DSM-5 Mental Disorders

Question 1

Antisocial Personality Disorder

Answer 1

Antisocial personality disorder is characterized by a pattern of disregard for and violation of the rights of others that has occurred since age 15 and involves at least three characteristic symptoms (e.g., failure to conform to social norms with respect to lawful behavior, deceitfulness, impulsivity, reckless disregard for the safety of self and others, lack of remorse). The person must be at least 18 years old and have a history of conduct disorder before 15 years of age

Question 2

Bipolar II Disorder

Answer 2

A diagnosis of bipolar II disorder requires at least one hypomanic episode and at least one major depressive episode. A hypomanic episode lasts for at least four consecutive days and involves at least three symptoms that are also associated with a manic episode but are not severe enough to cause marked impairment in functioning or require hospitalization. A major depressive episode lasts for at least two weeks and involves at least five characteristic symptoms, at least one of which must be a depressed mood or a loss of interest or pleasure

Question 3

Conversion Disorder

Answer 3

The symptoms of conversion disorder involve disturbances in voluntary motor or sensory functioning and suggest a serious neurological or other medical condition (e.g., paralysis, seizures, blindness, loss of pain sensation) with evidence of an incompatibility between the symptom and recognized neurological or medical conditions

Question 4

Disruptive Mood Dysregulation Disorder

Answer 4

A depressive disorder marked by severe, recurrent temper outbursts displayed verbally and/or behaviorally that occurs, on average, three or more times a week, and a persistently irritable or angry mood between outbursts. Symptoms have been present for 12 or more months, occur in at least two settings, and have an onset before age 10. The diagnosis cannot be assigned for the first time before age 6 or after 18. If criteria for both this disorder and oppositional defiant disorder are met, only this disorder should be diagnosed. And, while bipolar disorders are episodic conditions (i.e., periods of mood disturbance can be differentiated from how the child usually is), this disorder is not an episodic condition

Question 5

Gender Dysphoria (in Children)

Answer 5

For gender dysphoria in children, the diagnostic criteria are a marked incongruence between assigned gender at birth and experienced or expressed gender as evidenced by a strong desire to be the opposite sex and at least five symptoms (e.g., strong preference for wearing clothes of the other gender, strong presence for wearing clothes of the other gender, strong preference for cross-gender roles during play, strong preference for toys and activities typically used or engaged in by the other gender, strong preference for playmates of the opposite gender, strong desire for primary and/or secondary sex characteristics of one’s experienced gender). Symptoms must have a duration of at least six months and cause clinically significant distress or impaired functioning

Question 6

Insomnia Disorder

Answer 6

Insomnia disorder is characterized by dissatisfaction with sleep quality or quantity that is associated with at least one characteristic symptom - difficulty initiating sleep; difficulty maintaining sleep; early-morning awakening with an inability to return to sleep. The sleep disturbance occurs at least three nights each week, has been present for at least three months, occurs despite sufficient opportunities for sleep, and causes significant distress or impaired functioning

Question 7

Major Depressive Episode

Answer 7

Lasts at least two weeks, represents a noticeable change from the person’s usual functioning, and includes at least five symptoms (at least one must be depressed mood or loss of interest or pleasure): (a) depressed mood (in children and adolescents, the mood may be irritable); (b) markedly diminished interest or pleasure in all or nearly all activities; (c) significant weight loss or gain and a decrease or increase in appetite; (d) insomnia or hypersomnia; (e) psychomotor agitation or retardation; (f) fatigue or loss of energy; (g) feelings of worthlessness or excessive or inappropriate guilt; (h) impaired ability to think or concentrate or indecisiveness; and/or (i) recurrent thoughts of death, suicidal ideation without a specific plan, or a suicide attempt or specific plan for committing suicide

Question 8

Mood Stabilizing Drugs (Lithium, Anticonvulsant Drugs)

Answer 8

Mood stabilizing drugs are used to alleviate mania and mood swings in bipolar disorder and include lithium and anticonvulsants (e.g., carbamazepine). Lithium is usually the drug-treatment-of choice for classic bipolar disorder, while an anticonvulsant drug may be more effective for patients who experience rapid mood swings or who have dysphoric mania

Question 9

Obsessive-Compulsive Disorder

Answer 9

OCD is characterized by recurrent obsessions and/or compulsions that are time-consuming or cause clinically significant distress or impairment in functioning. Obsessions are persistent thoughts, impulses, or images that the person experiences as intrusive and unwanted and that he attempts to ignore or suppress, and compulsions are repetitious and deliberate behaviors or mental acts that the person feels driven to perform either in response to an obsession or according to rigid rules. A combination of exposure with response prevention and the tricyclic clomipramine or an SSRI is usually the treatment-of-choice for OCD

Question 10

Paraphilic Disorders

Answer 10

The paraphilic disorders include voyeuristic, exhibitionistic, frotteuristic, sexual sadism, pedophilic, fetishistic, and transvestite disorders. These disorders are characterized by an “intense and persistent sexual interest other than sexual interest in genital stimulation or preparatory fondling with phenotypically normal, physically mature, consenting human partners…[that] is currently causing distress or impairment to the individual or… has entailed personal harm, or risk of harm, to others” (APA, 2013, pp. 685-686)

Question 11

Retrograde Amnesia

Answer 11

A loss of memory for events that occurred or information that was acquired prior to the trauma or other event that caused the amnesia

Question 12

Sensate Focus

Answer 12

Technique used in sex therapy to reduce performance anxiety and increased sexual excitement. Involves “nongenital pleasuring” initially, gradually building to genital stimulation with a ban on intercourse

Question 13

Substance-Induced Disorders

Answer 13

The substance-induced disorders include substance intoxication, substance withdrawal, and substance/medication-induced mental disorders. The latter “are potentially severe, usually temporary, but sometimes persisting central nervous system (CNS) syndromes that develop in the context of the effects of substances of abuse, medications, or toxins” (APA, 2013, p. 487) and include, among others, substance/medication-induced psychotic disorder, and substance/medication-induced neurocognitive disorders

