DSM-5 Study Guide Questions and Answers (graded A+)To pass 2022/2023

DSM-5 Study Guide Questions and Answers (graded A+)To pass 2022/2023A 10- year- old boy who has severe developmental delay exhibits immediate and involuntary repetition and ambient sounds and vocalizations made by other people. What is the term for this phenomenon? A. Dysarthria B. Echolalia C. Echopraxia D. Word salad B. Echolalia Echolalia The pathological, parrotlike, and apparently senseless repetition (echoing) of a word or phrase just spoken by another person. A 19- year- old college freshman wears a wizard hat every day around campus. When asked why, he tells people it is because "the hat helps me think better." He has had few friends but enjoys participating in medieval role- playing games. He earns excellent grades in class and grooms himself appropriately every day. His speech is fluent. His thought process is linear, although he perseverates on various wizard spells he has learned online. His affect is restricted. He denies any hallucinations or any changes in sleep, mood, appetitie, or energy. His unusual "style" has interfered with his getting a job, which he needs to remain in school. What is the likely diagnosis? A. Bipolar I disorder. B. Schizoaffective disorder. C. Schizophrenia D. Schizotypal personality disorder. D. Schizotypal personality disorder. This disorder is characterized by a pattern of deficits in interpersonal skills and a decreased capacity for close relationships. Cognitive and perceptual distortions and eccentric behavior are also evident. Theravada Buddhist monks living at a temple bring a 27- year-old Laotian man to the hospital. The man apparently has fasted for 17 days. The man is acutely dehydrated and emaciated. The pt is admitted to the medicine service. He is delirious at first, but when he improves, the psychiatric consult service is called b/c of his "odd manner". The pt is unkempt and unshaven, which is in sharp contrast to the two other members of his order. The pt does not speak English and one of the monks translates to help the psychiatrist with the evaluation. The pt appears withdrawn and responds very briefly to the other monks, at times laughing inappropriately. The monks say that the man's family, who had recently emigrated from Laos, brought him to the order nearly 1 year ago. Although he has been withdrawn since they have known him, the monks say that this is the first time he has embarked on such a fast. He told them that he was instructed to do so by "spirits", who watch his daily activities and comment on whether he is being appropriately observant. The members of his order are familiar with the names of the spirits from Lao folk traditions, but they are not familiar with this particular tradition of fasting. They acknowledge that the man is from a remote part of Laos, of which the are unfamiliar with the customs. What is the likely diagnosis? A. Culturally appropriate behavior. B. Major depressive disorder. C. Psychotic disorder due to another medical condition. D. Schizophrenia. D. Schizophrenia. Is a psychotic disorder characterized by a combination of specific positive and negative symptoms. Positive symptoms of schizophrenia include hallucinations, delusions, disorganized speech, inappropriate affect, and disorganized behavior (absence of goal- orientation often manifested in failure to perform activities of daily living). Negative symptoms of schizophrenia include a flat or blunted affect (the absence or a severe restriction of observable emotion), avolition (a loss of willpower and decisiveness), alogia (a speech disturbance in schizophrenia involving poverty of speech), decrease in the amount of speech or poverty of content of speech (speech that contains little or no meaningful information), and anhedonia (a loss of ability to experience pleasure). Match each description with the personality disorder for which it is most highly characteristic (each disorder may be used once, more than once, or not at all): A. Antisocial personality disorder B. Borderline personality disorder. C. Histrionic personality disorder. D. Narcissistic personality disorder. _ Consistently uses physical appearance to draw attention to onself. _ Failure to conform to social norms and without remorse. _ Grandiose sense of self- importance. _ Self- dramatization, theratrically, and exaggerated expression of emotion. C. Histrionic personality disordder- Consistently uses physical appearance to draw attention to onself. A. Antisocial personality disorder - Failure to conform to social norms and without remorse. B. Borderline personality disorder- Frantic efforts to avoid real or imagined abandonment. D. Narcissistic personality disorder- Grandiose sense of self- importance. C. Histrionic personality disorder- Self- dramatization, theatricality, and exaggerated expression of emotion. Match each mental disorder with the most accurate statement regarding prevalence by gender (each item may be use once, more than once, or not at all): A. More prevalent among men. B. More prevalent among