually sudden
Differentials
- Dissociative Identity Disorder
- PTSD
- Substance-related disorders
- neurocognitive disorders
- posttraumatic amnesia due to brain injury
- seizure disorder
- catatonic stupor
- facticious disorder and malingering
- normal and age related changes in memory
Comorbidity
- PDD
- MDD
- Adjustment Disorder

Question 18

Q

Frotteuristic Disorder

Answer

A

Diagnostic Criteria
- Over a period of at least 6 months
  - recurrent intense sexual arousal from touching or rubbing against a nonconsenting person
    - manifested by fantasies, urges, or behaviors
- Has acted on sexual urges with nonconsenting or the sexual urges or fantasies cause clinically significant distress
Specifiers
- in a controlled environment
- in full remission
Prevalence
- acts may occur in up to 30% adult males
- 10-14% of adult males outpatient settings
- appear to be fewer females
Differentials
- Conduct disorder and antisocial personality disorder
- Substance use disorder
Comorbidity
- hypersexuality and other paraphillic disorders
- exhibitionistic disorder and voyeuristic disorder
- APD, depressive, bipolar, anxiety, and substance

Question 19

Q

Fetishistic Disorder

Answer

A

Diagnostic Criteria
- over a period of at least 6 months
  - recurrent and intense sexual arousal from either nonliving objects or a highly specific focus on nongenital body parts
- Fantasies, sexual urges or behaviors cause clnically significant distress
- Fetish objects are not limited to articles of clothing used in cross dressing or things like vibrators
Specifiers
- body parts
- non living objects
- other
- in a controlled environment
- in full remission
Development and Course
- usually during puberty is onset
- reported almost exclusively in males
Differential Diagnosis
- Transvestic Disorder
- Sexual masochism disorder or paraphic disorder
- fetishistic behavior without fetishistic disorder

Question 20

Q

Somatic Symptom and Related Disorders
- Diagnostic Criteria
  - one or more somatic symptoms that are distressting or result in a significant disruption of daily life
  - Excessive thoughts, feelings or behaviors related to somatic symptoms or associated health concerns manifested by one:
    - disproportionate and persistant thoughts about seriousness of symptoms
    - high level of anxiety about health
    - time and energy devoted to symptoms
  - one somatic symptom may be continuously present (6 months typically)
  - Specify
    - predominant pain
      - if predominantly involve pain
    - persistent
      - more than 6 months
    - Severity
      - mild: one symptom
      - moderate: 2 or more
      - Severe: 2 or more, plus multiple somatic complaints
- Prevalence
  - not known
  - higher than somatization disorder (
  - around 5-7%
- Onset
  - common in older individuals
    - maybe underdiagnosed in older adults
- Gender
  - females tend to report more somatic symptoms
- Differentials
  - other med conditions
  - GAD
  - depressive disorders
  - illness anxiety disorder
  - conversion disorder (neurological)
  - delusional disorder
  - BDD
  - OCD
- Comorbidity
  - high comorbidity with medical disorders
  - anxiety and depressive

Answer

A

Somatic Symptom Disorder

Question 21

Q

Feeding and Eating Disorders
- Diagnostic Criteria
  - repeated regurgitation of food over a period of 1 month (several times a week, typically daily)
    - may be re-chewed, reswallowed, or spit-out
  - not associated with gastrointestinal or medical condition
  - no excuslively with AN, BN, or avoidant or restrictive food intake
  - specify if
    - in remission
      - after full criteria was met, but has not been met for a sustained period of time
- Prevalence/Onset
  - typically higher in individuals with intellectual disability
  - can occur during infancy, childhood, adolescence, adulthood
    - infancy: 3-12 months and remits spontaneously, but can be fatal
      - appears self-soothing
- Gender
- Differentials
  - gastrointestinal conditions
  - AN or BN
- Comorbidity
  - concurrent med condition
  - anxiety

Answer

A

Rumination Disorder

Question 22

Q

Unspecified Bipolar and Related Disorder

Question 23

Q

Grief
- feelings of emptiness and loss
MDE
- depressed mood
- inability to anticipate happiness

Answer

A

Grief vs Major Depressive Episode

Question 24

Q

Feeding and Eating Disorders
- Diagnostic Criteria
  - eating or feeding disturbance (lack of interest, avoidance based on sensory characteristics of food, concern of aversive consequence) manifested by failure to meet appropriate nutritional or energy needs by ** 1 or more of the following:**
    - weight loss (lack of growth in kids)
    - nutritional deficiency
    - dependence on enternal feeding or oral nutritional supplements
    - interference psychosocial functioning
  - not better explained by lack of food or culturally sanctioned practice
  - not exclusively by the course of AN or BN, no evidence of the way in which one’s body weight or shape is experienced
- Prevalence
- Onset
  - commonly develops in infancy or early childhood and may persist to adulthood
- gender
  - equally common in girls and boys
  - in ASD more common in boys
- Differentials
  - other medical conditions
  - specific neurological
  - RAD
  - ASD
  - specific phobia, social anxiety
  - AN
  - OCD
  - MDD
  - Schizo
  - Factitious
- Comorbidity
  - Anxiety, OCD, ASD

Answer

A

Avoidant/Restrict Food Intake Disorder

Question 25

Q

Cluster B
- Diagnostic Certeria
  - pervasive patter of instability of interpersonal relationships, self-image, and affects, marked impulsivity, beginning by early adulthood. 5 or more off the following:
    - efforts to avoid abandonment
    - pattern of unstable and intense personal relationships. Alternating between idealization and devaluation
    - identity disturbance: unstable self-image
    - impulsivity in two areas that are self-damaging (not suicidal or self-mutilating)
    - recurrent suicidal behavior, gestures, or threats, or self-mutilating beahvior
    - affective instability due to a marked reactivity of mood (intense episodic mood)
    - chronic feelings of emptiness
    - inappropriate, intense anger
    - transient, stress-related paranoid ideation
- Prevalence
  - 1.6%, but higher in mental health and psychiatric inpatient
  - decreases in older age groups
  - 75% in females
- Onset
  - chronic instability in early adulthood
  - risk of suicide in young adult years and wanes in aging
  - 30s and 40s have greater stabliity
- Differential
  - depressive and bipolar
  - other personality disorders
  - personality change due to another medical condition
  - substance use disorders
  - identity problems
    *

Answer

A

Borderline Personality Disorder

Question 26

Q

Depressive Disorder
- persistent disturbance in mood that predomintate in clinical picture
  - depressed mood or interest loss
- Findings show
  - developed during substance intoxication or withdrawal
  - substance is capable of producing symptoms
- not exclusively during delirium
- mild substance use disorder is comorbid–> 1 as 4th character
- moderate/severe substance use disorder is comorbid –> 2 as 4th character
- no comorbid substance use disorder–> 9 as 4th character
- Specifiers:
  - onset during intoxication or withdrawal

Answer

A

Substance/Medication Induced Depressive Disorder

Question 27

Q

Somatic Symptom and Related Disorders
- Diagnostic Criteria
  - medical symptom or condition is present
  - psycholigcal or behavioral factors adversely affect the med condition in one or more:
    - factors have influenced the course as shown by a close temporal association between psych factors and development and delayed recovery
    - interfere with treatment
    - constitute well-established health risks for individual
    - influence the underlying pathophysiology which exacerbates symptoms to necessitate med attentions
  - not better explained by another med condition
  - Specify
    - mild: increases med risk
    - moderate: aggrevates
    - severe: results in hospitalization
    - extreme: results in severe, life-threatening risk
- Prevalence
  - unclear
  - more common than somatic symptom disorder
- Onset
  - can occur across the lifespan
    - can be characteristic of life stages
- Gender
- Differentials
  - mental disorder due to another medical condition
  - adjustment disorder
  - somatic symptom disorder
  - illness anxiety disorder
- Comorbidity
  - requires relavent psychological or behavioral syndrome or trait

Answer

A

Psychological Factors Affecting Other Medical Conditions

Question 28

Q

Characterized by disruption of and discontinuity in the normal integration of consciousness, memory, identity, emotion, perception, body representation, motor control and behavior
Positive
- dissociative symptoms
  - fragmentation of identity
  - depersonalization
  - derealization
- inability to access information or control mental functions
Negative
- amnesia

Answer

A

Dissociative Disorders

Question 29

Q

Pattern of detachment from social relationships and a restricted range of emotional expression

Answer

A

Schizoid Personality Disorder

Question 30

Q

mood reactivity
two or more:
- weight gain
- hypersomnia
- heavy feeling in arms or legs
- rejection sensitivity

Answer

A

Atypical Features for Depressive Specifier

Question 31

Q

Manic Episode (at least one in lifetime)
- persistent elevated or irritable mood and increased goal-directed activity
  - lasts at least 1 week
- During mood disturbance at least 3 or 4 if only irritable
  - increase self-esteem
  - less need for sleep
  - more talkative
  - flight of ideas
  - distractability
  - increase in goal directed activity
  - involvement in high risk activity
- cause marked impairment in functioning
Hypomanic Episode (common but not required for diagnosis)
- persistently elevated or irritable mood
  - lasts at least 4 consecutive days
- 3 of the following symptoms or 4 if only irritable
  - inflated self-esteem
  - decreased need for sleep
  - more talkative
  - flight of ideas
  - distractible
  - increase in goal-directed activity
  - involvement in high risk activities
- change in functioning and is observable by others
- not severe enough to cause impairment in functioning
**Major Depressive Episode **(common, but not required for bipolar 1)
- present during same two-week period
  - One of the following
    - depressed mood or loss of interest
  - 4 or more of the following
    - weight loss or gain
    - sleep disturbances
    - psychomotor agitation or retardation
    - fatigue
    - feelings of worthlisness
    - lack of ability to concentrate
    - thoughts of death (recurrent)
  - cause impairment in functioning

Answer

A

Bipolar 1 Disorder

Question 32

Q

Persecutory Delusions

Answer

A

belief that one is going to be harmed, harrassed, by an individual, organization etc.
most common delusion

Question 33

Q

Schizophrenia

Answer

A

lasts for at least 6 months
includes at least 1 month of the active phase of symptoms

Question 34

Q

Specifiers for Bipolar and Related Disorders

Answer

A

Anxious distress
Mixed features
- manic or hypomanic episode with mixed features
  - full criteria for manic or hypomanic
  - at least 3 of the following
    - dysphoria or depressed mood
    - loss of interest
    - psychomotor retardation
    - fatigue
    - feelings of worthlessness
    - thoughts of death
- Depressive episode, with mixed features
  - full criteria met for MDE
  - at least three of the following manic/hypomanic symptoms
    - elevated mood
    - inflated self-esteem
    - more talkative
    - flight of ideas
    - increase in energy/goal-directed
    - increase in risk activitives
    - decreased need for sleep
Rapid Cycling
- applied to Bipolar I or II
- at least 4 mood episodes in last 12 months
  - meet criteria for manic, hypomanic, or MDE
- episodes marked by partial or full remission for 2 months or one of opposite polarity
Meloncholic features
Atypical features
Psychotic features
- mood-congruent or mood-incongruent
Catatonia
- can be applied to mania or depression
Peripartum Onset
Seasonal Pattern
Remission type
- partial
  - less than 2 months without symptoms
- full
  - no symptoms for at least 2 months
Severity
- mild, moderate, severe

Question 35

Q

Context
Continuum
Cultural relativism

Answer

A

What are the 3 C’s to classifying psychological disorders

Question 36

Q

Histrionic Personality Disorder

Answer

A

A pattern of excessive emotionality and attention seeking

Question 37

Q

Cluster A
- Diagnostic Certeria
  - pervasive patter of detachment from social relationships and a restricted range of expression of emotions in interpersonal settings, beginning by early adultood, indicated by 4 or more:
    - neither desires or enjoys close relationships
    - chooses solitary activities
    - has little interest in have sexual experieces
    - takes pleasure in few activies
    - lacks few friends other than first degree relatives
    - appears indifferent to praise or criticism
    - shows emotional coldness, detachment, or flattened affect
  - if met prior to onset of schizophrenia (premorbid)
- Prevalence
  - 4.9% is comorbid
  - very uncommon in clinical settings
  - 3.1% prevalence in alcohol study
- Onset
  - first apparent in childhood and adolescence with solitariness, poor peer relations, underachievement
  - slightly more often in males
- Differential
  - other mental disorders with psychotic symptoms
  - ASD
  - personality changes due to another med condition
  - substance use disorder
  - other personality disorders and personality traits
    *