Question 14

Acute Stress Disorder

Answer 14

The diagnosis of acute stress disorder requires the development of at least nine symptoms following exposure to actual or threatened death, severe injury, or sexual violation in at least one of four ways (direct experience of the event; witnessing the event in person as it happened to others; learning that the event occurred to a close family member or friend; repeated or extreme exposure to aversive details of the event). Symptoms can be from any of five categories (intrusion, negative mood, dissociative symptoms, avoidance symptoms, arousal symptoms) and have a duration of three days to one month

Question 15

Attention-Deficit/Hyperactivity Disorder (ADHD)

Answer 15

ADHD is the appropriate diagnosis when an individual has at least six symptoms of inattention and/or six symptoms of hyperactivity-impulsivity, and the symptoms had an onset before 12 years of age, are present in at least two settings (e.g., home and school), and interfere with social, academic, or occupational functioning. About 15 percent of children with ADHD continue to meet the full diagnostic criteria for the disorder as young adults and another 60 percent meet the criteria for ADHD in partial remission. In adults, inattention predominates the symptom profile. Treatment usually involves a CNS stimulant (e.g., Methylphenidate) and behavioral and cognitive-behavioral techniques

Question 16

Body Dysmorphic Disorder

Answer 16

The essential feature of body dysmorphic disorder is a preoccupation with one or more perceived defects or flaws in physical appearance that are not observable or appear minor to others. In addition, at some point, the person has engaged in repetitive behaviors (e.g., mirror checking, excessive grooming, skin picking) or mental acts (e.g., comparing his/her appearance with that of others) in response to these concerns

Question 17

Cyclothymic Disorder

Answer 17

Cyclothymic disorder involves fluctuating hypomanic symptoms and numerous periods of depressive symptoms that do not meet the criteria for a major depressive episode, with symptoms lasting for at least two years in adults or one year in children and adolescents

Question 18

Dissociative Amnesia

Answer 18

A diagnosis of dissociative amnesia requires an inability to recall important personal information that cannot be attributed to ordinary forgetfulness and causes clinically significant distress or impaired functioning. It is often related to exposure to one or more traumatic events. The most common forms of amnesia are localized and selective

Question 19

Generalized Anxiety Disorder (GAD)

Answer 19

GAD involves excessive anxiety and worry about multiple events or activities, which are relatively constant for at least six months, the person finds difficult to control, and cause clinically significant distress or impaired functioning. Anxiety and worry must include at least three characteristic symptoms (or at least one symptom for children) - restlessness or feeling keyed up or on edge; being easily fatigued; difficulty concentrating; irritability; muscle tension; sleep disturbance. Treatment usually involves cognitive-behavioral therapy or a combination of cognitive-behavioral therapy and pharmacotherapy

Question 20

Intellectual Disability

Answer 20

Intellectual disability is diagnosed in the presence of (a) deficits in intellectual functions (e.g., reasoning, problem solving, abstract thinking); (b) deficits in standards of personal independence and social responsibility and impair functioning across multiple environments in one or more activities of daily life; and (c) an onset of intellectual and adaptive functioning deficits during the developmental period. Four degrees of severity (mild, moderate, severe, and profound) are based on adaptive functioning in conceptual, social, and practical domains

Question 21

Major Neurocognitive Disorder

Answer 21

Major neurocognitive disorder (formerly dementia) is diagnosed when there is evidence of significant decline from a previous level of functioning in one or more cognitive domains that interferes with the individual’s independence in everyday activities and does not occur only in the context of delirium. Mild neurocognitive disorder (formerly cognitive disorder NOS) is the appropriate diagnosis when there is evidence of a modest decline from a previous level of functioning in one or more cognitive domains that does not interfere with the individual’s independence in everyday activities and does not occur only in the context of delirium. Subtypes are based on etiology and include major and mild neurocognitive disorder due to Alzheimer’s disease, vascular disease, dramatic brain injury, HIV infection, Parkinson’s disease, and Huntington’s disease

Question 22

Narcissistic Personality Disorder

Answer 22

Narcissistic personality disorder involves a pervasive pattern of grandiosity, need for admiration, and lack of empathy as indicated by at least five characteristic symptoms (e.g., has a grandiose sense of self-importance; is preoccupied with fantasies of unlimited success, power, beauty, love; believes he/she is unique and can be understood only by other high-status people; requires excessive admiration; has a sense of entitlement; lacks empathy; is often envious of others or believes others are envious of him/her)

Question 23

Obsessive-Compulsive Personality Disorder

Answer 23

Obsessive-compulsive personality disorder is characterized by a persistent preoccupation with orderliness, perfectionism, and mental and interpersonal control that severely limits the individual’s flexibility, openness, and efficiency. At least four characteristic symptoms must be present (e.g., exhibits perfectionism that interferes with task completion, is excessively devoted to work and productivity to the exclusion of leisure activities and friendships, is reluctant to delegate work to others unless they are willing to do it his way, adopts a miserly spending style toward self and others)

Question 24

Parkinson’s Disease

Answer 24

Movement disorder involving bradykinesia (slowness of movement), rigidity, and resting tremor. About 20-60 percent of patients eventually develop neurocognitive disorder due to Parkinson’s disease

Question 25

Schizoaffective Disorder

Answer 25

Schizoaffective disorder is a psychotic disorder involving an uninterrupted period of disturbance during which there are concurrent symptoms of a mood disorder and the active-phase symptoms of a mood disorder and the active-phase symptoms of schizophrenia, with at least a two-week period in which hallucinations and delusions are present without predominant mood symptoms

Question 26

Separation Anxiety Disorder

Answer 26

Separation anxiety disorder involves developmentally inappropriate and excessive fear or anxiety related to separation from home or attachment figures as evidenced by at least three symptoms (e.g., recurrent excessive distress when anticipating or experiencing separation from home or major attachment figures, persistent excessive fear of being alone, repeated complaints of physical symptoms when separation from an attachment figure occurs or is anticipated). The disturbance must last at least four weeks in children and adolescents or six months in adults and must cause clinically significant distress or impaired functioning

