DSM-5-TR Diagnosis

Question 1

Intellectual Developmental Disorder

(=Intellectual Disability)

Answer 1

Deficits in general mental abilities (intellectual functions and learning from experience) and impairment in everyday adaptive functioning.
In conceptual, social, and practical domains.

Onset during the developmental period.

4 severity levels:

• mild
• moderate
• severe
• profound

Question 2

Language Disorder

Answer 2

Difficulties in the acquisition and use of language due to deficits in comprehension or production that include:

1. reduced vocabulary
2. limited sentence structure
3. impairments in discourse

The onset of symptoms is in the early developmental period.

Question 3

Speech Sound Disorder

Answer 3

Difficulty with speech sound production that interferes with intelligibility or prevents verbal communication of messages.

The onset of symptoms is in the early developmental period.

Question 4

Childhood-Onset Fluency Disorder

(Stuttering)

Answer 4

A disturbance in the normal fluency and time patterning of speech that is inappropriate for the individual’s age and language skill.

The onset of symptoms is in the early developmental period.

Question 5

Social (Pragmatic) Communication Disorder

Answer 5

Difficulty with pragmatics; deficits in understanding and following social rules of verbal and nonverbal communication in naturalistic contexts, changing language according to the needs of the listener or situation, and difficulties following rules for conversations and storytelling.

The onset of symptoms is in the early developmental period.

Pragmatics - the social use of language and communication.

Question 6

Autism Spectrum Disorder

Answer 6

• Deficits in social communication and social interaction
• Restricted and repetitive patterns of behavior, interests or activities

Symptoms must be present in the early developmental period.

3 levels of severity:

• Level 3 - “Requiring very substantial support”
• Level 2 - “Requiring substantial support”
• Level 1 - “Requiring support”

Question 7

Attention-Deficit/Hyperactivity Disorder

(ADHD)

Answer 7

A pattern of inattention (wandering off task, lacking persistence, having difficulty sustaining focus, and being disorganized and is not due to defiance or lack of comprehension) and/or hyperactivity-impulsivity (excessive motor activity when it is not appropriate, or excessive fidgeting, tapping, or talkativeness) that interferes with functioning or development.

1. Combined presentation
2. Predominantly inattentive presentation
3. Predominantly hyperactive/impulsive

Symptoms were present before 12.

Symptoms have persisted for at least 6 months.

3 severity levels:

• mild
• moderate
• severe

Question 8

Specific Learning Disorder

Answer 8

Difficulties learning and using academic skills

1. With impairment in reading (=Dyslexia)
2. With impairment in written expressions
3. With impairment in mathematics (=Dyscalculia)

The learning difficulties begin during school-age years.

Symptoms have persisted for at least 6 months

3 severity levels:

• mild
• moderate
• severe

Question 9

Motor Disorders

Answer 9

Includes:

• Developmental coordination disorder
• Stereotypic movement disorder
• Tic disorders

For Developmental coordination disorder and Stereotypic movement disorder - onset of symptoms is in early developmental period.

For Tic disorders - onset is before age 18.

Question 10

Delusional Disorder

Answer 10

Requires:
Delusions but no other psychotic symptoms.

The presence of delusions for 1 month or longer.

Question 11

Brief Psychotic Disorder

Answer 11

One or more symptoms:

• delusions,
• hallucinations,
• disorganized speech
• grossly disorganised or catatonic behavior

Duration of an episode is at least 1 day but less than 1 month

Question 12

Schizophreniform Disorder

Answer 12

Two or more symptoms:

1. delusions
2. hallucinations
3. disorganised speech
4. grossly disorganised or catatonic behavior
5. negative symptoms (diminished emotional expression)

An episode lasts for at least 1 month but less than 6 months.

Question 13

Schizophrenia

Answer 13

Two or more symptoms during a 1 month period:

1. delusions
2. hallucinations
3. disorganized speech
4. grossly disorganised or catatonic behavior
5. negative symptoms (diminished emotional expression)

At least 1 month of symptoms, disturbance must persist for at least 6 months.

