DSM 5 Quiz Flashcards

Question

Bipolar Disorder: Hypomanic Episode (Criteria 3)

Answer 1

Episode is associated with an unequivocal change in functioning that is uncharacteristic of the individual when not symptomatic

Answer 2

Disturbance in mood and change in functioning are observable by others

Answer 3

Episode is not severe enough to cause marked impairment in social or occupational functioning or to necessitate hospitalization. No psychotic features (that = manic) Episode not attributable to physiological effect of a substance Full hypomanic episode that emerges during antidepressant treatment but persists at a full syndromal level beyond the physiological effect of the medication is sufficient evidence for a hypomanic episode

Answer 4

1 week vs 4 days of expansive or irritable mood and abnormally and persistently increased activity or energy

Answer 5

Five or more of the following symptoms have been present during the same 2-week period and represent a change from previous functioning: 1. Depressed mood most of the day nearly every day (subjective report or observations made by others. In children/adolescents, can be irritable mood) 2. Markedly diminished interest/pleasure in almost all activities most of the day nearly every day (subjective report or observation) 3. Significant weight loss/gain 4. Insomnia or hypersomnia nearly every day 5. Psychomotor agitation or retardation nearly every day (observable by others) 6. Fatigue/loss of energy nearly every day 7. Feelings of worthlessness or excessive or inappropriate guilt nearly every day 8. Diminished ability to concentrate, indecisiveness nearly every day (subjective report or observation) 9. Recurrent thoughts of death (not just fear of dying) recurrent suicidal ideation or attempt

Answer 6

depressed mood or loss of interest/pleasure

Answer 7

Symptom cause clinically significant distress or impairment in social occupational or other areas of functioning

Answer 8

Episode not attributable to physiological effects of a substance or another medical condition

Answer 9

1. Criteria have been met for at least one manic episode 2. Occurrence of the manic and major depressive episode (major depressive episode not requited for diagnosis) is not better explained by other disorder 3. Age of onset usually 18

Answer 10

1. Meet criteria for a current or past hypomanic episode AND criteria for a current or past major depressive episode 2. There has never been a manic episode 3. Occurrence of hypomanic/major depressive episodes is not explained by another psychotic disorder 4. Symptoms of depression or the unpredictability caused by frequent alternation between periods of depression and hypomania causes clinically significant distress or impairment in social occupational or other areas of functioning 5. Onset: Mid 20's

Answer 11

1. Bipolar I: Manic episode, earlier onset | 2. Bipolar II: Hypomania

Answer 12

1. Severe recurrent temper outbursts manifested verbally and or behaviorally that are grossly out of proportion in intensity or duration to situation or provocation 2. Temper outbursts are inconsistent with developmental level 3. Mood between temper outbursts is persistently irritable or angry most of the day nearly every day and is observable by others

Answer 13

1. . present in at least two settings and severe in at least one 2. Occur on average 3+ times a week 3. have been present for 12+ months. Within those 12 months, no period of 3+ months without all symptoms

Answer 14

1. The onset of disruptive mood dysregulation disorder must be before age 10 years. 2. The diagnosis should not be made for the first time before age 6 years or after age 18 years.

Answer 15

Five or more of the following symptoms have been present during the same 2-week period and represent a change from previous functioning: a. Depressed mood most of the day nearly every day (subjective report or observations made by others. In children/adolescents, can be irritable mood) b. Markedly diminished interest/pleasure in almost all activities most of the day nearly every day (subjective report or observation) 1. Significant weight loss/gain 2. Insomnia or hypersomnia nearly every day 3. Psychomotor agitation or retardation nearly every day (observable by others) 4. Fatigue/loss of energy nearly every day 5. Feelings of worthlessness or excessive or inappropriate guilt nearly every day 6. Diminished ability to concentrate, indecisiveness nearly every day (subjective report or observation) 7. Recurrent thoughts of death (not just fear of dying) recurrent suicidal ideation or attempt

Answer 16

One symptom must be either depressed mood or loss of interest/pleasure

Answer 17

1. Symptom cause clinically significant distress or impairment in social occupational or other areas of functioning 2. Episode not attributable to physiological effects of a substance or another medical condition 3. Occurrence not better explained by another disorder 4. Never been a manic or hypomanic episode

Answer 18

Five (or more) of the symptoms have been present during the same 2-week period and represent a change from previous functioning

Answer 19

May appear at any age, likelihood of onset increases with puberty. Incidence peaks in 20’s

