AVOIDANT PERSONALITY DISORDER
Avoidant Personality Disorder is characterized by a pervasive pattern of:
- social inhibition
- feelings of inadequacy
- 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.
BIPOLAR II DISORDER
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 social or occupational 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.
DEPENDENT PERSONALITY DISORDER
Dependent Personality Disorder 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 characteristic symptoms - e.g.,
- has difficulty making decisions without advice and reassurances from others;
- fears disagreeing with others because it might lead to a loss of support;
- has difficulty initiating projects on his/her 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.
GENITO-PELVIC PAIN/PENETRATION DISORDER
This disorder is diagnosed in the presence of persistent difficulties involving at least one of the following:
- vaginal penetration during intercourse;
- genito-pelvic pain during intercourse or penetration attempts;
- anxiety about genito-pelvic pain before, during, or as a result of vaginal penetration;
- tensing of pelvic floor muscles during attempted vaginal penetration.
Symptoms have persisted for, at a minimum, about six months and cause clinically significant distress.
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.
Acculturation refers to the extent to which an individual from one cultural group has adopted the beliefs, attitudes, values, and other characteristics of another cultural group and can be conceptualized in terms of four categories:
ACUTE STRESS DISORDER
Acute Stress Disorder involves 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
plus at least nine symptoms from any of five categories —
- negative mood,
- dissociative symptoms,
- avoidance symptoms,
- arousal symptoms.
Symptoms have a duration of three days to one month and cause clinically significant distress or impaired functioning.
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 stressors.
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.
A diagnosis of Agoraphobia requires the presence of marked fear 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/she 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, is not proportional to the threat posed by the situations, and causes clinically signiﬁcant distress or impaired functioning.
The essential features of Anorexia Nervosa are
- a restriction of energy intake that leads to a significantly low body weight;
- an intense fear of gaining weight or becoming fat or behavior that interferes with weight gain: and
- a disturbance in the way the person experiences his or her body weight or shape or a persistent lack of recognition of the seriousness of his/her low body weight.
ANTISOCIAL PERSONALITY DISORDER
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;
- 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.
ATTENTION-DEFICIT/HYPERACTIVITY DISORDER (ADHD)
ADHD is the appropriate diagnosis when the individual has at least six symptoms of inattention and/or six symptoms of hyperactivity-impulsivity and symptoms had an onset prior to 12 years of age. are present in at least two settings (e.g.. home and school, and interfere with social, academic, or occupational functioning.)
AUTISM SPECTRUM DISORDER
For a diagnosis of Autism Spectrum Disorder. the individual must exhibit
- 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;
- 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
- the presence of symptoms during the early developmental period
- impaired functioning as the result of symptoms.
BECK DEPRESSION INVENTORY — SECOND EDITION [BDI-II)
THE BDI-ll is used to assess the mood, cognitive, behavioral, and physical aspects of depression for individuals ages 13 to 86.
BORDERLINE PERSONALITY DISORDER
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
BRIEF PSYCHOTIC DISORDER
Brief Psychotic Disorder is characterized by the presence of one or more of four characteristic symptoms
- 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.
Bulimia Nervosa is characterized by
- recurrent episodes of binge eating that are accompanied by a sense of a lack of control
- inappropriate compensatory behavior to prevent weight gain (e.g.. self-induced vomiting. excessive exercise): and
- self-evaluation that is unduly inﬂuenced by body shape and weight.
For the diagnosis, binges and compensatory behaviors must occur, on average, at least once a week for three months.
Clinical interviews are the most common method for collecting information about a client’s history and current situation and are useful for obtaining information that is not available from other sources and for establishing and maintaining a good working relationship with the client.
There are three basic types of clinical internews:
- semi-structured, and
COLLATERAL SOURCES OF INFORMATION
Important information about a client can be obtained from family members, friends, physicians, previous therapists, social service agencies, teachers, employers, clergy, and other collateral sources.
lt may also be appropriate to refer a client to another professional or agency for a specialized evaluation - e.g.. to a physician, neurologist, psychiatrist, or psychologst.
