Psych Diagnostic criteria Flashcards

Question

Dependent

Answer 1

5+ * Difficulty making everyday decisions * Needs others to assume responsibility for decisions * Reluctant to disagree; fears loss of support * Hesitates to take initiative due to poor self-confidence * Tries hard for nurture, support from others. Will volunteer to do unpleasant things if it will win support * Fears being unable to care for self; helpless, distressed when alone * Urgently seeks another when one relationship ends * Unrealistically fearful of being left alone to take care of him/her self

Answer 2

4+ * Such preoccupation with organization that the major point is lost * Perfectionism that interferes with task completion. * Devoted to work and productivity to the exclusion of leisure, family, and friends * Overly conscientious, scrupulous, and inflexible about morality, ethics, or values * Can’t discard worn-out or worthless items even when no sentimental value * Reluctant to delegate tasks; or must perform exactly to own specifications * Miserly style of spending money; hoards money for future catastrophes * Pervasive rigidly and stubbornness

Answer 3

A. Evidence of significant/modest cognitive decline from a previous level of performance in one or more cognitive domains based on: 1. Concern of the individual, a knowledgeable informant, or the clinician that there has been a significant/mild decline in cognitive function; and 2. A substantial/modest impairment in cognitive performance, preferably documented by standardized neuropsychological testing or, in its absence, another quantified clinical assessment. B. The cognitive deficits interfere/do not interfere with independence in everyday activities (i.e., at a minimum, requiring assistance with complex instrumental activities of daily living such as paying bills or managing medications). C. The cognitive deficits do not occur exclusively in the context of a delirium. D. The cognitive deficits are not better explained by another mental disorder (e.g., major depressive disorder, schizophrenia).

Answer 4

Features: • predominant complaint is dissatisfaction with sleep quality or quantity, associated with 1 or more: – Difficulty initiating – Difficulty maintaining sleep – Early morning awakening and unable to fall back to sleep • Causes distress or impairment • Occurs minimum of 3 nights/week • Exists for minimum of 3 months • Sleep problem exists even with opportunity for sleep

Answer 5

• Per self-report, presence of excessive sleepiness (hypersomnolence) even though there has been a sleep period of at least 7 hours, with at least one of the following: – periods of sleep or lapses into sleep within same day – Prolonged main sleep episode of 9+ hours/daily that is unrefreshing – Problems becoming full awake after an abrupt awakening • Occurs at least 3 times/week, for minimum 3 months • Accompanied by distress or impairment in functioning • Too much nocturnal sleep or sleepiness during daytime • Diminished quality of wakefulness (problems awakening or staying awake) • Sleep inertia ---- known as sleep drunkenness—involves impaired performance and less vigilance after a sleep episode); may appear confused, combative upon awakening.

