1
Q
This helps psychiatrists, psychologists, and other health providers accurately diagnose mental illness so that the appropriate treatment can be sought and dispensed.
A
DSM-5
2
Q
categorizes 298 mental disorders based on an established set of criteria, such as behavioral or emotional patterns and the duration of these patterns.
A
DSM-5
3
Q
Cannot be attributed solely substance use, medical conditions or another mental disorder.
A
DSM ( DIAGNOSTIC AMD STATISTICAL MANUAL OF MENTAL DISORDERS)
4
Q
Significantly deviate from cultural or societal norms. Are persistent and recurrent present for a specified duration, rather than isolated or transient.
A
Diagnostic and Statistical Manual of Mental Disorders (DSM)
5
Q
uses categorical approach to diagnosis, but it also uses dimensional approaches to mental disorders
A
DSM-5
6
Q
forces clinicians to define one threshold to define one as “diagnosable”.
A
Categorical system
7
Q
Describe the degree of an intentity that is present
A
Dimensional system
8
Q
Disorder categories in earlier DSMs were overly narrow, result in the widespread use of
A
NOS (NOT OTHERWISE SPECIFIED)
9
Q
It add other specified disorder and unspecified disorder
A
NOS (NOT OTHERWISE SPECIFIED)
10
Q
Used when a patient does meet full criteria for a disorder, but the clinician chooses to specify the reason why.
A
Other specified
11
Q
Clinician wants to communicate the specific reason the criteria are not met.
A
Other specified
12
Q
Used when a patient does meet full criteria for a disorder, but the clinician chooses not to specify the reason (often due to limited information)
A
Unspecified
13
Q
Clinician does not specify the reason, often in emergency or time-limited settings.
A
Unspecified
14
Q
Begins with disorders that typically manifest early in life ((neurodevelopmental, schizophrenia spectrum, and other psychotic disorders). Followed by disorders common in adolescence and young adulthood (bipolar, depressive, and anxiety disorders).
Ends with disorders relevant to adulthood and later life
(neurocognitive disorders
A
DSM-5
15
Q
contains tools like Cultural Formulation and Glossary of Cultural Concepts of Distress
A
DSM-5
16
Q
a cluster of symptoms recognized within a specific cultural group.
A
Cultural syndrome
17
Q
an unexpected death occurring during sleep, often associated with or superstitious explanations.
A
Bangungot
18
Q
culturally rooted expressions used to convey severe stress psychological pain.
A
Cultural idioms of distress
19
Q
– a phrase used to express intense stress or mental strain.
A
Nababaliw na ako
20
Q
A
21
Q
illness believed to be caused by a strong gaze or envy treated by folk rituals.
A
Na-usog
22
Q
Non-axial
A
DSM-5
23
Q
DSM IV MULTI AXIAL SYSTEM
A
Axis 1: clinical disorders
Axis 2: personality disorders and mental retardation
Axis 3: general medical conditons
Axis 4: psychosocial and environmental problems
Axis 5: global assessment of functioning
24
Q
Section 1: Basic Use of the DSM
Clinical Case Formulation
A
Must include social, psychological, and biological factors.
Simple checking of symptoms is not enough for diagnosis.
Clinical judgment is needed to assess severity and impact.
Symptoms often reflect normal emotional responses unless they disrupt functioning.
Clinicians must assess predisposing, precipitating, perpetuating, and protective factors.
Aim: to develop a treatment plan informed by the individual’s cultural and social context.
DSM-5 does not recommend specific treatments.
25
A mental disorder diagnosis must serve a? In guiding clinicians in predicting outcomes and planning treatment
practical clinical purpose
26
receiving a diagnosis does not automatically mean that treatment is required. Decisions should consider:
Severity of symptoms
Prominence or salience of symptoms
Distress experienced by the patient
Disability
Risks and benefits
27
Subcategories that do not overlap but together cover the entire diagnosis. “Specify whether”
Subtypes
28
Only one subtype can be assigned per diagnosis. Defines distinct forms of the diagnosis.
Subtypes
29
Additional that may coexist and are not collectively exhaustive. “Specify” or “ Specify if”
Specifiers
30
Multiple specifiers can be assigned. Indicate course, severity, and other descriptive features
Specifiers
31
Inpatient. the primary condition found to account for why the individual was admitted.
