DSM-V Diagnosis Flashcards
ADHD symptoms of Inattention
Inattention: Six (or more) of the following symptoms have persisted for at least 6 months to a degree that is inconsistent with developmental level and that negatively impacts directly on social and academic/occupational activities:
Note: The symptoms are not solely the manifestation of oppositional behavior, defiance, hostility, or failure to understand tasks or instructions. For older adolescents and adults (age 17 and older), at least five symptoms are required.
(a)
Often fails to give close attention to details or makes careless mistakes in schoolwork, at work, or during other activities (e.g., overlooks of misses details, work is inaccurate).
(b)
Often has difficulty sustaining attention in tasks or play activities (e.g., has difficulty remaining focused during lectures, conversations, or lengthy reading).
(c)
Often does not seem to listen when spoken to directly (e.g., mind seems elsewhere, even in the absence of any obvious distraction).
(d)
Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (e.g., starts tasks but quickly loses focus and is easily sidetracked).
(e)
Often has difficulty organizing tasks and activities (e.g., difficulty managing sequential tasks: difficulty keeping materials and belongings in order; messy, disorganized work; has poor time management; fails to meet deadlines).
(f)
Often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort (e.g., schoolwork or homework; for older adolescents and adults, preparing reports, completing forms, reviewing lengthy papers).
(g)
Often loses things necessary for tasks or activities (e.g., school materials, pencils, books, tools, wallets, keys, paperwork, eyeglasses, mobile telephones).
(h)
Is often easily distracted by extraneous stimuli (for older adolescents and adults, may include unrelated thoughts).
(i)
Is often forgetful in daily activities (e.g., doing chores, running errands; for older adolescents and adults, returning calls, paying bills, keeping appointments).
Diagnostic Criteria for Attention-Deficit/Hyperactivity Disorder (ADHD)
(A) A persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development, as characterized by (1) and/or (2): o (1) Inattention: o (2) Hyperactivity and Impulsivity:
B)
Several inattentive or hyperactive–impulsive symptoms were present before age 12 years.
• (C)
Several inattentive or hyperactive-impulse symptoms are present in two or more settings (e.g., at home, school, or work; with friends or relatives; in other activities).
• (D)
There must be clear evidence that the symptoms interfere with, or reduce the quality of, social academic, or occupational functioning.
• (E)
The symptoms do not occur exclusively during the course of schizophrenia or another psychotic disorder and are not better explained by another mental disorder (e.g., mood disorder, anxiety disorder, dissociative disorder, personality disorder, substance intoxication or withdrawal).
Adhd symptoms of hyperactivity/impulsivity
Six (or more) of the following symptoms have persisted for at least 6 months to a degree that is inconsistent with developmental level and that negatively impacts directly on social and academic/occupational activities:
Note: The symptoms are not solely a manifestation of oppositional behavior, defiance, hostility, or a failure to understand tasks or instructions. For older adolescents and adults (age 17 or older), at least five symptoms are required.
(a)
Often fidgets with or taps hands or feet or squirms in seat.
(b)
Often leaves seat in situations when remaining seated is expected (e.g., leaves his or her place in the classroom, in the office or other workplace, or in other situations that require remaining in place).
(c)
Often runs about or climbs in situations where it is inappropriate
Note: In adolescents or adults, may be limited to feeling restless.
(d)
Often unable to play or engage in leisure activities quietly.
(e)
Is often “on the go,” acting as if “driven by a motor” (e.g., is unable to be or is uncomfortable being still for extended time, as in restaurants, meetings; may be seen by others as being restless or difficult to keep up with).
(f)
Often talks excessively.
(g)
Often blurts out answers before a question has been completed (e.g., completes people’s sentences; cannot wait for a turn in conversation).
(h)
Often has difficulty waiting his or her turn (e.g., while waiting in line).
(i)
Often interrupts or intrudes on others (e.g., butts into conversations, games or activities; may start using other people’s things without asking or receiving permission; for adolescents and adults, may intrude into or take over what others are doing).