Answer

A

Schizoid Personality Disorder

DSM Criteria

Question 38

Q

Substance/Medication-Induced Anxiety Disorder

Answer

A

Panic attacks or anxiety is predominant in the clinical picture
evidence in findings
- symptoms developed during or soon after a substance
- substance is capable of producing symptoms
disturbance is not better explained by another disorder
- do not persist 1 month after cessation or onset before meds
not exclusively during delirium
specifiers:
- with onset during intoxication
- withonset during withdrawal
- with onset after medication use
- type of medication or substance

Question 39

Q

abnormally elevated or irritable mood and energy that predominates the clinical picure
evidence of direct pathophysiological consequence of med condition
no just during delirium
causes clinically significant distress
Specificiers
- manic features
  - full criteria for manic or hypomanic episode
- manic or hypomanic like episode
  - D not met for manic:
    - not attributible to physiological effects of substance
  - F not met for hypomanic:
    - not attributible to physiological effects of substance
- mixed features
  - symptoms of depression also present, but do not predominate clinical picture

Answer

A

Bipolar and Related Disorder Due to Another Medical Condition

Question 40

Q

Dissociative Disorders

Answer

A

Characterized by disruption of and discontinuity in the normal integration of consciousness, memory, identity, emotion, perception, body representation, motor control and behavior
Positive
- dissociative symptoms
  - fragmentation of identity
  - depersonalization
  - derealization
- inability to access information or control mental functions
Negative
- amnesia

Question 41

Q

Psychotic Features Depressive Specifier

Answer

A

mood-congruent psychotic features
- consistent with depressive themes
mood-incongruent psychotic features
- does not include typical depressive themes

Question 42

Q

Recurrent

Answer

A

more than expected (panic attacks)

Question 43

Q

DSM-II

Answer

A

Similar to DSM-I
- Eliminated term “reaction”
182 disorders
Minimal changes
- Increased attention to children and adolescence
- “homosexuality not a d/o”
- More psychodynamic perspective

Question 44

Q

erotomanic delusions

Answer

A

when an individual believes falsely that another person is in love with him or her

Question 45

Q

full description found in Personality disorders
pervasive pattern of social and interpersonal deficits
- reduced capacity for close relationships
- cognitive or perceptual distortions
- eccentricities of behavior
onset usually in early adulthood
- in some cases in childhood and adolescence
abnormalities of beliefs, thinking, and perception are below the threshold for diagnosis of psychotic d/o

Answer

A

Scizotypal personality Disorder

Question 46

Q

Major Depressive Disorder

Answer

A

Depressive Disorders
- 5 or more symptoms that are change in previous functioning
  - one has to be
    - **depressed mood or loss of interest **
  - diet change (weight loss or gain)
  - insomnia or hypersomnia
  - psychomotor agigation or retardation
  - loss of energy
  - worthliness or guilt
  - lack of concentration or indeciveness
  - thoughts of death
- clinically significant distress
- not related to substance or medical condition
- never hypermanic or manic episode
- Specifiers and Severity
  - mild, moderate, severe
  - psychotic features
  - in partial remission, in full remission
  - unspecified
- Not better explained by
  - schizoaffective
  - schizophrenia
  - schiophreniform
  - delusional disorder

Question 47

Q

presentation and symptoms of bipolar disorders, but do not meet full criteria
clinician states why it does not meet full criteria
Examples of presentations
- short-duration hypomanic episodes (2-3 days) and major depressive episodes
  - meet full criteria for hypomanic, but short
  - do not overlap in time with major depressive episode (at least one lifetime history)
- hypomanic episodes with insufficient symptoms and major depressive episodes
  - at least one lifetime history of MDE
  - hypomanic episode do not meet full criteria, but experienced one or more
  - hypomanic symptoms do not overlap with MDE
- hypomanic episode without prior major depressive episode
  - never met full criteria for MDE or manic episode
- short-duration cyclthymia
  - multiple episodes of hypomanic (not meeting criteria)
  - multiple episodes of MDE (not meeting criteria)
  - less than 2 years for adults or 1 for kids

Answer

A

Other Specified Bipolar and Related Disorder

Question 48

Q

emotional response to real or perceived imminent threat

Question 49

Q

Other Specified Somatic Symptom and Related Disorder

Answer

A

Somatic Symptom and Related Disorders
- Brief somatic symptom disorder
  - less than 6 months
- Brief illness anxiety
  - less than 6 months
- illness anxiety disorder without excessive health related behaviors
- pseudocyesis
  - false belief of being pregnant that is associated with objective signs and reported symptoms of pregancy

Question 50

Q

A pattern of instability in interpersonal relationships, -image, and affects, and marked impulsivity

Answer

A

Borderline Personality Disorder

Question 51

Q

Obesseive-Compulsive and Related Disorder due to Another Medical Condition

Answer

A

Obsessions, compulsions, preoccupations with appearance, hoarding, skin picking, hair-pulling, other body focused rep behaviors or other symptoms predominante in clinical picture
lab findings show direct pahophysiological consequence of med condition
not better explained by another mental disorder
not during dilirium
clinically significant distress
specifiers
- with obsessive-compulsive disorder-like symptoms
- with appearance preoccupations
- with hoarding symptoms
- with hairpulling symptoms
- with skin picking symptoms

Question 52

Q

Avoidant/Restrict Food Intake Disorder

Answer

A

Feeding and Eating Disorders
- Diagnostic Criteria
  - eating or feeding disturbance (lack of interest, avoidance based on sensory characteristics of food, concern of aversive consequence) manifested by failure to meet appropriate nutritional or energy needs by ** 1 or more of the following:**
    - weight loss (lack of growth in kids)
    - nutritional deficiency
    - dependence on enternal feeding or oral nutritional supplements
    - interference psychosocial functioning
  - not better explained by lack of food or culturally sanctioned practice
  - not exclusively by the course of AN or BN, no evidence of the way in which one’s body weight or shape is experienced
- Prevalence
- Onset
  - commonly develops in infancy or early childhood and may persist to adulthood
- gender
  - equally common in girls and boys
  - in ASD more common in boys
- Differentials
  - other medical conditions
  - specific neurological
  - RAD
  - ASD
  - specific phobia, social anxiety
  - AN
  - OCD
  - MDD
  - Schizo
  - Factitious
- Comorbidity
  - Anxiety, OCD, ASD

Question 53

Q

Depressive Disorder Due to Another Medical Condition

Answer

A

Depressive Disorder
- depressed mood or loss of interest the predominates clinical picture
- findings suggest it is a direct pathophysiological consequence of med condition
- no exclusively during delirium
- Specifiers
  - depressive features
  - major-depressive like features
  - mixed features
- considerations
  - temporal
  - features atypical to mood disorder

Question 54

Q

Delusions

Answer

A

Schizophrenia Spectrum and Other Psychotic Disorders
fixed beliefs that are not amenable to change in light of conflicting evidence.
deemed bizarre
- if clearly implausible and not understandable
thought withdrawal
- express a loss of control over mind or body are bizzarre
- include the belived that one’s thoughts have been removed by some outside force
delusions of control
- actions are being acted on or manipulated by some outside force

Question 55

Q

Social Anxiety Disorder (Social Phobia)

Answer

A

Anxiety Disorder
fear or anxiety in one or more social situations in which the individual is exposed to scrutiny of others
- with children must occur with peers, not just adults
fears they will act in a way that will show anxiety symptoms and will be negatively evaluated
social situations provoke anxiety
social situations are avoided or endured with intense fear
out or proportion
lasting 6 or more months
Prevalence
- 7% in the US
Age of onset
- 13
- 75% have onset between 8-15
specifier:
- performance only

Question 56

Q

IV:
- listed 25 “culture bound syndromes”
- list was heterogeneous
V:
- now a “Glossary of Cultural Concepts of Distess”
  - Lists 9 of the best studied concepts
- Section III includes chapter on cultural formulation

Answer

A

Cultural improvements from DSM IV to DSM V

Question 57

Q

Pattern of disregard for, and violation of, the rights of others

Answer

A

Antisocial Personality Disorder

Question 58

Q

DSM-IV

Answer

A

six year effort
comprebensive lit reviews
worked with developers of ICD-10 to coordinate
Minimal changes
- 297 disorders
- “Clinical significance” added
- More conservative in terms of need for science to back up criteria
  *

Question 59

Q

six year effort
comprebensive lit reviews
worked with developers of ICD-10 to coordinate
Minimal changes
- 297 disorders
- “Clinical significance” added
- More conservative in terms of need for science to back up criteria
  *

Question 60

Q

Hypomanic Episode

Answer

A

not required for Bipolar 1, but common
persistently elevated or irritable mood
- lasts at least 4 consecutive days
3 of the following symptoms or 4 if only irritable
- inflated self-esteem
- decreased need for sleep
- more talkative
- flight of ideas
- distractible
- increase in goal-directed activity
- involvement in high risk activities
change in functioning and is observable by others
not severe enough to cause impairment in functioning

Question 61

Q

nocturnal panic attack

Answer

A

waking from sleep in a state of panic

Question 62

Q

Excoriation (Skin-Picking) Disorder

Answer

A

Recurrent skin picking in skin lesionss (spend at least an hour a day)
repeated attempts to stop
causes clinically significant stress
not attributable to other
not ususally in presence of others
prevalence
- 1.4%
gender differences
- 3/4 are female
age of onset
- typically in adolescence or puberty
- may present at various ages

Question 63

Q

presented for the purposes of identifying a panic attack–> not a mental disorder, noted as a specifier
abrupt surge of intense fear or discomfort that reaches a peak within minues with 4 or more of the following symptoms
- palpitations
- sweating
- trembling
- shortness of breath
- chest pain
- nausea
- dizziness
- chills or heat
- paresthesias
- derealization
- fear of losing control
- fear of dying

Answer

A

Panic Attack Specifier

Question 64

Q

Sexual Masochism Disorder

Answer

A

Over a period of at least 6 months
- recurrent and intense sexual arousal from the act of being humiliated, beaten, bound, or otherwise made to suffer, as manifested by fantasies, urges, or behaviors
- Fantasies, sexual urges, or behaviors cause clinically significant distress
Specificiers
- with asphyxiophilia
  - practice of achieving sexual arousal related to restriction of breathing
- in a controlled environment
- in full remission
Prevalence
- 2.2% males and 1.3% females
Development
- mean age of onset is 19.3

Answer 62

A

Specifiers for Bipolar and Related Disorders

Answer 63

A

Other Specified Trauma Stressor-Relate Disorder

Answer 64

A

Lasts more than one day and remits by 1 month

Answer 65

A

Disorders
- Avoidant
- Dependent
- Obsessive-Compulsive
Characteristics
- anxious
- fearful
Prevalence
- 9.1%

Answer 66

A

Recurrent

Answer 67

A

with poor insight specifier

Answer 68

A

Effect of culture on DSM diagnoses

Answer 69

A

Major Depressive Episode

Answer 70

A

Anxiety Disorders
Marked fear or anxiety about 2 or more of the following:
- public transportation
- open spaces
- enclosed spaces
- standing in line or in a crowd
- outside of the home alone
Individual avoids these situations because of thoughts that escape might be difficult or help might be difficult in the event of panic like symptoms
situations provoke fear
actively avoided, require companion
out of proportion
6 months or more
diagnosed irrespective of panic disorder
Prevalence
- 1.7% recieve a diagnosis every year
Gender differences
- 2:1 female to male
comorbidity
- majority of cases are comorbid

Answer 71

A

Catatonia Depressive Specifier

Answer 72

A

Feeding and Eating Disorders
- Dignostic Criteria
  - recurrent episodes of binge eating
    - eating, in a descrete period of time (2 hours), an amount that is larger than what most individuals would eat
    - a sense of a lack of control
  - recurrent inapproriate compensatory behaviors in order to prevent weight gain; vomiting, laxatives, etc
  - bince eating and compensatory behavior occur on **average once a week for three months **
  - self-eval is influenced by body shape and weight
  - does not occur exclusively during episodes of AN
  - Severity
    - Mild: 1-3 per week
    - Moderate: 4-7
    - Severe: 8-13
    - Extreme: 14 or more
- Prevalence
  - within normal BMI (18.5-30)
  - 1%-1.5%
- Onset
  - highest among young adults, peaks in older adolescence
  - rare before puberty and after 40
  - crude mortality is 2% per decade
  - cross over from BN to AN happens in 10 to 15%
- Gender
  - more in females, but little is known about females
- Differentials
  - AN
  - BED
  - MDD
  - Klein-Levin Syndrome
    - neurological condition with disturbed eating, but not overconcerned with weight or body shape
  - Borderline Personlity Disorder
    - both can be given
- Comorbidity
  - depressive
  - anxiety