Question 27

Tardive Dyskinesia

Answer 27

Potentially irreversible extrapyramidal side-effect associated with long-term use of a first-generation (traditional) antipsychotic drug. Symptoms include rhythmical, stereotyped movements of the muscles of the face, limbs, and trunk (similar to Huntington’s chorea). In some cases, symptoms are alleviated by a GABA agonist or by gradual withdrawal of the drug

Question 28

Alcohol Withdrawal

Answer 28

Diagnosed in the presence of at least two characteristic symptoms within several hours to a few days following cessation or reduction of alcohol consumption: autonomic hyperactivity; hand tremor; insomnia; nausea or vomiting; transient illusions or hallucinations; anxiety; psychomotor agitation; generalized tonic-clonic seizures

Question 29

Benzodiazepines

Answer 29

A type of anxiolytic (antianxiety drug). More effective for alleviating anticipatory anxiety than panic symptoms. Side-effects include drowsiness, ataxia, slurred speech, and other signs of CNS depression. Abrupt cessation can cause rebound hyperexcitability

Question 30

Bulimia Nervosa

Answer 30

Characterized by (a) recurrent episodes of binge eating that are accompanied by a sense of a lack of control; (b) inappropriate compensatory behavior to prevent weight gain (e.g., self-induced vomiting, excessive exercise); and (c) self-evaluation that is unduly influenced by body shape and weight. Treatment usually includes nutritional counseling, cognitive-behavioral therapy, and in some cases, antidepressants

Question 31

Delusions

Answer 31

False beliefs that are firmly held despite what other people believe and/or the existence of clear and indisputable evidence to the contrary

Question 32

Factitious Disorder

Answer 32

Individuals with factitious disorder imposed on self falsify physical or psychological symptoms that are associated with their deception, present themselves to others as being ill or impaired, and engage in the deceptive behavior even in the absence of an obvious external reward for doing doing so. Individuals with factitious disorder imposed on another falsify physical or psychological symptoms in another person, present that person to others as being ill or impaired, and engage in the deceptive behavior even in the absence of an external reward. For both types of fictitious disorder, falsification of symptoms can involve feigning, exaggeration, simulation, or induction (e.g., by ingestion of a substance or self-injury)

Question 33

HIV/AIDS (Acquired Immune Deficiency Syndrome)

Answer 33

AKA HIV disease. A viral disease caused by the human immunodeficiency virus (HIV), which may be transmitted by sexual contact, blood-to-blood contact, and from a pregnant woman to her unborn child. HIV suppresses the body’s immune system and, therefore, results in a vulnerability to a range of opportunistic infections include Kaposi’s sarcoma (a form of cancer) and a rare form of pneumonia. These diseases are known as opportunistic infections because they take advantage of a compromised immune system that is no longer able to fight them off

Question 34

Loose Associations (Derailment of Thought)

Answer 34

Involve abrupt shifts from one fragmented thought to another with little if any logical connection between the thoughts

Question 35

MAOIs (Monoamine Oxidase Inhibitors)

Answer 35

Antidepressant drugs that inhibit the enzyme that deactivates sopamine, norepinephrine, and serotonin. MAOIs appear to be most effective for treating non-endogenous and atypical depression. Side-effects include anticholinergic effects, insomnia, agitation, confusion, and weight gain. When taken in conjunction with other drugs or foods containing tyramine, they can cause a hypertensive crisis

Question 36

Neurocognitive Disorder due to Alzheimer’s Disease

Answer 36

This disorder is diagnosed when the criteria for major or mild neurocognitive disorder are met, there is an insidious onset and gradual progression of impairment in one or more cognitive domains (or at least two domains for major neurocognitive disorder), and the criteria for probable or possible Alzheimer’s disease are met. It involves a slow, progressive decline in cognitive functioning

Question 37

Outline for Cultural Formulation

Answer 37

The DSM-5’s Outline for Cultural Formulation provides guidlines for assessing four factors: the client’s cultural identity; the client’s cultural conceptualization of distress; the psychosocial stressors and cultural factors that impact the client’s vulnerability and resilience; and cultural factors relevant to the relationship between the client and therapist

Question 38

Positive Symptoms of Schizophrenia

Answer 38

These include delusions, hallucinations, disorganized speech, and grossly disorganized behavior. The active phase symptoms of schizophrenia include delusions, hallucinations, and/or disorganized speech and may also include grossly disorganized behavior or negative symptoms

Question 39

Schizophreniform Disorder

Answer 39

The diagnostic criteria for schizophreniform disorder are identical to those for schizophrenia except that the disturbance is present for at least one month but less than six months and impaired social or occupational functioning may occur but is not required

Question 40

Specific Learning Disorder

Answer 40

Specific learning disorder is diagnosed when a person exhibits difficulties related to academic skills as indicated by the presence of at least one characteristic symptom that persists for at least six months despite the provision of interventions targeting those difficulties. The diagnosis requires that the individual’s academic skills are substantially below those expected for his age, interfere with academic or occupational performance or activities of daily living, began during the school-age years, and are not better accounted for by another condition or disorder or other factor such as uncorrected visual or auditory impairment or psychosocial adversity

Question 41

Uncomplicated Bereavement

Answer 41

Included in the DSM-5 with other conditions that may be a focus of clinical attention and is described as “ a normal reaction to the death of a loved one” (APA,2013, P. 716). Uncomplicated bereavement may include symptoms of a major depressive episode, but the individual usually experiences the symptoms as normal and may be seeking treatment for insomnia, anorexia, or other associated symptoms

Question 42

Alcohol Withdrawal Delirium (Delirium Tremens)

Answer 42

Alcohol-induced disorder diagnosed in the presence of prominent disturbances in attention, awareness, and cognition following cessation or reduction of alcohol consumption that are sufficiently severe to warrant clinical attention. Common associated features include autonomic hyperactivity, vivid hallucinations, delusions, and agitation

