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Comp 2012-MFT DSM

Terms in this set (49)

Agoraphobia
Anxiety about being in places or situations from which escape might be difficult, embarrassing or help may not be available if one had panic-like symptoms
Compulsions
Repetitive behaviors or mental acts that the person feels driven to perform to reduce distress or to prevent some dreaded event
Obsessions
Recurrent, intrusive, and anxiety-provoking thoughts, impulses or images
Post-Traumatic Stress Disorder (PTSD)
1. Exposure to traumatic event
2. Felt intense fear, helplessness or horror
3. Re-experience the traumatic event
4. Avoidance of stimuli associated with trauma
5. Numbing of responsiveness
6. Increased arousal
7. For more than 1 month
Generalized Anxiety Disorder
1. Excessive anxiety & worry about many things
2. Feels restless, edgy, keyed up
3. Tires easily
4. Trouble concentrating
5. Irritable
6. Increased muscle tension
7. Trouble sleeping
8. For at least 6 months
Panic Attack
1. Palpitations, pounding heart, increased pulse rate
2. Chest pain
3. Nausea
4. Shortness of breath
5. Feeling of smothering or choking
6. Chills/Hot flashes
7. Dizziness Numbness or tingling
8. Fear of losing control, going crazy, or dying
9. Perspiration
10. Trembling or shaking
11. Derealization or depersonalization
Manic Episode
1. Mood is abnormally & persistently elevated, expansive or irritable
2. Inflated self-esteem or grandiosity
3. Decreased need for sleep
4. More talkative than usual or pressured speech
5. Flight of ideas or feels thoughts are racing
6. Distractibility
7. Increased goal-directed or motor activity
8. Excessive involvement in pleasurable, but risky activities (spending spree, sexual encounters, risky business deals)
9. For at least a week
Depression
1. Depressed mood, most of the day
2. Insomnia or hypersomnia
3. Fatigue
4. Problems thinking, concentrating, making decisions
5. Appetite decrease or increase
6. Diminished interest or pleasure in activities [Dep]
7. Weight ~ significant gain or loss [Dep]
8. Motor agitation or retardation [Dep]
9. Feeling worthless, excessive guilt [Dep]
10. Thoughts of death or suicide [Dep]
11. Hopelessness [dysthymia]
12. Low self-esteem [dysthymia]
13. Minimum time requirements [2 weeks for major depressive episode / 2 years for dysthymia]
Schizoid Personality Disorder
1. Neither desires nor enjoys social relationships
2. Prefers solitary activities
3. Has little interest in sex with others
4. Gets pleasure from few activities
5. Lacks close friends
6. Appears indifferent to praise or criticism
7. Shows emotional coldness, detachment, flat affect
Obsessive-Compulsive Personality Disorder
1. Preoccupied with details, lists, order to extent that the point of the activity is lost
2. Extreme perfectionism à projects not completed
3. Excessive devotion to work à exclusion of leisure & friendships
4. Inflexible about morals
5. Unable to discard useless objects
6. Reluctance to delegate, unless someone does it to own standard
7. Miserly spending, money is hoarded
8. Rigidity & stubbornness
Narcissistic Personality Disorder
1. Has grandiose sense of self-importance
2. Is preoccupied with fantasies of power, success, love
3. Believes he or she is special or unique
4. Requires excessive admiration
5. Has sense of entitlement
6. Takes advantage of others to achieve own needs
7. Lacks empathy
8. Is often envious of others
9. Is arrogant, haughty
Borderline Personality Disorder
1. Frantic efforts to avoid real or imagined abandonment
2. Pattern of unstable, intense relationships [idealizeà devalue]
3. Identity disturbance
4. Impulsivity in two or more areas that are self-damaging [substance, spending, sex, binging]
5. Recurrent suicidal behavior, gestures, threats
6. Affective instability due to reactive mood
7. Chronic feelings of emptiness
8. Inappropriate intense anger
9. Transient, stress-related paranoid ideas or dissociative symptoms
Substance Dependence
1. Tolerance
a) Need more to produce desired effect
b) Diminished effect with same amount
2. Withdrawal
a) Meets the criteria for withdrawal from that substance
b) Uses a similar substance to block withdrawal symptoms
3. Substance in larger amount or over longer period of time than intended
4. Desire or unsuccessful efforts to control or cut down use
5. Significant time obtaining/using/recovering
6. Important social, occupational or recreational activities eliminated or reduced
7. Continued use despite knowing that it causes recurrent physical or psychological problems
Psychotic symptoms associated with Schizophrenia
1. Delusions
2. Hallucination
3. Disorganized behavior
4. Disorganized speech
5. Negative symptoms
Negative Symptoms
Symptoms that suggest that something has been taken away or is missing from the patient, [not added like a hallucination.]