Answer 73

A

compulsions

Answer 74

A

Manic Episode

Answer 75

A

Presence of two or more distinct personality states or an experiences of possession
recurrent episodes of amnesia
recurrent, inexplicable instrusions into their conscious functioning and impulses
alterations of sense of self
odd changes of perception
intermittent functional neurological symptoms
- stress often produces transient exacerbation of dissociative symptoms

Answer 76

A

Other Specified Obsessive-Compuslve and Related Disorded

Answer 77

A

Diagnostic Criteria
- enduring pattern of inner experience that deviates markedly from expectations of culture in 2 or more:
  - Cognition
  - Affectivity
  - Interpersonal functioning
  - Impulse Control
- pattern is inflexible and pervasive
- pattern leads to clinically sgnificant distress
- pattern is stable and of long duration–> traced to adolescence or early adulthood
Prevalence
Onset
- those diagnosed before 18, must have features for at least 1 year
- requires onset no later than early adulthood
Gender
- antisocial is more common in males
- borderline, histrionic, dependent more common in females
Differential
- other mentale disorders and personality traits
- psychotic disorders
- anxiety and depressive disorders
- PTSD
- personality changes due to another medical condition
  - like brain tumor
Comorbid

Answer 78

A

Transvestic Disorder

Answer 79

A

there is no obvious cue or trigger (panic attack)

Answer 80

A

A pattern of preoccupation with orderliness, perfectionism, and control

Answer 81

A

Diagnostic Criteria
- Presence of one or both
  - Depersonalization
    - experiences of unreality, detachment, or being an outside observer with respect to one’s thoughts, feelings, sensations, body or actions
  - Derealization
    - experiences of unreality or detachment with respect to surroundings
- reality testing remains intact
- not better explained by schizophrenia, panic disorder, MDD, acute stress disorder, PTSD, or another dissociate disorder
Prevalence
- 2%
- gender ratio is roughly equally
Development
- mean age of onset is 16
- 20% experience onset after age 20
- only 5% after age 25
Differentials
- Illness Anxiety Disorder
- MDD
- OCD
- other Dissociative Disorders
- Anxiety Disorders
- Psychotic Disorders
- Substance/Medication-Induced Disorders
Comorbidity
- unipolar depression
- anxiety disorder
- PTSD was low
- Personlity disorder
  - avoidant
  - borderline
  - OCPD

Answer 82

A

Three major sections
- Introductin and how to use the DSM
- Diagnostic criteria and codes
- Emerging measures and models
  - Assessment toold
  - cultural formulation
  - alternative model for personality disorders
  - conditions for further study

Answer 83

A

modify culturally determined criteria to be more equivalent across cultures
specific diagnostic criteria changed to petter apply across diverse cultures
address cultural concepts of distress

Answer 84

A

Feeding and Eating Disorders
- Dignostic Criteria
  - recurrent episodes of binge eating
    - eating, in a descrete period of time (2 hours), an amount that is larger than what most individuals would eat
    - a sense of a lack of control
  - Episodes associated with 3 or more:
    - eating much more rapidly than normal
    - uncomfortably full
    - large amounts of food when not hungry
    - eating alone because you are embarrassed about how much food
    - disgusted, depressed, or guilty after
  - distress about binge eating
  - at least once a week for 3 months
  - not associated with compensatory behaviors
- Prevalence
  - 1.6 % for females
  - 0.8% for males
- Onset
  - typically begins in young adulthood or adolescence
- Gender
  - higher in females slightly
- Differentials
  - BN
  - bipolar and depressive
  - Borderline personlity
- Comorbidity
  - bipolar, depressive, anxiety

Answer 85

A

Semi-structured interview

16 questions that focuses on individual experience and social context
Objective is to assess cultural factors using a person-centered approach (we are not putting people into a box, we are seeing it from their perspective)

Divided into 2 columns,

Questions on the right, instructions on the left
Two versions: one for client, one for an informant,

12 Supplementary Modules

Provide additional questions to flesh out domains assessed briefly in the 16-item CFI (core CFI)
Questions that can be used during the cultural assessment of particular groups, such as children and adolescents, older adults, immigrants and refugees, and caregivers

Answer 86

A

experiences of unreality or detachment from one’s mind, self or body (depersonalization)
experienct of unreality or detachment from one’s surroundings (derealization)
intact reality testing
no evidenct of any distinction between individuals with predominantly depersonalization vs derealization
- can have one or the other or both

Answer 87

A

Delusional Disorder

Answer 88

A

What is the purpose of the DSM?

Answer 89

A

Sexual Masochism Disorder

Answer 90

A

Acute Stress Disorder

Answer 91

A

Over a period of at least 6 months
- recurrent and intense sexual arousal from the exposure of one’s genitals to an unsuspecting person, fantasies, urges, or behaviors
Individual has acted on these sexual urges with a nonconsenting person, or the sexual urges or fantasies cause distress
Specifiers
- sexually aroused by exposing genitals to prepubertal children
- sexually aroused by exposing genitals to physically mature indiviuals
- sexually aroused by exposing genitals to prepubertal children and to physically mature individuals
- in a controlled environment or in full remission
Prevalence
- 2-4% in males, but unknown in females
  - may be half as often in females
Development and Course
- become aware during adolescence
- age may be associated with decreasing
Differentials
- Conduct and antisocial
- Substane USe disorders
Comorbity
- Depressive, bipolar, anxiety, substance
- hypersexuality, ADHD, other paraphillic, antisocial

Answer 92

A

Diagnostic Criteria
- Over a period of at least 6 months
  - recurrent, intense sexually arousing fantasies, sexual urges, or behaviors involving prepubescent child or children (13 years or younger)
- Has acted on these urges, or these sexual urges or fantasies cause marked distress or interpersonal difficulty
- The individual is at least 16 and at least 5 years older than the child in A
  - do not include an individual in late adolescence involved in an ongoing sexual relationship with a 12 or 13 year old
Specifiers
- exclusive type (attracted to only children)
- nonexclusive
- sexually attracted to females
- sexually attracted to both
- limited to incest
Prevalence
- 3-5% in males, but unknown in females
Development
- minimum of age 16
Differentials
- antisocial personality disorder
- alcohol and substance use disorders
- OCD
Comorbidity
- substance use disorders
- depressive, bipolar, anxiety, antisocial disorder, paraphilic

Answer 93

A

Exhibitionistic Disorder

Answer 94

A

Feeding and Eatin disorders
Diagnostic Features
- Persistent eating of nonnutritve, nonfood substances over a period of at least 1 month
- inappropriate to developmental level
  - minimum of age 2 is suggested
- not culturally supported or socially normative
Prevalence
- unclear
Development and course
- childhood onset is most common
  - in normally developing children
- in adults
  - in intellectual disability
- during pregnancy
Gender
- both, but only in females during pregnancy
Differentials
- AN
  - nonfood
- Factitious D/O
  - intentional to have a physical symptom
- Nonsuicidal self-injury and personality d/o
  - swallow items for self-harm
Comorbidity
- autism spectrum
- intellectual disability

Answer 95

A

Somatic Symptom and Related Disorders
- Diagnostic Criteria
  - one or more somatic symptoms that are distressting or result in a significant disruption of daily life
  - Excessive thoughts, feelings or behaviors related to somatic symptoms or associated health concerns manifested by one:
    - disproportionate and persistant thoughts about seriousness of symptoms
    - high level of anxiety about health
    - time and energy devoted to symptoms
  - one somatic symptom may be continuously present (6 months typically)
  - Specify
    - predominant pain
      - if predominantly involve pain
    - persistent
      - more than 6 months
    - Severity
      - mild: one symptom
      - moderate: 2 or more
      - Severe: 2 or more, plus multiple somatic complaints
- Prevalence
  - not known
  - higher than somatization disorder (
  - around 5-7%
- Onset
  - common in older individuals
    - maybe underdiagnosed in older adults
- Gender
  - females tend to report more somatic symptoms
- Differentials
  - other med conditions
  - GAD
  - depressive disorders
  - illness anxiety disorder
  - conversion disorder (neurological)
  - delusional disorder
  - BDD
  - OCD
- Comorbidity
  - high comorbidity with medical disorders
  - anxiety and depressive

Answer 96

A

Antisocial Personality Disorder

Answer 97

A

Panic Disorder

Answer 98

A

symptoms characteristic of anxiety disorder cause clnicaly significant distress or impairment, but do not meet criteria
clinicians chooses to communicate why the criteria is not met
- limited symptom attacks
- generalized anxiety not occuring more days than not
- khal cap (wind atttacks)–> see glossary of cultural concepts
- ataque de nervios

Answer 99

A

Harmonized with WHO’s ICD

Answer 100

A

extreme loss of motor skill or even constant hyperactive motor activity

Answer 101

A

Anxious Distress Depressive Specifier

Answer 102

A

Development of DSM V

Answer 103

A

reptitive behaviors or mental acts that an individual feels driven to perform in respornse to an obsession or according to rules that must be applied rigidly

Answer 104

A

Culture shapes the experience and expression of the symptoms, signs, and behaviors that are criteria for diagnosis

Answer 105

A

Histrionic Personality Disorder

DSM Criteria

Answer 106

A

Anxiety Disorder
Marked anxiety or fear about a specific object or situation
provokes immediate fear or anxiety
actively avoided or endured with fear
out of proportion to actual danger
6 months or more
Specify if:
- animal
- natural environment
- blood-injection-injury
- situational
- other (this is where vomiting is)
Prevalence
- 7-9% adults
- 16% in adolscents
Gender Differences
- females more than males

Answer 107

A

substantial portions of morbidity associated with schizophrenia
diminished emotional expression
- reductions in the expressions of the emotion in the face, eye contact, intonation of speech, and movements of the hand, head, and face that normally give an emotional speech emphasis
avolition
- is a decrease in motivated self-initiated activities
- others include:
  - alogia
    - dimished speech output
  - anhedonia
    - decreased ability to experience pleasure from positive stimuli
  - asociality
    - apparent lack of interest in social interactions

Answer 108

A

Pattern of detachment from social relationships and a restricted range of emotional expression

Answer 109

A

Cultural syndromes:
- Clusters of invariant symptoms that tend to co-occur among individuals in specific cultural groups, communities, or contexts
Cultural idioms of distress:
- A way of talking about suffering among people in a cultural group
- Ex: For western clinicians, major depressive disorder (MDD) is considered a “syndrome,” or cluster of symptoms that appear to “hang together.” But it can also be considered an “idiom of distress,” in that Westerners commonly talk of feeling “depressed” in everyday life.
Cultural explanations of distress or perceived causes:
- Cultural explanation or perceived cause for etiology, sxs, illness, or distress

Answer 110

A

Hypomanic Episode

Answer 111

A

Obsessive-Compuslive Personality Disorder

DSM Criteria

Answer 112

A

characterized by symptomatic presentation equivalent to that of schizophrenia except the duration (less than 6 months) and the absense of the requirement of the decline in functioning

Answer 113

A

Schizophrenia Spectrum and other psychotic disorders
- diagnostic criteria
  - one or more delusions with a duration of 1 month or longer
  - schizophrenia has never been met
    - hallucinations are not prominent and are related to delusional theme
  - function is not markedly impaired
  - if manic or major depressive episode has occured, have been brief relative to the duration of delusional periods
- prevalence
  - 0.2%
    - percusatory is the most frequent subtype
    - delusional, jealous,
      - more frequent in men
    - cultural context must be taken into consideration
- ontset
  - can occur in younger age groups, usually more prevalent in older individuals
- differentials
  - ocd and related disorders
  - delirum, major neurocognitive disorder, psychotic disorder due to another med condition, and substance-induced psychotic disorder
  - schizophrenia and schizophreniform disorder
  - depressive and bipolar disorders and schizoaffective disorders
- comorbid
- subtypes
  - erotomanic type
    - central theme of delusion is that another person is in love with them
  - grandiose type
    - conviction of having some great (but unrecognized) talen or insight or having made some important discovery
  - jealous type
    - his or her spouse is unfaithful
  - persecutory type
    - the individuals belief that he or she is being conspired against, cheated, spied on… in the pursuit of longterm goals
  - somatic type
    - bodily functions or sensations
  - mixed type
    - no one delusional theme predominates
  - unspecified
    - belief cannot be clearly determined
  - with bizarre content
    - they are clearly implausible, not understandable, and not derived from ordinary life experiences
- specifiers
  - after 1 year duration with disorder
    - first episode, currently in acute episode
    - first episode, currently in partial remisison
    - first episode, currently in full remission
    - mutiple epsidsodes with same as above
    - continuous
    - unspecified
    - severity

Answer 114

A

Field trials
Robust debate about scientific evidence supporting contents
Major changes
- 541 diagnoses
- Reorganized to emphasize dimensional approach
- Integrated findings from neuroscience and genetics research
Principles:
- Usable by clinicians
- Guided by research
- Continuity with previous DSMs
- No a priori constraints on changes
- “Living Document”

Answer 115

A

What is Psychopathology not?