Question 43

Beta-Blockers (Propranolol)

Answer 43

Propranolol and other beta-blockers block or diminish the cardiovascular excitatory response to the hormones epinephrine and norepinephrine. They are used to treat cardiovascular disorders, glaucoma, and migraine headache and are also useful for reducing the physical symptoms of anxiety. Common side-effects of propranolol include bradycardia, nausea, diarrhea, dizziness, decreased sexual ability, and trouble sleeping

Question 44

Catecholamine Hypothesis

Answer 44

Theory that attributes depression to deficient norepinephrine and mania to excessive norepinephrine

Question 45

Dependent Personality Disorder

Answer 45

Involves a pervasive and excessive need to be taken care of, which leads to submissive, clinging behavior and a fear of separation as manifested by at least five symptoms (e.g., has difficulty making decisions without advice and reassurance from others, fears disagreeing with others because it might lead to a loss of support, has difficulty initiating projects on his own, goes to great lengths to gain nurturance and support from others, is unrealistically preoccupied with fears of being left to care for him/herself

Question 46

First-Generation (Traditional) Antipsychotics

Answer 46

The first-generation antipsychotic drugs (e.g., phenothiazines) are used for the management of schizophrenia and other psychoses. They are most effective for positive symptoms (delusions, hallucinations, agitation, thought disorders). Side-effects include anticholinergic effects, extrapyramidal effects (e.g., tardive dyskinesia), and neuroleptic malignant syndrome. These drugs exert their beneficial effects primarily by blocking dopamine receptors, and their effectiveness provides support for the dopamine hypothesis which attributes schizophrenia to overactivity at dopamine receptors

Question 47

Hoarding Disorder

Answer 47

Involves a persistent difficulty discarding or parting with possessions regardless of their actual value. The difficulty results in the accumulation of items that block and clutter living areas and significantly interferes with their intended use and stems from a perceived need to save the items and distress associated with discarding them. If living areas are cluttered, it’s only because of intervention by third parties

Question 48

Major Depressive Disorder

Answer 48

A diagnosis of major depressive disorder requires the presence of at least five symptoms of a major depressive episode nearly every day for at least two weeks, with at least one symptom being depressed mood or loss of interest or pleasure. Symptoms are depressed mood (or, in children and adolescents, a depressed or irritable mood); markedly diminished interest or pleasure in most or all activities; significant weight loss when not dieting or weight gain or a decrease or increase in appetite; insomnia or hypersomnia; psychomotor agitation or retardation; fatigue or loss of energy; feelings of worthless or excessive guilt; diminished ability to think or concentrate; recurrent thoughts of death, recurrent suicidal ideation, or a suicide attempt. Symptoms cause clinically significant distress or impaired functioning. Treatment usually includes cognitive-behacioral therapy and an SSRI or other antidepressant

Question 49

Masked Depression

Answer 49

A form of depression in which physical symptoms (pain, paresthesias, anorexia, etc.) predominate, and the individual often denies experiencing a depressed mood

Question 50

Neuroleptic Malignant Syndrome (NMS)

Answer 50

A rare, but potetially fatal side-effect or the antipsychotic drugs. It involves a rapid onset of motor, mental, and autonomic symptoms including muscle rigidity, tachycardia, hyperthermia, and altered consciousness. To avoid a potentially fatal outcome, the drug must be stopped as soon as symptoms of NMS develop

Question 51

Panic Attack

Answer 51

A sudden surge of intense fear or discomfort that peaks within minutes and includes four or more symptoms (e.g., palpitations, pounding heart, or accelerated heart rate; sweating; trembling; shortness of breath; chest pain or discomfort; nausea; feeling unsteady. light-headed, or faint; chills or heat sensations; numbness or tingling; derealization of depersonalization; fear of losing control; fear of dying). Panic attacks can occur in the context of any anxiety disorder as well in the context of some other mental disorders (e.g., depressive disorders, PTSD, substance use disorders) and other medical conditions. Panic disorder requires at least two unexpected panic attacks. Unexpected (uncued) panic attacks are not associated with any internal or external trigger (they occur “out of the blue”)

Question 52

Posttraumatic Stress Disorder

Answer 52

The diagnosis of PTSD requires exposure to actual or threatened death, serious injury, or sexual violence; presence of at least one intrusion symptom related to the event; persistent avoidance of stimuli associated with the event; negative changes in cognition or mood associated with the event; and marked change in arousal and reactivity associated with the event. Symptoms must have a duration of more than one month and must cause clinically significant distress or impaired functioning. The treatment-of-choice is a comprehensive cognitive-behavioral intervention that incorporates exposure, cognitive restructuring, and anxiety management or similar techniques

Question 53

Schizotypal Personality Disorder

Answer 53

Is diagnosed in the presence of (a) pervasive social and interpersonal deficits involving acute discomfort with and reduced capacity for close relationships and (b) eccentricities in cognition, perception, and behavior as manifested by the presence of at least five symptoms (e.g., ideas of reference, odd beliefs or magical thinking that influence behavior, bodily illusions and other unusual perceptions, is suspicious or has paranoid ideation, inappropriate or constricted affect, lacks close friends or confidents other than first-degree relatives, excessive social anxiety)

Question 54

Specific Phobia

Answer 54

Characterized by intense fear of or anxiety about a specific object or situation, with the individual either avoiding the object or situation or enduring it with marked distress. The fear or anxiety is not proportional to the danger posed by the object or situation, is persistent (typically lasting for at least six months), and causes clinically significant distress or impaired functioning. The treatment-of-choice is exposure with response prevention (especially in vivo exposure)

Question 55

Vascular Neurocognitive Disorder

Answer 55

Vascular neurocognitive disorder is diagnosed when the criteria for major or mild neurocognitive disorder are met, the clinical features are consistent with a vascular etiology, and there is evidence of cerebrovascular disease from the individual’s history, a physical examination, and/or neuroimaging that is considered sufficient to account for his symptoms. This disorder often has a stepwise, fluctuating course with a patchy pattern of symptoms that is determined by the location of the brain damage