Question 14

Schizoaffective Disorder

Answer 14

• Active phase of schizophrenia concurrent with mood disorder
• Delusions or hallucinations for 2 or more weeks w/o mood disorder (depressive or manic)

Question 15

Manic EPISODE

Answer 15

A distinct period of abnormally and persistently

• elevated, expansive or irritable mood
• and increased activity and energy
• lasts at least 1 week, present most of the day nearly every day

Symptoms represent a noticeable change from usual behavior:

1. Inflated self-esteem or grandiosity
2. decreased need for sleep
3. more talkative than usual or pressure to keep talking
4. Thoughts are racing
5. Distractibility
6. Increase in goal-directed activity or psychomotor agitation
7. Involvement in activities with a high potential for painful consequences

The mood disturbance is severe to cause impairment in functioning or to necessitate hospitalization, or there are psychotic features

Lasts at least 1 week, present most of the day nearly every day

Question 16

Hypomanic EPISODE

Answer 16

A distinct period of abnormally and persistently

• elevated, expansive or irritable mood
• and increased activity and energy
• lasts at least 4 consecutive days, present most of the day nearly every day

Symptoms represent a noticeable change from usual behavior:

1. Inflated self-esteem or grandiosity
2. decreased need for sleep
3. more talkative than usual or pressure to keep talking
4. Thoughts are racing
5. Distractibility
6. Increase in goal-directed activity or psychomotor agitation
7. Involvement in activities with a high potential for painful consequences

The mood disturbance is NOT severe enough to cause impairment in functioning or to necessitate hospitalization. No Psychotic features

lasts at least 4 consecutive days, present most of the day nearly every day

Question 17

Major Depressive EPISODE

Answer 17

5 or more symptoms are present:

1. depressed mood most of the day
2. diminished interest or pleasure in all activities most of the day
3. significant weight loss or weight gain
4. insomnia or hypersomnia
5. psychomotor agitation or retardation
6. fatigue or loss of energy
7. feelings of worthlessness or excessive or inappropriate guilt
8. diminished ability to think or concentrate, or indecisiveness
9. recurrent thoughts of death, recurrent suicidal ideation without a specific plan, a specific suicide plan, or a suicide attempt

2 week period

Question 18

Bipolar I

Answer 18

Must have at least 1 manic episode that lasts for at least 1 wk, and present most of the day + nearly every day.

Hypomanic or major depressive episodes are NOT required for Dx (but commonly occur).

Question 19

Bipolar II

Answer 19

At least 1 hypomanic episode lasting >4 consecutive days PLUS at least 1 depressive episode lasting >2 wks.

Question 20

Cyclothymia

(Cyclothymic Disorder)

Answer 20

Numerous hypomanic and depressive episodes for at least 2 years (1 year for children and adolescents) that do not meet full criteria for either.

For at least 2 yrs (1 yr in children and adolescents) and no more than 2 mo symptoms free.

Question 21

Disruptive Mood Dysregulation Disorder

Answer 21

Chronic, severe and persistent irritability with:

• severe temper outbursts that are verbal or behavioral
• mood switches between irritability and temper outbursts
• temper outbursts occur 3 or > times per week
• Symptoms are present for 12 or > months in at least 2 or 3 settings
• Dx btw age 6-18 yrs but symptoms present before age 10

For children 6-18 years old ONLY.

Question 22

Major Depressive Disorder

(MDD)

Answer 22

A period of at least 2 weeks where there is a change from the previous level of functioning and either depressed or irritable mood and loss of interest or pleasure in nearly all activities.

5 or more of the following symptoms (happen nearly every day):

1. depressed mood most of the day
2. diminished interest or pleasure in all activities most of the day
3. significant weight loss or weight gain
4. insomnia or hypersomnia
5. psychomotor agitation or retardation
6. fatigue or loss of energy
7. feelings of worthlessness or excessive or inappropriate guilt
8. diminished ability to think or concentrate, or indecisiveness
9. recurrent thoughts of death, recurrent suicidal ideation without a specific plan, a specific suicide plan, or a suicide attempt

3 severity levels:

• mild
• moderate
• severe

Question 23

Persistent Depressive Disorder

Answer 23

• Chronic major depressive disorder and the previous dysthymic disorder
• Emphasizes chronicity rather than severity and allows for the presence of major depressive episode
• During the 2 yr (1 yr children and adolescents)
• Has not been w/o symptoms for >2 mo at a time

3 severity levels:

• mild
• moderate
• severe

Question 24

Premenstrual Dysphoric Disorder

Answer 24

• Clinically significant distress or interference with work, school, usual social activities or relationships with others
• Symptoms:
  
  • mood lability
  • irritability or anger
  • depressed mood, hopelessness, or self-deprecating thoughts
  • anxiety
• Symptoms present in the final week before menses, improve within a few days after onset and become minimal or absent in the week post-menses.