Answer 116

A

Cluster A
- Diagnostic Certeria
  - Pervasive Pattern of social and interpersonal deficits marked by acute discomfort with, and reduced capacity for, close relationships as well as by cognitive and perceptual distortions and eccentricities of behavior, with 5 or more
    - ideas of reference
    - odd beliefs or magical thinking
    - unusual perceptual experiences
    - odd thinking and speech
    - suspiciousness or paranoid ideation
    - inappropriate or constricted affect
    - behavior or appearance that is odd, eccentric, peculiar
    - lack of close friends
    - exessive social anxiety that is associated with paranoid fears
- Prevalence
  - 0-1.9% in clinical, but estimated to be higher in general
- Onset
  - stable course
  - may be first apparent in childhood or adolescence
- Differential
  - other mental disorders with psychotic symptoms
  - neurodevelopmental disorders
  - personality change due to another medical condition
  - substance use disorders
  - other personality disorders and personality traits
- Comorbidity

Answer 117

A

full description found in Personality disorders
pervasive pattern of social and interpersonal deficits
- reduced capacity for close relationships
- cognitive or perceptual distortions
- eccentricities of behavior
onset usually in early adulthood
- in some cases in childhood and adolescence
abnormalities of beliefs, thinking, and perception are below the threshold for diagnosis of psychotic d/o

Answer 118

A

Paranoid Personality Disorder

DSM Criteria

Answer 119

A

Other specified Anxiety Disorder

Answer 120

A

Unspecified Anxiety Disorder

Answer 121

A

with muscle dysmorphia specificer

Answer 122

A

Paranoid Personality Disorder

Answer 123

A

Cluster A
- Diagnostic Certeria
  - pervasive patter of detachment from social relationships and a restricted range of expression of emotions in interpersonal settings, beginning by early adultood, indicated by 4 or more:
    - neither desires or enjoys close relationships
    - chooses solitary activities
    - has little interest in have sexual experieces
    - takes pleasure in few activies
    - lacks few friends other than first degree relatives
    - appears indifferent to praise or criticism
    - shows emotional coldness, detachment, or flattened affect
  - if met prior to onset of schizophrenia (premorbid)
- Prevalence
  - 4.9% is comorbid
  - very uncommon in clinical settings
  - 3.1% prevalence in alcohol study
- Onset
  - first apparent in childhood and adolescence with solitariness, poor peer relations, underachievement
  - slightly more often in males
- Differential
  - other mental disorders with psychotic symptoms
  - ASD
  - personality changes due to another med condition
  - substance use disorder
  - other personality disorders and personality traits
    *

Answer 124

A

Schizophrenia and Other Psychotic Disorders
- Diagnostic Criteria
  - An uninterrupted period of illness during which there is a major mood episode ( major depressive or manic) concurrent with criterion A of schizophrenia
  - delusions or hallucinations for 2 or more weeks in the absense of a major mood episode (depressive or major) during the lifetime duration of the illness
  - symptoms that meet criteria for a major mood episode are present for the majority of the total duration of the active and residual portions of the illness
  - not due to substance
- Specifiers
  - bipolar type
    - manic episode
  - depressive
  - with catatonia
  - episode type
  - severity
- Onset
  - early adulthood
    - can occur anywhere from adolescence to late in life
- Prevalence
  - 0.3%
- Differentials
  - other mental disorders and medical conditions
  - psychotic disorder due to another med condition
  - schizophrenia, bipolar and depressive disorders
- Comorbid
  - substance use and anxiety disorders
- other
  - suicide risk is 5%
    - higher in north america

Answer 125

A

Any patient, any setting, especially:

Cases of social and cultural differences
Difficulties evaluating symptoms
Difficulties evaluating severity and impairment
Disagreement between client and clinician over course of care
Limited adherence or engagement in treatment

Answer 126

A

Avoidant Personality Disorder

DSM Criteria

Answer 127

A

Premenstrual Dysphoric Disorder

Answer 128

A

Melancholic Features Depressive Specifier

Answer 129

A

with excessive acquisition specifier

Answer 130

A

Who is the CFI for?

Answer 131

A

Obsessive-compulsive Personality Disorder

Answer 132

A

Diagnostic Criteria
- Disruption of identity characterized by 2 or more distinct personality states (possession in some cultures). Involves discontinuity in sense of sense and agency accompanied by alterations in
  - affect, behavior, consciousness, memory, perception, cognition, and/or sensory-motor functioning
- Recurrent gaps in recall of everyday events, personal info, and or traumatic events that inconsistent with ordinary forgetting
- clinically significant distress
- not culturally accepted or religious practice
  - children, not better explained by imaginary playmates
Prevalence
- 1.5%
- equal across genders
  - women predominate adult clinical, but not child
    - more acute
  - males deny traumatic histories
Development
- may manifest at any age, may increasingly intrude into awareness with advancing age
- triggered by
  - removal from the traumatizing situation
  - individuals children reaching the same age at which abuse happened
  - later traumatic experiences
  - death of abuser
- 70% have attempted suicide
Differentials
- MDD
- Other specified dissociative disorder
- Bipolar Disorders
- PTSD
- Psychotic Disorders
- Personlity Disorders
- Conversion Disorders
- Facticious DIsorder
- Malingering
- Seizure
Comorbid
- often recieve the comorbid diagnosis
- PTSD
- Personality Disorders
- Conversion
- Eating Disorders
- Substance Related Disorders
- OCD
- Sleep Disorders

Answer 133

A

Obsessive-Compulsive and Related Disorders
- Persistent Difficulty discarding possessions regardless of value
- due to need to save items and distress associated with discarding
- results in accumulation of possessions and compromises living and if uncluttered it is only due to third parties
- clinically significant distress–> cannot maitain safe enviro
- specifiy if
  - with excessive aquisition
    - if difficulty discardting is accompanied by excessive aquisition that is not need need or for which there is no space
- Prevalence
  - 2-6%
- Age of onset
  - usually emerge 11-15
  - interfere with functioning around mid 20s
  - clinically significant impairment around 30s
- gender differebces
  - greater differences among males
  - clinical samples more females
  - 3 times more likely in older adults
  - diagnostically: females display more excessive aquisition
- comobidity
  - 75% have a comorbidy anxiety or mood disorder

Answer 134

A

Generalized Anxiety Disorder

Answer 135

A

Frotteuristic Disorder

Answer 136

A

Is diagnosis of a mental disorder equivalent to need for treatment?

Answer 137

A

when an individual believes that he or she has exceptional abilities, wealth or fame

Answer 138

A

Specifiers for Depressive Disorders

Answer 139

A

Pattern of acute discomfort in close relationships, cognitive or perceptual distortions, and eccentricities of behavior

Answer 140

A

Diagnostic Criteria
- over a period of at least 6 months
  - sexual arousal from cross-dressing from fantasies, urges, or behaviors
- Fantasies, urges, behaviors causes distress
Specifiers
- fetishism
  - sexual aroused by fabrics, materials, garments
  - decreases likelihood of gender dysphoria
- autogynephilia
  - thoughts or images of self as female
  - increases likelihood of gender dysphoria in men
- controlled environment
- full remission
Prevalence
- rare in males (less than 3%)
  - majority are heterosexual
- extremely rare in females
Development
- first signs begin in childhood
- sometimes continuous and others are episodic
Differentials
- fetishistic disorder
- gender dysphoria
Cormobidity
- other paraphillia

Answer 141

A

Mood episode and the active-phase episode of schizophrenia occur together and were preceeded or follow by at least 2 weeks of hallucinations without prominant mood symptoms

Answer 142

A

Schizotypal Personality Disorder

DSM Criteria

Answer 143

A

Schizophreniform Disorder

DSM Criteria

Answer 144

A

Specific Objectives of CFI is DSM-V

Answer 145

A

With
- anxious distress
  - 2 of the following:
    - tense, restless, concentration difficulty, fear that something awful will happen, feel might lose control
- mixed features
  - 3 of the following:
    - elevated mood, inflated self-esteem, more talkative, flight of ideas, increase in energy, excessive involvement, decreased need for sleep
  - features observable by others
  - do not meet criteria for full hypomania or mania
- melancholic features
  - one of the following at most severe stage of episode
    - loss of pleasure
    - lack of reactivity
  - three of the following
    - depressed mood
    - worse in morning
    - early-morning awakening
    - psychomotor agitation or retardation
    - weight loss
    - guilt
- Aypical features
  - mood reactivity
  - two or more:
    - weight gain
    - hypersomnia
    - heavy feeling in arms or legs
    - rejection sensitivity
- Psychotic features
  - mood-congruent psychotic features
    - consistent with depressive themes
  - mood-incongruent psychotic features
    - does not include typical depressive themes
- Catatonia
  - extreme loss of motor skill or even constant hyperactive motor activity
- Peripartum onset
  - during pregnancy or 4 weeks after delivery
  - can be with or without psychotic features
- Season Pattern
  - recurrent MDD
    - temporal relationship
    - full remissions
    - last two years demonstrate relationship
    - seasonal outnumber nonseasonal
Severity
- mild, moderate, severe
Remission status
- partial or full

Answer 146

A

What did research on the OCF (from the DSM-IV) find?

Answer 147

A

Anxiety Disorders
- Excessive anxiety and worry occurring more days than not in the past 6 months
- difficulty controlling worry
- 3 or more of the symptoms (only 1 in kids)
  - restlessness
  - easily fatigued
  - difficulty concentrating and mind blank
  - irritability
  - muscle tension
  - sleep disturbance
- Prevalence
  - 0.9% in adolescents
  - 2.9% in adults in US
  - .4-3.6% in other countries
  - more common in European descent
- Gender differences
  - 2:1 female to male ratio
- age of onset
  - median age of onset 30 (manifested as anxious temperament)
  - spread across broad range
  - most AD are sooner in life

Answer 148

A

Cluster B
- Diagnostic Certeria
  - pervasive patter of instability of interpersonal relationships, self-image, and affects, marked impulsivity, beginning by early adulthood. 5 or more off the following:
    - efforts to avoid abandonment
    - pattern of unstable and intense personal relationships. Alternating between idealization and devaluation
    - identity disturbance: unstable self-image
    - impulsivity in two areas that are self-damaging (not suicidal or self-mutilating)
    - recurrent suicidal behavior, gestures, or threats, or self-mutilating beahvior
    - affective instability due to a marked reactivity of mood (intense episodic mood)
    - chronic feelings of emptiness
    - inappropriate, intense anger
    - transient, stress-related paranoid ideation
- Prevalence
  - 1.6%, but higher in mental health and psychiatric inpatient
  - decreases in older age groups
  - 75% in females
- Onset
  - chronic instability in early adulthood
  - risk of suicide in young adult years and wanes in aging
  - 30s and 40s have greater stabliity
- Differential
  - depressive and bipolar
  - other personality disorders
  - personality change due to another medical condition
  - substance use disorders
  - identity problems
    *

Answer 149

A

Mixed Features Depressive Specifier

Answer 150

A

How does the CFI work

Answer 151

A

Reactive Attachment Disorder

Answer 152

A

Other Specificied Depressive Disorder

Answer 153

A

Mild
- few symptoms
- manageable
Moderate
- between mild and severe in symptoms and ability to manage
Severe
- symptoms substantially in excess of those needed to qualify
- high impairment

Answer 154

A

thinks beliefs are probably true

Answer 155

A

recognizes the beliefs are probably not true

Answer 156

A

Bulimia Nervosa

Answer 157

A

manic or hypomanic episode with mixed features
- full criteria for manic or hypomanic
at least 3 of the following
- dysphoria or depressed mood
- loss of interest
- psychomotor retardation
- fatigue
- feelings of worthlessness
- thoughts of death
Depressive episode, with mixed features
- full criteria met for MDE
at least three of the following manic/hypomanic symptoms
- elevated mood
- inflated self-esteem
- more talkative
- flight of ideas
- increase in energy/goal-directed
- increase in risk activitives
- decreased need for sleep