Answer 20

Developmentally inappropriate and excessive fear/anxiety concerning separation from those to whom the individual is attached, at least 3 of the following 1. Recurrent excessive distress when anticipating or experiencing separation from home or from major attachment figures 2. Persistent and excessive worry about losing major attachment figures or about possible harm to them (illness, injury, disasters, death) 3. Persistent and excessive worry about experiencing an untoward event (kidnapping, lost, accident, becoming ill) that causes separation from a major attachment figure 4. Persistent reluctance or refusal to go out, away from home, to school/work/anywhere because of fear of separation 5. Persistent and excessive fear of or reluctance about being alone or without major attachment figures at home or in other settings 6. Persistent reluctance or refusal to sleep away from home or sleep without being near major attachment figure 7. Repeated nightmares involving the fear of separation 8. Repeated complaints of physical symptoms when separation from major attachment figure occurs or is anticipated

Answer 21

1. The fear/anxiety/avoidance is persistent, lasting at least 4 weeks in children and adolescents and 6 months or more in adults

Answer 22

Periods of heightened separation anxiety from attachment figures are part of normal early development and may indicate the development of secure attachment relationships (e.g. around 1 year of age, when infants may suffer from stranger anxiety). Onset of separation anxiety disorder may be as early as preschool age and may occur at any time during childhood and more rarely in adolescence

Answer 23

Recurrent unexpected panic attacks (a surge of intense fear or intense discomfort that reaches a peak within minutes, during which time four or more of the following symptoms occur) 1. Palpitations, pounding heart, accelerated heart rate 2. Sweating 3. Trembling or shaking 4. Sensations of shortness of breath or smothering 5. Feelings of choking 6. Chest pain or discomfort 7. Nausea or abdominal distress 8. Feeling dizzy, unsteady, lightheaded or faint 9. Chills or heat sensations 10. Numbness/tingling sensations 11. Derealization or depersonalization 12. Fear or losing control or going crazy 13. Fear of dying 14. Culture specific symptoms may be seen, should not count as one of the four

Answer 24

At least one of the attacks has been followed by 1 month or more of one or both of the following a. Persistent concern or worry about additional panic attacks or their consequences (losing control, heart attack) b. A significant maladaptive change in behavior related to the attacks (behaviors designed to avoid having panic attacks such as avoidance of exercise or unfamiliar situations)

Answer 25

Median age onset 20-24 Only few have full remission without relapse in a few years A small number of cases begin in childhood, onset after age 45 is unusual but can occur

Answer 26

The anxiety and worry are associated with three or more of the following symptoms (with at least some symptoms having been present for more days than not for the past 6 months) * **Only 1 item is required in children 1. Restlessness or feeling keyed up or on edge 2. Being easily fatigued 3. Difficulty concentrating or mind going blank 4. Irritability 5. Muscle tension 6. Sleep disturbance

Answer 27

with at least some symptoms having been present for more days than not for the past 6 months

Answer 28

Many individuals with GAD report that they have felt anxious and nervous all of their lives. The median age at onset for GAD is 30 years; however, age at onset is spread over a very broad range. The median age at onset is later than that for the other anxiety disorders. The symptoms of excessive worry and anxiety may occur early in life but are then manifested as an anxious temperament. Onset of the disorder rarely occurs prior to adolescence.

Answer 29

1. Recurrent and persistent thoughts, urges or images that are experienced at some time during the disturbance, as intrusive and unwanted that in most individuals cause marked anxiety or distress 2. The individual attempts to suppress such thoughts, urges, or images, or to neutralize them with some other thought or action (i.e. performing a compulsion)

Answer 30

1, Repetitive behaviors (hand washing, ordering, checking) or mental acts (praying, counting, repeating words silently) that the individual feels driven to perform in response to an obsession or according to rules that must be applied rigidly 2. Behaviors or mental acts are aimed at preventing or reducing anxiety or distress or preventing some dreaded event or situation, however these behaviors or acts are not connected in a realistic way with what they are designed to neutralize or prevent and are clearly excessive * **Young children may not be able to articulate the aims of these behaviors or mental acts

Answer 31

1. The obsessions or compulsions are time-consuming (take more than 1 hour per day) or cause clinically significant distress or impairment in social, occupational or other important areas of functioning

Answer 32

1. Tic-related: The individual has a current or past history of a tic disorder. 2. With good or fair insight: The individual recognizes that obsessive-compulsive disorder beliefs are definitely or probably not true or that they may or may not be true. 3. With poor insight: The individual thinks obsessive-compulsive disorder beliefs are probably true. 4. With absent insight/delusional beliefs: The individual is completely convinced that obsessive-compulsive disorder beliefs are true.

