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114 Cards in this Set
- Front
- Back
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What is Axis I?
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Clinical disorders and other conditions not coded on Axis II. example: Schizophrenia and depression
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What is Axis II?
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Personality disorders and Mental retardation
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What is Axis III?
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Medical conditions not classified elsewhere - Physical disorders
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What is Axis IV?
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Psychosocial and environmental problems that affect diagnosis and treatment. Example death of a family
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What is Axis V?
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Global Assessment of Functioning (GAF) - a numerical designation reflection current functioning and/or the highest level of functioning in the past year.
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Mental Retardation
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Sub-average intellectual functioning and impairment in adaptive functioning with onset before the age of 18.
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IQ - Borderline Intellectual Functioning
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IQ = 71-84
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IQ - Mild
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IQ = (50-55) to 70
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IQ- Moderate
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IQ= (35-40) to (50-55)
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IQ - Severe
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IQ = (20-25) to (35-40)
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IQ - Profound
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IQ = Below (20-25)
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Pervasive Development Disorders (PDD)
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Characterized by severe and pervasive impairment in several areas of development: reciprocal social interaction skills, communication skills, or the presence of stereotyped behavior, interests, and activities.
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PDD -Autistic Disorder - Manifest by what age and areas
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Manifest prior to age 3 and must be manifest by delays or abnormal functioning in at least one of the following areas: social interaction, language as used in social communication, or symbolic or imaginative play
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PDD- Rett's Disorder
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The development of multiple specific deficits following a period of normal functioning after birth. Normal psychomotor development through the first 5 months of life. Between ages 5 and 48 months , head growth decelerates
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PDD - Asperger's Disorder
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In contrast to Autistic Disorder, there are no clinically significant delays or deviance in language acquisition and they do not have clinically significant delays in cognitive development or in age-appropriate self-help skills, adaptive behavior, and curiosity about the environment in childhood.
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What is the treatment coice and age of onset for PDD?
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Onset is age 3
Treatment choice: behavior modification with family support |
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Attention-Deficit and Disruptive Behavior Disorders (ADD/ADHD)
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A persistent pattern of inattention and/or hyperactivity-impulsivity that is more frequently displayed and more severe than typically observed in individuals at a comparable level of development.
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Some hyperactive-impulsive or inattentive symptoms that cause impairment must have been present before what age?
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7 and symptoms is present in two or more settings (school or work and or at home)
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Criteria for ADD - 6 or more of the following symtoms of inattention have persisted for at least 6 months to a degree that is maladaptive and inconsistent with developmental level
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1. Often fails to give close attention to details or makes careless mistakes in schoolwork, work, or other activities,
2. often has difficulty sustaining attention in tasks or play activities. 3. often does not seem to listen when spoken to directly 4. often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace 5. often has difficulty organizing tasks and activities 6. often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort 7. often loses things necessary for tasks or activities 8. is often easily distracted by extraneous stimuli 9. is often forgetful in daily activities. |
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Criteria for ADHD - 6 or more of the following symptoms of hyperactivity-impulsivity have persisted for at least 6 months to a degree that is maladaptive and inconsistent with developmental level:
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Hyperactivity:
1. often fidgets with hands or feet or squirms in seat 2. often leaves seat in classroom or in other situations in which remaining seated is expected 3. often runs about or climbs excessively in situations in which it is inappropriate 4. often has difficulty playing or engaging in leisure activities quietly 5. is often "on the go" or often acts as if "driven by a motor" 6. often talks excessively Impulsivity: 1. often blurts out answers before questions have been completed. 2. often has difficulty awaiting turn 3. often interrupts or intrudes on others |
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Disruptive behavior disorders: Conduct Disorder
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A repetitive and persistent pattern of behavior in which the basic rights of others or major age-appropriate societal norms or rules are violated. Agressive conduct that causes or threatens physical harm to other people or animals, nonagressive conduct that causes property loss or damage, deceitfulness or theft, and serious violations of rules during the past 12 months, with at least one behavior present in the past 6 months .
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Two subtypes of Conduct Disorder are provided based on the age at onset of the disorder.
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1. Childhood-onset type: at least one criterion characteristic of Conduct Disorder prior to age 10 years. Usually male, frequently display physical aggression toward others, have disturbed peer relationships, may have had oppositional defiant disorder during early childhood.