Answer 158

A

Diagnostic Criteria
- Over a period of 6 months
  - recurrent and intense sexual arousal from observing an unsuspecting person who is naked, taking off their clothes, engaging in sexual activities, as manifested by fantasies, urges, or behaviors
  - has acted on urges with nonconsentingperson, or sexual urges or fantasies cause clinically significant distress or impairment…
  - must be at least 18
Specifiers
- in a controlled environment
  - living in institutional setting or restricted
- in full remission
  - for at least 5 years
Prevalence
- 12% in males and 4% in females
- 3:1 male to female
Development and Course
- must be at least 18
- likely to vary with age
Differentials
- conduct disorder and antisocial personality disorder
- substance use disorders
Comorbidity
- hypersexuality
- other paraphilic disorders: exhibitionistic disorder
- depressive, biopolar, anxiety, substance use disorder
- ADHD, conduct, and antisocial personality disorder

Answer 159

A

Progression of mental illness classification starting at 1840

Answer 160

A

Guides in assessing cultural factors infliencing clients’ perspectives of symptoms and treatment outcomes

Questions about clients’ background in terms of culture, race, ethnicity, religion or geographical origin
Opportunity for clients to define their distress in their own words and relate this to how others, who may not share their culture, see their problems
Gives clinicians a more comprehensive foundation on which to base both diagnosis and care
Much more individual

Answer 161

A

Brief Psychotic Disorder

DSM Criteria

Answer 162

A

applied to Bipolar I or II
at least 4 mood episodes in last 12 months
- meet criteria for manic, hypomanic, or MDE
episodes marked by partial or full remission for 2 months or one of opposite polarity

Answer 163

A

Schizophrenia

Answer 164

A

A patter of submissive and clinging behavior related to an excessive need to be taken care of

Answer 165

A

Schizophrenia

Answer 166

A

Depressive Disorder
- consolidation of chronic MDD and dysthymic from DSM IV
  - depressed mood most of the time for at least 2 years
    - 1 year in children
  - two or more of these symptoms
    - appetite problems
    - sleep disturbances
    - fatigue
    - low self-esteem
    - poor concentration or decision making
    - hopelessness
  - not without symptoms for more than 2 months
  - MDD may be continuously present for 2 years
    - not noted as seperate diagnoses, but a specifier
  - no manic or hypermanic episodes
  - not better explained by any type of schizophrenia
  - Specifiers
    - anxious, mixed, atypical features, mood-congruent with psychotic, mood-incongruent with psychotic, peripartum onset
    - partial remission, full remission
    - early or late onset
    - pure dysthymic syndrome, persistent MDD, intermittent major depressive episodes with current episode, intermittent major depressive episode without current episode
    - mild, moderate, severe
  - Prevalence
    - 0.5%
    - 1.5% for chronic MDD
  - Age of onset
    - often has insidious, early onset, which is usually chronic (before 21)
    - higher likelihood of comorbid personality disorder and substance use
  - Gender Differences
    - N/A

Answer 167

A

characterized by at least 1 month of delusions, but no other psychotic symptoms

Answer 168

A

Catatonia (more indepth)

Answer 169

A

Schizotypal Personality Disorder

Answer 170

A

What are the components of the CFI

Answer 171

A

Substance Intoxication and Withdrawal

Answer 172

A

3 of the following:
- elevated mood, inflated self-esteem, more talkative, flight of ideas, increase in energy, excessive involvement, decreased need for sleep
features observable by others
do not meet criteria for full hypomania or mania

Answer 173

A

Depersonalization/Derealization DSM Diagnostic Criteria

Answer 174

A

previously Factious disorder by proxy
- falsification of physical or psychological signs or symptoms, or induction of injury or disease, IN ANOTHER, associated with identified deception
- presents another individual (victim) to others as ill, impaired, or injured
- deceptive behavior is evident even in absence of obvious external rewards
- perpetrator receives diagnosis

Answer 175

A

unexpected

Answer 176

A

Cluster B
- Diagnostic Certeria
  - A pervasive pattern of disregard for and violation of the rights of others, occuring since age 15. 3 or more:
    - failrure to conform to social norms regarding laws (grounds for arrest)
    - deceitfulness, repeated lying for personal profit or pleasure
    - impulsivity
    - irritability and aggresiveness (physical fights)
    - disregard for safety of self and others
    - consistent irresponsibility
    - lack of remorse: indifferent or rationalizing hurting, mistreating or stealing
  - at least 18
  - evidence of conduct disorder before 15
  - not exclusively during schizophrenia or bipolar
- Prevalence
  - 0.2%-3.3%
  - highest prevalence is males with alcohol use disorder which is 70%
- Onset
  - cannot be diagnosed before 18, but must be present before 15
  - usually becomes less evident by 40s
  - more common in males than females
    - underdiagnosed in females
- Differential
  - substance use disorders
  - schizophrenia and bipolar disorders
  - other personality disorders
  - criminal behavior not associated with a personality disorder
- Comorbidity

Answer 177

A

Substance/Medication Induced Bipolar Related Disorder

Answer 178

A

Cluster C
- Diagnostic Certeria
  - pervasive and excessive need to be taken care of that leads to submissive and clinging behavior and fears of separation, beginning by early adulthood, indicated by 5 or more:
    - difficulty making everyday decisions without advice and reassurance
    - needs others to assume responsibilit for most areas of his or her life
    - difficulty expressing disagreement with others because of fear of loss of support or disapproval
    - difficulty initiating projects or doing things on own
    - goes to excessive lengths to obtain support
    - uncomfortable or helpless when alone due to fear of being unable to care for self
    - seeks relationship as a source of care and support when one ends
    - unrealisticly preccocupied with fears of being left
- Prevalence
  - 0.49%
  - more frequently diagnosed in women
- Onset
  - should be used with caution if at all in children and adolescents
- Differential
  - other mental disorders and medical conditions
  - other personality disorders and personality traits
  - personality change due to another medical condition
  - substance use disorders
- Comorbidity

Answer 179

A

involve the conviction that a major catastrophe will occur

Answer 180

A

Dissociative Identity Disorder DSM Criteria

Answer 181

A

belief that certain gestures, comments, environmental cues, are directed at oneself

Answer 182

A

Brief Psychotic Disorder

Answer 183

A

It’s complex. Consider:

Symptom severity
Symptom salience (e.g., suicidal ideation)
Patient distress and/or disability

Answer 184

A

Dependent Personality Disorder

Answer 185

A

Overall Changes from DSM IV to 5

Answer 186

A

Pedophilic Disorder

Answer 187

A

With dissociative symptoms
- Depersonalization
  - feeling detached from mental processes or body, as if in a dream, unreality of self or body
- Derealization
  - unreality of surroundings
delayed expression
- full criteria not met until 6 months after event

Answer 188

A

Multi-axial system eliminated
- Removes artificial distinctions between medical and mental disorders
“Not otherwise specified” (NOS) eliminated
- New option Not Elsewhere Classified includes specifiers of why condition does not meet a more specific disorder
Organization of chapters
- to demonstrate how disorders relate to one another
Addresses age and development as a part of diagnosis and classification
Culture discussed more explicitly to bring greater attention to cultural cariations
- Outline for cultural formation
- Framework for assessing cultural features of a client’s problem

Answer 189

A

Unspecified Depressive Disorder

Answer 190

A

Trauma and Stressor-Related Disorders
- consistent pattern of inhibited, emotionally withdrawn behavior toward adult caregiver manifested by
  - rarely seeking comfort when distressed
  - rarely responding to comfort when distressed
- persistent social and emotional disturbance characterized by 2:
  - minimal social responsiveness
  - limited positive affect
  - episodes of unexplained irritability, sadness or fearfulness
- child has experienced patterns of extremes or insufficient care, evidenced by 1:
  - social neglect or deprivation in having basic emotional needs mets
  - repeated changes of primary caregiver
  - rearing in unusual settings
- care is presumed to be responsible for disturbed behavior
- does not meet ASD
- evident before age 5
- has developmental age of at least 9 months
- Specify if
  - persistent
    - present for more than 9 months
  - severe
    - exhibits all symotoms at high levels
- social neglect is a required risk factor

Answer 191

A

actual or threatened death, serious injury, or sexual violence in 1 or more:
- direct traumatic event
- witnesss event occuring to others esp. caregiver
  - not media
- learning even occured to parent or caregiver
presence of 1 or more symptoms associated with event:
- distressing memories
  - may appear as play reenactment
- distressing dreams related to event
  - may not be able to tell it is related
- flashbacks making it feel like the event is recurring–> play may reenactment
- psychological distress
- psychological distress
one in the following:
- persistent avoident stimuli after event
  - places or physical reminders
  - avoid people or conversations or interpersonal situations
- negative alterations in cognitions
  - frequency of negative emotional states
  - diminished interest
  - socially withdrawn
  - reduction in positive emotions
alterations in arousal and reactivity in 2:
- irritable behavior
- hypervigilance
- exaggerated startle response
- problems with concentration
- sleep disturbance
duration more than 1 month
*

Answer 192

A

PTSD for child 6 years and younger

Answer 193

A

Dissociative Amnesia

Answer 194

A

Avoidant Personality Disorder

Answer 195

A

Negative Symptoms

Answer 196

A

10 class of drugs, alcohol, caffeine, cannabis, hallucinogens, inhalants, opiods, sedatives, hynoptics, stimulants, tobacco, and other
taken in excess, but not fully distinct
intense activation of reward system that normal activities may be neglected
drugs of abuse directly activate the reward pathway
two groups: substance use (intoxication, withdrawal, and other substance/medication-induced mental disorders) and substance-induced

Answer 197

A

Other Specified Somatic Symptom and Related Disorder

Answer 198

A

Substance-Related and Addictive Disorders

Answer 199

A

Other specified Feeding or Eating Disorder

Answer 200

A

Referential Delusions

Answer 201

A

Manic Episode (at least one in lifetime)
- persistent elevated or irritable mood and increased goal-directed activity
  - lasts at least 1 week
- During mood disturbance at least 3 or 4 if only irritable
  - increase self-esteem
  - less need for sleep
  - more talkative
  - flight of ideas
  - distractability
  - increase in goal directed activity
  - involvement in high risk activity
- cause marked impairment in functioning
Hypomanic Episode (common but not required for diagnosis)
- persistently elevated or irritable mood
  - lasts at least 4 consecutive days
- 3 of the following symptoms or 4 if only irritable
  - inflated self-esteem
  - decreased need for sleep
  - more talkative
  - flight of ideas
  - distractible
  - increase in goal-directed activity
  - involvement in high risk activities
- change in functioning and is observable by others
- not severe enough to cause impairment in functioning
**Major Depressive Episode **(common, but not required for bipolar 1)
- present during same two-week period
  - One of the following
    - depressed mood or loss of interest
  - 4 or more of the following
    - weight loss or gain
    - sleep disturbances
    - psychomotor agitation or retardation
    - fatigue
    - feelings of worthlisness
    - lack of ability to concentrate
    - thoughts of death (recurrent)
  - cause impairment in functioning

Answer 202

A

Coordinated with development if ICD-9
Changes from DSM II
- 265 disorders
- Multiaxial classification system
Aim to produce a science-driven document (as opposed to psychodynamic)
Work on construction and validation of criteria
development of semistructured interviews
Biology and genetics played a key role
This was revised

Answer 203

A

Schizoaffective Disorder

DSM Criteria

Answer 204

A

Sexual Sadism Disorder

Answer 205

A

Cluster B
- Diagnostic Certeria
  - pervasive patter of grandiosity (fantasy or behavior), need for admiration, and lack of empathy, beginning by early adulthood, and indicated by 5 or more:
    - grandiose sense of self importance
    - preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love
    - believes he or she is special and unique and can only associate with people of high status
    - requires excessive admiration
    - sense of entitlement
    - interpersonally exploitative
    - lacks empathy
    - envious of others and believe people envy him ro her
    - arrogant
- Prevalence
  - 0-6.2%
  - 50-75% are male
- Onset
- Differential
  - other personality disorders and personality traits
  - mania or hypomania
  - substance use disorders

Answer 206

A

Persistent Depressive Disorder (Dysthymia)

Answer 207

A

at least 2 years (1 if you are a child or adolescent)
- numerous periods with hypomanic symptoms not meeting criteria for episode
  - insufficient number, severity, pervasiveness, or duration
- numerous periods with depressive symptoms not meeting criteria for episode
  - insufficient number, severity, pervasiveness, or duration
- where both of these symptoms have been present half of time and not without symptoms for 2 months
- clinically significant distress must be present
never met criteria for major depressive, manic, or hypomanic episode
- upon the occurence of these: a disorder change is due
Prevalence
- 0.4-1%
- mood disorder clinics: 3-5%
age of onset
- adolescence or early life
- for children who have it: mean of 6.5
gender difference
- equal