For ADHD you must specify (3 things)
Severity, remission, type
• Specify whether:
o Combined presentation: If both Criterion A1 (inattention) and Criterion A2 (hyperactivity-impulsivity) are met for the past 6 months.
o Predominantly inattentive presentation: If Criterion A1 (inattention) is met but Criterion A2 (hyperactivity–impulsivity) is not met for the past 6 months.
o Predominantly hyperactive–impulsive presentation: if Criterion A2 (hyperactivity–impulsivity) is met but Criterion A1 (inattention) is not met for the past 6 months.
• Specify if:
o In partial remission: When full criteria were previously met, fewer than the full criteria have been met for the past 6 months, and the symptoms still result in impairment in social, academic, or occupational functioning.
• Specify current severity:
o Mild: Few, if any, symptoms in excess of those required to make the diagnosis are present, and symptoms result in no more than minor impairments in social or occupational functioning.
o Moderate: Symptoms or functional impairment between “mild” and “severe” are present.
o Severe: Many symptoms in excess of those required to make the diagnosis, or several symptoms that are particularly severe, are present, or the symptoms result in marked impairment in social or occupational functioning
Diagnostic Criteria for Oppositional Defiant Disorder
A)
A pattern of angry/irritable mood, argumentative/defiant behavior, or vindictiveness lasting at least 6 months as evidenced by at least four symptoms from any of the following categories, and exhibited during interaction with a least one individual who is not a sibling.
Note: The persistence and frequency of these behaviors should be used to distinguish a behavior that is within normal limits from behavior that is symptomatic. For children younger than 5 years, the behavior should occur on most days for a period of at least 6 months unless otherwise noted (Criterion A8). For individuals 5 years or older the behavior should occur at least once per week for 6 months, unless otherwise noted (Criterion A8). While these frequency criteria provide guidance on a minimal level of frequency to define symptoms, other factors should also be considered, such as whether the frequency and intensity of the behaviors are outside a range that is normative for the individual’s developmental level, gender, and culture.
• (B)
The disturbance in behavior is associated with distress in the individual or others in his or her immediate social context (e.g., family peer group, work colleagues), or it impacts negatively on social, educational, occupational, or other important areas of functioning.
• (C)
The behaviors do not occur exclusively during the course of a psychotic, substance-use, depressive, or bipolar disorder. Also, the criteria are not met for disruptive mood disorder.
Specify current severity:
Mild: Symptoms are confined to only one setting (e.g., at home, at school, at work, with peers).
Moderate: Some symptoms are present in at least two settings.
Severe: Some symptoms are present in three or more settings.
Angry/Irritable Mood symptoms of ODD
o (1) Often loses temper. o (2) Is often touchy or easily annoyed. o (3) Is often angry or resentful.
Argumentative/Defiant Behavior symptoms of ODD
o (4)
Often argues with authority figures or, for children and adolescents, with adults.
o (5)
Often actively defies or refuses to comply with requests from authority figures or with rules.
o (6)
Often deliberately annoys others.
o (7)
Often blames others for his or her mistakes or misbehavior.
Vindictiveness symptom of odd?
o (8)
Has been spiteful or vindictive at least twice within the past 6 months.
Diagnostic Criteria for Conduct Disorder
• (A)
A repetitive and persistent pattern of behavior in which the basic rights of others or major age-appropriate societal norms or rules are violated, as manifested by the presence of at least three of the following 15 criteria in the past 12 months from any of the categories below, with at least one criterion present in the past 6 months:
• (B)
The disturbance in behavior causes clinically significant impairment in social, academic, or occupational functioning.
• (C)
If the individual is 18 years or older, criteria are not met for Antisocial Personality Disorder.
For cd specify (3 things)
Specify whether:
• Childhood-onset type: Individuals show at least one symptom characteristic of conduct disorder prior to age 10 years.
• Adolescent-onset type: Individuals show no symptom characteristic of conduct disorder prior to age 10 years.
• Unspecified onset: Criteria for a diagnosis of conduct disorder are met, but there is not enough information available to determine whether the onset of the first symptom was before or after age 10 years.