Question 56

Adjustment Disorders

Answer 56

The adjustment disorders involve the development of emotional or behavioral symptoms in response to one or more identifiable psychosocial stressors within three months of the onset of the stressor(s). Symptoms must be clinically significant as evidenced by the presence of marked distress that is not proportional to the severity of the stressor and/or significant impairment in functioning, and they must remit within six months after termination of the stressor or its consequences

Question 57

Autism Spectrum Disorder

Answer 57

For a diagnosis of autism spectrum disorder, the individual must exhibit (a) persistent deficits in social communication and interaction across multiple contexts as manifested by deficits in social-emotional reciprocity, nonverbal communication, and the development, maintenance, and understanding of relationships; (b) restricted, repetitive patterns of behavior, interests, and activities as manifested by at least two characteristic symptoms (e.g., stereotyped or repetitive motor movements, use of objects, or speech; inflexible adherence to routines, or ritualized patterns of behavior); (c) the presence of symptoms during the early developmental period; and (d) impaired functioning as the result of symptoms. The best outcomes are associated with an ability to communicate by age 5 or 6, an IQ over 70, and a later onset of symptoms

Question 58

Borderline Personality Disorder

Answer 58

The essential feature of borderline personality disorder is a pervasive pattern of instability in interpersonal relationships, self-image, and affect, and marked impulsivity. At least five characteristic symptoms must be present (e.g., frantic efforts to avoid abandonment; pattern of unstable, intense interpersonal relationships that are marked by fluctuations between idealization and devaluation; an identity disturbance involving a persistent instability in self-image or sense of self; recurrent suicide threats or gestures; transient stress-related paranoid ideation or severe dissociative symptoms)

Question 59

Delirium

Answer 59

A diagnosis of delirium requires (a) a disturbance in attention and awareness that develops over a short period of time, represents a change from baseline functioning, and tends to fluctuate in severity over the course of a day and (b) an additional disturbance in cognition (e.g., impaired memory, disorientation, impaired language, deficits in visuospatial ability, perceptual distortions). Symptoms must not be due to another neurocognitive disorder and must not occur during a severely reduced level of arousal (e.g., during a coma), and there must be evidence that symptoms are the direct physiological consequence of a medical condition, substance intoxication or withdrawal, and/or exposure to a toxin

Question 60

Down Syndrome

Answer 60

Autosomal disorder usually caused by the presence of an extra chromosome 21. The cause of 10 to 30 percent of all cases of mild to moderate intellectual disability. Associated with physical abnormalities including slanting, almond-shaped eyes, heart lesions, cataracts, and respiratory defects

Question 61

Hallucinations

Answer 61

Sensory perceptions occurring without external stimulation of the associated sensory organ

Question 62

Korsakoff Syndrome

Answer 62

Alcohol-induced disorder characterized by anterograde and retrograde amnesia and confabulation. Has been linked to a thiamine deficiency. (In the DSM-5, this condition is called alcohol-induced major neurocognitive disorder, amnestic-confabulatory type.)

Question 63

Malingering (in DSM-5)

Answer 63

Malingering is included in the DSM-5 with other conditions that may be a focus of clinical attention. It involves the intentional production, faking, or gross exaggeration of physical or psychological symptoms to obtain an external reward (e.g., to avoid criminal prosecution or obtain financial compensation)

Question 64

Narcotic-Analgesics

Answer 64

The drugs classified as narcotic-analgesics (opioids) have both sedative and analgesic properties. Chronic use of a narcotic-analgesic results in tolerance and psychological and physical dependence. Withdrawal symptoms resemble those associated with a bad case of the flu

Question 65

Opioid Withdrawal

Answer 65

Opioid withdrawal occurs following cessation or reduction in opioid use that has been heavy and prolonged or after administration of an opioid antagonist following a period of opioid use. The diagnosis requires at least three characteristic symptoms - dysphoric mood; nausea or vomiting; muscle aches; lacrimation (excessive secretion of tears) or rhinorrhea (excessive mucus secretion from the nose); pupillary dilation, piloerection (“goose bumps” or erection of hair on the skin), or sweating; diarrhea; yawning; fever; and/or insomnia

Question 66

Persistent Depressive Disorder (Dysthymia)

Answer 66

Persistent depressive disorder is characterized by a depressed mood (or in children and adolescents, a depressed or irritable mood) on most days for at least two years in adults or one year in children and adolescents as indicated by the presence of at least two characteristic symptoms (i.e., poor appetite or overeating, insomnia or hypersomnia, low energy or fatigue, low self-esteem, poor concentration or difficulty making decisions, feelings of hopelessness). During the two- or one-year period, the individual has not been symptom-free for more than two months, and symptoms cause clinically significant distress or impaired functioning

Question 67

Schizoid Personality Disorder

Answer 67

Schizoid personality disorder involves a pervasive pattern of detachment from interpersonal relationships and a restricted range of emotional expression in social settings with at least four characteristic symptoms - doesn’t desire or enjoy close relationships; almost always chooses solitary activities; has little interest in sexual relationships; takes pleasure in few activities; lacks close friends or confidents other than first-degree relatives; seems indifferent to praise or criticism; exhibits emotional coldness or detachment

Question 68

Social (Pragmatic) Communication Disorder

Answer 68

Social (pragmatic) communication disorder involves persistent difficulties in the social use of language and nonverbal communication that limit effective communication, social participation, social relationships, academic achievement, or work performance. Autism spectrum disorder (ASD) includes similar social communication deficits; If these deficits are present, a diagnosis of social (pragmatic) communication disorder can be made only if the person has never displayed the restricted/repetitive patterns of behavior, interests, or activities that are associated with ASD

Question 69

Tourette’s Disorder

Answer 69

Tourette’s disorder is characterized by the presence of at least one vocal tic and multiple motor tics that may appear simultaneously or at different times, may wax and wane in frequency, have persisted for more than one year, and began prior to age 18