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
- serious violation of rules
Symptoms must cause signiﬁcant impairment in functioning, and the disorder cannot be assigned to individuals over age 18 who meet the criteria for Antisocial Personality Disorder.
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. Symptoms cause significant distress or impairment in functioning.
A diagnosis of Delirium requires
- a disturbance in attention and awareness that develops over a short period of time (ordinarily hours to a few days), represents a change from baseline functioning, and tends to fluctuate in severity over the course of a day and
- an additional disturbance in cognition, e.g..
- impaired memory
- impaired language
- deﬁcits in visualspatial 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 not the direct physiological consequence of a medical condition, substance intoxication or withdrawal, and/or exposure to a toxin.
A diagnosis of Dissociative Amnesia requires an inability to recall important personal information that cannot be attributed to ordinary forgetfullness and causes clinically significant distress or impaired functioning.
It is often related to exposure to one or more traumatic events.
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 five years old or the equivalent developmental level.
A diagnosis of Erectile Disorder requires the presence of at least one of three symptoms
- marked difficulty in obtaining an erection during sexual activity
- marked difficulty in maintaining an erection until completion of sexual activity
- marked decrease in erectile rigidity
on all or almost all occasions of sexual activity. Symptoms have persisted for at least six months and cause clinically significant distress.
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 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 Factitious Disorder, falsification of symptoms can involve feigning, exaggeration, simulation, or induction [e.g. by ingestion of a substance or self-injury).
FAMILY LIFE CYCLE STAGES
McGoldrick, Carter, and Garcia-Preto’s (2011) family life cycle distinguishes between seven predictable stages
- leaving home
- forming a couple
- families with young children
- families with adolescents
- launching children and moving into midlife
- families in late middle age
- families nearing the end of life
and identifies the developmental tasks that families face during the transition to each stage. Inadequate accomplishment of any task can lead to crisis and disequilibrium.
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 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.
For Gender Dysphoria in Adolescents and Adults, the marked incongruence between assigned gender and experienced or expressed gender must be manifested by at least two symptoms — e.g,
- marked mcongruence between one’s primary and/or secondary sex characteristics and one’s experienced or expressed gender
- strong desire for the primary and/or 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 ….
GENERALIZED ANXIETY DISORDER (GAD)
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 impairments in functioning.
Anxiety and worry must include at least three characteristic symptoms for adults and at least one symptom for children —
- restlessness or feeling keyed up or on edge
- being easily fatigued
- difficulty concentrating
- muscle tension
- sleep disturbance.
GRAPHIC ASSESSMENT TECHNIQUES
Graphic assessment techniques include the genogram and ecomap.
The **genogram **depicts family relationships over several generations and provides information on significant life events, family structure and roles. etc.
The ecomap provides information on the strength and nature of relationships between family members and people, institutions, and agencies in the social environment.
HISTRIONIC PERSONALITY DISORDER
Histrionic Personality Disorder is 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.
The primary goals of the initial interview with new clients are to
- establish rapport (e.g. by joining the family);
- describe the structure and process of therapy
- identify and prioritize client problems
- clarify client expectations and goals for therapy; and
- define the next steps (who will be attending future sessions. setting up the next appointment. etc.)
Intellectual Disability is diagnosed in the presence of
- deficits in intellectual functions (e.g.. reasoning, problem solving, abstract thinking)
- deficits in adaptive functioning that result in a failure to meet community standards of personal independence and social responsibility and impair functioning across multiple environments in one or more activities of daily life; and
- 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.
MAJOR DEPRESSIVE DISORDER
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.
- 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 worthlessness 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.
MAJOR AND MILD NEUROCOGNITIVE DISORDERS
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 individuals 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, Traumatic Brain Injury, HIV infection, Parkinson’s Disease, and Huntington‘s Disease.
