Anxiety Disorders
Criteria for Specific Phobia do not include:
A. marked fear or anxiety about a specific object or situation
B. the phobic object or situation almost always provokes immediate fear or anxiety
C. the phobic object or situation is actively avoided or endured with intense fear or anxiety
D. the fear or anxiety is out of proportion to the actual danger posed by the specific object or situation
E. the fear, anxiety, or avoidance is intermittent throughout 5 months
The fear, anxiety, or avoidance is intermittent throughout 5 months
True or False: To be diagnosed with Premenstrual Dysphoric Disorder, the client must present with at least five symptoms in the final week before the onset of menses, start to improve within a few days after the onset of menses, and become minimal or absent in the week postmenses
True
The three letter acronym used for Obsessive Compulsive Disorder.
OCD
Carol reports excessive worry, irritability, sleep disturbance, and feeling restless.
GAD score: 15
a. anxiety
b. anxiety unspecified
c. adjustment disorder
d. generalized anxiety disorder
generalized anxiety disorder
Which document do you need to include diagnosis?
a. Prog Note
b. Discharge Summary
c. Intake
d. ISP
e. All of the Above
All of the Above
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?
A. Specific phobia
B. Autism spectrum disorder
C. Selective mutism
D. Social anxiety disorder
E. Psychotic disorder NOS
C. Selective Mutism:
Diagnostic Criteria Includes:
A. Consistent failure to speak in specific social situations (in which there is an expectation for speaking, e.g., at school) despite speaking in other situations B. The disturbance interferes with educational or occupational achievement or with social communication. C. The duration of the disturbance is at least 1 month (not limited to the first month of school). D. The failure to speak is not due to a lack of knowledge of, or comfort with, the spoken language required in the social situation. E. The disturbance is not better accounted for by a Communication Disorder (e.g., Stuttering) and does not occur exclusively during the course of a Persuasive Developmental Disorder.
In distinguishing grief from a major depressive episode, it is useful to consider that in grief the predominant affect is: A. Persistent depressed mood and the inability to anticipate happiness and pleasure. B. Feelings of emptiness and loss. C. Severe recurrent temper outbursts with irritable mood. D. Elated mood with grandiose delusions. E. Self critical or pessimistic ruminations.
What is Answer B. Symptoms of Grief include: Feelings of emptiness and loss.
Other differentiating features between grief and MDD include: The dysphoria in grief is likely to decrease in intensity over days to weeks and occurs in waves. The pain in grief may be accompanied by positive emotions and humor. The thought content features a preoccupation with thoughts and memories of the deceased. In grief, self esteem is generally preserved. Persistent depressed mood and the inability to anticipate happiness or pleasure. The depressed mood of an MDE is more persistent and not tied to specific thoughts or preoccupations. Self-critical and pessimistic ruminations. Feelings of worthlessness and self loathing. Suicidal thoughts because of feeling worthless, undeserving life or unable to cope with the pain of depression.
Formerly known as mental retardation, this disorder has a new name in the DSM-5.
Intellectual Disability and/or Intellectual Developmental Disorder
Characterized by a child under the age of 18 (after aage 6) exhibiting persistent irritability and frequent episodes of extreme behavioral dyscontrol (age in-appropriate temper tantrums at least 3 times per week)
disruptive mood dysregulation disorder
PHQ 2 and/or PHQ 9
Selective Mutism occurs before what age?
A. 4
B. 3
C. 8
C. 8
The onset of the selective mutism is usually before the age of 5 years, but the disturbance may not come to clinical attention until entry into school, where there is an increase in social interaction and performance task such as reading aloud. It is associated with social anxiety.
Rachel is 14 years old and reported having a depressed mood for most of the day consistently past 13 months, poor appetite, low self esteem, and feelings of hopelessness .Rachel denies using any substances.
Persistent depressive disorder
Replacing the diagnosis of mixed episode this specifier can be applied to episodes of major depression, hypomania and mania.
mixed features
PHQ 9 score: 20
a. depression/anxiety
b. depression
c. depression, unspecified
d. major depressive disorder severe depression with non psychotic features
major depressive disorder severe depression with non psychotic features
a. Generalized anxiety disorder
b. Adjustment Disorder with depressive mood
c. Schizophrenia
d. None
Generalized Anxiety Disorder
This category applies to presentation in which symptoms characteristic of an anxiety disorder that cause clinically significant distress or impairment in social, occupational, or other important areas of functioning predominate but do not meet the full criteria for an of the disorders in anxiety and do not meet the criteria for adjustment disorder with anxiety or adjustment disorder with mixed anxiety and depressed mood
unspecified anxiety disorder
this category applies to presentation in which symptoms characteristic of a depressive disorder that cause clinically significant distress or impairment in social, occupational, or other important areas of functioning predominate but do not meet the full criteria for any of the disorders in the depressive disorders diagnostic class and do not meet criteria for adjustment disorder with depressed mood or adjustment disorder with mixed anxiety and depressed mood
Unspecified Depressive Disorder
A helpful resource within the DSM-5 for therapists working with diverse populations
cultural formulation interview
This diagnosis is characterized by nondelusional preoccupations with partner's infidelity
Other specified obsessive-compulsive and related disorder, Obsessional Jealousy
Greg says he wants therapy to discuss issues he is having with his father. Which Z-Code would you use?
a. unknown
b. stressful life
c. parent child relational problem
Parent Child Relational Problem
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. Which of the following should be included in the differential diagnosis?
a. Major depressive disorder
b. Agoraphobia
c. Panic disorder
d. Social anxiety disorder, performance only
e. Generalized anxiety disorder
D.
Explanation: Single episode, panic attack; does not meet the criteria for panic disorder. The context should make the physician include social anxiety disorder, performance only in the differential.
When recording the name of the a diagnosis, what order should the terms be in?
a. single or recurrent episode, major depressive disorder, severity/psychotic/remission specifiers
b. severity/psychotic/remission specifiers, single or recurrent episode, major depressive disorder
c. major depressive disorder, single or recurrent episode, severity/psychotic/remission specifiers
d. major depressive disorder, single or recurrent episode, severity/psychotic/remission specifiers, followed by as many specifiers without codes that apply to the current episode or the most recent episode if the major depressive disorder is in partial or full remission
d. major depressive disorder, single or recurrent episode, severity/psychotic/remission specifiers, followed by as many specifiers without codes that apply to the current episode or the most recent episode if the major depressive disorder is in partial or full remission
A new, non-substance related diagnosis, found in the Substance-Related and Addictive Disorders chapter of the DSM-5.
Gambling Disorder
Characterized by not having any symptoms present no more than 6 months after stressors has subsided
adjustment disorder
False