Question 70

Agoraphobia

Answer 70

A diagnosis of agoraphobia requires the presence of marked fear of or anxiety about at least two of five situations (using public transportation, being in open spaces, being in enclosed spaces, standing in line or being part of a crowd, and being outside the home alone). The individual fears or avoids these situations due to a concern that escape might be difficult or help will be unavailable in case he develops incapacitating or embarrassing symptoms; and the situations nearly always provoke fear or anxiety and are actively avoided, require the presence of a companion, or are endured with intense fear or anxiety. The fear or anxiety is persistent and is not proportional to the threat posed by the situations. Treatment-of-choice is in vivo exposure with response prevention (flooding)

Question 71

Avoidant Personality Disorder

Answer 71

Avoidant personality disorder is characterized by a pervasive pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation, as indicated by at least four characteristic symptoms (e.g., avoids work activities involving interpersonal contact due to a fear of criticism, rejection, or disapproval; is unwilling to get involved with people unless certain of being liked; is preoccupied with concerns about being criticized or rejected; views self as socially inept, inferior, or unappealing to others)

Question 72

Brief Psychotic Disorder

Answer 72

Brief psychotic disorder characterized by the presence of one or more of four characteristic symptoms (delusions, hallucinations, disorganized speech, grossly disorganized or catatonic behavior) with at least one symptom being delusions, hallucinations, or disorganized speech. Symptoms are present for at least one day but less than one month with an eventual return to full premorbid functioning

Question 73

Delusional Disorder

Answer 73

Delusional disorder involves one or more delusions that last at least one month. Overall psychosocial functioning is not markedly impaired, and any impairment is directly related to the delusions. The DSM-5 distinguishes between the following subtypes: erotomanic, grandiose, jealous, persecutory, somatic, mixed, and unspecified

Question 74

Enuresis

Answer 74

Enuresis involves repeated voiding of urine into the bed or clothes at least twice a week for three or more consecutive months. Urination is usually involuntary but can be intentional and is not due to substance use or a medical condition. Enuresis is diagnosed only when the individual is at least 5 years old or the equivalent developmental level. The bell-and-pad (urine alarm) is the most common treatment

Question 75

Histrionic Personality Disorder

Answer 75

characterized by a pervasive pattern of emotionality and attention-seeking as manifested by at least five characteristic symptoms (e.g., discomfort when not the center of attention, inappropriately sexually seductive or provocative, rapidly shifting and shallow emotions, consistent use of physical appearance to gain attention, considers relationships to be more intimate than they are)

Question 76

Lithium

Answer 76

Drug used to alleviate mania and mood swings in bipolar disorder. Lithium can be toxic and blood levels need to be monitored. Retention of lithium is affected by the body’s sodium levels and users must make sure their salt levels do not fluctuate. Early signs of toxicity include diarrhea, nausea, vomiting, sedation, slurred speech, coordination problems, and confusion

Question 77

Manic Episode

Answer 77

A period, lasting at least one week, of abnormally and persistently elevated, expansive, or irritable mood. At least three characteristic signs are present: (a) inflated self-esteem or grandiosity; (b) decreased need for sleep; (c) more talkative or pressure to keep talking; (d) flight of ideas or the sense that one’s thoughts are racing; (e) distractibility; (f) increase in goal-directed activity or psychomotor agitation; and/or (g) excessive involvement in pleasurable activities that have a high potential for painful consequences. The mood disturbance is severe enough to cause marked impairment in social or occupational functioning or to require hospitalization to prevent harm to self or others, or there are psychotic features

Question 78

Negative Symptoms of Schizophrenia

Answer 78

involve a restriction in the range and intensity of emotions and other functions. Examples include affective flattening (reduced body language, expressionless, unresponsive face, poor eye contact); alogia (poverty of thought and speech); and avolition (restricted initiation of goal-directed behavior)

Question 79

Oppositional Defiant Disorder

Answer 79

involves a recurrent pattern of an angry/irritable mood, argumentative.defiant behavior, or vindictiveness as evidenced by at least four characteristic symptoms that are exhibited during interactions with at least one person who is not a sibling. Examples of symptoms include often loses temper, often argues with authority figures, often actively refuses to comply with requests from authority figures or with rules, and often blames others for his/her mistakes

Question 80

Phenylketonuria (PKU)

Answer 80

Potential cause of intellectual disability due to an inability to metabolize the amino acid phenylalanine. Can be prevented by providing a diet low in phenylalanine

Question 81

Schizophrenia

Answer 81

A diagnosis of schizophrenia requires the presence of at least two active phase symptoms (i.e., delusions, hallucinations, disorganized speech, grossly disorganized behavior, negative symptoms) for at least one month, with at least one symptom being delusions, hallucinations, or disorganized speech. There must be continuous signs of the disorder for at least six months, and symptoms must cause significant impairment in functioning. Treatment usually includes an antipsychotic drug, cognitive-behavioral therapy, psychoeducation, social skills training, supported employment, and other interventions for the individual with schizophrenia and psychosocial interventions for his/her family

Question 82

Social Anxiety Disorder

Answer 82

Involves intense fear or anxiety about one or more social situations in which the individual may be exposed to scrutiny by others. The individual fears that he/she will exhibit anxiety symptoms in these situations that will be negatively evaluated; he/she avoids the situations that will be negatively evaluated; he/she avoids the situations or endures them with intense fear or anxiety; and his/her fear or anxiety is not proportional to the threat posed by the situations. The fear, anxiety, and avoidance are persistent and cause clinically significant distress or impaired functioning. Exposure with response prevention is an effective treatment, and its benefits may be enhanced when it is combined with social skills training or cognitive restructuring and other cognitive techniques

Question 83

Tricyclics (Imipramine, Clomipramine)

Answer 83

The tricyclic antidepressants (TCAs) are believed to work by blocking the reuptake of norepinephrine, dopamine, and/or serotonin. They are most effective for alleviating somatic, vegatative symptoms. Side-effects include anticholinergic effects, confusion, drowsiness, weight gain, and cardiovascular symptoms. Imipramine has also been found useful for treating enuresis, while clomipramine is an effective treatment for panic disorder, agoraphobia, bullimia nervosa, and OCD