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 in order to obtain an external reward (e.g.. to avoid criminal prosecution or obtain financial compensation).
MENTAL STATUS EXAM
A mental status exam (MSE) uses observation, questions, and simple tasks to obtain information on several aspects of a client’s current mental state (e.g.. appearance, thought content. affect) and is useful for determining if a client’s symptoms warrant referral to a physician or psychiatrist.
MINNESOTA MULTIPHASIC PERSONALITY INVENTORY-2 (MMPI-2)
The MMPI-2 is an objective measure of personality for individuals aged 18 and older. It is used to assist with diagnosis and treatment planning and provides scores on a number of clinical, content, supplementary, and validity scales.
NARCISSISTIC PERSONALITY DISORDER
Narcissistic Personality Disorder involves a
- pervasive pattern of grandiosity
- a need for admiration
- a 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
Narcolepsy is characterized by attacks of an irrepressible need to sleep with lapses into sleep or daytime naps that occur at least three times per week and have been present for at least three months.
The diagnosis also requires episodes of cataplexy, a hypocretin deficiency, or a rapid eye movement latency less than or equal to 15 minutes.
NEUROCOGNITIVE DISORDER DUE TO ALZHEIMER’S DISEASE
Neurocognitive Disorder Due to Alzheimer’s Disease 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:
For Major Neurocognitive Disorder, probable Alzheimer’s Disease, there must be evidence of
- a causative genetic mutation or there must be a decline in memory and at least one other cognitive domain,
- a steadily progressive and gradual decline in cognition without extended plateaus,
- and no evidence of a mixed etiology.
Otherwise, possible Alzheimer’s disease is diagnosed.
For Mild Neurocognitive Disorder, probable Alzheimer’s Disease, there must be evidence of a causative genetic mutation; and, for possible Alzheimer’s Disease, there must be
- no evidence of a causative genetic mutation and evidence of a decline in memory,
- a steadily progressive and gradual decline in cognition without extended plateaus,
- and no evidence of a mixed etiology.
OBSESSIVE-COMPULSIVE DISORDER (OCD)
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/she attempts to ignore or suppress.
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.
OBSESSIVE-COMPULSIVE PERSONALITY DISORDER
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/her way:
- adopts a miserly spending style toward self and others.
OPPOSITIONAL DEFIANT DISORDER
Oppositional Defiant Disorder 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 — e.g.
- often loses temper;
- often argues with authority figures;
- often actively refuses to comply with requests from authority figures or with rules;
- often blames others for his/her mistakes.
Symptoms have persisted for at least six months and have caused distress for the individual or others in his/her immediate social environment.
Panic Disorder is characterized by recurrent 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.
PARANOID PERSONALITY DISORDER
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
The Parapliilic Disorders include:
- Sexual Sadism
- Transvestic 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).
PERSISTENT DEPRESSIVE DISORDER
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 at least one year in children and adolescents as indicated by the presence of at least two characteristic symptoms —
- 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.
POSTTRAUMATIC STRESS DISORDER (PTSD)
For adults, adolescents. and children older than six years of age, 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
- marked change in arousal and reactivity associated with the event.
For children six years of age or younger, this diagnosis requires
- exposure to actual or threatened death. serious injury. or sexual violence in at least one of the following ways; or learning that the event occurred to a caregiver
- presence of at least one intrusion symptom related to the event
- persistent avoidance of stimuli related to the event or negative changes in cognitions and mood related to the event
- alterations in arousal and reactivity associated with the event.
For individuals of all ages, symptoms must have a duration of more than one month and must cause clinically signiﬁcant distress or impaired functioning.
Premature Ejaculation is diagnosed in the presence of a persistent or recurrent pattern of ejaculation during partnered sexual activity within about one minute of vaginal penetration or before the person desires it. The disturbance must have been present for at least six months, be experienced on all or almost all occasions of sexual activity, and cause clinically significant distress.