Principal diagnosis
32
Determined after admission and diagnostic evaluation
Principal diagnosis
33
Outpatient. the primary issue prompting the outpatient encounter and treatment.
Reason for visit
34
Based on the main concern addressed during the visit
Reason for visit
35
Indicates a strong presumption that the full diagnostic criteria will eventually be met, but current information is insufficient for a definitive diagnosis
provisional diagnosis
36
DSM-5 DIAGNOSIS CLASSES
37
DSM-5 DIAGNOSIS CLASSES
1. Neurodevelopmental Disorders
2. Schizophrenia Spectrum and Other
Psychotic Disorders
3. Bipolar and Related Disorders
4. Depressive Disorders
5. Anxiety Disorders
Conduct Disorders
6. Obsessive-Compulsive and Related
Disorders
7. Trauma and Stressor-Related
Disorders
8. Dissociative Disorders
9. Somatic Symptom and Related
Disorders
10. Feeding and Eating Disorders
11. Elimination Disorders
12. Sleep-Wake Disorders
13. Sexual Dysfunctions
14. Gender Dysphoria
15. Disruptive, Impulse Control, and
16. Substance Related and Addictive
Disorders
17. Neurocognitive Disorders
18. Personality Disorders
19. Paraphilic Disorders
20. Other Disorders
38
is both a disorder and a basic emotion present across many mental health conditions. Freud recognized its complexity long ago; research shows it involves both biological and psychological factors.
Anxiety Disorers
39
future-oriented negative mood state. Shadow of intelligence.
Anxiety
40
future-oriented, linked to unpredictability and lack of control.
Anxiety
41
immediate reaction to current danger, activates fight-or-flight response.
Fear
42
Both can be adaptive, but excessive forms become problematic
Fear and anxiety
43
sudden, intense fear or discomfort with physical symptoms (e.g., heart palpitations, shortness of breath, dizziness).
Panic attack
44
Types of panic attack
Expected (cued) and unexpected (uncued)
45
occurs in known fear situations (e.g., heights, social
settings). Panic disorder.
Expected (cued)
46
occurs suddenly without warning. Specific phobia, social anxiety disorder.
Unexpected (uncued)
47
An abrupt surge of intense fear or intense discomfort that reaches a peak within minutes, and during which time four (or more of the following symptoms occur. [Note: The abrupt surge can occur from a calm state or an anxious state.]:
Panic attack
48
1. Palpitations, pounding heart, or accelerated heart rate
2. Sweating
3. Trembling or shaking
4. Sensations of shortness of breath or smothering
5. Feelings of choking
6. Chest pain or discomfort
7. Nausea or abdominal distress
8. Feeling dizzy, unsteady, light-headed, or faint
9. Chills or heat sensations
10. Paresthesias (numbness or tingling sensations)
11. Derealization (feelings of unreality) or depersonalization (being detached from oneself)
12. Fear of losing control or "going crazy"
13. Fear of dying
Panic attack
49
[Note: Culture-specific symptoms (eg, tinnitus, neck soreness, headache, uncontrollable screaming or crying) may be seen. Such symptoms should not count as one of the four required symptoms.]
Panic attack
50
At least 6 months of excessive anxiety and worry (apprehensive expectation) on most day.Difficulty controlling the worry process
Generalized Anxiety Disorder
51
Normal worry stops after a challenge ends, but this disorder, worrying never stops —it shift to the next crisis.
GAD - GENERALIZED ANXIETY DISORDER
52
Muscle tension, mental agitation, fatigue, irritability, difficulty sleeping. But here the patients worry about minor, everyday events more than other anxiety disorders
GENERALIZED ANXIETY DISORDER(GAD)
53
Excessive anxiety and worry (apprehensive expectation), occurring more days than not for at least 6 months about a number of events or activities (such as work or school performance)
Generalized anxiety disorder
54
The individual finds it difficult to control the worry
The anxiety and worry are associated with at least three (or more) of the following six sympcoms (with at least some symptoms present for more days than not for the past 6 months)
[Note: Only one item is required in children;
GENERALIZED ANXIETY DISORDER
55
The anxiety and worry are associated with at least three (or more) of the following six symptoms (with at least some symptoms present for more days than not for the past 6 months)
[Note: Only one item is required in children;
1. Restlessness or feeling keyed up or on edge
2. Being easily fatigued
3. Difficulty concentrating or mind going blank
4. Irritability
5. Muscle tension
6. Sleep disturbance (difficulty falling or staying asleep of restless.
unsatisfying sleep)
Generalized anxiety disorder
56
The anery, worry or physical symptoms cause dinically significant distress or impairment in social, occupational, or other important areas of functioning
The disturbance is not attributable to the physological effects of a substance (eg, a drug of abuse, a medication) or another medical condition (eg, hyperthyroidism).