2. Adolescent-onset type: defined by the absence of any criteria characteristic of Conduct Disorder prior to age 10 years. Compared with Childhood onset type, these individuals are less likely to display aggressive behaviors and tend to have more normative peer relationships. |
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Oppositional Defiant Disorder
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A pattern of negativistic, hostile, and defiant behavior lasting at least 6 months, during which four (or more) of the following are present:
1. often loses temper 2. often argues with adults 3. often actively defies or refuses to comply with adults' requests or rules. 4. often deliberately annoys people 5. often blames others for his/her mistakes or misbehavior 6. is often touchy or easily annoyed by others 7. is often angry and resentful 8. is often spiteful or vindictive. |
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Treatment of choice for Attention deficit and disruptive behavior disorders
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behavioral interventions and medications (ex. Ritalin - stimulants)
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Pica
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Eating disorder - eating of one or more nonnutritive substance on a persistent basis for a period of at least 1 month. This is usually associated with other mental disorders (ex. Pervasive Developmental Disorder, Mental Retardation)
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Rumination Disorder
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The repeated regurgitation and rechewing of food occurring after feeding that develops in an infant or child after a period of normal functioning and lasts for at least 1 month.
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Age of onset for Rumination Disorder
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Between ages 3 months and 12 months
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Anorexia Nervosa
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Individuals refuses to maintain a minimally normally body weight, is intensely afraid of gaining weight, and exhibits a significant disturbance in the perception of the shape or size of his/her body.
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Bulimia Nervosa
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Binge eating and inappropriate compensatory methods to prevent weight gain. Compensatory behaviors must occur, on average, at least twice a week for 3 months
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Encopresis
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An Elimination Disorder that is repeated passage of feces into inappropriate places (ex. floor or clothing). Most often this is involuntary but occasionally may be intentional. The event must occur at least once a month for at least 3 months, and the chronological age of the child must be at least 4 years.
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Enuresis
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The essential feature of this Elimination Disorder is repeated voiding of urine during the day or at night into be or clothes. Most often this is involuntary but occasionally may be intentional. To qualify ,must occur at least twice per week for at least 3 months or else must cause clinically significant distress or impairment in social, academic(occupational), or other importnat areas of functioning.
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Treatment of choice of Elimination disorders
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rule out medical or physical conditions, then, behavior modifications
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Separation anxiety disorder
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Other disorders of childhood - is excessive anxiety concerning separation from the home or from those to whom the person is attached. This disturbance must last for a period of at least 4 weeks, begin before age 18, and cause clinically significant distress or impairment in social, academic (occupational), or other important areas of functioning.
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Selective Mutism
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Other disorders of childhood- the persistent failure to speak in specific social situations (ex. school, with playmates) where speaking is expected, despite speaking in other situations. The disturbance must last for at least 1 month and is not limited to the first month of school
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Delirium
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is characterized by a disturbance of consciousness and a change in cognition that develop over a short period of time.
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Dementia
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multiple cognitive deficits that include impairment in memory
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Substance Dependence
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There is a pattern of repeated self-administration that can result in tolerance, withdrawal, and compulsive drug taking behavior. A diagnosis can be applied to every class of substance except caffeine.
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Substance intoxication
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Due to the recent ingestion of (or exposure to) a substance.
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Korsakoff's syndrome
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Is a neurological disorder caused by a lack of thiamine (vitamin B1) in the brain. Its onset is linked to chronic alcohol abuse and/or severe malnutrition.
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Amphetamine Abuse
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Two (or more) of the following, developing during, or shortly after, use of amphetamine or related substance:
(1) tachycardia or bradycardia (2) pupillary dilation (3) elevated or lowered blood pressure (4) perspiration or chills (5) nausea or vomiting (6) evidence of weight loss (7) psychomotor agitation or retardation (8) muscular weakness, respiratory depression, chest pain, or cardiac arrhythmias (9) confusion, seizures, dyskinesias, dystonias, or coma |
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Cocaine-Related disorders
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Clinically significant maladaptive behavioral or psychological changes (e.g. euphoria or affective blunting; changes in sociability; hypervigilance; interpersonal sensitivity; anxiety, tension, or anger; stereotyped behaviors; impaired judgment; or impaired social or occupational functioning) that developed during, or shortly after, use of cocaine.