Answer 208

A

DSM and ICD

Answer 209

A

According to DSM-5

Characterized by clinically significant disturbance in cognition, emotion regulation, or behavior that reflects a dysfunction in the psychological, biological, or developmental processes underlying mental functioning.
Usually associated with significant distress or disability in social, occupational, or other important activities.
Often viewed on a continuum

Answer 210

A

Narcissistic Personality disorder

DSM Criteria

Answer 211

A

Schizoaffective

Answer 212

A

DSM -V Criticisms

Answer 213

A

Dissociative Identity Disorder

Answer 214

A

Exposure to actual or threatened death, serious injury, or sexual violence in 1 or more:
- direct experience in traumatic event
- witnessing event as occured to others
- learned even occured to close friend or fam
- experiencing repeated or extreme exposure to aversive details of the traumatic even
9 symptoms from any of the 5 categories
- intrusion symptoms
  - distressing memories
  - distressing dreams
  - dissociative reactions
  - psychological distress in reaction to external cues
- negative mood
  - inability to experience positive emotions
- dissociative symptoms
  - altered sense of reality of one’s surroundings or one’s self
  - inability to remember an important aspect of traumatic event
- avoidance symptoms
  - effort to avoid distressing memories, thoughts or feelings
  - effort to avoid external reminders
- arousal symptoms
  - sleep disturbance
  - irritable behavior
  - hypervigilance
  - problems with concentration
  - exaggerated startle response
duration is 3 days to 1 month

Answer 215

A

Anxiety Disorder Due to Another Medical Condition

Answer 216

A

Dissociative Amnesia DSM Diagnostic Criteria

Answer 217

A

Disruptive Mood Dysregulation

Answer 218

A

Objective of CFI

Answer 219

A

Meet **criteria for hypomanic episode and depressive episode **with no manic episode
Fluctuations cause clinically significant distress
- hypomanic episode
  - persistently elevated or irritable mood
  - lasts at least 4 consecutive days
  - 3 of the following symptoms or 4 if only irritable
    - inflated self-esteem
    - decreased need for sleep
    - more talkative
    - flight of ideas
    - distractible
    - increase in goal-directed activity
    - involvement in high risk activities
  - change in functioning and is observable by others
  - not severe enough to cause impairment in functioning
depressive episode
- present during same two-week period
- One of the following
  - depressed mood or loss of interest
- 4 or more of the following
  - weight loss or gain
  - sleep disturbances
  - psychomotor agitation or retardation
  - fatigue
  - feelings of worthlisness
  - lack of ability to concentrate
  - thoughts of death (recurrent)
- cause impairment in functioning
Specifiers
- current episode of hypomanic and depressive
- others are consistent with depressive specifiers
  *

Answer 220

A

Pattern of disregard for, and violation of, the rights of others

Answer 221

A

Anxiety Disorders
developmentally inappropriate fear or anxiety related to separation from an individual they are attached to
3 of the following:
- recurrent excessive distress
  - when anticipating or experiencing separation
  - worry about losing individual or harm
  - worry about an untoward event that causes separation
- reluctance
  - to or refusal to go out because of fear of separation
  - about being alone
  - to sleep away from home or go to sleep without
- nightmares about separation
- complaints about physical symptoms
6 months or more in adults, 4 weeks in children
*

Answer 222

A

Grossly Disorganized or Abnormal Motor Behavior (Including Catatonia)

Answer 223

A

Obsessions

Answer 224

A

BDD specifier
preoccupied with the idea that body is insufficiently muscular

Answer 225

A

mood reactivity
two or more:
- weight gain
- hypersomnia
- heavy feeling in arms or legs
- rejection sensitivity

Answer 226

A

Specific Phobia

Answer 227

A

Bipolar II Disorder

Answer 228

A

emotional response to real or perceived imminent threat

Answer 229

A

2 of the following:
- tense, restless, concentration difficulty, fear that something awful will happen, feel might lose control

Answer 230

A

repetitive, seemingly, driven, non functional motor behavior
- premotor sensory urges

Answer 231

A

Selective Mutism

Answer 232

A

erotomanic delusions

Answer 233

A

Active Avoidance

Answer 234

A

Cluster B
- Diagnostic Certeria
  - pervasive pattern of excessive emotionality and attention seeking, beginning by early adulthood. 5 or more:
    - uncomfortable in situations where they are not the center of attention
    - interactions are characterized by inappropriate sexually seductive or provocative behavior
    - rapidly shifting or shallow emotions
    - physical appearance to draw attention
    - style of speech that is excessively impressionistic and lacking detail
    - self-dramatization, theatrical, exaggerated emotion
    - suggestible (influenced by others)
    - considers relationships more intimate than they are
- Prevalence
  - 1.84%
  - more frequent in females
- Onset
- Differential
  - other personality disorders and personality traits
  - personality change due to another medical condition
  - substance use disorders
- Comorbidity

Answer 235

A

nihilistic delusions

Answer 236

A

General Personality Disorder

Answer 237

A

symptoms characteristic of anxiety disorder cause clnicaly significant distress or impairment, but do not meet criteria
clinicians chooses not to communicate why the criteria is not met
insufficient information

Answer 238

A

At this point, there were several different diagnostic systems

Differed in emphasis on phenomenology, etiology, and course as defining features
Some included only a handful of diagnostic categories; others thousands
Differed with respect to whether the principle objective was clinical use, research, or statistics

A need for a classification to

Minimized confusion
Create consensus among the field
Help mental health professionals communicate using a common diagnostic language
(way for people to communicate within the field)

Answer 239

A

Somatic Symptom and Related Disorders
- Diagnostic Criteria (previously hypochondiasis)
  - preoccupation with having serious illness
  - somatic symptoms not present, or if present they are mild. if med condition is presentm the preoccupation is excessive
  - high level of anxiety about health and easily alarmed about personal health status
  - performs excessive health related behaviors or exhibits maladaptive avoidance
  - present for last 6 months, but specific illness may change
  - Specify if
    - care-seeking
      - medical care frequently used
    - care avoidant
      - medical care rarely used
- Prevalence
  - 1.3-10%
  - or 3-8% for 6 months
- Onset
  - generally thought to be chronic relapsing
  - increases with age
- Gender
- Differentials
  - other med conditions
  - somatic symptom
  - anxiety disorders
  - OCD
  - MDD
  - psychotic
- Comorbidity
  - anxiety and depressive

Answer 240

A

Hallucinations

Answer 241

A

These developments created a need for a

1840 US government

Government collected census data on mentla illness
40 years later there were 7 categories of mental illness

1917 Bureau of the Census

Used Statistical Manual for the Use of Institutions for the Insane
separated mental illness into 22 groups

WWII U.S. Army (1940-1045ish)

nomenclature developed by Army to better incorporate presentations of WWII servicemen and veterans

1940 WHO

Concurrently WHO published ICD-6
26 diagnoses
10 categories fo rpsychoses, 9 for psychoneurosis, and 7 for disorders of character, behavior, and intelligence

Answer 242

A

or thought disorder
inferred from the individual’s speech
- derailment or loose association
  - may switch from one topic to another
- tangentiality
  - answers to questions may be obliquely related or completely unrelated
- incoherence
  - speech may severely disorganized that is nearly incomprehensible and resembles receptive aphasia in its linguistic disorganization
  - must be severe enough to impair communication

Answer 243

A

Substance/Medication-Induced Anxiety Disorder

Answer 244

A

Conversion Disorder (Functional Neurological Symptom Disorder)

Answer 245

A

Presense of obsessions, compulsions, or both
- Obsessions
  - recurrent and persistent thoughts, urges, or images that are experienced, cause unwanted distress or anxiety
- Compulsions
  - repititve behaviors
  - preventing and reducing anxiety
- time consuming (1 hr per day)
- not attributable to substance
- not due to medical condition
- specify if
  - with good or fair insight
    - recognizes beliefs are noth true
  - with poor insight
    - believes beliefs are probably true true
  - with absent insight/delusional beliefs
    - completely convinced that beliefs are true
  - tic related
    - current or past history of tic disorder

Answer 246

A

Representation of developmental issues related to diagnosis
- Organization reflects a lifespan approach
- Integrated gender and cultural issues
Integration of scientific findings from the latest research in genetics and neuroimaging
Autism Spectrum Disorder
- Colsolidation of autistic disorder, Asperger’s disorder, and pervasive development disorder
Streamlined classification of bipolad and depressive disorders
- Inclusion of all of the component criteria within the respective criteria for each disorder.
- Explanatoy notes for differentiating bereavement and major depressive disorders
Restructuring of substance use disorders for consistence and clarity
- New overarching category of substance use disorders
- Differentation between “dependence” and “addiciton”
Enhanced specificity for major and mild neurocognitive disorders
Transition in conceptualizing personality disorder
- No major changes
Section III: new disorders and features
- Highlights disorders that require urther study but are not sifficiently well established to be in the main DSM
Online enhancements
- Cultural Formulation Interview
- Online assessment tools

Answer 247

A

Pattern of distrust and suspiciousness such that others’ motives are interpreted as malevolent

Answer 248

A

Somatic Symptom and Related Disorders
- Diagnostic Criteria
  - One or more symptoms of altered voluntary motor or sensory function
  - clinical findings provide evidence of incompatibility between symtpom and recognized neurological or med conditions
  - symptom or deficit is not better explained by anything else
  - clinically significant distress
  - Specify if
    - with weakness or paralysis
    - abnormal movemt
    - swallowing symptoms
    - speech symptoms
    - attacks or seizures
    - anesthesia or sensory loss
    - special sensory symptom
    - mix symptoms
  - specify if
    - acute epsiode
      - less than 6 months
    - persistent
      - more than 6 months
  - specify if
    - psychological stressor
    - without psychological stressor
- Prevalence
  - 5% of neurology clinics
  - .002%
- Onset
  - non-epiletic attacks peaks in 30s
  - motor symptoms peak in 40s
  - symptoms can be transient or persistent
  - better prognosis if younger
Gender
- 2 or 3 times more common in females
Differentials
- neurological disease
- somatic symptom disorder
- factitious disorder or malingering
- dissociative disorder
- BDD
- panic disorder
Comorbidity
- anxiety (panic), depressive
- somatic symptom

Answer 249

A

convinced the beliefs are true

Answer 250

A

Trichotillomania (hairpulling)

Answer 251

A

Fetishistic Disorder

Answer 252

A

persistent disturbance in mood that predominates clinical picture
- elevated or irritable mood
Findings show
- symptoms develop during or soon after intoxication or withdrawal
- substance is capable of producing symptoms
no just during dilirium
causes clinically significant distress
Specifier
- onset during intoxication
- onset during with drawal

Answer 253

A

Inability to recall autobiographical info that is inconsistent with normal forgetting, but may or may not involve purposeful travel or bewildered wandering (fugue)–> fugue is rare
Can be localized
- an event or period of time
Selective
- specific aspect of an event
Generalized
- idendity and life history

Answer 254

A

Major Depressive Disorder

Answer 255

A

Trauma and stressor-related Disorders
- exposure to actual or threatened death serious injury, or sexual violence in 1 or more
  - direct experience
  - witness occurring to others
  - learning occured to close friend or family
  - experiencing repeated or extreme exposure to details of event
    - does not relate to media unless work related
- 1 or more of the following after event
  - recurrent, distressing memories of event
    - child: repititive play
  - recurrent, distressing dreams
    - child: frightening dreams without recognizeable content
  - dissociate reactions, loss of awareness of present surroundings
    - child: reenactment
  - intense or prolonged psychological distress at exposure to internal or external cues that symbolize aspect of event
  - marked physiological reaction
persistent avoidance of stimuli associated with event
- memories, thoughts, or feelings
- external reminders
Negative alterations in cognitions and mood as evidenced by 2:
- inability to remember an important aspect of event
- persistent or exaggerated negative beliefs about oneself
- distorted cognitions about the cause of event
- diminshed interest in activities
- feelings of detachment
- inability to experience positive emotions
alterations in arousal and reactivity with even in 2:
- irritability or angry outburst
- self-destructive behavior
- hypervigilence
- exaggerated startle response
- difficulty concentrating
- sleep disturbance
distrubance is more than 1 month
not attributable to substance

Answer 256

A

abnormally elevated or irritable mood and energy that predominates the clinical picure
evidence of direct pathophysiological consequence of med condition
no just during delirium
causes clinically significant distress
Specificiers
- manic features
  - full criteria for manic or hypomanic episode
- manic or hypomanic like episode
  - D not met for manic:
    - not attributible to physiological effects of substance
  - F not met for hypomanic:
    - not attributible to physiological effects of substance
- mixed features
  - symptoms of depression also present, but do not predominate clinical picture