Answer 6

``` • persistent or recurrent pattern of disrupted sleep primarily due to an alteration of the circadian system or misalignment between the person’s circadian rhythm and sleep-wake requirements of the environment – Delayed sleep phase type – Advanced sleep phase type – Shift work – Irregular sleep-wake type – Non-24-hour sleep-wake type ```

Answer 7

* more common in childhood * content of nightmare usually involves threats to security, survival, or self-esteem * person quickly becomes alert upon awakening and has full recall of nightmare * associated with REM sleep * often occurs during times of stress

Answer 8

* sudden arousal from sleep with displays of intense fear, panicky scream; signs of increased autonomic arousal * not assoc. with dreaming (occurs during delta sleep) * difficult to soothe individual * no recall for event * usually begins in childhood and later resolves

Answer 9

* Person may rise and walk about environment * blank, staring facial expression * No recall of event * difficult to awaken or communicate with * occurs during stage 3-4 sleep (first third of night) * common in childhood; most outgrow in adolescence

Answer 10

Rapid Eye Movement Sleep Behavior Disorder • Repeated episodes of arousal during sleep that are accompanied by vocalization and/or complex motor behaviors • Behaviors occur during REM sleep; typical after 90 minutes of sleep onset, and during later parts of sleep episode • Person awakens and is alert, not confused or disoriented – Greater prevalence in males – Associated with neurodegenerative disorder – Course is progressive

Answer 11

 Currently, or by history, must meet criteria A, B, C, and D  A. Persistent deficits in social communication and social interaction across contexts, not accounted for by general developmental delays, and manifest by all 3 of the following: › 1. Deficits in social-emotional reciprocity › 2. Deficits in nonverbal communicative behaviors used for social interaction › 3. Deficits in developing and maintaining relationships  B. Restricted, repetitive patterns of behavior, interests, or activities as manifested by at least 2 of the following: › 1. Stereotyped or repetitive speech, motor movements, or use of objects › 2. Excessive adherence to routines, ritualized patterns of verbal or nonverbal behavior, or excessive resistance to change › 3. Highly restricted, fixated interests that are abnormal in intensity or focus › 4. Hyper-or hypo-reactivity to sensory input or unusual interest in sensory aspects of environment;  C. Symptoms must be present in early childhood, but may not become fully manifest until social demands exceed limited capacities  D. Symptoms limit and impair everyday functioning. › AAP recommends formal screening for ASDs at 18 & 24 months of age

Answer 12

 A. Persistent difficulties in the social use of verbal and nonverbal communication as manifest by deficits in all of the following: › 1) Using communication for social purposes, such as greeting and sharing information, in a manner that is appropriate for the social context; › 2) Changing communication to match context or the needs of the listener, such as speaking differently in a classroom than on a playground, communicating differently to a child than to an adult, and avoiding use of overly formal language.; › 3) Following rules for conversation and storytelling, such as taking turns in conversation, rephrasing when misunderstood, and knowing how to use verbal and nonverbal signals to regulate interaction; › 4) Understanding what is not explicitly stated (e.g. inferencing) and nonliteral or ambiguous meanings of language, for example, idioms, jokes, metaphors and multiple meanings that depend on the context for interpretation.  B. Deficits result in functional limitations in effective communication, social participation, social relationships, academic achievement, or occupational performance.  C. Onset in the early developmental period (but deficits may not become fully manifest until social communication demands exceed limited capacities).  D. Deficits are not better explained by low abilities in the domains of word structure and grammar, or by intellectual disability, global developmental delay, Autism Spectrum Disorder, or another mental or neurologic disorder.

Answer 13

Criteria must be met in all 3 categories:  1. Deficit in intellectual functioning: Reasoning; Problem solving; Planning; Abstract thinking; Judgment; Academic learning (ability to learn in school via traditional teaching methods); Experiential learning (the ability to learn through experience, trial and error, and observation). Mental abilities are measured by IQ tests. A score of approximately 2 standard deviations below average represents a significant cognitive deficit. The tests used to measure IQ must be standardized and culturally appropriate. This is typically an IQ score of 70 or below.  2. Deficits or impairments in adaptive functioning: This includes skills needed to live in an independent and responsible manner. Measured using standardized, culturally appropriate tests. Various skills are needed for daily living: -Communication -Social skills -Personal independence at home or in community settings: Refers to the ability to take care of yourself (bathing, dressing, feeding). It also includes the ability to safely complete day-to-day tasks without guidance (cooking, cleaning, laundry). There are also routine activities performed in the community (shopping for groceries, and accessing public transportation).  3. These limitations occur during the developmental period or evident during childhood/adolescence. If these problems began after this developmental period, the correct diagnosis would be neurocognitive disorder (i.e.: a traumatic brain injury from a car accident could cause similar symptoms. Intellectual Disability, mild: IQ score of 70-55(ish) or 2 standard deviations below the mean Borderline Intellectual Function (low average function): 71-84 ``` Degree IQ % of total cases Need for support Moderate 35-40 to 50-55 10% Limited Severe 20-25 to 35-40 3%-4% Extensive Profound Less than 20-25 1%-2% Constant ```