The disturbance is not better explained by another mental disorder (eg. anxiety or worry about having panic attacks in panic disorder, negative evaluation in social anxiety disorder)
Generalized anxiety disorder
57
Content of worry in adult Adults: Family health, children’s misfortunes, job responsibilities, household chores, punctuality.
Generalized Anxiety Disorder
58
Content of worry in Children: Academic, athletic, and social competence, as well as family-related concerns.
Generalized anxiety disorder
59
Content of worry in Older Adults: Health concerns, sleep difficulties (which worsen anxiety)
Generalized anxiety disorder
60
Requires an unexpected panic attack plus substantial anxiety about having another one or its consequences. Individuals often fear death, incapacitation, or losing control during attacks. Some do not report fear of future attacks but change their behavior (e.g., avoiding places, neglecting duties) to reduce distress
Panic Disorder
61
A. Recurrent unexpected panic atracks.
B. At least one of the attacks has been followed by 1 month (or more) of one or both of the following: (a) Persistent concern or worry about additional panic attacks or their consequences (eg. losing control, having a heart attack, "going crazy"), or
(b) A significant maladaptive change in behavior related to the artacks (eg, behaviors designed to avoid having panic attacks, such as avoidance of exercise or unfamiliar situations).
C. The disturbance is not attributable to the physiological effects of a substance (eg. a drug of abuse, a medication) or another medical condition (eg, hyperthyroidism, cardiopulmonary disorders).
D. The disturbance is not better explained by another mental disorder (eg. the panic attacks do not occur only in response to feared social situations, as in social anxiety disorder).
Panic disorder
62
About 60% of people with panic disorder experience?
Nocturnal panic
63
They occur most often between 1:30 a.m. and 3:30
a.m. this occurs during delta wave (slow-wave) sleep, the deepest stage of sleep
Nocturnal panic
64
Not nightmares: Nightmares occur in REM sleep,
which happens later in the cycle, so this is not dream-related. Patients are awake and clearly remember the attacks.
Nocturnal panic
65
Common in children, involve screaming and moving as if chased; children do not wake up and have no memory of the event. Occur in stage 4 sleep and may involve sleepwalking
Sleep terrors (under nocturnal panic)
66
Term coined in 1871 by **Karl Westphal;** literally means “fear of the marketplace.”
Agoraphobia
67
Modern stressful locations include shopping malls and other crowded spaces. Patients seek out “safe” places or people, even if they cannot actually prevent harm, and often plan rapid escape routes (e.g., sitting near doors). Some individuals avoid situations to prevent panic attacks.
Agoraphobia
68
Others endure these situations with intense dread, especially if unavoidable (e.g., going to work, traveling) Use (or abuse) of drugs and alcohol to manage panic symptoms is common. Avoidance of feared situations is a primary coping strategy, though not all agoraphobic individuals avoid completely—some persist despite severe anxiety
Agoraphobia
69
Marked fear or anciety abour two (or more) of the following five
1. Using public tansporcation (eg. sutomobiles, buses, trains.
ships, planes)
2. Being in open spaces
3. Being in enclosed places (eg shops, cheaters, anemas)
4. Standing in line or being in a crowvd
S. Being outside the home alone.
Agoraphobia
70
The individual fears or avoids these stuations due to thoughts that escape might be difficult or help might not be available an the event of developing panic-like symptoms or other incapacitating or embarrassing symptoms (e g. fear of falling in the elderly: fear of incontence).
The situations almost always provoke fear or anxiery
The situations are actively avoided. require the presence of a companion, or are endured with intense fear or anxiety.
Agoraphobia
71
is an irrational fear of a specific object or situation that significantly interferes with daily functioning
Specific phobia
72
Some individuals adapt by avoiding or restructuring their lives (e.g., moving to avoid driving in
snow). Fear is out of proportion to actual danger. Avoidance of feared situations is common and persistent.
