NCMHCE- Diagnosis (DSM V) Exam Review 2023 Update

NCMHCE- Diagnosis (DSM V) Exam Review 2023 Update Acute Stress Disorder - ANS-The primary feature is the development of characteristic negative mood, and arousal, avoidance, dissociative, and intrusion symptoms that typically begin immediately after a trauma and last for a minimum of three days up to a month. The person is exposed to an event that involved or threatened death, serious injury, or sexual violation. At least nine symptoms need to be experienced which include but are not limited to exaggerated startle response, altered sense of reality, sleep disturbance, distressing memories, recurrent dreams, and an inability to experience positive emotions. The event is persistently re-experienced by the person and there is typically a noted avoidance of stimuli that arouse recollections. This type of disturbance causes significant distress or an impairment to social, occupational, or other areas of necessary functioning. D: Adjustment Disorders, panic disorders, PTSD CBT, Stimulant Use Disorder - ANS-Substance abuse and dependence is now a single disorder measured on a continuum from mild to severe. Each substance is addressed as a separate use disorder but based on same overarching criteria. 11 criteria, 2-3 must be met in order to diagnose mild, six or more for severe. Duration of symptoms: 12 months. - AA, family therapy, antabus. LEAST: psychodynamic treatment Adjustment disorder with.... (depressed mood, anxiety, disturbance of conduct) - ANSCHANGED. stress-response syndromes of emotional or behavioral symptoms in response to an identifiable stressor occuring within 3 months of the onset. Once the stressor has ended, the symptoms do not presist for more than an additional 6 months. 1 or more of the following: depressed mood (sadness and depression); anxiety (nervousness, jitteriness, worry, separation anxiety), disturbance of conduct (sudden changes in behavior combined with feelings of depression or anxiety); maladaptive reactions. 6 subtypes: Depressed mood, anxiety, mixed anxiety and depressed mood, disturbance of conduct, mixed disturbance of emotions and conduct, unspecified. studies suggest that adults with adjustment disorders have a good long-term prognosis while adolescents with this disorder eventually may develop major psychiatric illnesses. Antisocial Personality Disorder - ANS-****Reckless and and lacks empathy. High risk of criminality******** Pervasive pattern of disregard for and violation of the rights of others, occuring since age 15 years, as indicated by 3+ 1. Failure to conform ot social norms with respect to lawful behaviors, as indicated by repeatedly performing acts that are grounds for arrest. 2. Deceitfulness, as inidcated by lying, use of aliases, conning 3. Impulsivity or failure to plan ahead 4. Irritability and aaggressiveness, physical fights or assaults. 5. Reckless disregard for safety of self and others 6. COnsistent irresponsibilty , failure to susteain consistent work behavior or honor financial obligations 7. Lack of remorse. B. at least 18 years. evidence of CD with onset before age 15 years. C/D: Narsissitic PD- APD seeks materialistic gain while NPD seeks personal glory. T: Individual therapy accompanied by family or couples therapy. Once improvement is seen group therapy useful. psychodynamic interventions generally used. cognitive interventions. Personality Disorders - ANS-Impairments in personality (self and interpersonal) and the presence of pathological personality traits. ADHD - ANS-CHANGED. Symptoms are devided into 2 categories: Inattention and Hyperactivity/Impulsivity. Predominantly inattention or hyperactivity: 6+ in subtype, less than 6 in second subtype. Combined: 6+ in both subtypes. Most kids have combined. Children under 17 must have at least 6 symptoms while 17+ must have 5. SOme of the symptoms must be present before age 12.Symptoms will appear over the course of many months, often with the symptoms of impulsiveness and hyperactivity preceding those of inattention, which may not appear for a year or more. Disruptive Mood Dysregulation Disorder (DMDD) - ANS-Characterized by severe and recurrent temper outbursts that are grossly out of proportion in intensity and duration to the siatuion. Occur on average 3+/week for 12m+. Between outbursts display a persistently irritable or angry mood all day and nearly every day. Symptoms must be present in at least two settings and must be severe in at least one of these settings (school, home, with peers). During 12+ month period must not have gone three or more consecutive months without symptoms. Onset before age 10 and cannot be diagnosed for the first time before age 6 or after age 18. More severe than ODD. Non-episodic, like Bipolar disorder. Alcohol Use Disorder (AUD) - ANS-CHANGED. Abuse + Dependence. Mild, moderate and severe.Severity is based on number of criteria met. 2 of the 11 criteria during the same 12-month period. Criteria: Larger amounts or longer period than intended, persistant desire or unsuccessful efforts to cut down, time spent in activities nec to obtain, use or recover from alcohol, craving, failure to fulfill major role obligations, social or interpersonal problems, use in situations in which it is physically hazardous, physical or psych problems exacerbated by, tolerance, withdrawal. Remission- sustained- 12 months or longer. Anxiety Disorders - ANS-Generalized Anxiety disorder (GAD, obsessive-compulsive disorder (OCD), panic disorder, PTSD, Social phobia. Brain: Amygdala and hippocampus play large roles. Women 60% more likely. Treatment: CBT, Behavorial, relaxation, medication, T: CBT, Behavioral therapy (In vivo desensitization). Reduce anxiety. Bipolar Disorder - ANS-Brain disorder that causes unusual shifts in mood, energy, activity and ability to carry out day-to-day tasks. Often develops in late teens and early adult years. Manic