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Hallucinogen related Disorders
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Marked anxiety or depression, ideas of reference, fear of losing one's mind, paranoid ideation, impaired judgment, or impaired social or occupational functioning
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Schizophrenia
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is a disorder that lasts for at least 6 months and includes at least 1 month of active-phase symptoms of the following: delusions, hallucinations, disorganized speech, grossly disorganized or catatonic behavior -NOT due to substance abuse
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2 broad categories for characteristic symptoms of schizophrenia
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1. (active phase) positive symptoms include distortions in thought content (delusions), perception (hallucinations), language and thought process (disorganized speech), and self-monitoring of behavior (grossly disorganized or catonic behavior)
2. negative symptoms include restrictions in the range and intensity of emotional expression (affective flattening), in the fluency and productivity of thought and speech (alogia), and in the (lack) initiation of goal-directed behavior (avolition) |
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Five sub-classifications of schizophrenia - Paranoid Type
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1. Paranoid type: Delusions or auditory hallucinations are present, but thought disorder, disorganized behavior, or affective flattening are not. Delusions are persecutory and/or grandiose, but in addition to these, other themes such as jealousy, religiosity, or somatization may also be present. Anxious, anger, aloofness, and argumentativeness
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2nd subtype of schizophrenia - Disorganized type
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Disorganized type: Where thought disorder and flat affect are present together. The prominent symptoms of this subtype are disorganized speech and behavior, lack of emotional expression, and difficulties performing daily activities.
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3rd type of schizophrenia - Catatonic Type
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This is the rarest subtype of schizophrenia. The predominant symptoms involve some form of psychomotor disturbance. Examples include a significant or complete lack of responsiveness to one’s surroundings, maintaining a rigid or bizarre posture, excessive movement that has no purpose, or mindlessly repeating another person’s words or movements.
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4th type of schizophrenia - Undifferentiated type
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This subtype is diagnosed when clear symptoms of schizophrenia are present, but they don’t meet the criteria for one of the other four subtypes.
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5th type of schizophrenia - Residual
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This subtype is diagnosed when the person has had at least one schizophrenic episode. However, there are currently no prominent positive symptoms but there is still evidence of the disorder (e.g. strange beliefs or behaviors, or speech that is still a little disorganized).
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Schizophreniform disorder
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are identical to those of Schizophrenia except for two differences: the total duration of the illness (including prodromal, active, and residual phases) is at least 1 month but LESS then 6 months and impaired social or occupational functioning during some part of the illness is not required
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Schizoaffective disorder
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Must be a period of at least two weeks of psychosis without mood disorder, and these symptoms cannot be due to medication(s), substance use or another medical condition.
he mood component may be elevated or depressed (bipolar or depressive subtype), or simultaneously elevated and depressed (mixed episode), and these abnormal mood components alternate with, or occur together with, distortions in perception. |
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Delusional disorder
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is an uncommon psychiatric condition in which patients present with circumscribed symptoms of non-bizarre delusions, but with the absence of prominent hallucinations and no thought disorder, mood disorder, or significant flattening of affect. "Someone is out to get them"
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six subtypes of the delusional disorder
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1. erotomanic (believes that someone is in love with him/her)
2. grandiose (believes that he/she is the greatest, strongest, fastest, richest, and/or most intelligent person ever) 3. jealous (believes that the love partner is cheating on him/her) 4. persecutory (believes that someone is following him/her to do some harm in some way) 5. somatic (believes that he/she has a disease or medical condition) 6. mixed, i.e., having features of more than one subtype. |
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Brief psychotic disorder
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is a period of psychosis whose duration is generally shorter, non re-occurring, and not better accounted for by another condition.