Answer 257

A

Excoriation (Skin-Picking) Disorder

Answer 258

A

Obsessive-compulsive and related disorder
- recurrent pulling out of one’s hair, resulting in hair loss
- repeated attempts to stop
- clinically significant distress
- not attributable
- 10:1 female to male

Answer 259

A

Context
Continuum
Cultural relativism

Answer 260

A

Feeding and Eating Disorders
- Dignostic Criteria
  - Restriction of energy intake relative to requirements, leading to signifanctly low body weight (less than minimally normal)
  - intense fear of gaining weight or becoming fat, or persistant behavior that interferes with weight gain
  - disturbance in the way in which one’s body weight or shape is experience, lack of recognition of seriousness of the curren low body weight
  - specify
    - in partial remission or full remission
  - subtypes
    - binge-eating/purging type
      - binge eat also purge
    - restricting
      - last 3 months, not engaged binge-purge, primarily though dieting, fasting, or exercise
  - Severity
    - mild: BMI > 17
    - moderate: BMI 16-16.99
    - severe: BMI 15-15.99
    - extreme: BMI
- Prevalence
  - 0.4%
- Onset
  - commonly begins during adolesence
  - rarely begins before puberty or after 40
- Gender
  - occurs across cultures
    - post-industrialized societies
- Differentials
  - Medical conditions
  - MDD
  - schizo
  - substance use
  - Social anxiety
  - BN
  - Avoidant/restrictive food intake
- Comorbidity
  - bipolar
  - depressive
  - anxiety

Answer 261

A

Cluster A
- Diagnostic Certeria
  - pervasive distrust and suspiciousness of others such their motives are interpreted as malevolent, beginning by early adulthood and present in a variety of contexts with 4 or more:
    - suspects that others are exploiting, harming, or deceiving
    - preoccupied with unjustified doubts about loyalty or trustworthiness of friends or associates
    - reluctant to confide in others because of unwarranted fear that the info will be used maliciously against him or her
    - reads hidden meaning or threatening meanings
    - persistening bears grudges
    - perceieves attacks on character that are not apparent
    - recurrent suspicions of fidelity
    - if with schizophrenia add (premorbid)
- Prevalence
  - 2.3%
  - may be more common in males
- Onset
  - first apparent in childhood and adolescence as solitary with poor peer support, social anxiety, eccentric
- Differential
  - other mental disorders with psychotic symptoms
  - personality change due to another medical condition
  - substance use
  - paranoid traits associated with physical handicaps
  - other personality disorders and personality traits
- Comorbidity
  - substance abuse

Answer 262

A

Grossly disorganized or abnormal motor behavior
- childlike silliness to unpredictable agitation
  - problems may be noted in goal-directed activity to difficulties in performing activities of daily living
Catatonia
- marked decrease in reactivity to environment
  - negativism
    - resistance to instructions
  - rigid inappropriate posture
  - mutism and stupor
    - lack of motor and verbal responses
  - catatonic excitement
    - excessive motor activity without cause

Answer 263

A

Binge-Eating

Answer 264

A

during pregnancy or 4 weeks after delivery
can be with or without psychotic features

Answer 265

A

Separation Anxiety Disorder

Answer 266

A

Mixed Features for Bipolard and Related Disorders

Answer 267

A

Disorganized Thinking

Answer 268

A

Dependent Personality Disorder

Answer 269

A

DSM-V Structure

Answer 270

A

one of the following at most severe stage of episode
- loss of pleasure
- lack of reactivity
three of the following
- depressed mood
- worse in morning
- early-morning awakening
- psychomotor agitation or retardation
- weight loss
- guilt

Answer 271

A

What is Psychopathology?

Answer 272

A

Obesseive-Compulsive and Related Disorder due to Another Medical Condition

Answer 273

A

Adjustment Disorders

Answer 274

A

Depressive Disorder
- full criteria for depressive disorder is not met
- clinican chooses not to specify reason

Answer 275

A

Cluster C
- Diagnostic Certeria
  - pervasive pattern of preoccupation with orderliness, perfectionism, and mental and interpersonal control, at the expense of flexibility, openness, and efficiency, beginning by early adulthood, indicated by 4 or more:
    - preoccupied with details, rules, lists, order, organization, schedules to the extent that major point of activity is lost
    - shows perfectionism that inferes with task completion
    - exvessively devotes to work and productivity to exclusion of leisure activities
    - overconscientious, scrupulous, and inflexible about matters of morality, ethics, or value
    - unable to discard worn-out or worthless objects even when that have no sentimental value
    - reluctant to delegate tasks or to work with others unless they submit to exactly his or her way of doing things
    - adopts a miserly spending style
    - rigidity and stubbornness
- Prevalence
  - 2.1%-7.9%
  - twice as often among males
- Onset
- Differential
  - OCD
  - hoarding disorder
  - other personality disorders and personality traits
  - personality change due to another medical conditiion
  - substance use disorders
- Comorbidity

Answer 276

A

recurrent MDD
- temporal relationship
- full remissions
- last two years demonstrate relationship
- seasonal outnumber nonseasonal

Answer 277

A

Substance Use Disorder

Answer 278

A

Cluster C
- Diagnostic Certeria
  - pervasive pattern of social inhibition, feelings of inadequacy, hypersensitivy to negative eval, beginning by early adulthood, indicated by 4 or more:
    - avoids occupational activties that involve significant interpersonal contact due to fear of criticism, disapproval, or rejection
    - unwilling to get invoved with people unless certain of being like
    - restrain in intimate relationships due to fear of being shamed
    - preoccupied with being criticized or reject in social situations
    - feelings of inadequacy in new interpersonal situations
    - views self as socially inept, unappeally, inferior
    - reluctant to take risks or enage in new activites
- Prevalence
  - 2.4%
- Onset
  - should be used with great caution in children and adolescents
  - may dissipate with age
- Differential
  - anxiety disorders
  - other personality disorders and personliaty traits
  - personality change due to another medical change
  - substance use disorders
- Comorbidity

Answer 279

A

Why was there a need for a common diagnostic system?

Answer 280

A

Obsessions, compulsions, preoccupations with appearance, hoarding, skin picking, hair-pulling, other body focused rep behaviors or other symptoms predominante in clinical picture
evidence in lab findings that
- symptoms developed during or soon after meds
- meds are capable of producing symptoms
sympoms not better explained by ocd that is not substance induced
- sympmoms did not precede onset
not primarily during dilirium
*

Answer 281

A

Depressive Disorder (new to DSM 5)
- recurrent temper outburts (verbal or behavioral)
- inconsistent with developmental age
- 3 or more times per week
- persistently irritable or angry
- present for 12 months or more
  - no period of 3 plus months without symptoms
- 2 out of 3 settings
- diagnosis made age 6-18
- age of onset criteria before 10
- no day with manic or hypermanic episode
cannot be comord with
- ODD
  - more of a mood component
    - most people with DMDD meet ODD, but not reverse
- intermittant explosive
  - does not require persistent disruption of mood between bursts
- bp
  - cannot have hypomanic or manic episode, persistent mood
can be comorbid with
- MDD, ADHD, CD, substance-abuse
at risk to develop: unipolar depressive or anxiety disorders

Answer 282

A

nocturnal panic attack

Answer 283

A

grandiose delusions

Answer 284

A

Psychotic Features Depressive Specifier

Answer 285

A

Unspecified Bipolar and Related Disorder

Answer 286

A

STRUCTURE

Deleting the multiaxial system
Legitimate disorders removed or remodeled (e.g., Asperger’s Disorder)
“Clinically significant distress or impairment in social or occupational functioning” - Still no procedures to make this determination
Remains a psychiatric “checklist” versus comprehensive assessment

IMPLICATIONS of DX

Increasing tendency to “medicalize” patterns of behavior and mood that are not considered to be particularly extreme
Pathologizing normal behavior (e.g., the argument of Disruptive Mood Disregulation Disorder being akin to temper tantrum disorder)
Changes make it easy to diagnose sub-clinical disorders (e.g., changes to Bipolar Disorder, dropping bereavement exclusion for depressive disorders)
Conversely, DSM-5 is normalizing pathological behaviors (e.g., some construe DSM-5 is normalizing pedophilia)

INFLUENCES

Undue influence of politics, pharmaceutical industry, research grants
Sacrificing science, i.e., over-relying on reliability at the sake of validity

Answer 287

A

Anxiety Disorders
Recurrent unexpected panic attacks
- Panic attack
  - abrupt surge of intense fear or discomfort that reaches a peak within minues with 4 or more of the following symptoms
    - palpitations
    - sweating
    - trembling
    - shortness of breath
    - chest pain
    - nausea
    - dizziness
    - chills or heat
    - paresthesias
    - derealization
    - fear of losing control
    - fear of dying
at least one attacks has been followed by 1 month of one or both:
- persistent worry about additional panic attacks
- maladaptive change in behavior related to attacks

Answer 288

A

hoarding specifier
- if difficulty discardting is accompanied by excessive aquisition that is not need need or for which there is no space
- 80-90%

Answer 289

A

focus on preoccupations regarding health and organ functions

Answer 290

A

Body dysmorphic-like disorder with actual flaws
- the flaws are observable by others
body dysmorphic-like disorder without repetitive behaviors
- not performed repetitive behaviors or mental acts in response to appearance concerns
body-focuses repetitive hahavior disorder
- recurrent body focused repetitive behavior and attempts to decrease or stop
obsessional jealousy
- percieved infidelity leading to repeated behaviors
Shubo-kyofu
- fear of having a body deformity
Koro
- sudden anxiety that the penis will decede into the body
Jikoshu-kyofu
- fear of having an offensive body odor

Answer 291

A

Peripartum Onset Depressive Specifier

Answer 292

A

Personality Disorders Cluster C

Answer 293

A

PTSD Specifiers

Answer 294

A

Delusions

Answer 295

A

with good or fair insight specifier

Answer 296

A

Anxiety Disorder
consistent failure to speak in specific social situations where there is an expectation to speak despite speaking in other situations
interferes with educational, occupational, or social
at least 1 month (not limited to first month of school)
not attributed to lack of knowledge
not explained by communication d/o
Age of onset
- usually before 5
Prevalence
- 0.03-1% depending on the setting
Gender difference
- does not vary by gender

Answer 297

A

Other Specified Dissociative Disorder

Answer 298

A

Factitious Disorder Imposed In Another

Answer 299

A

Major changes of DSM V

Answer 300

A

Substance/Medication-Induced Obsesive-Compulsive and Related Disorder

Answer 301

A

perception-like experiences that occur wuthout an external stimulus
vivid and clear, with the full force and impact of normal perceptions and not under voluntary control
auditory
must occur in the context of a clear sensorium
within normal experience or part of religious experience
- hyponagogic
  - while falling asleep
- hypnopompic
  - waking up

Answer 302

A

Personality Disorders Cluster A

Answer 303

A

Adjustment Disorder Specifiers

Answer 304

A

clinically significant impairment with symptoms related to bipolar and related disorders
- criteria not fully met
clinicians not to specify why the criteria has not fully been met

Answer 305

A

Schizophrenia and Other Psychotic Disorders
- Diagnostic Criteria
  - Presence of one or more of the following (has to be at least 1,2, or 3)
    - delusions
    - hallucinations
    - disorganized speech
    - grossly disorganized or catatonic behavior
  - episode is 1 day to 1 month and then returns to ful functioning
  - not better explained by major depressive or bipolar disorder
- Specifiers
  - marked stressor
  - without marked stressor
  - with postpartum onset
  - with catatonia
  - severity
- Onset
  - adolesence or early adulthood
  - average age being mid 30s
- Prevalence
  - 9%
    - more common in developing countries
    - 2:1 females to males
    - be aware of culture
- Differentials
  - other med conditions
  - substance related disorders
  - depressive and bipolar disoders
  - other psychotic disorders
  - malingering and facticious
  - personality disorders
- Comorbid

Answer 306

A

Depressive Disorder
- depressive symptoms with clinically significant distress
  - do not feel full criteria for any of the disorders
- specificers
  - recurrent brief depression
    - depressed mood and four other symptoms
    - 2-13 days per month
  - short duration depressive episode (4-13 days)
    - depressed affect and 4 of the 8 symptoms for depresive episode
  - Depressive episode with insufficient symptoms
    - depressed affect and 1 of the 8 symptoms for DE