Specific Phobia
73
Blood–injection–injury type, Situational type (e.g., planes, elevators, enclosed places), Natural environment type (e.g., heights, storms, water), Animal type, and Other type (e.g., choking, vomiting, contracting illness, children’s fears of loud sounds or costumes
Specific phobia
74
five major categories of specific phobia
Blood–injection–injury type, Situational type (e.g., planes, elevators, enclosed places), Natural
environment type (e.g., heights, storms, water), Animal type, and Other type (e.g., choking,
vomiting, contracting illness, children’s fears of loud sounds or costumes
75
Marked fear or anxiety about a specific object or situation (eg-flying heighis, animals, receiving an injection, seeing blood).
[Note: In children, the fear may be expressed by crying. cantrums, freezing, or clinging]
The phobic object or situation almost always provokes immediate tear or anxiety.
The phobic object or situacion is actively avoided or endured with intense fear or anxiety.
The fear or anxiety is out of proportion to the actual danger posed by the specific object or situation and to the sociocultural context.
Specific Phobia
76
E. The fear, anxiety, or avoidance is persistenc, typically lasting for 6 months or more.
F. The fear anxiety or avoidance causes clinically significant distress or impairment in social, occupational o r other important areas of functioning
G. The disturbance is nor better explained by the symptoms of another mental disorder, including fear, anxiety and avoidance of sicuations associated with panic-like symptoms or other incapacitating symptoms (as in agoraphobia): objects or situations related to obsessions (as in obsessive-compulsive disorder): reminders of traumatic events (as in posttraumatic stress disorder); separation from home or actachment figures (as in separation anxiety disorder): or social situations (as in social anxiety disorder).
Specific Phobia
77
is marked by unrealistic and persistent worry that harm will come to parents/loved ones or that the child will be separated from them (e.g., being lost, kidnapped, or injured) Children often refuse to go to school, leave home, or sleep alone. Symptoms may include nightmares, physical complaints, distress, and anxiety
Separation Anxiety Disorder
78
Fear is tied specifically to school settings.
School Phobia
79
can cause severe impairment in skilled performance, such as an athlete being unable to
complete routine tasks (e.g., throwing a baseball) or an actor avoiding stage roles due to performance anxiety/stage fright. Not equivalent to typical shyness, as many with this are otherwise socially active or outgoing.
Social Anxiety Disorder (social phobia)
80
Individuals often experience noticeable and uncontrollable physical reactions, such as: Blushing → intense embarrassment, leading to social avoidance, Sweating → reluctance to shake hands., Trembling, Paruresis (bashful bladder) → males unable to urinate in public restrooms unless in a private stall.
Social Anxiety Disorder (Social Phobia)
81
Marked fear or anxiety about one or more social or performance situations where the person may be observed, scrutinized, or evaluated negatively. Behaviors such as eating, writing, or urinating are not impaired when done privately only when others are present and evaluation is feared
Social Anxiety Disorder (Social Phobia)
82
A. Marked fear or aniety about one or more social situations in which the individual is exposed t o possible scrutiny by others.
Examples include social interactions (eg, having a conversa-tion, meeting unfamiliar people), being observed (eg, eating or drinking) and performing in front of others (eg- giving a speech). [Note: In children, the anxiety must occur in peer
settings and not just in interactions with adults]
B. The individual fears that he o r she will act in a way or show anxiety symptoms chat will be negatively evaluated (ie. will be humiliating or embarrassing: will lead to rejection or offend
others)
C. The social situations almost always provoke fear or aniety. [Note: i n children, the fear o r anxiecy may be expressed by crying, tantrums, freezing, clinging, shrinking, o r failing to speak in social situations.]
D. The social situations are avoided o r endured with intense fear or anxiety.
Social Anxiety Disorder
83
E.The fear or anxiety is out of proportion to the actual threat posed by the social situaton and to the sociocultural context.
F.The fear, anxiety, or avoidance is persistent, typically lasting for 6 months or more
G.The fear, anxiety, or avoidance causes clinically significant datress or impairment in socal, occupational or acher important areas of functoning
H. The fear, anxiety or avoidance is not attributed to the effects of a substance (eg a drug of abuse, a medication) or anotver medical condition.
The fear, anxiety, or avoidance is not better explained by the symptoms of another mental disorder, such as panic disorder, body dysmorphic disorder, or autom spectrum disorder.
J. if another medical condition (eg, Parkinson's disease, obesity, dafigurement from burns or injury) is present, the fear, anxiety, or avondance & clearly unrelated or is excessive.