Question 25

Separation Anxiety Disorder

Answer 25

**Fearful or anxious** about separation from attachment figures to a degree that is **developmentally inappropriate**. ## Footnote **6 months or >** in adults; **at least 4 weeks** in children and adolescents.

Question 26

Selective Mutism

Answer 26

Consistent **failure to speak** in social situations in which there is an expectation to speak (school) even though the individual speaks in other situations. ## Footnote At least **1 month** (not limited to the 1st month of school).

Question 27

Specific Phobia

Answer 27

* **Fearful or anxious** about a specific object or situation (flying, heights, animals, receiving an injection). This fear or anxiety are **out of proportion** to the actual danger * Individual actively **avoids** these objects or situations * Causes clinically significant **distress or impairment** ## Footnote 6 months or more

Question 28

Social Anxiety Disorder

Answer 28

* Fear or anxiety about 1 or more **social situations** involving possible scrutiny by others due to fear of **negative evaluation**. * May include **social interactions** (having a conversation, meeting unfamiliar people), *being observed* (eating or drinking), *performing in front of others* (giving a speech). * In children should occur in **peer settings** and not just during interactions with adults. ## Footnote 6 months or more

Question 29

Panic Disorder

Answer 29

Recurrent **unexpected panic attacks**. Symptoms: 1. palpitations, pounding heart or accelerated heart rate 2. sweating 3. trembling or shaking 4. shortness of breath or smothering 5. feelings of choking 6. chest pain or discomfort 7. nausea or abdominal distress 8. feeling dizzy, unsteady, light-headed or faint 9. chills or heat sensations 10. numbness or tingling sensations 11. derealization or depersonalization 12. fear of losing control or "going crazy" 13. fear of dying ## Footnote At least 1 attack has been **followed by 1 month** of persistent concern or **worry** about having more panic attacks or **changes in person's behavior** in maladaptive ways because of the panic attacks.

Question 30

Agoraphobia

Answer 30

* **Avoiding certain situations** because there is fear that one might not be able to **escape** the situation if they develop panic-like/ incapacitating/ embarrassing symptoms. * **Fear or anxiety** about 2 or more of the situations: 1. Using public transport 2. Being in open spaces 3. Being in enclosed spaces 4. Standing in line or being in a crowd 5. Being outside of home alone ## Footnote 6 months or more

Question 31

Generalized Anxiety Disorder

Answer 31

* Excessive anxiety and **worry** about a number of real life events and activities * Very difficult to **control** the worry * At least **3 of the following symptoms** (only 1 for children) must be present: 1. restlessness 2. easily fatigued 3. difficulty concentrating 4. irritability 5. muscle tension 6. sleep disturbance 7. it interferes with functioning ## Footnote At least 6 months

Question 32

Obsessive-Compulsive Disorder

Answer 32

* Presence of obsessions, compulsions or both. * Time consuming (take more than 1 hour per day) or distressful/disruptive * Recurrent thoughts (obsessions) or Repetitive behavior (compulsions)

Question 33

Body Dysmorphic Disorder

Answer 33

* **Preoccupation** with perceived body defects. * **Repetitive behaviors** (mirror checking, skin picking) or **mental acts** (comparing appearance with others) in response to the appearance concerns

Question 34

Hoarding Disorder

Answer 34

* **Difficulty discarding** or parting with possessions * Feel the need to save **everything** * Possessions **congest and clutter active living area** * Causes clinically significant **distress** or impairment

Question 35

Trichotillomania and Excoriation

Answer 35

* Trichotillomania = Hair-Pulling disorder * Excoriation = Skin picking disorder ## Footnote Tries to stop, can't -> distress

Question 36

Reactive Attachment Disorder

Answer 36

* The child is emotionally **withdrawn**/ inhibited toward adult caregiver * Persistent social and emotional **disturbance** * History of **extreme insufficient care/neglect** ## Footnote **The child is at least 9 months**. The disturbance is evident **before age 5 yrs**