• Flat or blunted affect
• Reduced amount or fluency of speech
• Avolition ~ Loss of the will to do things
Disorganized Speech
• Loose associations
• Mental associations not governed by logic, but by rhymes, puns and other rules not apparent to observer, or by no rules at all
• Must be so badly impaired that it materially interferes with communication
Disorganized Behavior
• Physical actions that don't appear goal direct
• The lack of understandability suggests behavior is bizarre
Hallucinations
• False sensory perception that occurs in the absence of a related sensory stimuli
• Can be any of the sense, but usually auditory or visual
• Must occur when individual is fully conscious
• Delirium hallucinations aren't evidence of psychotic disorder
Delusions
• A false belief that can't be explained by one's culture or education
• Can't be persuaded that the belief is incorrect, despite evidence to contrary
• Grandeur ~ believes they are of exalted station, God, movie star.
• Guilt ~ they have committed an unpardonable sin or error
• Ill Health ~ they believe they have a terrible disease
• Jealousy ~ they are convinced their partner is unfaithful
• Passivity ~ they believe they are being controlled by outside influence, like radio waves
• Persecution ~ they feel they are being interfered with
• Poverty ~ they fear they are facing destitution, contrary to evidence
• Reference ~ they feel they are being talked about, perhaps in the press or on TV
• Thought Control ~ they believe ideas are being put into their minds by others
Dementia
1. Memory impairment - Unable to learn new info or recall learned information
2. Disturbance in one of following
a. language
b. recognizing objects
c. motor skills
d. executive skills
Delirium
1. Disturbance in consciousness
2. Sudden onset
3. Not due to dementia
4. Caused by substance or medical condition
Somatization Disorder
1. History of many physical complaints before age 30
2. Four pain symptoms
3. Two gastrointestinal symptoms
4. One sexual symptom
5. One pseudoneurological symptom
6. Either (1) or (2):
1) Symptoms can't be explained medically or by substance abuse
2) If related to a medical condition, complaints exceed what is expected.