Specify if:
• With limited prosocial emotions: To qualify for this specifier, an individual must have displayed at least two of the following characteristics persistently over at least 12 months and in multiple relationships and settings. These characteristics reflect the individual’s typical pattern of interpersonal and emotional functioning over this period and not just occasional occurrences in some situations. Thus, to assess the criteria for the specifier, multiple information sources are necessary. In addition to the individual’s self-report, it is necessary to consider reports by others who have known the individual for extended periods of time (e.g., parents, teachers, co-workers, extended family members, peers).
• Lack of remorse or guilt: Does not feel bad or guilty when he or she does something wrong (excludes remorse when expressed only when caught and/or facing punishment). The individual shows a general lack of concern about the negative consequences of his or her actions. For example, the individual is not remorseful after hurting someone or does not care about the consequences of breaking rules.
• Callous–lack of empathy: Disregards and is unconcerned about the feelings of others. The individual is described as cold and uncaring. The person appears more concerned about the effects of his or her actions on himself or herself, rather than their effects on others, even when they result in substantial harm to others.
• Unconcerned about performance: Does not show concern about poor/problematic performance at school, at work, or in other important activities. The individual does not put forth the effort necessary to perform well, even when expectations are clear, and typically blames others for his or her poor performance.
• Shallow or deficient affect: Does not express feelings or show emotions to others, except in ways that seem shallow, insincere, or superficial (e.g., actions contradict the emotion displayed; can turn emotions “on” or “off” quickly) or when emotional expressions are used for gain (e.g., emotions displayed to manipulate or intimidate others).
Specify severity:
• Mild: Few if any conduct problems in excess of those required to make the diagnosis are present, and conduct problems cause relatively minor harm to others (e.g., lying, truancy, staying out after dark without permission, other rule breaking).
• Moderate: The number of conduct problems and the effect on others are intermediate between those specified in “mild” and those in “severe” (e.g., stealing without confronting a victim, vandalism).
• Severe: Many conduct problems in excess of those required to make the diagnosis are present, or conduct problems cause considerable harm to others (e.g., forced sex, physical cruelty, use of a weapon, stealing while confronting a victim, breaking and entering).
For cd Aggression to People and Animals symptoms
o (1) Often bullies, threatens, or intimidates others. o (2) Often initiates physical fights. o (3) Has used a weapon that can cause serious physical harm to others (e.g., a bat, brick, broken bottle, knife, gun). o (4) Has been physically cruel to people. o (5) Has been physically cruel to animals. o (6) Has stolen while confronting a victim (e.g., mugging, purse snatching, extortion, armed robbery). o (7) Has forced someone into sexual activity.
Destruction of Property symptom of cd
o (8)
Has deliberately engaged in fire setting, with the intention of causing serious damage.
o (9)
Has deliberately destroyed others’ property (other than by fire setting).
Deceitfulness or Theft symptoms of cd
o (10)
Has broken into someone else’s house, building, or car.
o (11)
Often lies to obtain goods or favors or to avoid obligations (i.e., “cons” others)
o (12)
Has stolen items of nontrivial value without confronting a victim (e.g., shoplifting, but without breaking and entering; forgery).
Serious Violations of Rules symptoms for cd
o (13)
Often stays out at night despite parental prohibitions, beginning before age 13 years.
o (14)
Has run away from home overnight at least twice while living in parental or parental surrogate home, or once without returning for a lengthy period.
o (15)
Is often truant from school, beginning before age 13 years
Diagnostic Criteria for Substance-Use Disorder
• (A)
A problematic pattern of substance use leading to clinically significant impairment or distress, as manifested by at least two of the following, occurring within a 12-month period:
Specify if:
In early remission: None of the criteria have been met for at least 3 months but for less than 12 months (with the exception of “craving”)
In sustained remission: None of the criteria have been met at any time during a period of 12 months or longer (with the exception of “craving”)
Specify if:
In a controlled environment: This additional specifier is used if the individual is in an environment where access to substance is restricted.
Specify current severity:
Mild: Presence of two to three symptoms
Moderate: Presence of four to five symptoms
Severe: Presence of six or more symptoms