Question 37

Disinhibited Social Engagement Disorder

Answer 37

* A pattern of behavior that involves **culturally inappropriate**, **overly familiar behavior with strangers**. * A child has experienced extremes of **insufficient care** ## Footnote The child is **at least 9 months**

Question 38

Posttraumatic Stress Disorder for adults and children older than 6 yo | (PTSD)

Answer 38

Exposure to actual or threatened death, serious injury or sexual violence. **Intrusion symptoms** (at least 1 should be present): 1. recurrent, involuntary, and intrusive distressing memories of the traumatic event (s) 2. Recurrent distressing dreams 3. dissociative reactions (flashbacks) when the individual feels or acts as if the traumatic event is recurring 4. intense **psychological** distress when exposed to the cues of traumatic events 5. marked **physiological** reactions when exposed to the cues of traumatic events **Persistant avoidance** of stimuli associated with the traumatic event (1 or both are present): 1. Avoidance of distressing memories, thoughts or feelings 2. Avoidance of external reminders (people, places, conversations, activities, objects, situations) **Negative alterations in cognitions and mood** (2 or more of the following): 1. Inability to remember an important aspect of the traumatic event 2. Persistent and exaggerated negative beliefs or expectations about oneself, others or the world 3. Dirsorted cognitions about the cause or consequences of traumatic event 4. negative emotional state 5. diminished interest or participation in significant activities 6. feelings of detachment or estrangement from others 7. persistent inability to experience positive emotions Marked **alterations in arousal or reactivity** (2 or more of the following): 1. Irritable behavior and angry outbursts 2. reckless or self-destructive behavior 3. hypervigilance 4. exaggerated startle response 5. problems with concentration 6. sleep disturbance ## Footnote Duration of the disturbance is **>1 month**

Question 39

Posttraumatic Stress Disorder in children 6 yo and younger | (PTSD)

Answer 39

Exposure to actual or threatened death, serious injury or sexual violence. **Intrusion symptoms** (at least 1 should be present): 1. recurrent, involuntary, and intrusive distressing memories of the traumatic event (s) 2. recurrent distressing dreams 3. dissociative reactions (flashbacks) when the individual feels or acts as if the traumatic event is recurring 4. intense **psychological** distress when exposed to the cues of traumatic events 5. marked **physiological** reactions when exposed to the cues of traumatic events **At least 1 symptom** of persistent avoidance of stimuli OR negative alterations in cognitions and mood. Marked **alterations in arousal or reactivity** (2 or more of the following): 1. Irritable behavior and angry outbursts 2. hypervigilance 3. exaggerated startle response 4. problems with concentration 5. sleep disturbance ## Footnote Duration of the disturbance is **>1 month**

Question 40

Acute Stress Disorder

Answer 40

* Exposure to a traumatic **stressor** (actual or threatened death, serious injury, sexual violence) * Presence of 9 or more **PTSD-like symptoms** (intrusion, negative mood, dissociation, avoidance and arousal) * Duration of the disturbance is **at least 3 days and up to 30 days**

Question 41

Adjustment Disorders

Answer 41

* Symptoms or behaviors are **clinically significant** but do not meet the full criteria for another mental disorder * The symptoms do NOT represent **normal bereavement** and are NOT better explained by prolonged grief disorder * Occurs within **3 months** of stressor and lasts **no longer than 6 months** after stressor or its consequences terminated

Question 42

Prolonged Grief Disorder

Answer 42

The death of a person who was **close** (at least 12 months ago for adults and 6 months - for children and adolescents) **Intense yearning/ longing** for the deceased person and/or preoccupation with thoughts and memories about them **Symptoms** (at least 3 are present): 1. identity disruption 2. sense of disbelief about the death 3. avoidance of reminders that the person is dead 4. intense emotional pain related to the death 5. difficulty reintegrating into relationships and activities 6. emotional numbness 7. feeling that life is meaningless as a result of the death 8. intense loneliness as a result of the death ## Footnote Symptoms have occurred nearly every day for **at least the last month**.