Answer 33

In the United States, the mean age at onset of OCD in 19.5 years, and 25% of cases start by age 14 years. Onset after 35 years is unusual but does occur. Males have an earlier age at onset than females

Answer 34

Exposure to actual or threatened death, serious injury, or sexual violence in one or more of the following ways 1. Directly experiencing the traumatic event(s) 2. Witnessing in person the event(s)as it occurred to others 3. Learning that the traumatic event(s) occurred to a close family member/friend. In cases of actual or threatened death of a family member/friend the event(s) must have been violent or accidental 4. Experiencing repeated or extreme exposure to aversive details of the traumatic event(s) 5. Does not apply to exposure through electronic media unless this exposure is work related

Answer 35

Presence of one or more of the following intrusion symptoms associated with the traumatic event(s) beginning after the traumatic event(s) occurred: 1. Recurrent, involuntary and intrusive distressing memories of the traumatic event(s) * *Children >6 repetitive play may occur in which themes of aspects of the traumatic event(s) are expressed 2. Recurrent distressing dreams in which the content and/or affect of the dream are related to the traumatic event(s) * *In children, there might be frightening dreams without recognizable content 3. Dissociative reactions (flashbacks) in which the individual feels or acts as if the traumatic event(s) were recurring. * *In children, trauma-specific reenactment may occur in play 4. Intense or prolonged psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event(s) 5. Marked physiological reactions to internal or external cues that symbolize or resemble an aspect of the traumatic event(s)

Answer 36

Persistent avoidance of stimuli associated with the traumatic event(s), beginning after the traumatic event(s) occurred as evidenced by one or both of the following: 1. Avoidance of or efforts to avoid distressing memories, thoughts, or feelings about or closely associated with the traumatic event(s) 2. Avoidance of or efforts to avoid external reminders (people, places, conversations, activities, objects, situations) that arouse distressing memories, thoughts of feelings about or closely associated with the traumatic event(s)

Answer 37

Negative alternations in cognition and mood associated with the traumatic event(s) beginning or worsening after the traumatic event(s) occurred, as evidenced by two or more of the following: 1. Inability to remember an important aspect of the traumatic event 2. Persistent and exaggerated negative beliefs about oneself, others, or the world 3. Persistent, distorted cognitions about the cause or consequences of the traumatic event(s) that lead the individual to blame him/herself or others 4. Persistent negative emotional state 5. Markedly diminished interest or participation in significant activities 6. Feelings of detachment or estrangement from others 7. Persistent inability to experience positive emotions

Answer 38

Marked alterations in arousal and reactivity associated with the traumatic event(s) beginning or worsening after the traumatic event(s) occurred, as evidenced by two or more of the following 1. Irritable behavior and angry outbursts (with little or no provocation) typically expressed as verbal or physical aggression toward people or objects 2. Recklessness or self-destructive behavior 3. Hypervigilance 4. Exaggerated startle response 5. Problems with concentration 6. Sleep disturbance

Answer 39

1. Duration of the disturbance is more than 1 month

Answer 40

1. With Dissociative Symptoms: Depersonalization, Derealization (Not due to substance) 2. With delayed expression: If the full diagnostic criteria are not met until at least 6 months after the event (although the onset and expression of some symptoms may be immediate

Answer 41

Exposure to actual or threatened death, serious injury, or sexual violence in one or more of the following ways 1. Directly experiencing the traumatic event 2. Witnessing in person the event as it occurred to others, especially primary caregivers (electronic medium does not count) 3. Learning that the traumatic event(s) occurred to a parent or caregiver

Answer 42

Presence of one or more of the following symptoms associated with the traumatic event(s), beginning after the traumatic event(s) occurred: 1. Recurrent involuntary and intrusive distressing memories of the traumatic event(s) 2. Spontaneous and intrusive memories may not necessarily appear distressing and may be expressed as play reenactment 3. Recurrent distressing dreams in which the content and/or affect of the dream are related to the traumatic event(s) 4. It may not be possible to ascertain that the frightening content is related to the traumatic event 5. Dissociative reactions (flashbacks) where the child feels or acts as if the traumatic event(s) were recurring. May occur in play 6. Intense or prolonged psychological stress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event(s) 7. Marked physiological reactions to reminders of the traumatic event(s

