KEY TERMS: DSM-IV
Terms
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- Hallmark of Retardation, Categories of Retardation, Sex Ratio
- HALLMARKS: IQ <70, deficits in adaptive fx in at least 2 areas, and onset before age 18; CATEGORIES: Mild, Moderate, Severe, Profound, Unspec; SEX RATIO=1.5:1 (males to females)
- Hallmark of a Learning Disorder
- HALLMARKS: significant discrepancy (1-2 SD) between IQ and academic achievement
- Autism (including sex ratio) vs. Rett's vs. Asperger's vs. Disintegrative Disorder
- AUTISTIC D/O: impairment in social interaction, communication, and restricted repetoire of activities w/onset prior to age 3 (4 or 5:1, male to female); RETT'S D/O: normal pre&perinatal dvpt and through 5 mo, normal head circ, sudden decelration in head circumference btwn 5-48mo and then stereotype mvmt, social, lang, females only; ASPERGER'S: social and bx but no language or cognitive delays, more common in males; DISINTEGRATIVE D/O: normal dvpt for 2 yrs followed by sig loss of skills before age 10 in at least 2 areas, lang, soc skills, play, motor skills, bowel/bladder control, more common in males
- ADHD vs. Conduct disorder vs. Oppositional Defiant disorder
- ADHD: at least 6 mo of inattention and/or impulsivity before age 7, 6-9x more common in males; CONDUCT D/O: persistnent pattern of bx in which basic rights of others or major age-appropriate social norms/rules are violated; ODD: reucrrent pattenr of negativistic, defiant, disobedient bx twds auth figures, pers at least 6 mo
- Separation anxiety disorder; reactive attachment disorder (hypervigilance)
- SEPARATION ANXIETY D/O: dvptly inapp and excessive anx re: being away from home or loved ones, onset before age 18, may be due to parental anxiety or enmeshment; REACTIVE ATTACHMENT D/O: sign dist in social relatedness in most contexts, onset before age 5, due to grossly pathological care, Inhibited or Disinhibited Types
- Substance Abuse vs. Substance Dependence
- SUBSTANCE ABUSE: maladaptive pattern of substant use resulting in recurrent and significant problems directly related to the repeated substance use; SUBSTANCE DEPENDENCE: cluster of cognitive, behavioral, and physiological sx that indicate impaired control and continued use despite adverse consequences
- Alcohol and Sedative/Hypnotic/Anxiolytic Intoxication and Withdrawal
- ETOH + INTOXICATION: behavioral and psychological changes, slurred speech, incoordination, impaired memory and concentration, and possible stupor or coma; ETOH + WITHDRAWAL: autonomic hyperactivity, insomnia, nausea, vomiting, transient hallucinations, psychomotor agitation, and seizures, can be potentially fatal
- Caffeine Intoxication
- can be caused by more than 2-3 cups of brewed coffee; restlessness, flushed face, diuresis, GI distress, muscle twitching, insomnia, rambling speech, agitation, tachycardia, can mimic anxiety d/o (difference=flushed face and diuresis)
- Cocaine and Amphetamine Intoxication and Withdrawal
- COC/AMPH INTOXICATION: euphoria, hypervigilance, anger, impaired judgment, psychomotor agitation, tachycardia, nausea/vomiting, muscular weakness, pupillary dilation, perspiration or chills, respiratory problems, weight loss, confusion, seizures, coma; COC/AMPH WITHDRAWAL: dysphoria, fatigue, unpleasant dreams, increased appetite, psychomotor agitation or retardation
- Opioid Withdrawal
- Flu-like symptoms of nausea and vomiting, muscle aches, diarrhea, fever, insomnia, pupillary dilation, dysphoric mood
- Paranoid vs. Disorganized vs. Catatonic vs. Undifferentiated Schizophrenia
- PARANOID: preoccupation w/one ore more delusions or frequent auditory hallucinations w/o disorganized speech, catatonic bx, flat or inappropriate affect; DISORGANIZED: prominent disorganized speech, bx, flat or inappropriate affect; CATATONIC: at least two of motoric immobility, excessive and purposeless motor activity, negativism or mutism, peculiarities of voluntary mvmt, or echolalia; UNDIFFERENTIATED: doesn't meet criteria for other subtypes
- Schizophrenia vs. Schizophreniform vs. Brief Psychotic Disorder
- SCHIZOPHRENIA: presence of 2 or more characteristic sx present for sig amt of time in 1-mo period: delusions, hallucinations, disorganized speech, grossly dis/catatonic bx, negative sx, must be fx below prev level and sx persist for at least 6 mo w/1 mo of active sx; SCHIZOPHRENIFORM D/O: meets all criteria for schizophrenia except that disorder lasts at least 1 mo but less than 6 mo; BRIEF PSYCHOTIC D/O: one or more of the following, delusions, hallucinations, disorg speech, grossly disorg/catatonic bx, lasts anywhere from 1 day to 1 mo, w/ or w/o marked stressor or w/postpartum depression