Question 43

Dissociative Identity Disorder

Answer 43

* Two or more **distinct personalities** * Discontinuity in sense of **self** and sense of agency * **Alterations** in affect, behavior, consciousness, memory, perception, cognition and/ or sensory-motor functioning * Recurrent **gaps in the recall of everyday events**, important personal information and/ or traumatic events * In children the symptoms are **NOT** better explained by imaginary playmates or other fantasy play

Question 44

Dissociative Amnesia

Answer 44

**Inability to recall** important autobiographical information, usually **traumatic or stressful**. ## Footnote **Localized**: an event or period of time **Selective**: specific aspect of an event **Generalized**: identity and life history

Question 45

Depersonalization/ Derealization Disorder

Answer 45

Experiences of unreality or detachment from * one's mind, body or self (**depersonalized**) * one's surroundings (**derealization**) ## Footnote During these experiences reality testing remains intact.

Question 46

Somatic Symptom Disorder

Answer 46

* One or more somatic symptoms that are distressing or result in significant **disruption in daily life**. * **Excessive** thoughts, feelings or behaviors related to the somatic symptoms or associated health concerns ## Footnote More than **6 months** 3 severity levels: * mild * moderate * severe

Question 47

Illness Anxiety Disorder

Answer 47

* preoccupation with **having or acquiring a serious illness** * **somatic** symptoms are not present or only mild in intensity * high level of **anxiety** about health * excessive health-related **behaviors** (care-seeking type) or maladaptive **avoidance** (care-avoidant type) ## Footnote at least **6 months** (feared illness may change)

Question 48

Conversion Disorder

Answer 48

* **Altered voluntary motor or sensory function** not explained by medical tests * Evidence of **incompatibility** between symptom and neurological or medical conditions ## Footnote Also known as: Functional Neurological Symptom Disorder

Question 49

Factitious Disorder

Answer 49

* **Falsification of physical or psychological symptoms** (imposed on self or other) or induction of injury or disease, involving deception * Absence of obvious **external reward**

Question 50

Pica Disorder

Answer 50

Eating **nonnutritive**, nonfood substances. ## Footnote At least **1 month**

Question 51

Rumination Disorder

Answer 51

* Previously swallowed food that may be partially digested is brought up into the mouth without apparent nausea, involuntary retching or disgust. * Regurgitated food may be re-chewed, re-swallowed or spit out ## Footnote At least **1 month**

Question 52

Avoidant/ Restrictive Food Intake Disorder

Answer 52

An **eating or feeding disturbance** (1 or more of the following): 1. significant weight loss 2. significant nutritional deficiency 3. dependence on enteral feeding or oral nutritional supplements 4. marked interference with psychosocial functioning

Question 53

Anorexia Nervosa

Answer 53

3 key features: 1. persistent energy intake **restriction**, which leads to a **significantly low body weight** 2. intense **fear of gaining weight** or becoming fat or persistent behavior that interferes with weight gain 3. **disturbance** in self-perceived weight or shape ## Footnote 4 levels of severity: * Mild * Moderate * Severe * Extreme

Question 54

Bulimia Nervosa

Answer 54

* 3 key features: 1. recurrent episodes of **binge eating** 2. recurrent inappropriate **compensatory behaviors** to prevent weight gain (self-induced vomiting, misuse of medications, fasting or excessive exercise) 3. self-evaluation that is unduly influenced by **body shape and weight gain** * The binge-eating and compensatory behaviors occur **at least once a week for 3 months** ## Footnote levels of severity: * Mild * Moderate * Severe * Extreme

Question 55

Binge Eating Disorder

Answer 55

* Recurrent episodes of **binge-eating**. Eating in a discrete period of time (usually 2 hours) an amount of food that is definitely larger than most people would eat in a similar period of time (w/o purge) * **Lack of control** over eating during the episode * **3 or more** of the following: * eating much more rapidly than normal * eating until feeling uncomfortably full * eating large amounts of food when not feeling physically hungry * eating alone because of embarassment * feeling disgusted with oneself, depressed or very guilty * At least **once a week for 3 months** ## Footnote levels of severity: * Mild * Moderate * Severe * Extreme

Question 56

Enuresis

Answer 56

* Repeated **voiding of urine** into bed or clothes, either involuntary or intentional * At least **twice a week for at least 3 consecutive months** ## Footnote Age is **at least 5 years**

Question 57

Encopresis

Answer 57

* Repeated **passage of feces into inappropriate places**, either involuntary or intentional * At least one event occurs **each month for at least 3 months** ## Footnote Age is **at least 4 years**