7. Symptoms not intentionally produced.
Hypochondriasis
1. Preoccupation with fears of having disease, misinterpretation of bodily symptoms
2. Preoccupation persists despite medical assurances
3. Fears of disease not delusional
4. Duration is at least 6 months
Anorexia Nervosa
1. Refusal to maintain body weight [<85% of normal]
2. Intense fear of gaining weight, becoming fat, even though underweight
3. Disturbance in way body is perceived, undue influence of weight on self-evaluation, or denial of seriousness of low weight
4. Amenorrhea
Bulimia Nervosa
1. Binge eating that feels out of control
2. Compensatory behavior in order to prevent weight gain
3. Self-evaluation unduly influenced by body & weight
Attention-Deficit/Hyperactivity Disorder
1. Inattention
2. Hyperactivity
3. Impulsivity
Oppositional Defiant Disorder
1. Negative behavior
2. Hostile behavior
3. Defiant behavior
-Loses temper
-Argues with adults
-Actively defies rules
-Deliberately annoys people
-Blames others for mistakes
-Often touchy, easily annoyed
-Often angry, resentful
-Often spiteful, vindictive
Conduct Disorder
1. Aggression → People/animals
2. Destruction of Property
3. Deceitfulness or Theft
4. Serious violation of rules
Cyclothymic Disorder
1. For at least 2 years, periods of depressive symptoms & hypomanic symptoms [less severe than mania]
2. But do not meet the criteria for major depressive episode
3. During the 1st 2 years, no major depressive, manic or mixed episode
4. Not a schizophrenia related disorder
5. Not due to a substance or medical condition
6. Symptoms cause significant distress or impairment
Substance Abuse
1. Maladaptive pattern of use→ significant impairment & distress & 1 or more in a year
2. Failure to fulfill major role obligations - work, school, home
3. Use when physically hazardous
4. Substance related legal problems
5. Continued use despite it causing recurring interpersonal/social problems
6. Never diagnosed as Substance Dependent
7. Substance Intoxication
8. Substance Withdrawal
Paranoid Personality Disorder
1. Pervasive distrust, suspicion of others
2. Suspects, without basis, that others are exploiting, harming, deceiving
3. Is preoccupied with unjustified doubts of loyalty or trustworthiness of people
4. Is reluctant to confide in others
5. Reads hidden, demeaning, threatening meaning into benign actions
6. Persistently bears grudges
7. Perceives attacks on reputation
8. Has unjustified suspicions about fidelity of others
Schizotypal Personality Disorder
1. Acute discomfort with social relationships, eccentric behavior/thinking
2. Ideas of reference
3. Odd beliefs
4. Unusual perceptual experiences
5. Odd speech
6. Suspiciousness
7. Inappropriate or constricted affect
8. Odd or eccentric appearance and behavior
9. Lack of close friends
10. Excessive social anxiety
Schizophreniform Disorder
1. Two or more psychotic symptoms, each present during a 1-month period
2. Only need one psychotic symptom if:
-Delusion is bizarre [spending night in space capsule]
-Auditory hallucinations
i.Voice commenting on patient's thought/behavior
ii.2 voices talking to each other
3. Less than 6 months
4. Impairment in functioning is not required
Phobia
1. Excessive and unreasonable fear of an object or situation
2. Immediate anxiety upon exposure to object or situation
3. Client recognizes unreasonable nature of fear
4. The object or situational trigger is avoided or endured with anxiety
5. The avoidance or distress significantly interferes with the client's daily life.
Social Phobia
1. Persistent fear of social interactions where evaluation by others is possible
2. Fear of acting in social situations in an embarrassing or humiliating way
3. Exposure to social situations → anxiety or panic [situationally bound]
4. Client recognizes fear as excessive and unreasonable
5. Feared social situations are avoided or endured under duress
6. The fear and distress interfere with the client's ADLs
Acute Stress Disorder
Very similar to PTSD, but lasts 2 days→ 4 weeks

1. Exposure to traumatic event
2. Felt intense fear, helplessness or horror
3. Re-experience the traumatic event
4. Avoidance of stimuli associated with trauma
5. Increased Arousal
6. Presence of 3+ symptoms of dissociation
Obsessive Compulsive Disorder (OCD)
• Obsessions
-Attempt to suppress
-Recognized as product of own mind