Answer 43

One or more of the following symptoms, representing either persistent avoidance of stimuli associated with the traumatic event(s) or negative alterations in cognition and mood associated with the traumatic event(s) must be present, beginning after or worsening after the event(s): 1. Persistent avoidance of stimuli a. Avoidance or efforts to avoid activities, places, or physical reminders that arouse recollections of the traumatic event(s) b.Avoidance of or efforts to avoid people, conversations or interpersonal situations that arouse recollections of the traumatic event Negative alterations in cognitions a.Substantially increased frequency of negative emotional states b. Markedly diminished interest in participation in significant activities including constriction of play c. Socially withdrawn behavior d. Persistent reduction in expression of positive emotions

Answer 44

Alterations in arousal and reactivity associated with the traumatic event(s) beginning or worsening after the traumatic event(s) occurred, as evidenced by two or more of the following: 1. Irritable behavior and angry outbursts (with little or no provocation) typically expressed as verbal or physical aggression towards people or objects (including extreme temper tantrums) 2. Hypervigilance 3. Exaggerated startle response 4. Sleep disturbance

Answer 45

Duration of the disturbance is more than 1 month

Answer 46

1. With Dissociative Symptoms: Depersonalization, Derealization (Not due to substance) 2. With delayed expression: If the full diagnostic criteria are not met until at least 6 months after the event (although the onset and expression of some symptoms may be immediate

Answer 47

PTSD can occur at any age, beginning after the first year or life. Symptoms usually begin within the first three months after the trauma, although there may be a delay of months, or even years, before the criteria for the diagnosis are met

Answer 48

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 in the past 6 months: 1. Aggression to people and animals 2. Destruction of property 3. Deceitfulness or theft 4. Serious violations of rules

Answer 49

1. Often bullies, threatens or intimidates others 2. Often initiates physical fights 3. Has used a weapon that can cause serious harm to others 4. Has been physically cruel to people 5. Has been physically cruel to animals 6. Has stolen while confronting a victim 7. Has forced someone into sexual activity 8. Destruction of property

Answer 50

1. Has deliberately engaged in fire setting with the intention of causing serious damage 2. Has deliberately destroyed others’ property

Answer 51

1. Has broken into someone else’s house building or car 2. Often lies to obtain goods or favors or to avoid obligations (cons) 3. Has stolen items of nontrivial value without confronting a victim

Answer 52

1. Often stays out at night despite parental prohibitions, beginning before age 13 2. Has run away from home overnight at least twice while living in the parental or parental surrogate home, or once without returning for a lengthy period 3. Is often truant from school beginning before age 13

Answer 53

1. The disturbance in behavior causes clinically significant impairment in social, academic, or occupational functioning 2. If the individual is 18 years or older, criteria are not met for antisocial personality disorder

Answer 54

1. Lack of remorse or guilt 2. Callous: lack of empathy 3. Unconcerned about performance 4. Shallow of deficient affect

Answer 55

disregards and is unconcerned about the feelings of others. Described as cold and uncaring. Appears more concerned about the effects of his or her actions on his/herself rather than their effects on others, even when they result in substantial harm to others

Answer 56

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).

Answer 57

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 confront¬ing a victim, vandalism).

Answer 58

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).

Answer 59

The onset of CD may occur as early as the preschool years, but the first significant symptoms usually emerge during the period from middle childhood through middle adolescence. ODD is a common precursor to the childhood-onset type of conduct disorder. Conduct disorder may be diagnosed in adults, however, symptoms of CD usually emerge in childhood or adolescence, and onset is rare after age 16 years

Answer 60

Childhood-onset type: Individuals show at least one symptom characteristic of CD 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

Answer 61

1. Often loses temper 2. Is often touchy or easily annoyed 3. Is often angry and resentful

Answer 62

1. Often argues with authority figures or, for children or adolescents, with adults 2. Often actively defies or refuses to comply with requests from authority figures or with rules 3. Often deliberately annoys others 4. Often blames others for his or her mistakes or

Answer 63

Has been spiteful or vindictive at least twice within the past six months

Answer 64

A pattern of angry/irritable mood, argumentative/defiant behavior, or vindictiveness lasting at least six months as evidenced by at least four symptoms from any of the following categories, and exhibited during interaction with at least one individual who is not a sibling

Answer 65

1. For children younger than 5 years, the behavior should occur on most days for a period of at least six months 2. For individuals 5 years or older, the behavior should occur at least once per week for at least six months

Answer 66

Symptoms are confined to only one setting

Answer 67

Some symptoms are present in at least two settings

Answer 68

Some symptoms are present in three or more settings

Answer 69

The first symptoms of ODD usually appear during the preschool years and rarely later than early adolescence

DSM 5 Quiz Flashcards

(93 cards)