Specify if: Performance only: If the fear is restricted to speaking or performing in public
Social Anxiety Disorder
84
develops after exposure to traumatic events such as war, terrorism (e.g., 9/11), natural disasters, physical assault (especially rape), accidents, sudden loss of a loved one, or the COVID pandemic
PTSD Posttraumatic Stress Disorder
85
Re-experiencing: Intrusive memories, nightmares, and flashbacks accompanied by intense emotions.
Avoidance: Avoiding reminders of trauma.
Emotional numbing: Detachment, restricted affect, reduced responsiveness
Posttraumatic stress disorder
86
Intrusive memories, nightmares, and flashbacks accompanied by intense emotions.
Re-experiencing
87
Avoiding reminders of trauma.
Avoidance
88
Inability to recall aspects of trauma, guilt, distorted blame.
Cognitive/memory numbing
89
Chronic overarousal, exaggerated startle response, irritability, anger
Hyperarousal
90
Cannot be diagnosed until at least 1 month post-trauma, since many people recover naturally within weeks
Posttraumatic Stress Disorder
91
Symptoms appear 6 months or more after trauma
Delayed-onset PTSD:
92
Around 50% of ASD cases later develop?
PTSD
93
Introduced in DSM-IV for severe early trauma reactions within the?
First month
94
A. Exposure to actual or threatened death, serious injury, or sexual violence in one (or more) of the following ways:
1. Directly experiencing the traumatic event(s).
2. Witnessing, in person, the event(s) as they occurred to others.
3. Learning that the event(s) occurred to a close relative or close friend. In cases of actual or threatened death of a family member or friend the event(s) must have been violent or accidental.
4. Experiencing repeated or extreme exposure to aversive details of the traumatic event(s) (eg, first responders collecting human remains police officers repeatedly exposed to details of child abuse).
Note Criterion A4 does not apply to exposure through electronic media, television, movies, or pictures, unless this exposure is work related.]
Posttraumatic Stress Disorder
95
C. Persistent avoidance of stimuli associated with the traumatic events), beginning after the traumatic events) occurred, as evidenced by one or both of the following
1. Avoidance of or efforts to avoid distressing memories, thoughts, or feelings, about or closely associated with the traumatic events).
2. Avoidance of or efforts to avoid external reminders (people, places, conversations, activities, objects, situations) that arouse distressing memories, thoughts, or feelings about or closely associated with the traumatic event (s).
D. Negative alterations in cognitions and mood associated with the traumatic events), beginning or worsening after the traumatic events) oc-curred, as evidenced by two (or more) of the following
1. Inabilicy to remember an important aspect of the traumatic event(s) (cypically due to dissociative amnesia and not to other factors such as head injury, alcohol, or drugs).
2. Persistent and exaggerated negative beliefs or expectations about oneself, others, or the world (eg, "I am bad," "No one can be trusted," "The world is completely dangerous," "My whole nervous system is permanently ruined").
3. Persistent distorted cognitions about the cause or consequences of the traumatic events) that lead the individual to blame himself/herself or others.
4. Persistent negative emotional state (eg, fear, horror, anger, guilt, or shame).
5. Markedly diminished interest or participation in significant activities.
6. Feelings of detachment or estrangement from others
7. Persistent inability to experience positive emotions (eg, inability to experience happiness, satisfaction, or loving feelings).
Posttraumatic Stress Disorder
96
B. Presence of one (or more) of the following intrusion symptoms associated with the traumatic events), beginning after the traumatic event(s) occurred
1. Recurrent, involuntary and intrusive distressing memories of the traumatic events). [Note: In children older chan 6 years, repetitive play may occur in which themes or aspects of the traumatic events) are expressed.)
2. Recurrent distressing dreams in which the content and/or affect of the dream are related to the traumatic event(s). [Note: In children, there may be frightening dreams without recognizable content.]
3. Dissociative reactions (e.g, flashbacks) in which the individual feels or acts as if the traumatic events) were recurring. (Such reactions may occur on a continuum, with the most extreme expression being a complete loss of awareness of present surroundings.) [Note In young children, trauma-specific reenactment may occur in play.)
4. Intense or prolonged psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event (5).
5. Marked physiological reactions to internal or external cues that symbolize or resemble an aspect of the traumatic event(s).