women. C. Equally prevalent among men and women. _ Restless legs syndrome. _ Major depressive disorder. _ Generalized anxiety disorder. B. More prevalent among women - Restless legs syndrome. B. More prevalent among women- Major depressive disorder. B. More prevalent among women- Generalized anxiety disorder A 45- year- old man presents to his primary care doctor, complaining of chronic chest pain for the past year. He has seen multiple specialists, who tell him the pain is from uncomplicated acid reflux; however, he thinks he must have serious heart disease. He continues to worry about his heart despite reassurance from multiple cardiologists; he acknowledges that it is possible the cardiologists are correct. He denies hallucinations, and there is no evidence of delusional content. His concern about his heart has prevented him from vacationing with his family. He denies feeling depressed or anxious or having any problems with sleep or appetitie, and he continues to enjoy hobbies at home. What is the likely diagnosis? A. Generalized anxiety disorder. B. Illness anxiety disorder. C. Major depressive disorder. D. Panic disorder. B. Illness anxiety disorder. This disorder is characterized by a preoccupation with being sick or with developing a disease. There are few or no somatic symptoms present, but the individual is primarily concerned with the idea that he or she is ill. The diagnosis can be used for individuals who do have a medical illness but whose anxiety is out of proportion to the diagnosis and who assume the worst possible outcome. The anxiety is incapacitating and causes emotional distress or impairs the individual's ability to function. Some individuals may visit physicians (care- seeking type) while others may not (care- avoidant type). A 22- year- old college student presents to a MH clinic for an initial visit. She has not turned in any of her papers on time this term b/c she worries about getting poor grades, and this worry has affected her ability to concentrate. She is also very concerned about getting a job after she graduates, despite multiple meetings with a career counselor. She says that she is concerned with the sanitation at the local gym and prefers to to play recreational sports b/c she might be injured. She does not have any rituals or checking behavior's. She describes her mood as "irritable" and says that she feels "tense all the time". Her appetite has not changed, and she continues to enjoy watching movies. She denies low energy and has not had any thoughts of harming herself. She tried cocaine last year but has not used any illicit substances or alcohol recently. What is the likely diagnosis? A. Adjustment disorder. B. Generalized anxiety disorder. C. Major depressive disorder. D. Obsessive- compulsive disorder. B. Generalized anxiety disorder. This disorder involves excessive anxiety and worry about a number of things that persists for a minimum of 6 months. The behavior is not due to a medical condition or substance. To meet criteria for premenstrual dysphoric disorder, how long must symptoms be present? A. 1 week. B. 1 month. C. 6 months. D. 1 year. D. 1 year. A 16- year- old boy presents to his high school counselor after running out of his programming class b/c he was asked to explain a piece of code. He has trouble answering and had felt this sort of difficulty in the past, but today it was worse. He is not able to explain clearly to the counselor what happened b/c he is still having the same speaking problems that he has in class. He speaks in broken words and keeps getting stuck on sounds like "aye" and "ah". He seems to spit out words. He writes down on a piece of paper that he has been thinking about dropping out of school b/c of his difficulty speaking; his older brother dropped out of school for similar problems. The counselor later observes him working in the computer lab and notices no abnormal behavior. What is the likely diagnosis? A Autism spectrum disorder. B. Childhood- onset fluency disorder (stuttering). C. Social anxiety disorder (social phobia). D. Tourette's disorder. B. Childhood- onset fluency disorder (stuttering). Is diagnosed when a child fails to use age and dialect appropriate speech sounds. The average age of onset is by age 6, but the range can be b/w 2-7 years of age. The disorder causes significant anxiety related to speaking or limitations in effective communication. Stress and anxiety can exacerbate the disroder. The disorder interferes with the individual's achievement in academics, occupation, and interpersonal communication. The individual may avoid situations due to fear that stem from humiliation and embarrassment. Police bring a 30- year- old homeless man to the psychiatric emergency department after he called 911 b/c he thought people were controlling his mind through "microwaves". He has no previous psychiatric or medical hx, and his urine toxicology screen is negative for illicit substances. On interview, he appears very guarded, with limited cooperation, b/c he feels that he does not belong on a psychiatric unit. "I am