and depressive and mixed episodes. Dysthymia- chronic/long term mild low mood. Hypomania - may last less than a week and is a less severe form of mania. May have psychotic symptoms, behavioral problems such as substance abuse. Lasts a lifetime. Episodes come back over time but between episodes many people are free of symptoms. Presence of 5 of 9 diagnostic symptoms with a min duration of 2 weeks and a change from previous functioning. BIPOLAR I: defined by manic or mixed episodes that last at least 7 days, or manic episodes that are so severe person is hospitalized. The individual may or may not have experienced depressive or hypomanic episodes during their illness. BIPOLAR II: Pattern of depressive episodes shifting back and forth with hypomanic episodes, no full blown manic or mixed. BIPOLAR NOS, CYCLOTHYMIC DISORDER: mild form of bipolar disorder. episodes of hypomania that shift back and forth with mild depression for at least 2 years. Do not meet requirements for other BD. RAPID-CYCLING BIPOLAR: 4 or more episodes of major depression, mania, hypomania, or mixed symptoms with a year. Affects more woman than men. Worsens if not treated. CO-EXIT with: substance abuse, anxiety disorders, ADHD, OCD. TREATMENT: Medication, CBT, family-focused, interpersonal, psycho-edu. Mood graphs, Child Abuse - ANS-DSM 5- Found under "conditions that may be a focus of clinical attention. Child maltreatment Conduct Disorder - ANS-A repetitive and presistent Patter of behavior in which the basic rights of others or major age-appropriate societal norms or rules are violated, as manifested by the presence of 3+ criteria in the past 12 months, with at least 1 present in the past 6 months. 1) Aggression to people and animals. 2) Destruction of property, 3)Deceitfulness or theft 4) Serious violations of rules. B. Behavior causes clinically sig impairment in social, academic, or occupation functioning. C. If 18+, not antisocial personality disorder. TYPES: CHildhood-onset- at least one criterion prior to age 10, Adolescent onset, absence prior to age 10. Severity. CAUSES: Genetics, environmental, psychological Anorexia - ANS-Persistent restriction of energy intake leading to significantly low body weight. Either an intense fear of gaining weight or of becoming fat, or persistant behavior that interferes with weight gain. Disturbance in the way one's body weight or shape is experienced, or persistant lack of recognition of the seriousness of current weight. D: Bulimia Nervosa, Avoidant/Restrictive Food intake Disorder, OCD T: Initial focus is to restore one's nutiritional state, stabilize eating use behavioral approaches, insight-oriented psychotherapy follows. Behavioral, cogntitive, eclectic, psychodynamics and family therapy. Bulimia Nervosa - ANS-Recurrent episodes of binge eating. Characterized by1 of the following: - Eating, in a desecrate period of time (within 2 hours, e.g.) an amount of food that is definitely larger than most people would eat during a similar period of time. - A sense of lack of control over eating during the episode. 2) Recurrent in appropriate compensatory behavior in order to prevent weight gain, such as self-induced vomiting, laxatives, or excessive exercise. 3) Binge eating and inappropriate compensatory behaviors both occur, on average, at least once a week for 3 months. T: CBT, interpersonal, nutritional counseling, insight oriented psychotherapy, pharmacotherapy. Self-esteem issues. Appetite suppressants and antidepressants. Binge Eating - ANS-Recurrent episodes of binge eating, an episode is characterized by BOTH: eating in a discrete period of time more.... AND a sense of lac˚ of control. 2) marked distress about eating 3) associated with 3+: eating much more rapidly, eating until fleeing uncomfortably full, eating large abouts when not feeling hungry, eating alone because of feeling embarrassed by how much one is eating, feeling disgusted with oneself. Pica - ANS-non-nutrive substances for at least one month, inappropriate to the developmental level of individual, not part of culturally supported or socially normative practices. OTHER SPECIFIED FEEDING OR EATING DISORDER- people who meet some but not all of the diagnostic criteria for other eating disorders. Oppositional Defiant Disorder (ODD) - ANS-Generally occurs in children from ages 6- 18, with an onset around 8. Characterized by a noncompliant, belligerent, argumentative interaction with authority figures, usually adults. Negative symptoms persist for a min of 6 months. The violation of social norms is not seen (as in CD). Learning Disorders - ANS-Math, reading or written expression. When substantially below that expected for the person's age, schooling and level of intelligence. Can be seen as early as kindergarten and as late as fourth grade. Sometimes not seen until adulthood. Low self esteem and social skills deficits may correlate all 3. Diagnosing: Get a written release to speak with teachers to make sure the educational setting is appropriate. TREATMENTS: Behavioral, cog-behavorial, psychodynamic, play therapy, reality therapy, family therapy and parent training. Structured settings, family involvement in order to help the family as a unit. OCPD - ANS-Pervasive pattern of preoccupation with orderliness, perfectionism, and mental/interpersonal control. This begins in early adulthood, is present in a variety of contexts and is indicated by 4 criteria out of list of 8. These symptoms interfere with normal functioning and create significant distress. Theyr are ultimately unproductive, paying more attention to the details of orderliness while sacrificing tas˚ completion. Work very hard but at the sacrifice of leisure or pleasurable activities. Relationships are characterized by control, warm expression and intimacy are seldom a part of their experiences or interpersonal relationships, shows rigidity and stubbornness, inflexible...