Abnormal Flashcards
What are the DSM-5 19 diagnostic categories?
Neurodevelopmental disorders, schizophrenia spectrum and other psychotic disorders, bipolar and related disorders, depressive disorders, anxiety disorders, obsessive compulsive and related disorders, trauma and stress related disorders, dissociative disorders, somatic disorders, feeding and eating disorders, elimination disorders, sleep wake disorders, sexual dysfunctions, gender dysphoria, disruptive impulsive control and conduct disorders, substance related and addictive disorders, personality disorders, paraphilic disorders.
When does a clinician use other specified disorder?
When clinician wants to indicate the reason why the person’s symptoms do not meet the criteria for the diagnosis.
When does a clinician use unspecified disorder?
When clinician does not want to indicate the reason why the person’s symptoms do not meet the criteria for the diagnosis.
When does a clinician use provisional?
When clinician does not have enough information for a firm diagnosis, but believes the full criteria for the diagnosis will eventually be met.
What three tools does the DSM-5 have to help clinicians consider and understand the impact of the client’s cultural background on diagnosis and treatment?
Outline for cultural formulation
Cultural formulation interview
Cultural concepts of distress
What type of criterion does the DSM-5 use?
Polythetic - person only needs a subset of characteristics from the larger list of illness criteria.
Does the DSM-5 use an axis system?
No, it is nonaxial - mental and medical listed together (primary diagnosis listed first). Psychosocial and contextual factors and levels of disabilities listed separately.
How is psychosocial and contextual factors, as well as levels of disabilities listed separately assessed and coded?
Psychosocial and contextual factors are coded using ICD codes and levels of disabilities are assessed using WHO disability assessment schedule or other appropriate measures.
What are the three tools the DSM 5 has to assess cultural impact?
- Outline for Cultural Formulation: provides guidelines for assessing.
- Cultural Formulation Interview: semi structured interview; 2 versions - one for the person and the other for an informant of the person.
- Cultural Concepts of Distress: usually broken-down into cultural syndromes, cultural idioms of distress, and cultural explanations.
What are 5 neurodevelopmental disorders?
- Intellectual Disabilities
- Autism Spectrum Disorder
- Attention Deficit/Hyperactivity Disorder (ADHD)
- Specific Learning Disorder
- Tourette’s Disorder
What is the diagnostic criteria for intellectual disabilities?
- Deficits in intellectual functioning reasoning (about IQ of 70 or below)
- Deficits in adaptive functioning (failure to meet society’s standards of personal independence and social responsibility)
- Onset was during developmental period
What are the DSM-5 severity levels for intellectual disabilities?
Mild, moderate, severe, and profound.
What is the main determinate for intellectual disabilities severity level?
Severity is based mainly on the person’s adaptive functioning which includes conceptual, social, and practical domains.
Is intellectual disabilities a lifelong condition?
No, with the right intervention a person may no longer meet the criteria or may meet one for a less severe form.
What is the strongest predictor for intellectual disabilities?
Low birth weight
What is the disorder formerly known as stuttering?
Childhood Onset Fluency Disorder
What is the criteria for Childhood Onset Fluency Disorder?
Disturbance in normal fluency and time patterning of speech that is not appropriate for age.
At what age does Childhood Onset Fluency Disorder begin?
Usually between 2 to 7
What happens for those diagnose with Childhood Onset Fluency Disorder when there is special pressure to communicate?
Symptoms may become worse
What is the prognosis for Childhood Onset Fluency Disorder?
65-85% children recover with severity level at age 8 being a good predictor of prognosis.
How is Childhood Onset Fluency Disorder treated?
Reducing psychological stress, increase frustration coping skills, habit reversal training (eg. stop speaking, breathe and start speaking on the exhale)
What is the diagnostic criteria for specific learning disorder?
- Persistent difficulty with academic skills (word reading, reading comprehension, spelling problems, writing issues, and mathematical difficulties) for at least SIX MONTHS.