not the problem", he says. "These microwaves are all around us, even if you cannot feel them." He denies any mood symptoms. Until a few years ago he was working full time, but he refuses to divulge his occupation "b/c I do not trust anyone". On examination, his speech is fluent with normal volume and rate, but his thought process is occasionally disorganized. His affect is blunted, and no psychomotor abnormalities are noted. He denies any hallucinations, but during the interview he occasionally stares behind the interviewer very intently, without responding to any questions. Which term best describes the man's experience of "microwaves"? A. Delusion. B. Hallucination. C. Ideas of reference. D. Illusion. A. Delusion. A false belief based on incorrect inference about external reality that is firmly held despite what almost everyone else believes and despite what constitutes incontrovertible and obvious proof or evidence to the contrary. The belief is not ordinarily accepted by other members of the person's culture or subculture (I.e it is not an article of religious faith). When a false belief involves a value judgement, it is regarded as a delusion only when the judgement is so extreme as to defy credibility. Delusional conviction can sometimes be inferred from an overvalued idea (in which case the individual has an unreasonable belief or idea but does not hold it as firmly as is the case with a delusion). Delusions are subdivided according to their content. A 22- year- old woman is brought to the hospital after being found wandering on a school playground. She is not able to read or fill out basic paperwork. On exam, she is noted to be pursuing the picture books in the pediatric waiting area and laughing in a childlike manner. She is wearing a T-shirt, sweatpants, and shoes with hook-and-loop fasteners and has a wristband with her identification and her mother's contact information. The woman can say her name and address and answer simple yes/ no questions but cannot answer compound or complicated questions. She begins to cry after not being able to answer many questions. A review of her records indicates that she has not psychiatric hx but still sees her pediatrician, accompanied by her mother. Recent testing places her at an IQ of 50. She has no basic laboratory abnormalities and a negative urine toxicology screen. What is the likely diagnosis? A. Conduct disorder. B. Dissociative identity disorder. C. Intellectual disability (intellectual developmental disorder). D. Selective mutism. C. Intellectual disability (intellectual developmental disorder). Intellectual disability replaces the term "mental retardation". It is a term that is more commonly used by the lay public, advocacy groups and federal statutes. Is characterized by both intellectual and adaptive functioning deficits that begin during the developmental period. Intellectual deficits occur in reasoning, problem solving, planning, abstract thinking, judgement, academics and an inability to learn from experience. Intellectual functioning deficits are manifested by clinical observation and standard intelligence testing. Adaptive functioning deficits are manifested in failure to meet developmental and sociocultural standards of personal independence and social responsiblity. There are limitations in activities of daily living, communication, independent living, and social interactions across multiple situations (e.g home, school, work). A. 40- year- old woman sees a psychiatrist for the first time. She complains of having had low energy and fatigue for the past year and endorses additional symptoms of depressed mood, poor sleep, and decreased concentration. She exhibits significant psychomotor retardation on exam. She denies any suicidal ideation or hallucinations. She takes medication for hypothyroidism but has not seen a primary care doctor in over 10 years. Her thyroid- stimulating hormone level is 7.6, and her urine toxicology screen is negative. What is the likely diagnosis? A Bipolar II disorder. B Depressive disorder due to another medical condition. C. Insomnia disorder. D. Major depressive disorder. B. Depressive disorder due to another medical condition. A 41- year- old man reports to the psychiatrist that he is afraid of dentists. He has a hx of extreme anxiety upon entering a dental office, to the point that he feels dizzy and nauseated. He becomes excessively anxious in the waiting room and has a very difficult time completing visits. He is so fearful about dentists that he reports he cannot take his own children to their dentist b/c he has "anxiety attacks" in the office. Rather, he insists that his wife take the children. His aversion to the dentists has led to his missing regular appointments for more than 6 years. He plans to go soon, only b/c he has severe tooth pain and believes he may need a root canal. He does not have anxiety in other contexts. What is the likely diagnosis? A. Adjustment disorder with anxiety. B. Generalized anxiety disorder. C. Posttraumatic stress disorder. D. Specific phobia. D. Specific phobia.