Symptoms generally last at least a day, but not more than a month, and there is an eventual return to full baseline functioning. |
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Shared Psychotic Disorder (Folie à deux)
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is a psychiatric syndrome in which symptoms of a delusional belief are transmitted from one individual to another. ( family member has a delusion and family members believes the delusion)
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Mood Disorder - Depressive Disorders: Major Depressive Episode
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Depressed mood and/or loss of interest or pleasure in life activities for at least 2 weeks and at least five of the following symptoms that cause clinically significant impairment in social, work, or other important areas of functioning almost every day
1. Depressed mood most of the day. 2. Diminished interest or pleasure in all or most activities. 3. Significant unintentional weight loss or gain. 4. Insomnia or sleeping too much. 5. Agitation or psychomotor retardation noticed by others. 6. Fatigue or loss of energy. 7. Feelings of worthlessness or excessive guilt. 8. Diminished ability to think or concentrate, or indecisiveness. 9. Recurrent thoughts of death |
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Dysthymia
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is a mood disorder consisting of chronic depression, with less severe but longer lasting symptoms than major depressive disorder. "down in the dumps"
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Dysthymic Disorder onset
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early onset - occurs before age 21
late onset - occurs at age 21 or older |
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Treatment of choice for a depressive disorder
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Anti-depressant medication and psychotherapy
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Manic episode
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is a period of seven or more days (or any period if admission to hospital is required) of unusually and continuously effusive and open elated or irritable mood, where the mood is not caused by drugs/medication or a medical illness (e.g., hyperthyroidism), and (a) is causing obvious difficulties at work or in social relationships and activities, or (b) requires admission to hospital to protect the person or others, or (c) the person is suffering psychosis.
Age of onset for a first Manic episode is the early 20s To be classed as a manic episode, while the disturbed mood is present at least three (or four if only irritability is present) of the following must have been consistently prominent: grand or extravagant style, or expanded self-esteem; pressured speech; reduced need of sleep (e.g. three hours may be sufficient); talks more often and feels the urge to talk longer; ideas flit through the mind in quick succession, or thoughts race and preoccupy the person; over indulgence in enjoyable behaviors with high risk of a negative outcome (e.g., extravagant shopping, sexual adventures or improbable commercial schemes).[ |
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Mixed episode
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a mixed state must meet the criteria for a major depressive episode and a manic episode nearly every day for at least one week.
is a condition during which symptoms of mania and depression occur simultaneously, such as agitation, anxiety, fatigue, guilt, impulsiveness, irritability, morbid or suicidal ideation, panic, paranoia, pressured speech and rage. |
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Hypomanic Episode
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(literally, "below mania") is a mood state characterized by persistent and pervasive elevated (euphoric) or irritable mood, as well as thoughts and behaviors that are consistent with such a mood state.
hypomanic episode as including, over the course of at least four days, elevated mood plus three of the following symptoms OR irritable mood plus four of the following symptoms: 1. pressured speech 2. inflated self-esteem or grandiosity 3. decreased need for sleep 4. flight of ideas or the subjective experience that thoughts are racing 5. easy distractibility and attention-deficit similar to attention deficit hyperactivity disorder 6. increase in psychomotor agitation 7 involvement in pleasurable activities that may have a high potential for negative psycho-social or physical consequences (e.g., the person engages in unrestrained buying sprees, sexual indiscretions, reckless driving, or foolish business investments). |
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Bipolar I Disorders
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is a mood disorder that is characterized by at least one manic or mixed episode. Bipolar I disorder sometimes occurs along with episodes of hypomania or major depression as well. (more manic episodes)
age of onset is 20 for both men and women |
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Bipolar II Disorders
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characterized by at least one hypomanic episode and at least one major depressive episode; with this disorder, depressive episodes can be more frequent and are more intense than hypomanic episodes.
People with bipolar disorder type II have never experienced a full manic episode, although they can experience periods of high energy and impulsiveness similar to but not as extreme as mania. The hypomanic episodes associated with bipolar II disorder must last all day for a period of at least four days. |
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Cyclothymic disorder
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is a type of chronic mood disorder widely considered to be a milder or subthreshold form of bipolar disorder. Cyclothymia is characterized by numerous extreme mood disturbances, with periods of hypomanic symptoms alternating with periods of mild or moderate depression.
For at least 2 years (1 year in children and adolescents), the presence of numerous periods with hypomanic symptoms and numerous periods with depressive symptoms that do not meet criteria for a Major Depressive Episode |
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Treatment of choice for Bipolar Disorders
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medication (lithium..etc) and psychotherapy
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Treatment choice of substance related disorders
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12-step program/self help groups, detoxification, outpatient or inpatient treatment. Therapeutic and residential communities
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Panic Attack
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A discrete period in which there us the sudden onset of intense apprehension, fearfulness, or terror, often associated with feelings of impending doom. during these attacks, symptoms such as shortness of breath, palpitations, chest pains or discomfort, choking or smothering sensations, and fear of "going crazy" or losing control are present.