- Academic skills significantly below expected for age and causes impairment overall.
- Occurs during school age years.
What are the DSM-5 severity specifiers for specific learning disorder?
Mild, moderate, and severe
What are the DSM-5 subtype specifiers for specific learning disorder?
- Impairment in reading
- Impairment in written expression
- Impairment in mathematics
What are typical IQ scores for those with specific learning disorder?
They tend to have average to above average range, but higher than normal rates of other problems and disorders.
What is the most common comorbid disorder with specific learning disorder?
ADHD (higher risk for antisocial and legal issues)
What is the prognosis for specific learning disorder?
Continue to have learning issues throughout adolescence and adulthood with reading problems increasing psychosocial issues.
Is specific learning disorder more common in females or males?
Males (2:1 to 3:1)
What is the diagnostic criteria for Autism Spectrum Disorder?
- Persistent deficits in social interaction and communication across multiple contexts.
- Restricted, repetitive patterns of behavior, interests and activities.
- Symptoms present during early development period.
- Symptoms cause significant impairment in functioning.
What is the DSM-5 severity specifiers for autism spectrum disorder?
Level 1: requiring support
Level 2: requiring substantial support
Level 3: requiring very substantial support
When would you see the earliest signs of autism spectrum disorder?
Usually observe abnormalities in social orienting and responsivity by about 12 months of age.
What are some of the associated features of autism spectrum disorder?
Intellectual impairments and/or language abnormalities. They also typically exhibit an uneven profile of cognitive abilities.
What are some of the biological links to autism spectrum disorder?
Abnormalities in the cerebellum, amygdala, hippocampus and abnormal levels of norepinephrine, serotonin, and dopamine.
The best outcome for autism spectrum disorder is linked to?
Ability to communicate verbally by age 5 or 6, an IQ over 70, and a later onset of symptoms.
What are some of the treatments for autism spectrum disorder?
Parent management training, special education, training in self care and social interaction skills, vocational training and placement, shaping and discrimination training
What are some of the motor tics indicated by the DSM-5?
Eye blinking, facial grimacing and gestures, jumping, smelling objects, and echokinesis (imitating someone else’s movements)
What are some of the vocal tics indicated by the DSM-5?
Grunting, snorting, barking, echolalia, and coprolalia (repeating socially undesirable words)
What are the three Tic Disorders that the DSM-5 includes?
- Tourette’s disorder
- Persistent (Chronic) Motor or Vocal Tic Disorder
- Provisional Tic Disorder
What is the diagnostic criteria for Tourette’s Disorder?
- Presence of at least ONE VOCAL tic and MULTIPLE MOTOR tics (may occur together or at different times)
- Persisted for more than ONE YEAR
- Began before 18
How does the frequency, severity and disruptiveness change for those with Tourette’s disorder?
They decrease in adolescence or adulthood.
What is the diagnostic criteria for Persistent (Chronic) Motor or Vocal Tic Disorder?
- Includes ONE or MORE motor OR vocal tics.
- Persisted for more than ONE YEAR
- Began before 18
What is the diagnostic criteria for Provisional Tic Disorder?
- Includes ONE or MORE motor AND/OR vocal tics.
- Persisted for more than ONE YEAR
- Began before 18
What is the most common comorbid disorder with Tourette’s disorder?
OCD, but hyperactivity, impulsivity and distractibility are also common.
Biologically, Tourette’s disorder is linked to what?
Elevated levels of dopamine and hypersensitivity of dopamine receptors in the caudate nucleus.
How do you treat Tourette’s disorder?
Pharmotherapy - antipsychotics, SSRIs for OCD symptoms, usually treated with clo
What is the diagnostic criteria for ADHD?
- Pattern of inattention and/or hyperactive/impulsivity for at least SIX MONTHS.
- Onset before age 12.
- Present in at least TWO SETTINGS
- At least SIX SYMPTOMS of inattentive and/or SIX SYMPTOMS of hyperactive/impulsivity.