Answer 14

Learning and using academic skills is substantially below expected levels for a child’s IQ, age, and education for at least 6 mos. beginning during school age years. DSM 5 term is Specific Learning Disability  With impairment in reading (dyslexia)  With impairment in written expression  With impairment in mathematics (dyscalculia)  Each is listed as mild, mod, or severe

Answer 15

Must meet 3 of the following criteria:  Recurrent, excessive anxiety or fear when separated or contemplating separation from home or from caregiver whom child has strong emotional attachment  Significant, persistent fear of losing a caregiver to illness, disaster, or death  Fear of being alone in the home or other settings  Reluctance/Refusal to participate in activity that would require separation from parent/caregiver (leaving home, going to school)  Fear of an event that would cause separation: kidnapping, accidents, illness  Persistent nightmares about separation  Difficulty sleeping without caregiver  Somatic symptoms (headaches, stomachaches, nausea) when separation is anticipated Fear is inappropriate and excessive for age and level of development (not the same as separation anxiety) Symptoms range from mild (anticipatory anxiety) to severe (panic and marked anxiety about separation) Symptoms must be present for at least 4 weeks

Answer 16

 A. A consistent pattern of inhibited, emotionally withdrawn behavior toward adult caregivers, manifested by both of the following:  The child rarely or minimally seeks comfort when distressed.  The child rarely or minimally responds to comfort when distressed.  B. A persistent social or emotional disturbance characterized by at least two of the following:  Minimal social and emotional responsiveness to others  Limited positive affect  Episodes of unexplained irritability, sadness, or fearfulness that are evident even during nonthreatening interactions with adult caregivers.  C. The child has experienced a pattern of extremes of insufficient care as evidenced by at least one of the following:  Social neglect or deprivation in the form of persistent lack of having basic emotional needs for comfort, stimulation and affection met by caring adults  Repeated changes of primary caregivers that limit opportunities to form stable attachments (e.g., frequent changes in foster care)  Rearing in unusual settings that severely limit opportunities to form selective attachments (e.g., institutions with high child to caregiver ratios)  D. The care in Criterion C is presumed to be responsible for the disturbed behavior in Criterion A (e.g., the disturbances in Criterion A began following the lack of adequate care in Criterion C).  E. The criteria are not met for autism spectrum disorder.  F. The disturbance is evident before age 5 years.  G. The child has a developmental age of at least nine months.  Specify if Persistent: The disorder has been present for more than 12 months.  Specify current severity: Reactive Attachment Disorder is specified as severe when a child exhibits all symptoms of the disorder, with each symptom manifesting at relatively high levels. Related Features:  Lack of conscience or empathy for others, manifesting in antisocial behavior  Severe aggression  Property destruction  Lying  Stealing  Hiding food from the family’s kitchen or refrigerator  Inappropriate sexual behavior  Manipulative behavior  Animal cruelty

Answer 17

Definition: Primary: failure to develop control over urination as evidenced by repeated voiding of urine into bed or clothes by at least 5 years of age  a frequency of 2X/week for 3 consecutive months  the frequency can be less given the presence of clinically significant distress or impairment in social, academic (occupational), or other important areas of functioning.  The behavior is not due to the direct effect of a substance or a general medical condition. Secondary: revert to wetting the bed or clothing after initially (for at least 6 months) developing control over micturition.

Answer 18

 Repeated passage of feces into inappropriate places, whether involuntary or intentional, in children over 4.  At least one event a month for at least 3 months.  The behavior is not due exclusively to the direct physiological effects of a substance or a general medical condition except through a mechanism involving constipation.  Primary VS Secondary  Continuous type (primary): the child has never become toilet trained  Discontinuous type (secondary): the child has initially been toilet trained and has subsequently become incontinent.  Retentive (constipation & overflow incontinence) vs Non-Retentive  Causes of retentive type: painful defecation, inadequate or punitive toilet training, fear of school bathroom, or toilet related fear  characterized by a cycle of several days of retention, a painful expulsion, and another period of retention. While the fecal mass is growing, there may be leakage around the mass.  Non-retentive encopresis applies to those children who simply do not control the expulsion of feces on a psychological, physiologic, or combined basis.