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Panic Attack
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A discrete period in which there us the sudden onset of intense apprehension, fearfulness, or terror, often associated with feelings of impending doom. during these attacks, symptoms such as shortness of breath, palpitations, chest pains or discomfort, choking or smothering sensations, and fear of "going crazy" or losing control are present.
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Agoraphobia
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Is an anxiety about, or avoidance of places or situations from which escape might be difficult (or embarrassing) or in which help may not be available in the event of having a panic attack or panic-like symptoms.
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Specific phobia (formally simple phobia)
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Is characterized by clinical significant anxiety provoked by exposure to a specific feared object or situation, often leading to avoidance behavior.
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Social phobia (social anxiety disorder)
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Is characterized by clinical significant anxiety provoked by exposure to a specific feared object or situation, often leading to avoidance behavior. Those younger than age 18 and only symptoms that persist for at least 6 months.
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Obsessive-Compulsive Disorder
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Is characterized by obsessions (which cause marked anxiety or distress) and/or by compulsions (which serve to neutralize anxiety).
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Post traumatic stress disorder
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Is the reexperiencing of an extremely traumatic event accompanied by symptoms of increased arousal and by avoidance of stimuli associated with the trauma. Full symptom picture must be present for more than 1 month.
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Acute stress disorder
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Symptoms similar to the of PTSD that occur immediately (within 1 month) in the aftermath of an extremely traumatic event.
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Generalized Anxiety Disorder
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At lease 6 months is persistent and excessive anxiety and worry. At least 3 (adults) or 1 (in children) additional symptoms need to be included: extremely fatigued, difficulty concentrating, irritability, muscle tension, and disturbed sleep
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Treatment of choice for anxiety fisorders
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Anti-anxiety /anti-depression medication and psychotherapy (supportive or cognitive-behavioral)
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Somatoform Disorders
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Is the presence of physical symptoms that suggest a general medical condition and not fully explained by a general condition, by the direct effects of a substance, or by another mental disorder.
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Somatization disorder begins before what age?
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Begins before age 30 years, extends over a period of years, and is characterized by a combination of pain, gastrointestinal, sexual, and pseudoneurological symptoms.
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Conversion disorder ( a somatoform disorder)
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Involves unexplained symptoms or deficits affecting voluntary motor or sensory function that suggest a neurological or other general medical condition. Psychological factors are judged to be associated with the symptoms or deficits.
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Pain disorder ( a somatoform disorder)
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By pain as the predominant focus of clinical attention. The pain causes significant distress or impairment in social, occupational, or other important areas of functioning.
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Hypochondriasis ( a somatoform disorder)
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Is the preoccupation with the fear of having, or the idea that has a serious disease based on the person's misinterpretation of bodily symptoms or bodily functions.
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Body dysmorphic disorder (a somatoform disorder)
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Is the preoccupation with an imagines or exaggerated defect in physical appearance. Complaints commonly involve imagined or alight flaws of the face or head such as hair thinning, acne, wrinkled, scars,vascular markings, paleness or redness of the complexion, swelling, or excessive facial hair.
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Treatment for somatoform disorder
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Nothing definitive. Early diagnosis to stop unnecessary medical/surgical interventions, cognitive/behavioral psychotherapy to turn attention away from symptoms
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Fictitious Disorders
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Characterized by physical or psychological symptoms that are intentionally produced or feigned in order to assume the sick role. Fabricating symptoms, self-inflicted conditions. Ex. Faking seizures.
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Dissociative disorders
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Is a disruption in the usually integrated functions of consciousness, memory, identity, or perception. The disturbance may be sudden it gradual, transient or chronic.
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Dissociative Amnesia
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Is characterized by an inability to recall important personal information, usually of a traumatic or stressful nature, that is too extensive to be explained by ordinary forgetfulness
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Dissociative Fugue
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Is characterized by sudden, unexpected travel away from home or one's customary place of work, accompanied by an inability to recall one's past and confusion about personal identity or the assumption of a new identity.