• Compulsions
-Driven to perform to reduce distress or to prevent some dreaded event
-Not functional or are excessive
Antisocial Personality Disorder
1. Pattern of disregard for rights of others since age 15
2. Failure to conform to social norms, respect lawful behavior
3. Deceitfulness, lying, conning others for profit or pleasure
4. Impulsivity, failure to plan ahead
5. Irritability, aggressiveness, repeated fights
6. Reckless disregard for safety of others
7. Consistent irresponsibility, failure to honor obligations
8. Lack of remorse
9. Individual is at least 18 years old
10. Evidence of conduct disorder before age 15
Histrionic Personality Disorder
1. Excessive emotionality, attention-seeking
2. Being uncomfortable when not center of attention
3. Rapidly shifting moods
4. Uses physical appearance to draw attention
5. Interactions characterized by provocative, seductive behavior
6. Exaggerates in dramatic manner
7. Is suggestible, easily influenced
8. Considers relationships more intimate than they are
Dependent Personality Disorder
1. Pervasive & excessive need to be taken care of → submissive & clinging, fear separation
2. Unable to make decisions without lots of advice/reassurance
3. Needs others to assume responsibility in major areas
4. Problem expressing disagreement for fear of disapproval
5. Trouble initiating projects
6. Goes to excessive lengths to get support
7. Fears being alone, will be helpless
8. Immediately seeks another relationship when one ends
9. Preoccupation with fears of being left to care for self
Avoidant Personality Disorder
1. Social inhibition, feelings of inadequacy & hypersensitivity to negative evaluation
2. At work avoids activities that involve interpersonal contact, due to fear of criticism, disapproval, rejection
3. Unwilling to be involved unless certain they will be liked
4. Restrained in relationships due to fear of being shamed or ridiculed
5. Preoccupation with rejection in social situations
6. Inhibited in new setting due to fears of inadequacy.
7. Believes self to be inept/unappealing or inferior
8. Reluctant to take risks because they might be embarrassing
Conversion Disorder
1. One or more symptoms affecting motor or sensory function that suggest a neurological or other general condition
2. Psychological factors are associated with symptom because initiation or exacerbation of symptom or deficit is preceded by conflicts or stressors
3. Symptom not intentionally feigned
4. Symptom cannot be fully explained by general medical condition, effects of substance, or culturally sanctioned behavior
5. Symptom or deficit causes significant distress/impairment in important areas of functioning
6. Symptom or deficit not limited to pain or sexual dysfunction, does not occur only during somatization disorder, is not accounted for by another disorder
Pain Disorder
1. Pain in one or more anatomical sites that warrant clinical attention
2. Pain causes significant distress and impairment in social, occupational, other areas of functioning
3. Psychological factors judged to have important role in onset, severity, maintenance of pain
4. Symptom not intentionally feigned
5. Pain not accounted for by mood, anxiety, psychosis, and is not related to intercourse
Body Dysmorphic Disorder
1. Preoccupation with imagined defects in appearance, excessiveness over slight anomaly
2. Preoccupation causes distress and impairment in social, occupational, other functioning
Factitious Disorder
1. Psychological disorder whereby people feign illness to gain attention
2. Intentional production or feigning of physical, psychological signs, symptoms
3. Motivation is to assume sick role
4. External incentives are absent
5. Munchausen's syndrome/ by proxy
Dissociative Identity Disorder
1. Presence of two or more distinct identities or personality states
2. At least two identities or personality states recurrently take control of behavior
3. Inability to recall personal information; too extensive for forgetfulness
4. Disturbance not due to direct physiological effects, substance abuse, or general medical condition
Depersonalization Disorder
1. "Self" becomes dissociated or separated from rest of personality
2. Derealization: feeling the world is not real, one is living in a dream
Dissociative Amnesia
1. One or more episodes of inability to recall personal information; usually a trauma; too extensive for ordinary forgetfulness
2. Disturbance does not occur during another disorder; not directly related to substance abuse, brain injury, or general medical condition
3. Symptoms cause clinically significant distress and impairment in social, occupational, other areas of functioning
Schizoaffective Disorder
1. An uninterrupted period of illness, during which, at some time, there is either a Major Depressive Episode, a Manic Episode, or a Mixed Episode concurrent with symptoms that meet Criterion A for Schizophrenia.
2. During the same period of illness, there have been delusions or hallucinations for at least 2 weeks in the absence of prominent mood symptoms.
3. Symptoms that meet criteria for a mood episode are present for a substantial portion of the total duration of the active and residual periods of the illness.
4. The disturbance is not due to the direct physiological effects of a substance or a general medical condition
5. Specify Type:
Bipolar Type: if the disturbance includes a Manic or a Mixed Episode
Depressive Type: if the disturbance only includes Major Depressive Episodes
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