Question 58

Delayed Ejaculation

Answer 58

Difficulty or inability to ejaculate despite the presence of adequate sexual stimulation and desire to ejaculate. ## Footnote >6 months

Question 59

Erectile Disorder

Answer 59

Repeated failure to **obtain or maintain erections** during partnered sexual activities. ## Footnote >6 months

Question 60

Female Orgasmic Disorder

Answer 60

**Difficulty experiencing orgasm** and/or markedly reduced intensity of orgasm sensation. ## Footnote >6 months

Question 61

Female Sexual Interest/Arousal Disorder

Answer 61

Absence or reduced frequency or intensity of at least three of six indicators: 1. sexual activity 2. sexual/erotic thoughts or fantasies 3. initiation of sexual activity 4. sexual excitement/pleasure during sexual activity 5. sexual interest/arousal in response to any internal or external sexual/erotic cues 6. genital or nongenital sensations during sexual activity ## Footnote >6 months

Question 62

Genito-Pelvic Pain/Penetration Disorder

Answer 62

Four commonly comorbid symptom dimensions: 1. difficulty having intercourse 2. genito-pelvic pain 3. fear of pain or vaginal penetration 4. tension of the pelvic floor muscles ## Footnote > 6 months

Question 63

Male Hyposexual Desire Disorder

Answer 63

Both low/absent desire for sex and deficient/absent sexual thoughts or fantasies are required. ## Footnote >6 months

Question 64

Premature Ejaculation

Answer 64

A persistent or recurrent pattern of ejaculation occurring during partnered sexual activity within approximately 1 minute following vaginal penetration and before the individual wishes it. ## Footnote >6 months

Question 65

Gender Dysphoria

Answer 65

A marked **incongruence** between the gender they have been assigned to (usually at birth, referred to as natal gender) and their experienced/expressed gender. ## Footnote >6 months

Question 66

Paraphilic Disorders

Answer 66

* Criterion A specifies the qualitative nature of the paraphilia (i.e., focus of desire) manifested by fantasies, urges and behaviors (fetishistic, pedophilic) * Criterion B specifies the negative consequences of the paraphilia (distress, impairment, risk of harm to others) Types include: * Voyeuristic * Exhibitionistic * Frotteuristic (touching or rubbing against non-consenting person) * Sexual Masochism * Sexual Sadism * Pedophilic (fantasies and urges involve sexual activity with prepubescent child) * Fetishistic * Transvestic (note: must cause clinically significant distress or impair functioning) ## Footnote >6 months

Question 67

Oppositional Defiant Disorder

Answer 67

A frequent and persistent pattern of **angry/irritable mood**, **argumentative/defiant behavior**, or vindictiveness. ## Footnote >6 months

Question 68

Intermittent Explosive Disorder

Answer 68

Recurrent outbursts representing a failure to control aggressive impulses as evidenced by EITHER of the following: * Verbal and/or physical aggression WITHOUT damage or injury **2x/week for 3 months** OR * Outburst involving damage to property and/or physical assault **3x/year**

Question 69

Conduct Disorder

Answer 69

A repetitive and persistent pattern of behavior in which the **basic rights** of others or major age-appropriate societal norms or **rules** are **violated**. These behaviors fall into four main groupings: 1. aggressive conduct that causes or threatens physical harm to other people or animals 2. nonaggressive conduct that causes property loss or damage 3. deceitfulness or theft 4. serious violations of rules ## Footnote 3 or more behaviors in the last 12 mo (1 being in last 6 mo)

Question 70

Pyromania

Answer 70

* Deliberate and purposeful fire setting on more than one occasion * Tension or affective arousal before the act * Fascination with, interest in, curiosity about, or attraction to fire and its situational contexts * Pleasure, gratification, or relief when setting fires or when witnessing or participating in their aftermath

Question 71

Kleptomania

Answer 71

* Recurrent failure to resist impulses to steal objects that are not needed for personal use or for their monetary value * Increasing sense of tension immediately before committing the theft * Pleasure, gratification, or relief at the time of committing the theft

Question 72

Substance-Related and Addictive Disorders: 10 classes

Answer 72

1. alcohol 2. caffeine 3. cannabis 4. hallucinogens 5. inhalants 6. opioids 7. sedatives, hypnotics, and anxiolytics 8. stimulants (amphetamine-type substances, cocaine, and other stimulants) 9. tobacco 10. other (or unknown) substances ## Footnote They produce such an intense activation of the reward system that normal activities may be neglected. All (except caffeine) >12 mo