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Dissociative identity disorder (formally multiple personality disorder)
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is characterized by the presence of two or more distinct identities or personality states that recurrently take control of the individual's behavior accompanied by an inability to recall important personal information that is too extensive to be explained by ordinary art forgetfulness.
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Depersonalization disorder (a dissociative disorder)
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Is characterized by a persistent or recurrent feeling of being detached from one's mental processes or body that is accompanied by intact reality testing. "Living in a dream or a movie"
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Sexual dysfunctions
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Are characterized by disturbance in sexual desire and in the psychophysiological changes that characterize the sexual response cycle and cause marked distress and interpersonal difficulty.
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Paraphilias
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Are characterized by recurrent, intense sexual urges, fantasies, or behaviors that involve nonhuman objects, the suffering or humiliation of oneself or one's partner, or children or other non consenting persons that occur over a period of at least 6 months. Situations and cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
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Pedophilia
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A paraphilias that focus on prepubescent children. The individual with pedophilia must be age 16 years or older and at least 5 years older than the child.
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Fetishism
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A paraphilia that use a non living objects
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What is the treatment of choice for a sexual disorder?
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Rule out medication complications for decreased libido. Then behavioral interventions, sometime medication
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Gender identity disorder
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There must be evidence of a strong and persistent cross-gender identification, which is the desire to be, or the insistence that one is, of the other sex. There must be also evidence of persistent discomfort about one's assigned sex or a sense of inappropriateness in the gender role of that sex.
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Personality disorder
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An enduring pattern of inner experience and behavior that deviates markedly from the expectations of the individual's culture, is pervasive and inflexible, has an onset in adolescence or early adulthood, is stable over time, and leads to distress or impairment.
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Paranoid personality disorder
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A pattern of distrust and suspiciousness such that others motives are interpreted as malevolent
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Schizoid personality disorder
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Is a pattern of detachment from social relationships and a restricted range of emotional expression
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Schizotypal personality disorder
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Is a pattern of acute discomfort in close relationships, cognitive or perceptual dispersions, and eccentricities of behavior
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** Antisocial personality disorder
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Is a pattern of disregard for, and violation of, the rights if others; can't confirm to social norms; conduct disorder by age 15; repeatedly get into physical fights or commit acts of physical assault. Individuals must be at least age 18 years and must have history of of some symptoms of conduct disorder before age 15
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** Borderline personality disorder
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Is a pattern of instability in interpersonal relationships, self image, and affects, and marked impulsivity. Also has a shift in moods and impulsive.
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** Histrionic personality disorder
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Is a pattern of excessive emotionality and attention seeking. They are "the life of the party." And if they are not the center if attention, they may do something dramatic to draw the focus of attention to themselves.
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** Narcissistic personality disorder
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Is a pattern of grandiosity, superior over others, boastful, devalue others, need for admiration, and lack of empathy. They would overestimate their abilities and inflate their accomplishments often appearing boastful and pretentious
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Avoidant personality disorder
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Is a pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation.
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Dependent personality disorder
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Is a pattern of submissive and clinging behavior related to an excessive need to be taken care of
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Obsessive-Compulsive personality disorder
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Is a pattern of preoccupation with orderliness, perfectionism, and control
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What is the treatment choice for personality disorder?
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Psychotherapy and awareness of transference and counter-transference issues
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Not Otherwise specified (NOS)
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Each major disorder also includes a NOS. For example: Anxiety Disorder NOS, indicates and anxiety disorder that doesn't meet the criteria for any other anxiety disorder
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General Medical Conditions
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There is a section for disorders "due to General Medical Conditions." i.e. Delirium related to general medical condition; anxiety related to general medical condition, etc.
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Examples of V-Codes
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Child abuse, relational problems, malingering, religious or spiritual problems, antisocial behavior, bereavement, occupational problem, academic problem, acculturation problem, and phase of life problem
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Ideas of referabcr
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Feeling that casual incidents and external events have a particular and unusual meaning that is specific to the person
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Magical thinking
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A False belief that ones thoughts, words, or actions will cause or prevent a specific outcome that defies common understanding of cause and effect. Normal part of child development
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Foile a deux
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Shared psychotic disorder. Ex: delusions develop in wife where husband has psychotic disorder. Relationship ends, so do delusions
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