DSM 5 Exam Study Guide Acute Stress Disorder - Answer -A. exposure to actual or threatened death, serious injury or sexual violation in 1 (or more) of the following: (same at PTSD) 1) directly experiencing the traumatic event(s) 2) witnessing, in person, the event(s) as it occurred to others 3) learning that the traumatic event(s) occurred to a close family member/close friend. In cases of actual or threatened death of a family member/friend, the event(s) must have been violent or accidental 4) experiencing repeated or extreme exposure to aversive details of the traumatic event(s) B. presence of 9 (or more) of the following symptoms from any of the 5 categories of : -intrusion -negative mood -dissociation -avoidance -arousal C. Duration...3 days to 1 month after trauma exposure D. ...clinically significant... E. ...not attributable to... *Note* more symptoms required for diagnosis of ASD(9) than PTSD(6) Additional Specifiers for Schizophrenia, Delusional Disorder and Schizoaffective Disorder - Answer -
Specify if: -with catatonia (refer to the criteria for catatonia associated with another mental disorder for definition) -use additional code 293.89 (F06.1) catatonia associated with schizophrenia to indicate the presence of the comorbid catatonia Specify current severity: -severity is rated by a quantitative assessment of the primary symptoms of psychosis (Clinician Rated Dimensions of Psychosis Symptom Severity) -note: Diagnosis of ___________ can be made without using this severity specifier Adjustment Disorders - Answer -A. the development of emotional or behavioral symptoms in response to an identifiable stressor(s) occurring within 3 months of the onset of the stressor B. These symptoms or behaviors are clinically significant, as evidenced by one or both of the following: -marked distress that is out of proportion to the severity or intensity of the stressor -significant impairment in...functioning C. The stress -related disturbance does not meet the criteria for another mental disorder... D. symptoms do not represent normal bereavement E. once the stressor or its consequences have terminated, the symptoms do not persist for more than an additional 6 months Specify whether: -with depressed mood -with anxiety -with mixed anxiety and depressed mood -with disturbance of conduct -with mixed disturbance of emotions and conduct *occur after exposure to a distressing event (either traumatic or non -traumatic) Adults with LOS and VLOS - Answer -Difficult to reliably determine the age of onset of symptoms of schizophrenia Pattern of symptoms and risk factors differ between individuals with EOS and those with later onset Age at Onset of Schizophrenia - Answer -Early Onset Schizophrenia (EOS) -before 40 years old Late Onset Schizophrenia (LOS) -from 40 -60 years old Very Late Onset Schizophrenia -like Psychotic Disorders (VLOS) -after 60 years old -paraphrenia Agoraphobia - Answer -A. Marked fear or anxiety about 2 or more of the follow 5 situations: -using public transportation -being in open spaces -being in enclosed spaces -standing in line or being in a crowd -being outside of the home alone *Note: fear of only one of these is likely to be diagnosed as a specific phobia* B. the individual fears/avoids these situations because of thoughts that escape might be difficult or help not available in the event of panic -like symptoms or other incapacitating symptoms C. the agoraphobic situations almost always provoke fear or anxiety D. actively avoided, require the presence of a companion, or are endured with intense fear or anxiety E. out of proportion to the actual danger... F. ...persistent, lasting 6 months... G. ...clinically significant... H. if another medical condition is present, the fear/avoidance is clearly excessive I. ...not better explained by... Alcohol Intoxication and Withdrawal Symptoms - Answer -Intoxication: 1) slurred speech 2) incoordination 3) unsteady gait 4) nystagmus 5) impairment in attention or memory 6) stupor or coma Withdrawal: 1) autonomic hyperactivity 2) increased hand tremor 3) insomnia 4) nausea or vomiting 5) transient visual, tactile or auditory hallucinations or illusions 6) psychomotor agitation 7) anxiety 8) generalized tonic -clonic seizures
Specify if: -with catatonia (refer to the criteria for catatonia associated with another mental disorder for definition) -use additional code 293.89 (F06.1) catatonia associated with schizophrenia to indicate the presence of the comorbid catatonia Specify current severity: -severity is rated by a quantitative assessment of the primary symptoms of psychosis (Clinician Rated Dimensions of Psychosis Symptom Severity) -note: Diagnosis of ___________ can be made without using this severity specifier Adjustment Disorders - Answer -A. the development of emotional or behavioral symptoms in response to an identifiable stressor(s) occurring within 3 months of the onset of the stressor B. These symptoms or behaviors are clinically significant, as evidenced by one or both of the following: -marked distress that is out of proportion to the severity or intensity of the stressor -significant impairment in...functioning C. The stress -related disturbance does not meet the criteria for another mental disorder... D. symptoms do not represent normal bereavement E. once the stressor or its consequences have terminated, the symptoms do not persist for more than an additional 6 months Specify whether: -with depressed mood -with anxiety -with mixed anxiety and depressed mood -with disturbance of conduct -with mixed disturbance of emotions and conduct *occur after exposure to a distressing event (either traumatic or non -traumatic) Adults with LOS and VLOS - Answer -Difficult to reliably determine the age of onset of symptoms of schizophrenia Pattern of symptoms and risk factors differ between individuals with EOS and those with later onset Age at Onset of Schizophrenia - Answer -Early Onset Schizophrenia (EOS) -before 40 years old Late Onset Schizophrenia (LOS) -from 40 -60 years old Very Late Onset Schizophrenia -like Psychotic Disorders (VLOS) -after 60 years old -paraphrenia Agoraphobia - Answer -A. Marked fear or anxiety about 2 or more of the follow 5 situations: -using public transportation -being in open spaces -being in enclosed spaces -standing in line or being in a crowd -being outside of the home alone *Note: fear of only one of these is likely to be diagnosed as a specific phobia* B. the individual fears/avoids these situations because of thoughts that escape might be difficult or help not available in the event of panic -like symptoms or other incapacitating symptoms C. the agoraphobic situations almost always provoke fear or anxiety D. actively avoided, require the presence of a companion, or are endured with intense fear or anxiety E. out of proportion to the actual danger... F. ...persistent, lasting 6 months... G. ...clinically significant... H. if another medical condition is present, the fear/avoidance is clearly excessive I. ...not better explained by... Alcohol Intoxication and Withdrawal Symptoms - Answer -Intoxication: 1) slurred speech 2) incoordination 3) unsteady gait 4) nystagmus 5) impairment in attention or memory 6) stupor or coma Withdrawal: 1) autonomic hyperactivity 2) increased hand tremor 3) insomnia 4) nausea or vomiting 5) transient visual, tactile or auditory hallucinations or illusions 6) psychomotor agitation 7) anxiety 8) generalized tonic -clonic seizures
