personality disorders
What is the difference between personality traits or features and personality disorders?
DSM p. 647
Personality traits are patterns of relating to self and others. Personality traits become a disorder when they are rigid and maladaptive and cause impairment/distress. Personality disorder are pervasive and stable over time.
How is Persistent Depressive Disorder different from Major Depression?
PDD: Depressed & 2 symptoms for 2 years (1 year for children) (Three symptoms ongoing and may include a major depressive episode)
MD: Depressed or Loss of Interest for 2 weeks plus 4 symptoms (5 symptoms)
What is the difference between Social Anxiety Disorder and Avoidant Personality Disorder?
Social Anxiety concerns fear about social situations and possible scrutiny of others (p. 202) that result in negative judgement.
Avoidant PD concerns a broader pattern life-long of social inhibition, feelings of inadequacy, hypersensitivity to judgement, unwilling to get involved with people, avoids careers around people (p. 672-3)
A client coming in for the first time for a mental health crisis assessment says she is crying frequently and saw her dead Mother at the foot of her bed last night. You ask when her Mother died and the client reports, "two weeks ago", the diagnosis is likely______?
Z code - Uncomplicated Bereavement (p. 716)
However, if this client additionally feels depressed, cannot sleep or eat and has lost 10 pounds in two weeks, cannot concentrate, and would like to die, the diagnosis would most likely be______? (p. 161)
If I eat a lot more food between 9-11pm than other people eat during an entire day, and feel that I do not have control over my eating but I am very worried about my weight so I use the stair master for 2 hours every night afterwards - what diagnosis is likely?
Bulimia Nervosa (p. 345)
What is the difference between Paranoid Personality Disorder and Delusional Disorder, Persecutory type?
Delusional Disorder (p. 90) criteria says "apart from the delusion - functioning is not seriously impaired".
PPD (p. 649) criteria - "pervasive distrust and suspiciousness beginning in early adulthood and present across many contexts".
If a female client presents with affective lability, irritability, depression, or anxiety about once a month and has five of the following symptoms at the same time (decreased interest, trouble concentrating, lethargy, change in appetite or sleeping, sense of being out of control, or physical symptoms), and starts to feel better after onset of menses, what diagnosis would be likely?
Premenstrual Dysphoric Disorder (p. 171)
List and describe the Dissociative Disorders.
DID: two or more personality states & gaps in personal information recall; Dissociative Amnesia: forgetting autobiographical information usually of trauma (with fugue - travel amnesia); Depersonalization- unreality/detachment from self Derealization- unreality/detachment from world (292-302)
A client who lost a 4 year old child in an automobile accident, woke up the morning after the death believing she had been visited by God and had been given miraculous healing powers so she could bring the dead back to life. She begged her family to bring her child to her so she could raise him from the dead. The family brings her in for a crisis assessment the next day. What is the likely diagnosis?
Brief psychotic disorder, with marked stressor
TRUE OR FALSE:
If you assess someone who is referred by a GP because they may be drinking too much, but they only have two symptoms, you will not be able to diagnose anything.
FALSE (p. 490-491)
2-3 symptoms, Mild severity
What is the difference between Obsessive Compulsive Disorder and Obsessive Compulsive Personality Disorder?
OCD (p. 237) has obsessions or compulsions in the criteria;
whereas OC PD (p. 678) concerns a pattern of orderliness, perfectionism, and control at the expense of flexibility, openness, and efficiency.
If a child is almost always irritable and has severe temper tantrums 2-3 times a week for one year, the diagnosis is likely -----?
Disruptive Mood Dysregulation Disorder (p. 156)
What is the difference between PTSD and Acute Stress Disorder and Adjustment Disorder?
PTSD - Symptoms for at least one month
ASD - Symptoms last 3 days to 1 month
Adj Disorder - stressor does not meet Criterion A for the other diagnoses OR symptoms do not meet criteria for PTSD (p. 279). Symptoms begin within 3 months.
What is the biggest difference between a Bipolar Disorder and Schizoaffective Disorder?
One of the criteria for Schizoaffective Disorder is that Delusions and Hallucinations must be present for 2 or more weeks in the absence of a mood episode (p. 105)
What is the biggest difference between Avoidant/Restrictive Food Intake Disorder and Anorexia Nervosa?
Avoidant/Restrictive criteria - no disturbance in the way weight or body shape is experienced (p. 332)
Anorexia Nervosa - intense fear of gaining weight and disturbance in the way weight or shape is experienced are both part of the criteria. (p. 338-9)
What is the difference between schizotypal and schizoid PD and schizophrenia?
Both PDs have some of the symptoms of schizophrenia (p. 652-3 & 655-6), but neither focus on delusions, hallucinations, or disorganized speech.
Schizophrenia (p. 99) criteria requires disturbance in work, interpersonal relationships, or self-care.
What is the difference between Bipolar 1 and Bipolar II?
If there has ever been a manic episode - Bipolar I is the diagnosis.
Bipolar II is hypomania - meaning the elevated mood lasted at least 4 days and did not result in serious consequences. (p. 133)
Bipolar I - elevated mood lasts at least one week and results in marked impairment or hospitalization or involves psychotic features. (p. 124)
What's the difference between Generalized Anxiety Disorder and Panic Disorder and Specific Phobia and Agoraphobia?
Generalized Anxiety - excessive worry most days for 6 months about many things
phobia - fear of a specific object/situation - avoided
Panic disorder - recurrent unexpected panic attacks followed by a month of worry about attacks or a change in behavior related to them to avoid
agoraphobia - marked anxiety about 2 situations for 6 months & fear of these situations leading to panic attacks so avoided or a companion becomes necessary
(p. 197-222)
What is the difference between Schizophreniform Disorder and Schizophrenia?
Schizophreniform lasts 1-6 months (p. 97);
Schizophrenia lasts 6 months +.
Schizopreniform gets a "provisional" if given prior to recovery. Why?
Do you agree with these statements? Substance Use disorders are recorded with the name of the specific substance AND only coded in the absence of a substance-induced disorder.
YES - Page 485 tells us both of these things.
A substance-induced disorder indicates the presence/absence and severity of the substance use disorder. (example provided on p. 497 for alcohol intoxication) -
Alcohol Intox & Alcohol Substance mild F10.129;
Alcohol Intox & Alcohol Substance mod F10.229
Alcohol Intox ONLY - F10.929
What is the difference between Narcissistic Personality Disorder and Mania or Hypomania?
While both types of disorders include grandiosity, mania also includes lack of sleep, pressured speech, flight of ideas, increase in activity level, and involvement in activities that may result in serious consequences (p. 124).
Further, NPD (p. 670) may also include a lack of empathy.
If I have always been extremely moody with highs and lows that do not qualify as mania or major depression, but they do cause me distress regularly - the diagnosis is likely ----?
Cyclothymic Disorder (p. 139)
How is PTSD similar to some of the anxiety disorders?
Worry and Criterion C - avoidance of stimuli associated with the traumatic event (p. 271)
What are the types of Delusional Disorders and define each one?
Erotomanic; Grandiose; Jealous; Persecutory; Somatic (p. 90)
What is the difference between Anorexia Nervosa; Binge-Eating/purging type and Bulimia Nervosa?
Bulimia Nervosa diagnosis does not include criteria for significantly low body weight. (p.344-5).