Psychopathology

Question 1

What distinguishes acute psychotic disorder, schizophreniform, and schizophrenia

Answer 1

acute psychotic: 1 day-1 month (full remits)

schizophreniform: 1 month-6 months
schizophrenia: 6+ mo (although only need 1 month of delusions, hallucinations, or disorganized speech)

Question 2

Severity of ID is based on

Answer 2

adaptive functioning

Question 3

For the 20-50% of cases of ID where the cause is known, what percentage is due to genetic factors

Answer 3

80-85%

5-10% are due to perinatal factors (asphyxia)
5-10% are due to postnatal factors

Question 4

What is worse for ASD, Level 1 or Level 3

Answer 4

Level 3 (requiring very substantial support)

Question 5

Is ASD more likely in males or females

Answer 5

males; serotonin appears to play a role in ASD

Question 6

How many vocal and motor tics are required for a dx of Tourettes

Answer 6

1+ vocal tics and 2+ motor tics (may occur together or at different times, may wax and wane in frequency); if less than this, called persistent (chronic) motor or vocal tic disorder

Occurred for 1+ year; started prior to 18 (average onset between 4 and 6 yrs old)

Question 7

Are comorbid mood symptoms (especially depressive symptoms) a negative or positive prognostic indicator for schizophrenia?

Answer 7

Positive

Question 8

Schizoaffective disorder requires all the sx of schizophrenia plus

Answer 8

Major mood or manic episode during psychotic illness

2 weeks WITHOUT mood/manic symptoms (so still having hallucinations or delusions)

Question 9

Timeline required for manic for hypomanic episode

Answer 9

manic- one week

hypomanic-4 days

Question 10

If the person has mania that causes an impairment in functioning, requires hospitalization, or has psychotic features, it’s automatically classified as

Answer 10

manic episode regardless of time

Question 11

Which is more severe, bipolar I or bipolar II

Answer 11

Bipolar I because it requires a manic episode (BP II = hypomanic)

Question 12

How long do you have to have hypomanic sx and subclinical depressive sx for a cyclothymia diagnosis

Answer 12

2 years

Question 13

Rapid cycling
A lack of recovery between episodes
Earlier onset (10-15 yo)

Typical or atypical bipolar

Answer 13

Atypical - second generation antipsychotic

Question 14

clinical perfectionism, core low self-esteem, intense mood states, and interpersonal difficulties are targets of what therapy for eating disorders

Answer 14

CBT-E

Question 15

3s of insomnia dx

Answer 15

dissatisfaction with sleep associated with 1 of 3:
falling asleep
staying asleep
early morning waking

>= 3 nights/week
>= 3 months

Question 16

Sleep walking and sleep terrors are examples of what type of dx

Answer 16

Non-REM sleep arousal disorders, usually occur during deep sleep (stage 3 or 4) in the first third of sleep period

Question 17

If a person is having trouble achieving erections in a dysfunctional romantic relationship, what is the most likely diagnosis

Answer 17

Not erectile disorder -
Before a diagnosis of a sexual dysfunction is assigned, it must be determined that
the person’s symptoms are not due to a nonsexual mental disorder,
a serious relationship disturbance or other stressor,
or the effects of a drug or medical condition.

Question 18

What % of time do you have to have difficulty getting an erection, maintaining an erection, or decrease in erectile rigidity for ED

Answer 18

75-100%

Question 19

If someone who has a hard time getting an erection, how can you rule out an organic cause

Answer 19

morning erections
erections when masturbating
erections with different sexual partner
or spontaneous erections occur in the absence of planned sex

Question 20

Duration req for gender dysphoria dx

Answer 20

6 mo

Question 21

Dutch protocol for gender dysphoria

Answer 21

gender affirmative model - kids know their authentic selves and dysphoria persists into adolescence in a small minority of cases

<12 yo: watchful waiting
puberty: social transition and puberty-blocking drugs are started for children who are persistent in their gender dysphoria
16 yo: can start sex hormone therapy
18 yo: gender affirming surgery

Question 22

Aversive counter conditioning used for paraphilia

Answer 22

Covert sensitization: replaces the sexual arousal elicited by the paraphilic object or behavior with fear or other undesirable response

Question 23

To assign a DSM-5 diagnosis of pedophilic disorder to a client, the client must be at least _____ years old.

Answer 23

16 (and >=5 yrs older than the kids arousing him/her)

Question 24

Is ODD more common in boys or girls

Answer 24

Boys (younger children)

Equal in older children/adolescents

Question 25

What percentage of kids with ODD go on to get diagnosed with conduct disorder

Answer 25

30

Question 26

ODD requires symptoms for ___ whereas conduct disorder requires symptoms for __

Answer 26

ODD - 6 mo | Conduct - 12 mo

Question 27

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 represent four categories: aggression to people and animals, destruction of property, deceitfulness or theft, and serious violation of rules.

Answer 27

conduct disorder CANNOT be simultaneously diagnosed with antisocial personality disorder in 18+

Question 28

Life-course persistent type of CD | Adolescence-limited type of CD

Answer 28

Life-course persistent type of CD - starts in childhood and continues to adulthood Adolescence-limited type of CD - temporary and situational type of antisocial behavior that’s due to a “maturity gap” between an adolescent’s biological and sexual maturity and his/her social maturity (do bad things to attain mature status)

Question 29

Two major interventions for conduct disorder

Answer 29

``` Parent Management Training Oregon Model (PMTO) Multisystemic Treatment (MST) ``` *Scared Straight does not work

Question 30

Intermittent explosive disorder requires destruction to

Answer 30

property or physical injury to people or animals aggressiveness has to be out of proportion to stiuation

Question 31

Can graham be dx with intermittent explosive disorder

Answer 31

no - need to be 6 years old

Question 32

Believing a celebrity you met 6 mo ago is in love with you is what type of delusion

Answer 32

erotomanic

Question 33

What distinguishes OCD and OCP

Answer 33

OCD - true obsessions and compulsions

Question 34

Disorder characterized by feeling like a robot or automaton, have vague somatic symptoms (e.g., lightheadedness), and experience anxiety or depression.

Answer 34

depersonalization

Question 35

Medications used to treat tic disorders decrease _____

Answer 35

Dopamine - antipsychotics

Question 36

For a diagnosis of anorexia, what is required

Answer 36

Low weight Intense fear of becoming fat Disturbance in self-perception DOES NOT require dieting or fasting; can include dieting, fasting, binging, and/or purging

Question 37

when a reinforcer is no longer reinforcing because the person is satiated (no longer desires the reinforcer).

Answer 37

satiation - can be prevented by switching from a continuous schedule to an intermittent schedule once the behavior is occurring at the desired level helps

Question 38

The severity of a substance use disorder is determined by

Answer 38

of sx

Question 39

When a client’s symptoms meet the DSM-5 diagnostic criteria for both panic disorder and agoraphobia, she would receive which of the following diagnoses?

Answer 39

panic disorder and agoraphobia

Question 40

Somatic symptom dx and conversion dx are largely _____, whereas facticious dx and malingering are largely ____

Answer 40

Somatic/conversion: typically unaware | Facticious/malingering: aware w/ some intention

Question 41

According to the DSM-5, the median age of onset of specific phobia is between _____ years of age.

Answer 41

7-11