Question 73

Gambling Disorder

Answer 73

Persistent and recurrent maladaptive gambling behavior that disrupts personal, family, and/or vocational pursuits. ## Footnote 12 mo

Question 74

Delirium

Answer 74

* A disturbance of attention or awareness (short period of time) * The disturbance in attention is manifested by reduced ability to direct, focus, sustain and shift attention easily distracted by irrelevant stimuli * The disturbance in awareness is manifested by a reduced orientation to the environment or at times even to oneself

Question 75

Mild Neurocognitive Disorder

Answer 75

* Allows for earlier detection and intervention * Deficits do not interfere with independent or everyday activity

Question 76

Major Neurocognitive Disorder

Answer 76

* Significant cognitive decline * Interfere with independent everyday activity Common Subtypes: * Alzheimer: Decline in memory, cognition * Frontotemporal lobar degeneration: Behavioral or language variant * Lewy body disease: Fluctuating cognition, visual hallucinations, REM sleep disorder * Vascular disease: Cognitive deficits, decline in complex attention * Traumatic-brain injury * Substance-induced

Question 77

What are the **3 cluster A personality disorders**?

Answer 77

1. Paranoid 2. Schizoid 3. Schizotypal

Question 78

What are the **4 cluster B personality disorders**?

Answer 78

1. Antisocial 2. Borderline 3. Histrionic 4. Narcissistic

Question 79

What are the **3 cluster C personality disorders**?

Answer 79

1. Avoidant 2. Dependent 3. Obsessive-compulsive

Question 80

Paranoid Personality Disorder | (Cluster A)

Answer 80

* A pattern of distrust and suspiciousness such that others' motives are interpreted as malevolent * No psychotic symptoms

Question 81

Schizoid Personality Disorder | (Cluster A)

Answer 81

A pattern of **detachment from social relationships** and a **restricted range of emotional expression.** ## Footnote More “detached” and “uninterested” in social relations (not as odd) when compared to schizotypal personality disorder. Note: Differentiate from psychotic disorders because NO psychotic symptoms; differentiate from Schizotypal due to no cognitive distortions or eccentricities.

Question 82

Schizotypal Personality Disorder | (Cluster A)

Answer 82

A pattern of **acute** **discomfort** in close **relationships**, cognitive or perceptual **distortions**, and **eccentricities** of behavior. ## Footnote More "odd" than Schizoid PD. Note: Differentiate from psychotic disorders because NO psychotic symptoms; differentiate from Schizoid PD due to HAVING cognitive distortions or eccentricities.

Question 83

Antisocial Personality Disorder | (Cluster B)

Answer 83

A pattern of **disregard** for and **violation** of the **rights** of others. ## Footnote History of symptoms before age 15. Must be at least 18 years to diagnose.

Question 84

Borderline Personality Disorder | (Cluster B)

Answer 84

A pattern of **instability** in interpersonal relationships, self-image, affect, and marked **impulsivity**. Key features include: * frantic efforts to avoid abandonment * unstable and intense relationships * a disturbed sense of self-image * impulsivity in at least two areas * recurrent suicidal behavior or self-harm * affective instability * chronic feelings of emptiness * inappropriate and intense anger * stress-related paranoid thoughts or severe dissociative symptoms

Question 85

Histrionic Personality Disorder | (Cluster B)

Answer 85

A pattern of excessive **emotionality** and **attention-seeking**.

Question 86

Narcissistic Personality Disorder | (Cluster B)

Answer 86

A pattern of **grandiosity**, need for **admiration**, and lack of **empathy**.

Question 87

Avoidant Personality Disorder | (Cluster C)

Answer 87

A pattern of social **inhibition**, feelings of **inadequacy**, and **hypersensitivity** to negative evaluation.

Question 88

Dependent Personality Disorder | (Cluster C)

Answer 88

A pattern of **submissive** and **clinging** behavior related to an excessive **need to be taken care of**.