- Best prognosis for schizophrenia
- Best prognosis: good prior fx, late onset, abrupt onset, mood disorder, a stressor, paranoid type, and for females
- Concordance rates for schizophrenia
- Identical twins (50%), child when both parents have it (45%), siblings/fraternal twins (10-15%), parent to child (5-10%)
- Schizoaffective vs. Mood disorder with psychotic features
- SCHIZOAFFECTIVE DISORDER: uninterrupted period of illness w/Major Dep, Manic, or Mixed Ep concurrent w/sx of Schizophrenia, + delusions/hallucinations for at least 2 wks w/o prominent mood sx; MOOD D/O w/PSYCHOTIC FEATURES: does not meet full sx for schizophrenia and mood sx are constant
- Delusional disorder: Eromatic vs Jealous vs. Grandiose vs. Persecutory vs. Unspecified
- DELUSIONAL DISORDERS: EROTOMATIC: that another person is in love with you; JEALOUS: that partner is being unfaithful; GRANDIOSE: inflated self-worth, power, knowledge, or special rltnshp w/someone of higher status; PERSECUTORY: that person or someone close to them is being persecuted or ill-treated; UNSPECIFIED: delusions w/another theme
- Bipolar I vs. Bipolar II Disorder
- BIPOLAR I: occurrence of one or more Manic or Mixed Episodes; person may have had one or more Major Dep Ep, equally common in males and females (id tw, 80%, frat tw/sib 20-25%); BIPOLAR II: one or mor Major Dep Ep and at least one Hypomanic Ep, may be more common in women than men
- Concordance rates for Bipolar
- Identical twins (80%), fraternal twins and siblings (20-25%)
- Treatment for Agoraphobia vs. Panic Disorder vs. Specific Phobia vs. Social Phobia vs. OCD vs. PTSD
- AGORAPHOBIA: flooding or exposure with response prevention, massed in vivo; PANIC DISORDER: med management w/antidepressant meds (Imipramine) and siutational in vivo exposure; SPECIFIC PHOBIA: in vivo massed exposure; SOCIAL PHOBIA: social skills training, relaxation, exposure training with cognitive restructuring; OCD: Anfranil (Clomipramine) or Prozac, flooding, thought stopping; PTSD: immediate debriefing after trauma, relaxation skills, working through the trauma to reduce arousal, EMDR
- Conversion vs. Somatization vs. Hypochondriasis
- CONVERSION DISORDER: one or more sx affecting voluntary motor or sensory fx that resemble neurological/med condition, not intentionally produced, UCS primary gain, more common in women, rural, and lower SES: SOMATIZATION DISORDER: hx of recurrent and multiple somatic complaints before age 30 and duration several yrs (4 pain sx, 2 GI sx, 1 sexual sx, 1 pseudoneurological sx), much more common in women; HYPOCHONDRIASIS: preoccupation w/fear of having or belief that one has a serious disease based on misperception of bodily sx, lasts at least 6 mo, equal male and female
- Factitious vs. Malingering vs. Somatoform
- FACTITIOUS: intentional sx production/reporting, absence of external incentives for bx; MALINGERING: intentional sx production/reporting, external incentive for bx; SOMATOFORM: presence of physical sx suggesting a physical d/o that are not fully explained by gen med condition, sx production is not intentional
- Melatonin
- Transvestism vs. Transexualism
- TRANSVESTISM: cross-dressing but wish to remain own sex; TRANSEXUALISM: desire to or becomes the opposite sex
- Paranoid Personality vs. Delusional Disorder Paranoid
- PARANOID PD: inflexible, maldaptive trait that causes functional impairment, pervasive distrust and suspiciousness of others and tend to misinterpret others' actions in negative way; DELUSIONAL D/O PARANOID: persistent, non-bizarre paranoid delusion of at least one month's duration, and otherwise person's bx is relatively unimpaired and not obviously odd
- OCD vs. Obsessive Compulsive Personality
- OCD is more intense; OCDP is a preoccupation with orderliness, perfectionism and control, resulting in inflexibility and inefficiency
- Avoidant vs. Schizoid vs. Schizotypal vs. Schizophrenia
- AVOIDANT PD: social discomfort & inhibition, fear of and hypersensitivity to negative eval and feeling inadequate; SCHIZOID PD: detachmt from and indifference to social rltnshp and restricted range of emotions; SCHIZOTYPAL PD: deficits in IP fx, discomfort w/and reduced capacity for close rltnshps and peculiarities in cognition, perception, ideation, appearance, and bx, appears detached and to lack desire for rltnshps; SCHIZOPHRENIA: presence of 2 or more characteristic sx, each present for significant amt of time during 1-mo period (delusions, hallucinations, disorg speech, disorg/catatonic bx, neg sx) and must persist for at least 6 mo