Answer 307

A

Severity Depressive Specifier

Answer 308

A

Voyeuristic Disorder

Answer 309

A

Depressive Disorder
- persistent disturbance in mood that predomintate in clinical picture
  - depressed mood or interest loss
- Findings show
  - developed during substance intoxication or withdrawal
  - substance is capable of producing symptoms
- not exclusively during delirium
- mild substance use disorder is comorbid–> 1 as 4th character
- moderate/severe substance use disorder is comorbid –> 2 as 4th character
- no comorbid substance use disorder–> 9 as 4th character
- Specifiers:
  - onset during intoxication or withdrawal

Answer 310

A

Cyclothymic Disorder

Answer 311

A

stereotyped movement

Answer 312

A

US armed forces wanted a guide for diagnosis of servicemen
Developed by American Psychiatric Association
Variant of ICD-6
106 disorders or “reactions” (to enviornment)
Only one diagnosis could be applied to children
Focus on clinical utility
- 3 categories of psychopathology
- organic brain syndromes
- functional disorders (impair in everyday life)
- mental deficiency (cognitive/attentional)

Answer 313

A

IV:
- listed 25 “culture bound syndromes”
- list was heterogeneous
V:
- now a “Glossary of Cultural Concepts of Distess”
  - Lists 9 of the best studied concepts
- Section III includes chapter on cultural formulation

Answer 314

A

Psychotic patients
- Misdiagnosis for psychotic patients occurred with patients from all ethno-cultural groups, especially recently settled immigrants.
- After using the CF, 49% of the patients with an intake diagnosis of psychotic disorder were re-diagnosed as non-psychotic and 5 % of the patients with a referral diagnosis of non-psychotic disorder were diagnosed as having a psychotic disorder.
Non-psychotic patients
- Adding the CFI to ordinary psychiatric diagnosing led to major revisions of diagnosis for 56% of patients
  Many in anxiety disorders, especially PTSD

Answer 315

A

Obsessive-Compulsive Disorder

Answer 316

A

presented for the purposes of identifying a panic attack–> not a mental disorder, noted as a specifier
abrupt surge of intense fear or discomfort that reaches a peak within minues with 4 or more of the following symptoms
- palpitations
- sweating
- trembling
- shortness of breath
- chest pain
- nausea
- dizziness
- chills or heat
- paresthesias
- derealization
- fear of losing control
- fear of dying

Answer 317

A

somatic delusions

Answer 318

A

Chronic and recurrent syndromes of mixed dissociate symptoms
- identity disturbance associated with less than marked discontinuities in sense of self and agency or alteratios of identities or episodes of possession in an individual who reports no dissociative amensia
Identity disturbance due to prolonged and intense coercive persuasion
- individuals who have been subjected to intest persuasion (brainwashing, thought reform, etc) may present with prolonged changes in, or conscious questioning of, their identity
Acute dissociative reaction to stressful events
- for acute, transcient conditions that typically last less than 1 month, and sometimes only a few hours or days
- conditions are characterized by constriction of consciousness; depersonalization; derealization, etc
Dissociative trance
- acute narrowing or complete loss of awareness of immediate surroundings that manifests as profound unresponsiveness or insensitivity to environmental stimuli

Answer 319

A

with depressed mood
- low mood, tearfulness, or feelings of hopelessness
with anxiety
- nervousness, worry, seperation anxiety
with mixed anxiety and depressed mood
- combo of the above
with disturbance of conduct
- disturbance of conduct
with mixed disturbance of emotions and conduct
- both emotional symptoms and conduct
unspecified
- maladaptive reactions that are not classifiable as one of the above

Answer 320

A

Schizotypal (Personality) Disorder

DSM Criteria

Answer 321

A

presentation and symptoms of bipolar disorders, but do not meet full criteria
clinician states why it does not meet full criteria
Examples of presentations
- short-duration hypomanic episodes (2-3 days) and major depressive episodes
  - meet full criteria for hypomanic, but short
  - do not overlap in time with major depressive episode (at least one lifetime history)
- hypomanic episodes with insufficient symptoms and major depressive episodes
  - at least one lifetime history of MDE
  - hypomanic episode do not meet full criteria, but experienced one or more
  - hypomanic symptoms do not overlap with MDE
- hypomanic episode without prior major depressive episode
  - never met full criteria for MDE or manic episode
- short-duration cyclthymia
  - multiple episodes of hypomanic (not meeting criteria)
  - multiple episodes of MDE (not meeting criteria)
  - less than 2 years for adults or 1 for kids

Answer 322

A

Disorders
- Paranoid
- Schizoid
- Schizotypal
Characteristics
- odd or eccentric
Prevalence
- 5.7%

Answer 323

A

Histrionic Personality Disorder

Answer 324

A

Schizophreniform Disorder

Answer 325

A

Depressive Disorder Due to Another Medical Condition

Answer 326

A

cluster of cognitive, behavioral, physiological sympoms indicated that individual continuses using substance despite significant substance related problems
- 10 classes (except caffeine)
- underlying change in brain cercuits that may persist beyond detox espectially if sever
- severe may benefit from long-erm approaches to treatment
- Criterion
  - impaired control
  - social impent
  - risky use
  - pharmalogical criteria
- Severity and Specifiers
  - based upon the number of symptom criteria endorsed
    - mild: 2 to 3 symptoms
    - moderate: four to five
    - sever: six or more
- Example: moderate alpraxolam use disorder NOT moderate sedative use. name the actual substance
- do not use the word addiction
- substance use describes a wider range of behavior

Answer 327

A

Trauma and Stress-Related Disorders
- development of emotional or behavioral symptoms in response to idetifiable stressor occurring within 3 months of onset of the stressor
- symptoms are clinically significant as evidenced by 1 or both:
  - marked distress out of proportion to the stressor taking into account context
  - significant impairment in functioning
- impairment does not meet criteria for another mental disorder and is not an exacerbation of a preexisting mental disorder
- do not represent normal bereavement
- once the stressor has terminated, sympoms do not persist for more than 6 months
- Prevalence
  - 5-20% in outpatient
  - 50% in hospital (used as a catch all)
- Gender differences
  - not in DSM

Answer 328

A

Depersonalization/Derealization

Answer 329

A

Agoraphobia

Answer 330

A

Obsessive Compulsive and Related Disorders
- preoccupation with one or ore defects or flaws in physical appearance that or not observable to others
- performced repetitive behaviors or mental acts in response to concern
- clinically significant distress
- not better explained by concerns with body fat or weigh in an individual whose diagnositic symptoms meet criteria for an eat disorder
- specify if
  - with muscle dysmorphia
    - preoccupied with the idea that body is insufficiently muscular

Answer 331

A

Personality Disorders Cluster B

Answer 332

A

Social Anxiety Disorder (Social Phobia)

Answer 333

A

Schizophrenia and Other Psychotic Disorders
- Diagnostic Criteria
  - two or more of the following, each present for a significant portion of the time during a 1 month period. At least 1, 2, or 3
    - Delusions
    - Hallucinations
    - Disorganized Speech
    - Grossly disorganized or catatonic behavior
    - Negative symptoms
  - level of functioning in one or more areas is markedly below the level of achieved prior to onset
  - continuous signs of disturbance persist for at least 6 months
    - must include at least 1 month of symptoms thtat meet Criterion A
  - schizoaffective, bipolar with psychotic features, and depressive have been ruled out
  - if history of ASD or communication disorder, the additional schizophrenia diagnosis is only made if prominent delusions
- Specifiers
  - first episode, currently in acute episode (etc.)
  - with catatonia
  - severity
- Onset
  - late teends and the mid 30s
    - prior to adolescence is rare
    - peak age for first psychotic episode is early to mid 20s for males and late 20s for females
- Prevalence
  - 0.3-0.7%
  - variations by race/ethnicity
  - negative symptoms/longer duration higher in males
  - mood symptoms and brief presentations equivalent in both
- Differentials
  - major depressive or bipolar with psychotic or catatonic features
  - schizoaffective
  - schizophreniform
  - delusional disorder
  - schizotypal personality disorder
  - obessive complusive disorder and BDD
  - PTSD
  - ASD or communication disorder
- Comorbid
  - substance abuse (over half)
  - anxiety disorders
- other
  - 5-6% commit suicide
  - 20% attempt suicide
  - life expectancy is reduced

Answer 334

A

Narcissistic Personality Disorder

Answer 335

A

A pattern of instability in interpersonal relationships, -image, and affects, and marked impulsivity

Answer 336

A

Hoarding Disorder

Answer 337

A

Intended to serve as a practical, funcitonal, and flexible guide for organizing informaiton that can aid in teh accurate diagnosis and treatmet of mental disorders.
Information is of value to all professionals associated with various aspects of mental health care.
Tool for collecting and communicating accurate publiv health statistics on mental disorder morbidity and mortality

Answer 338

A

recurrent and persistent thoughts, urges or images that are experiences as intrusive and unwanted

Answer 339

A

Trauma and Stressor-Related Disorder
- Pattern of behavior in which a child actively approaches and interacts with unfamiliar adults and exhibits 2:
  - reduced hesitance in approaching or interacting with unfamiliar adults
  - overly familiar verbal or physical behavior
  - diminished checking with adult caregiver
  - willingness to go off with unfamiliar adult with minimal or no hesitation
- not limited to impulsivity
- experienced pattern of extremes of insufficient care as evidenced by
  - social neglect or deprivation in lack of having basic emotional needs met
  - repeated changes in primary caregiver
  - rearing in unusual settings
- care is presumed responsible for the disturbed behavior
- developmental age of at least 9 months
specify if
- persistent
- severe

Answer 340

A

individual intentionally behaves in ways that are designed to prevent or minimize contact with phobic objects or situations

Answer 341

A

Anorexia Nervosa

Answer 342

A

Disinhibited Social Engagement Disorder

Answer 343

A

Diagnostic Criteria
- Over a period of 6 months
  - recurrent and intense sexual arousal from the physical or phsychological suffering of another person, as manifested by fantasies, urges or behaviors
  - acted on urges with a nonconsenting person, or urges or fantasies cause clinically significant distress
Specifiers
- in a controlled environment
- in full remission
Prevalence
- 2 to 30%
- less tha 10% among sexual offenders
Development
- aware as young adults
- mean age is 19.4

Answer 344

A

with absent/delusional belief specifier

Answer 345

A

An expectable or culturally approved response to a common stressor or loss
Socially deviant behavior (e.g., political, religious, or sexual) and/or conflicts that are primarily between the individual and society, unless the deviance or conflict results from a dysfunction in the individual

Answer 346

A

Illness Anxiety Disorder

Answer 347

A

Atypical AN
- all criteria are met for AN are met except that despite significant weight loss, individuals weight is within normal range
Bulimia Nervosa (of low frequency and/or limited duration)
- All criteria are met except, binge eating and compensatory behaviors occur, on average less than once a week and or less than 3 months
BED (of low frequency and/or limited duration)
- All criteria are met except, except binge eating behaviors occur on average less than once a week and or less than 3 months
Purging Disorder
- recurrent purging to influence weight or shape with the absense of binge eating

Answer 348

A

reflect a more inclusive description of the range of psychopathology across the globe, not just the particular constructs or exemplars most commonly encountered in the US, Western Europe, and Canada.
to help avoid misdiagnosis
improve raport
obtain clinically useful information
therapeutic efficacy
guide research
clarify cultural epidemiology

Answer 349

A

Adjustment-like disorder with delayed onset of symptoms that occur more than 3 months after the stress
Adjustment like disorder with prolonged duration of more than 6 months without prolonged duration of stressor
Ataque de nervios
Other cultural syndromes
persistent complex bereavement disorder
- severe and persistent grief and mourning reactions

Answer 350

A

A pattern of social inhibition, feelings of inadequacy, and hypersensitive to negative evaluation

Answer 351

A

Factitious Disorder

Answer 352

A

Feeding and Eating Disorders
- Diagnostic Criteria
  - repeated regurgitation of food over a period of 1 month (several times a week, typically daily)
    - may be re-chewed, reswallowed, or spit-out
  - not associated with gastrointestinal or medical condition
  - no excuslively with AN, BN, or avoidant or restrictive food intake
  - specify if
    - in remission
      - after full criteria was met, but has not been met for a sustained period of time
- Prevalence/Onset
  - typically higher in individuals with intellectual disability
  - can occur during infancy, childhood, adolescence, adulthood
    - infancy: 3-12 months and remits spontaneously, but can be fatal
      - appears self-soothing
- Gender
- Differentials
  - gastrointestinal conditions
  - AN or BN
- Comorbidity
  - concurrent med condition
  - anxiety

Answer 353

A

Posttraumatic Stress Disorder (6 and older)

Answer 354

A

Persecutory Delusions

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Psychopathology: DSM 5 Disorders Flashcards

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