Question 84

Anorexia Nervosa

Answer 84

The essential features of anorexia nervosa are (a) a restriction of energy intake that leads to a significantly low body weight; (b) an intense fear of gaining weight or becoming fat or behavior that interferes with weight gain; and (c) a disturbance in the way the person experiences his/her body weight or shape or a persistent lack of recognition of the seriousness of his/her low body weight. Onset is typically in adolescence. Treatment includes contingency management, cognitive therapy, and family therapy

Question 85

Binge-Eating Disorder

Answer 85

Binge-eating disorder is diagnosed in the presence of repeated episodes of binge eating that occur, on average, at least once a week for three months and are associated with three or more of the following: eating much more quickly than normal; eating until feeling uncomfortably full; eating large amounts of food when not feeling physically hungry; eating alone due to feeling embarrassed by how much one is eating; feeling disgusted with oneself, depressed, or very guilty after an episode. Binge-eating disorder does not include the recurrent inappropriate compensatory behavior (e.g., purging, excessive exercise) seen in bulimia nervosa

Question 86

Compulsions

Answer 86

Repetitious and deliberate behaviors or mental acts that the individual feels driven to perform either in response to an obsession or according to rules that must be applied rigidly. The goal of compulsive acts is to reduce distress or prevent a dreaded situation from happening, but the acts are either excessive or are not connected in a logical way to this goal. The individual may attempt to resist a compulsion but experiences anxiety and tension as the result of doing so

Question 87

Diagnostic Uncertainty

Answer 87

When using the DSM-5, diagnostic uncertainty about a client’s diagnosis is indicated by coding one of the following: Other specified disorder is coded when the clinician wants to indicate the reason why the client’s symptoms do not meet the criteria for a specific diagnosis, while unspecified disorder is coded when the clinician does not want to indicate the reason why the client’s symptoms do not meet the criteria for a specific diagnosis

Question 88

Flight of Ideas

Answer 88

A verbal presentation in which the client’s responses seem to “take off” based on a particular word or thought, unrelated to any logical progression or the original point of the communication

Question 89

Huntington’s Disease

Answer 89

Inherited disorder characterized by cognitive decline, chorea (involuntary tremors, twitching), and athetosis (slow writhing movements)

Question 90

Major Depressive Disorder with Permpartum Onset

Answer 90

The permpartum onset specifier is applied to major depressive disorder, bipolar I disorder, and bipolar II disorder when the onset of symptoms is during pregnancy or within four weeks postpartum. Symptoms may include anxiety and a preoccupation with the infant’s well-being or, in extreme cases, delusional thoughts about the infant

Question 91

Methylphenidate (Ritalin)

Answer 91

Psychostimulant drug used to treat ADHD. Common side-effects include dysphoria, decreased appetite, insomnia, and growth suppression

Question 92

Non-Rapid Eye Movement Sleep Arousal Disorders

Answer 92

This disorder involves recurrent episodes of incomplete awakening that usually occur during the first third of the major sleep episode and are accompanied by sleepwalking (getting out of bed during sleep and walking around) and/or sleep terror (an abrupt arousal from sleep that often begins with a panicky scream and is accompanied by intense fear and signs of autonomic arousal). The individual has limited or no recall of an episode upon awakening, and the disturbance causes significant distress or impaired functioning

Question 93

Panic Disorder

Answer 93

Panic disorder is characterized by recurrent (at least two) unexpected panic attacks with at least one attack being followed by one month of persistent concern about having additional attacks or about their consequences and/or involving a significant maladaptive change in behavior related to the attack. Cognitive behavioral interventions that incorporate exposure are the treatment-of-choice for this disorder

Question 94

Psychoactive (Psychotropic Drugs)

Answer 94

Agents that interact with the central nervous system in a way that produces changes in mood, consciousness, perception, and/or behavior. The psychoactive drugs exert their effects in various ways but all have one of two basic effects: They either increase or decrease the effectiveness of transmission at nerve synapses. Psychoactive drugs also have side-effects that may interfere with a person’s physical, psychological, and/or social functioning or well-being

Question 95

Second Generation (Atypical) Antipsychotics

Answer 95

Clozapine and other atypical (newer) antipsychotic drugs affect receptors for several neurotransmitters including dopamine, serotonin, and glutamate. These drugs are effective for both positive and negative symptoms of schizophrenia and are less likely to produce tar dive dyskinesia than the traditional antipsychotics. However, they can produce agranulocytosis (loss of the white blood cells that fight infection) and other blood dyscrasias, as well as neuroleptic malignant syndrome. Their use requires careful blood monitoring

Question 96

SSRIs (Selective Serotonin Reuptake Inhibitors)

Answer 96

Antidepressant drugs that include Prozac and Zoloft. Exert their effects by blocking the reuptake of serotonin. Side-effects include gastrointestinal disturbances, sexual dysfunction, insomnia, anxiety, headache, and anorexia. In comparison to the TCAs, the SSRIs are less cardiotoxic, safer in overdose, and less likely to produce cognitive impairments

Question 97

Vegetative Symptoms

Answer 97

Consist of sleep disturbances, changes in appetite or weight, loss of energy or frequent fatigue, and changes in sexual function. Useful for diagnostic screening purposes because they may indicate a serious mental disorder. If a client reports vegetative symptoms, the social worker should find out whether they reflect a change from the client’s precious functioning

Question 98

Anterograde Amnesia

Answer 98

A loss of memory for events and information subsequent to a trauma or other event that precipitated the amnesia. It involves an inability to form new memories