Answer 19

Inattention (a) often fails to give close attention to details or makes careless mistakes in schoolwork, work, or other activities (b) often has difficulty sustaining attention in tasks or play activities (c) often does not seem to listen when spoken to directly (d) often does not follow through on instructions and fails to finish school work, chores, or duties in the workplace (not due to oppositional behavior or failure to understand instructions) (e) often has difficulty organizing tasks and activities (f) often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort (such as schoolwork or homework) (g) often loses things necessary for tasks or activities (e.g., toys, school assignments, pencils, books, or tools) (h) is often easily distracted by extraneous stimuli (i) is often forgetful in daily activities Hyperactivity -Impulsivity (a) often fidgets with hands or feet or squirms in seat (b) often leaves seat in classroom or in other situations in which remaining seated is expected (c) often runs about or climbs excessively in situations in which it is inappropriate (in adolescents or adults, may be limited to subjective feelings of restlessness) (d) often has difficulty playing or engaging in leisure activities quietly (e) is often "on the go" or often acts as if "driven by a motor" (f) often talks excessively (g) often blurts out answers before questions have been completed (h) often has difficulty awaiting turn (i) often interrupts or intrudes on others (e.g., butts into conversations or games)  6 or more of the previously noted symptoms persisting for 6 months or longer qualifies for a diagnosis of ADHD in either the inattentive category or hyperactivity-impulsive category.  If both inattentive and hyperactive-impulsive symptoms are present, then a combined type diagnosis is given.  Symptoms need to have been present before the age of 12.  Some impairment from the symptoms is present in two or more settings, such as school or home.  There must be clear and significant evidence of a social, academic, or occupational impairment.  The symptoms are not better accounted for by another mental disorder.

Answer 20

 Includes at least 4 symptoms from any of these categories: angry and irritable mood; argumentative and defiant behavior; or vindictiveness  Occurs with at least one individual who is not a sibling  Occurs on its own, rather than as part of the course of another mental health problem, such as a substance use disorder, depression or bipolar disorder  On most days for at least six months  Angry and irritable mood:  Often loses temper  Is often touchy or easily annoyed by others  Is often angry and resentful  Argumentative and defiant behavior:  Often argues with adults or people in authority  Often actively defies or refuses to comply with adults' requests or rules  Often deliberately annoys people  Often blames others for his or her mistakes or misbehavior  Vindictiveness:  Is often spiteful or vindictive  Mild: Symptoms confined to 1 setting  Moderate: Symptoms presents in 2 settings  Severe: Symptoms present in 3 or more settings

Answer 21

Repetitive and persistent pattern of behavior in which either the rights of others or major age-appropriate societal rules or norms are violated as manifested by the presence of 3 or more of the following criteria in the past twelve months: Aggression to People & Animals:  Often bullies, threatens, or intimidates others.  Often initiates physical fights.  Has used a weapon that can cause serious physical harm to others (e.g., a bat, brick, broken bottle, knife, gun).  Has been physically cruel to people.  Has been physically cruel to animals.  Has stolen while confronting a victim (e.g., mugging, purse snatching, extortion, armed robbery).  Has forced someone into sexual activity. Destruction of Property:  Has deliberately engaged in fire setting with the intention of causing serious damage.  Has deliberately destroyed others property (other than by fire setting). Deceitfulness or Theft:  Has broken into someone else’s house, building, or car.  Often lies to obtain goods or favors or to avoid obligations (i.e., “cons” others).  Has stolen items of nontrivial value without confronting a victim (e.g., shoplifting, but without breaking and entering; forgery). Serious Violation of Rules:  Often stays out at night despite parental prohibitions, beginning before age 13 years.  Has run away from home overnight at least twice while living in parental or parental surrogate home (or once without returning for a lengthy period).  If often truant from school, beginning before age 13 years. Specifiers:  Childhood onset, Adolescent onset, Unspecified  With Limited Prosocial Emotions (2 for 12 mos):  Lack of remorse or guilt  Callous-lack of empathy  Unconcerned about performance  Shallow or deficient affect Increased risk for antisocial personality disorder

Psych Diagnostic criteria Flashcards

(45 cards)