Posttraumatic Stress Disorder
97
E. Marked alterations in arousal and reactivity associated with the traumatic events), beginning or worsening after the traumatic everds) oc-curred, as evidenced by two (or more) of the following:
1. Irritable behavior and angry outbursts (with little or no provocation) typically expressed as verbal or physical aggression toward people or objects
2. Reckless or self-destructive behavior.
3. Hypervigilance
4. Exaggerated startle response
5. Problems with concentration
6. Sleep disturbance (eg, difficulty falling or staying asleep or restless sleep).
F. Duration of the disturbance (Criteria B, C, D, and E) is more than 1 month.
G. The disturbance causes clinically significant distress or impairment in social, occupacional, or other important areas of functioning
H. The disturbance is not attributable to the physiological effects of a substance (e 8, medication alcohol or another medical conditions
Posttraumatic Stress Disorder
98
Specify whether:
With dissociative symptoms: The individual's symptoms meet the criteria for posttraumatic stress disorder, and in addition, in response to the stressor, the individual experiences persistent or recurrent symptoms of either of the following
1. Depersonalization: Persistent or recurrent experiences of feeling detached from, and as if one were an outside observer of, one's mental processes or body (eg feeling as though one were in a drear, feeling a sense of unreality of self or body or of time moving slowly).
2. Derealization: Persistent or recurrent experiences of unreality of surroundings (eg. the world around the individual is experienced as unreal, dreamlike. distant. or distorted).
Note: To use this subrype, the dissociative symptoms must nor be atbutable to the physiological effects of a substance (eg. blackouts, behavior during alcohol intoxication) or another medication condicion (e g. complex partial seizures) ]
Specify whether: With delayed expression: If the full diagnostic criteria are not mer until at least 6 months after the event (although the onset and expression of some symptoms may be immediate)
Posttraumatic Stress Disorder
99
Persistent or recurrent experiences of feeling detached from, and as if one were an outside observer of, one's mental processes or body (eg feeling as though one were in a drear, feeling a sense of unreality of self or body or of time moving slowly).
Depersonalization
100
Persistent or recurrent experiences of unreality of surroundings (eg. the world around the individual is experienced as unreal, dreamlike. distant. or distorted).
Derealization
101
intense longing, preoccupation with the deceased, difficulty moving on even after 12+ months for adults (6+ months for children)
Prolonged Grief Disorder
102
Prolonged Grief Disorder symptoms for children is?
Difficulty of moving on for 6 months
103
A. The death, at least 12 months ago, of a person who was close to the bereaved individual (for children and adolescents, at least 6 months ago).
B. Since the death, the development of a persistent grief response characterized by one or both of the following symptoms, which have been present most days to a clinically significant degree. In addition, the symptom(s) have occurred nearly every day for at least the last month:
1. Intense yearning/longing for the deceased person
2. Preoccupation with thoughts or memories of the deceased person (in children and adolescents, preoccupation may focus on the circumstances of the death)
Prolonged Grief Disorder
104
C. Since the death, at least 3 of the following symptoms have been present most days to a clinically significant degree. In addition, the symptoms have occurred nearly every day for at least the last month:
1. Identity disruption (e.g., feeling as though part of oneself has died) since the death
2. Marked sense of disbelief about the death
3. Avoidance of reminders that the person is dead (in
children and adolescents, may be characterized by efforts to avoid reminders)
4. Intense emotional pain (e.g., anger, bitterness, sorrow)
related to the death
5. Difficulty reintegrating into one’s relationships and activities after the death (e.g., problems engaging with friends, pursuing interests, or planning for the future)
6. Emotional numbness (absence or marked reduction of
emotional experience) as a result of the death
7. Feeling that life is meaningless as a result of the death
8. Intense loneliness as a result of the death
Prolonged Grief Disorder
105
D. The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.
E. The duration and severity of the bereavement reaction clearly exceed expected social, cultural, or religious norms for the individual’s culture and context.
F. The symptoms are not better explained by major depressive disorder, posttraumatic stress disorder, or another mental disorder or attributable to the physiological effects of a substance
(e.g., medication, alcohol) or another medical condition.
Prolonged Grief Disorder
106
Defined as anxious or depressive reactions to identifiable life stressors that are less severe than ASD or PTSD but still impairing
Adjustment Disorder
107
Symptoms interfere with school, work, or relationships. May include conduct problems in adolescence.
Stressors are not traumatic but still overwhelm coping capacity.
Chronic form: Symptoms last 6+ months after the stressor ends.