Question 99

Bipolar I Disorder

Answer 99

A diagnosis of bipolar I disorder requires at least one manic episode that lasts for at least one week, is present most of the day nearly every day, and includes at least three characteristic symptoms (e.g., inflated self-esteem or grandiosity, decreased need for sleep, flight of ideas). Symptoms must cause marked impairment in social or occupational functioning, require hospitalization to avoid harm to self or others, or include psychotic features. This disorder may include one or more hypomanic episodes or major depressive episodes. Treatment usually includes lithium or an anti-seizure medication and cognitive-behavior therapy or other form of therapy

Question 100

Conduct Disorder

Answer 100

The diagnosis of conduct disorder requires a persistent pattern of behavior that violates the basic rights of others and/or age-appropriate social norms or rules as evidenced by the presence of at least three characteristic symptoms during the past 12 months and at least one symptom in the past six months. Symptoms are divided into four categories: aggression to people and animals; destruction of property; deceitfulness or theft; and serious violation of rules. The disorder cannot be assigned to individuals over age 18 who meet the criteria for antisocial personality disorder

Question 101

Disinhibited Social Engagement Disorder

Answer 101

Disinhibited social engagement disorder is characterized by a pattern of behavior that involves inappropriate interactions with unfamiliar adults as evidenced by at least two symptoms (e.g., reduced or absence of reticence in approaching or interacting with unfamiliar adults, overly familiar behavior with unfamiliar adults). The child must have a developmental age of at least 9 months and have experienced extreme insufficient care that is believed to be the cause of the disturbed behavior

Question 102

Gender Dysphoria (in Adolescents and Adults)

Answer 102

The essential feature of gender dysphoria in adolescents or adults is a marked incongruence between assigned gender and experienced or expressed gender that is manifested by at least two symptoms (e.g., marked incongruence between one’s primary and/or secondary sex characteristics between one’s primary and/or secondary sex characteristics and one’s experienced or expressed gender, strong desire for the primary candor secondary sex characteristics of the opposite gender, strong desire to be of the opposite gender, strong conviction that one has the feelings and reactions that are characteristic of the opposite gender). Symptoms must have a duration of at least six months and cause clinically significant distress or impaired functioning

Question 103

Hypomanic Episode

Answer 103

A distinct period of abnormally and persistently elevated, expansive, or irritable mood that lasts for at least four days and is accompanied by at least three of the symptoms associated with a manic episode. The episode represents a clear change in mood and functioning but (in contrast to a manic episode) is not sufficiently severe to cause marked impairment in functioning or to require hospitalization, and there is an absence of psychotic symptoms

Question 104

Major Depressive Disorder with Seasonal Pattern

Answer 104

The seasonal pattern specifier is applied to major depressive, bipolar I disorder, and bipolar II disorder when there is a temporal relationship between the onset of a mood episode and a particular time of the year. This condition is also known as seasonal affective disorder (SAD) and, in the Northern Hemisphere, most commonly occurs during the winter months. People with SAD usually experience hypersomnia, increased appetite and weight gain, and a craving for carbohydrates

Question 105

Mild Neurocognitive Disorder

Answer 105

Mild neurocognitive disorder (formerly cognitive disorder NOS) is the appropriate diagnosis when there is evidence of a modest decline from a previous level of functioning in one or more cognitive domains that does not interfere with the individual’s independence in everyday activities and does not occur only in the context of delirium. Subtypes are based on etiology and include major and mild neurocognitive disorder due to Alzheimer’s disease, vascular disease, traumatic brain injury, HIV infection, Parkinson’s disease, and Huntington’s disease

Question 106

Obsessions

Answer 106

Persistent thoughts, impulses, or images that an individual experiences as senseless or intrusive and that cause marked distress. The thoughts are not simply excessive worries about real-life problems, and the person may attempt to ignore, suppress, or neutralize them with other thoughts or actions

Question 107

Paranoid Personality Disorder

Answer 107

Paranoid personality disorder involves a pervasive pattern of distrust and suspiciousness that entails interpreting the motives of others as malevolent. The diagnosis requires the presence of at least four characteristic symptoms (e.g., suspects that others are exploiting, harming, or deceiving him/her without a sufficient basis for doing so; reads demeaning content into benign remarks or events; persistently bears grudges; is persistently suspicious about the fidelity of his/her spouse or sexual partner without justification)

Question 108

Reactive Attachment Disorder

Answer 108

Reactive attachment disorder is characterized by a pattern of inhibited and emotionally withdrawn behavior toward adult caregivers as manifested by a lack of seeking or responding to comfort when distressed and a persistent social and emotional disturbance. The diagnosis requires evidence that is believed to be the cause of the disturbed behavior. Symptoms must be apparent before the child is 5 years of age, and the child must have a developmental age of at least 9 months

Question 109

Sedative-Hypnotics (Benzodiazepines)

Answer 109

Include barbiturates, anxiolytics, and alcohol. These drugs are generalized CNS depressants. At low doses, they reduce arousal and motor activity; at moderate doses, they induce sedation and sleep; at high doses, they can produce anesthesia, coma, and death. Benzodiazepines (e.g., Valium, Xanax) are the most commonly prescribed anxiolytic and are used to alleviate anxiety and treat sleep disturbances, seizures, cerebral palsy, and alcohol withdrawal. Common side-effects include drowsiness, dizziness, lethargy, slurred speech, and impaired psychomotor ability. They can also produce paradoxical agitation, impaired sexual functioning, confusion, and sleep disturbances

Question 110

Substance Use Disorders

Answer 110

The substance use disorders are characterized by “ a cluster of cognitive, behavioral, and physiological symptoms indicating that the individual continues using the substance despite significant substance-related problems” (APA, 2013. P. 483) as manifested by at least two symptoms during a 12-month period. The characteristic symptoms can be categorized in terms of four groups: (a) impaired control (e.g., substance used in larger amounts or for a longer period of time than intended. persistent desire or unsuccessful efforts to cut down or control use, craving for the substance); (b) social impairment (e.g., recurrent substance use despite persistent social problems caused or worsened by substance use, important activities given up due to substance use); (c) risky use (e.g., continued substance use despite knowing that doing so creates a physical or psychological problem); and (d) pharmacological criteria (tolerance, withdrawal)