Question 89

Obsessive-Compulsive Personality Disorder | (Cluster C)

Answer 89

A pattern of preoccupation with **orderliness**, **perfectionism**, and **control**. ## Footnote Note: do not confuse with obsessive-compulsive disorder in which there is obsessive thinking and behavioral compulsions.

Question 90

Developmental Coordination Disorder | (motor disorder)

Answer 90

**Deficits** in the acquisition and execution of coordinated **motor skills** and is manifested by **clumsiness** and **slowness**.

Question 91

Stereotypic Movement Disorder | (motor disorder)

Answer 91

**Repetitive**, seemingly driven, and apparently purposeless **motor behaviors**, such as hand flapping.

Question 92

Tic Disorders | (motor disorder)

Answer 92

The presence of **motor or vocal tics**, which are sudden, rapid, recurrent, nonrhythmic, stereotyped motor movements or vocalizations.

Question 93

Insomnia Disorder

Answer 93

**Dissatisfaction with sleep quantity or quality** (1 or more): 1. Difficulty initiating sleep 2. Difficulty maintaining sleep, frequent awakenings or problems returning to sleep after awakenings 3. early-morning awakening with inability to return to sleep ## Footnote * At least **3 nights per week** * Present for at least **3 months**

Question 94

Hypersomnolence Disorder

Answer 94

Self-reported **excessive sleepiness** despite a main sleep period lasting at least 7 hours (at least 1 of the following): 1. recurrent periods of sleep or lapses into sleep within the same day 2. a prolonged main sleep episode of more than 9 hours per day that is NONrestorative 3. Difficulty being fully awake after abrupt awakening ## Footnote Occurs at least **3 times a week**, for at least **3 months** Severity levels: * mild * moderate * severe

Question 95

Narcolepsy

Answer 95

Recurrent episodes of **irrepressible need to sleep, lapsing into sleep or napping** occurs within the same day ## Footnote Occurs at least **3 times a week** over **3 months** Severity levels: * mild * moderate * severe

Question 96

Obstructive Sleep Apnea Hypopnea

Answer 96

Evidence of obstructive apneas or hypopneas 1. Nocturnal **breathing disturbances**: snoring snorting/ gasping, or breathing pauses during sleep 2. **Daytime sleepiness, fatigue** or unrefreshing sleep ## Footnote Severity levels: * mild * moderate * severe

Question 97

Sleep-Related Hypoventilation

Answer 97

**Decreased respiration** associated with elevated CO2 levels.

Question 98

Circadian Rhythm Disorders

Answer 98

* Pattern of **sleep disruption** due to an alteration of the circadian system * The sleep disruption leads to **excessive sleepiness or insomnia, or both**

Question 99

Non-Rapid Eye Movement Sleep Arousal Disorders

Answer 99

* Recurrent episodes of **incomplete awakening** from sleep, accompanied by either **sleepwalking or sleep terrors** * No or little **dream** imagery is recalled * **Amnesia** for the episodes

Question 100

Nightmare Disorders

Answer 100

* **Extended, extremely dysphoric and well-remembered dreams**, usually involve efforts to avoid threats to survival or security, generally occurs during the 2nd half of the major sleep episode * On awakening, the individual rapidly becomes **oriented and alert** ## Footnote Severity levels: * mild * moderate * severe

Question 101

Rapid-Eye Movement Sleep Behavior Disorder

Answer 101

* **Arousal during sleep** associated with vocalization and/ or complex motor behaviors * Behaviors arise during **REM** sleep * Upon awakening, the individual is completely **awake, alert and not confused** or disoriented

Question 102

Restless Legs Syndrome

Answer 102

**An urge to move the legs**, usually accompanied by or in response to uncomfortable and unpleasant sensations in legs (ALL of the following): 1. The urge to move the legs begins or worsens during periods of rest or inactivity 2. The urge to move legs is partially or totally releived by movement 3. The urge is worse in the evenings or at night than during the day ## Footnote The symptoms occur at least **3 times per week** for at least **3 months**.

Question 103

Suicidal Behavior

Answer 103

* Individuals have engaged in potentially self-injurious behavior with at least some **intent to die** as a result of the act * A suicide attempt may or may not result in actual **self-injury**

Question 104

Nonsuicidal Self-Injury

Answer 104

Individuals have engaged in **intentional self-inflicted damage to their body** (cutting, burning, stabbing, hitting, excessive rubbing) in the absence of suicidal intent.