Racial/ethnic identity refers to a person’s sense of group or collective identity based on his/her perception that he/she shares a common racial or ethnic heritage with a particular group. A client’s racial/ethnic identity may have a substantial impact on assessment and treatment.
SCHIZOID PERSONALITY DISORDER
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 sacual relationships
- takes pleasure in few activities
- lacks close friends or confidents other than first-degree relatlves
- seems indifferent to praise or criticism
- exhibits emotional coldness or detachment
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, hallucination, or disorganized speech. There must be continuous signs of the disorder for at least six months, and symptoms must cause significant impairment in functioning.
SCHIZOTYPAL PERSONALITY DISORDER
Schizotypal Personality Disorder is diagnosed in the presence of
- pervasive social and interpersonal deficits involving acute discomfort with and reduced capacity for close relationships and
- 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.
SEPARATION ANXIETY DISORDER
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 at least six months in adults and must cause clinically significant distress or impaired functioning.
SOCIAL ANXIETY DISORDER
Social Anxiety Disorder 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 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 (typically lasting for at least six months) and cause clinically significant distress or impaired functioning.
Speciﬁc Phobia is 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.
STAGES OF PSYCHOSEXUAL DEVELOPMENT (FREUD)
Freud’s theory of psychosexual development proposes that the id’s libido (sexual energy) centers on a dtlferent part of the body during each stage of development and that personality results from the ways in which conflicts at each stage are resolved.
The five stages of development are oral, anal, phallic, latency, and genital.
STAGES OF PSYCHOSOCIAL DEVELOPMENT (ERIKSON)
Erikson’s theory of personality development proposes that the individual faces a different psychosocial crisis at different points throughout the lifespan, These are:
- trust vs. mistrust
- autonomy vs. shame and doubt
- initiative vs. guilt
- industry vs. inferiority
- identify vs. role confusion
- intimacy vs. isolation
- generativity vs. stagnation
- integrity vs. despair
The Substance-Induced Disorders include
- Substance Intoxication
- Substance Withdrawal
- 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. 48?) and include
- Substance/Medication-Induced Psychotic Disorder
- Substance/Medication-Induced Depressive Disorder
- Substance/Medication-Induced Neurocognitive Disorders
SUBSTANCE USE DISORDERS
The Substance Use Disorders are characterized by “a cluster of cognitive, behavioral, and physiological symptoms indicating that the the individual continues using the substance despite significant substance-related problems“ (APA. 2013. p. 483) as manifested by at least two symptoms during a l2-month period - e.i
- 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
- recurrent substance use despite persistent social problems caused or worsened by substance use
- recurrent substance use in situations in which it is physically dangerous to do so
- tolerance; withdrawal.
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, that may wax and wane in frequency but have persisted for more than one year, and that began prior to age 18.
Uncomplicated Bereavement is included in the DSM-5 with Other Conditions That May Be a Focus of Treatment 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.
UNIT OF TREATMENT
In family therapy, the family or couple (rather than the individual) is usually considered the “unit of treatment”.
However, the decision about which individuals to include in therapy is based on several factors including
- the nature of the presenting problem,
- who is involved with the presenting problem,
- the likelihood that the presence of one or more family members will hinder the therapy process,
- and the motivation and capacity of each family member to participate in therapy.
VINELAND ADAPTIVE BEHAVIOR SCALES, SECOND EDITION (VINELAND-II)
The Vineland-II is used to evaluate personal and social skills of children, adolescents, and adults with
- Intellectual Disability,
- Autism Spectrum Disorder,
- brain injury, or
- Major or Mild Neurocognitive Disorder
and to assist in the development of educational and treatment plans.
WECHSLER ADULT INTELLIGENCE SCALE-FOURTH EDITION (WAIS-IV)
The WAIS-IV is an individually administered intelligence test for individuals ages 16 to 90. It provides a Full Scale IQ score, scores on four Indexes, and subtest scores.
BIPOLAR I DISORDER
A diagnosis of Bipolar l 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 also include one or more episodes of hypomania or major depression.