Adjustment Disorder
108
Often used as a residual category for cases with significant anxiety/depression linked to life stress but not meeting criteria for other disorders
Adjustment Disorder
109
Emerges before age 5 due to inadequate or abusive caregiving, neglect, or multiple foster care placements.
Attachment Disorders (in children)
110
Reflects pathological responses to early extreme stress
DSM-5 changes: Separated into two distinct disorders, unlike DSM-IV where both were under “reactive attachment disorder”
Attachment Disorder (in children)
111
Emotionally withdrawn, inhibited type.
Child rarely seeks comfort, protection, or nurturance from caregivers.
Symptoms: lack of responsiveness, limited positive affect, heightened fear, sadness.
Reactive attachment Disorder (RAD)
112
Indiscriminately social, disinhibited type.
Child shows no hesitation in approaching strangers and may engage in inappropriate intimacy (e.g., leaving with an unfamiliar adult without caregiver check-in).
Often associated with harsh or inconsistent caregivin
Disinhibited Social Engagement Disorder (DSED)
113
A. A consistent pattem of inhibited, emotionally withdrawn behavior toward adult
caregivers, manifested by both of the following:
1. The child rarely or minimally seeks comfort when distressed.
2. The child rarely or minimally responds to comfort when distressed
B. A persistent social and emotional disturbance characterized by at least two of the following:
1. Minimal social and emotional responsiveness to others.
2. Limited positive affect.
3. Episodes of unexplained irritability, sadness, or fearfulness that are evident even during nonthreatening interactions with adult caregivers.
Reactive attachment Disorder (RAD)
114
C. The child has experienced a patter of extremes of insufficient care as evidenced by at least one of the following:
1. Social neglect or deprivation in the form of persistent lack of having basic emotional needs for comfort, stimulation, and affection met by caregiving adults.
2. Repeated changes of primary caregivers that limit opportunities to for stable attachments (e.g., trequent changes in foster care).
3. Rearing in unusual settings that severely imit opportunities to form selective attachments (e.g., institutions with high child-to-caregiver ratios).
D. The care in Criterion C is presumed to be responsible for the disturbed behavior in Criterion A (e.g., the disturbances in Criterion A began following the lack of adequate care in Criterion C).
E. The criteria are not met for autism spectrum disorder.
F. The disturbance is evident before age 5 years.
G. The child has a developmental age of at least 9 months.
Reactive attachment Disorder (RAD)
115
Reactive attachment Disorder (RAD) is persistent (specifiers) if lasted more than?
12 months
116
Reactive attachment disorder is specified as this level when a child exhibits all symptoms of the disorder, with each symptom manifesting at relatively high levels.
severe
117
A. A patter of behavior in which a child actively approaches and interacts with unfamiliar adults and exhibits at least two of the following:
1. Reduced or absent reticence in approaching and interacting with unfamiliar adults.
2. Overly familiar verbal or physical behavior that is not consistent with culturally sanctioned and with age appropriate social boundaries).
3. Diminished or absent checking back with adult caregiver after venturing away, even in unfamiliar settings.
4. Willingness to go off with an unfamiliar adult with minimal or no hesitation.
Disinhibited Social Engagement Disorder
118
B. The behaviors in Criterion A are not limited to impulsivity (as in attention-deficit/hyperactivity disorder) but include socially disinhibited behavior.
C. The child has experenced a pattem of extremes of insufficient care as evidenced by at least one of the following:
1. Social neglect or deprivation in the form of persistent lack of having basic emotional needs for comfort, stimulation, and affection met by caregiving adults.
2. Repeated changes of primary caregivers that limit opportunities to form stable attachments (e.g. frequent changes in foster care).
3. Rearing in unusual settings that severely limit opportunities to form selective attachments (e.g., institutions with high child-to-caregiver ratios).
Disinhibited Social Engagement Disorder
119
D. The care in Criterion C is presumed to be responsible for the disturbed behavior in Criterion A (e.g., the disturbances in Criterion A began following the pathogenic care in Criterion C).
E. The child has a developmental age of at least 9 months.
Disinhibited Social Engagement
120
Disinhibited Social Engagement Disorder can be into this if present for more than 12 months.
