Disorders I
This is the amount of time symptoms must be present for a diagnosis of PTSD.
At least one month
Side Note: 3 days up to less than 1 month would be acute stress disorder
Episode marked by some or all of the following: palpitations, sweating, feelings of choking, chest pain, dizziness, lightheadedness, fear of dying, fear of losing control, etc.
Panic Attack
A 31-year-old man narrowly escapes (without injury) from a house fire caused when he dropped the lighter while trying to light his crack pipe. Six weeks later, while smoking crack, he thinks he smells smoke and runs from the build-ing in a panic, shouting, “It’s on fire!”
Which of the following symptoms or circumstances would rule out a diagnosis of post traumatic stress disorder (PTSD)for this patient?
A.Having difficulty falling asleep.
B.Being uninterested in going back to work
C.Inappropriately getting angry at family members.
D.Experiencing symptoms only when smoking crack cocaine.
E.Concluding that “the world is completely dangerous.”
D. Experiencing symptoms only when smoking crack cocaine.
Erica recently lost her father to cancer. She has been experiencing difficulty with going to work and has been isolating from her friends. She reports significant feelings of grief, loss, tearfulness, and low mood.
Adjustment disorder with depressed mood
False
Marked by a severe and persistent fear of social or performance situations in which embarrassment or humiliation might occur.
Social Anxiety Disorder
True or False: Major depressive disorder involves 5 or more symptoms of depression experienced most of the day, nearly every day, for at least 2 consecutive weeks
True
Bill's sister is getting married in Hawaii, but he refuses to attend due to his fear of flying. Bill likely meets criteria for which disorder?
Specific Phobia
Kevin is afraid to leave the house and travel to public places or other locations where it would be difficult to escape and would be in crowds. He likely suffers from what disorder?
Agoraphobia
Jaime's sister was in a bad car crash that left her paralyzed. She has told Jaime about it in detail, to the point that Jaime is starting to be uncomfortable while driving. Does Jaime meet Criterion A for PTSD?
Yes
What is the difference between Oppositional Defiant Disorder and Conduct disorder?
Conduct Disorder is more severe (and calculated) than ODD and may include physical assault and damage to property
ODD behavior is less severe and typically not displayed towards animals, people, property destruction or theft. Conduct Disorder is more severe (and calculated / predatory).
True or False: Major Depressive disorder criteria include Depressed mood and 2 or more symptoms that occur more days than not for at least 2 years (adults).
False.
Persistent Depressive Disorder include the depressed mood and 2 or more symptoms that occur more days than not for at least 2 years (adults).
uClient is a 7-year-old male. During a game of soccer, a peer on the opposite team steals the ball from him and scores a goal. Client runs over to his peer, picks up the soccerball, and throws it at his head while yelling “You’re so stupid!” When the client is placed in time out for intentional aggression, he stomps off the field and yells “It’s not fair! I didn’t want to play your stupid game anyways!” While sitting in the timeout zone, the client is visibly acting upset through sighing loudly, complaining, and telling the counselor how much he hates soccer. The counselor does not respond. After about five minutes of this, the client decided to leave time out on his own, runs back into the soccer field, and begins to throw the soccer cones everywhere. He then runs over to the ball, and kicks it over the fence while yelling at the counselor to “come and catch me!”
Oppositional Defiant Disorder
A 9 year-old Caucasian girl with no past psychiatric history and appropriate developmental milestones presents with a consistent failure to speak at school for the past 2 months. She is talkative at home and interacts well with her siblings. This recent change in behavior has been affecting her performance at school. Which of the following is the most accurate diagnosis?
Selective Mutism
What specifier can be added on to (almost) any diagnosis?
Panic attack specifier
This disorder has a hallmark feature of worry over everything and anything.
Generalized Anxiety Disorder
If fear is intense enough, it may become THIS, which is the fear or avoidance of situations in which escape might be difficult or help unavailable when panic strikes.
Agoraphobia
Tom is 40 years old and has been unable to sleep. He is lacking interest in his normal activities and lacking energy to do anything. He has lost weight and feels like life is hopeless and it is difficult for him to wake up in the morning. He reports he cannot remember a period of his life where he did not feel this way.
Persistent Depressive Disorder (Dysthymia)
A 6-year-old girl has repeatedly approached strangers while in the park with her class. The teacher requests an evaluation of the behavior. The girl has a his-tory of being placed in several different foster homes over the past 3 years.Which diagnosis is suggested from this history?
Disinhibited social engagement disorder (DSED)
Which DSM 5 chapter is Antisocial Personality Disorder considered to be included in?
ASPD is dual-coded under Disruptive, Impulse-Control, and Conduct Disorders, AND Personality Disorders
Which of the following is not consistent with a diagnosis of disruptive mood dysregulation disorder?
A. Severe, recurrent temper outbursts manifested verbally and/or behaviorally out of proportion to the provocation.
B. The temper outbursts are appropriate for the patient’s developmental level.
C. Outbursts occur 3 or more times per week.
D. Outbursts occur for at least 12 months.
E. The diagnosis cannot be made before age 6 or after age 18.
B): Disruptive mood dysregulation disorder consists of temper tantrums that last for 12 months and occur at least 3 times per week. These outbursts occur out of proportion to the stimulus. The diagnosis cannot be made before age 6 or after age 18. The temper tantrums are NOT appropriate for the patient’s developmental level.
The criteria of extreme neglect in the developmental years is critical to diagnosis of this disorder.
Reactive Attachment Disorder
A 26 year old female actress with no past psychiatric history and medical history of mitral valve prolapse, presents to the emergency room complaining of palpitations, sweating, shortness of breath, nausea, dizziness, chills alternating with sensations of heat, numbness from her fingertips to all of her body and face, along with feelings that she is watching herself from the outside. She reports that everything happened very quickly, minutes before the last dress rehearsal where she is playing a very demanding, challenging role that she always wanted. The patient denies having similar experience in the past, but she admits that she tends to stress greatly prior to her first performance.
Social anxiety with performance only
Unspecified anxiety disorder
uClient is a 6-year-old male. After being issued a command to return to his place in line with his peers, the client quietly complies with the request. However, when the counselor is not looking, he leans over and scratches her leg with his nails as revenge for the command. The next week after the incident, the client goes on vacation with his family to Florida for the entire week. When the client returns to treatment, he approaches the counselor and asks “Does your leg still hurt?” The counselor is wearing pants, therefore the injury is not visible nor prominent at time of the inquiry.
Conduct Disorder
A teenage client comes to meet with you for an intake. He reports he is ordered by the court (his guardian ad litem specifically) to meet with you due to possible reunification with his father (who lost custody of the client when he was 5 years old due to physical abuse and neglect). He reports the guardian ad litem wants him to "talk to someone because she thinks I'm going to emotionally struggle with this, but I won't."
Client denies any impairment in social, academic, occupational, and/or daily functioning. He scores a 0 on both the PHQ-9 and GAD-7. He reports feeling "indifferent" about reunifying with dad, but states he is "annoyed that I'm being mandated to come here today."
Insurance demands that you diagnose this client to cover services. What do you diagnose him with?
Unspecified Stressor-Related Disorder
or
Adjustment Disorders, unspecified