Persistent
121
Disinhibited social engagement disorder is specified as this when the child exhibits all symptoms of the disorder, with each symptom manifesting at relatively high levels.
severe
122
Unlike other anxiety disorders, where danger comes from an external object or situation, in this kind of disorder the threat lies in internal thoughts, images, or impulses
Obsessive-Compulsive Disorder
123
Attempts to suppress these intrusive thoughts are as difficult as trying not to think of “pink elephants”—a nearly impossible task.
Obsessive-Compulsive Disorder
124
People with disorder struggle daily, often lifelong, to resist or neutralize unwanted thoughts
Obsessive-Compulsive Disorder
125
Defined as intrusive, nonsensical, and unwanted thoughts, images, or urges that the individual attempts to suppress or eliminate.
Obsessions
126
Defined as repetitive behaviors or mental acts performed to suppress obsessions and reduce distress. This provide temporary relief, reinforcing the cycle of OCD
Compulsion
127
Needing things to be symmetrical/aligned just so urges to do things over and over until they feel “just right”
Symmetry/exactness/ "just right" (Obesseion)
128
Putting things in a certain order repeating rituals
Symmetry/exact-ness/ "just right" (Compulsion)
129
Fears, urges to harm self or others
Fears of offending God
Forbidden thoughts or actions (aggressive/ sexual/religious) (Obsession)
130
Checking Avoidance
Repeated requests for reassurance
OCD
131
Fears of germs or contaminants
Cleaning/ Germs contamination (Obsession)
132
Needing things to be symmetrical/aligned just so urges to do things over and over until they feel “just right”
Symmetry/ordering/just right (Compulsion)
133
Fears of throwing anything away
Hoarding (Obsession)
134
Collecting/ saving objects with little or no actual or sentimental value such as food wrappings
Hoarding (Compulsion)
135
A. Presence of obsessions, compulsons or boch Obsessons are defined by (1) and (2)
1. Recurrent and persistent thoughts urges, or images that are expenenced, at some time during the disturbance, as incrusive and unwanted, and that in most individual cause marked ansecy or dopess
2. The individus artempes to ignore or suppress such thoughes, urges, or images, or to neutralze them with some other thought or action (le, by performing a compulsion)
Compulsions are defined by (1) and (2)
1. Repetitive behaviors (eg, hand washing, ordering, checling) or mental acts (eg, praying, counting, repesting words siendy) that che indiadual feels drven to perform in response to an dosession, or according to rules that muse be appled ngody
2. The behaviors or mental acts are aimed at preventing or seducing destress or preventing some dreaded event or situaton, however, chese behaviars or mental acts are not connected in a realate way with what they are denged to neutralize or prevent, or are clearly excessive
Obsessive-Compulsive Disorder
136
The obsessive-compubive symptoms are not attributable the physiclogical effects of a substance (eg, a drug of abuse, a medication) or anocher medical condition.
D. The dizurbance is nor better explained by the sympeams of an-ocher mencal disorder (e g, excessive worries, as in generaloed anniety disorder, preoccupation with appearance, as in body dysmorphic dsorder)
Obsessive-Compulsive Disorder
137
Specfy this if the OCD has the individual recognizes the obsessive-compulsive disorder beliefs are definitely or probably not true or that they may or may not be tue
With good or fair insight
138
Specify this if the OCD of the individual thinks obsessive-compulsive disorder beliefs are probably true
With poor insight:
139
Specify this if the individual is completely convinced that obsessve compulsive disorder beliefs are true
With absent insight/delusional
140
Specify this of the OCD of the indvidal has a current or past history of a tic disorder
Tic-related
141
involves preoccupation with imagined or exaggerated defects in appearance that are not observable to others
Body Dysmorphic Disorder
142
Formerly classified as a somatoform disorder, now placed under obsessive-compulsive and related disorders in DSM-5 due to its overlap with OCD
Body Dysmorphic Disorder
143
persistent, intrusive negative thoughts about perceived appearance flaws.
BDD (obsession)
144
behaviors to alleviate distress, e.g., mirror checking, grooming, skin picking, tanning, or avoiding mirrors
BDD (Compulsion)
145
belief that others constantly notice and judge their perceived defect.
Ideas of reference
146
many become housebound, avoid social interaction, or seek unnecessary cosmetic surger
Severe impairment (BDD)
147
High rates of suicidal ideation and attempts
BODY DYSMORPHIC DISORDER
148
A. Preoccupation with one or mare perceived defects or fians in physical appearance that are noe observable or appear sight co ochers
B. At some point during the course of the dearder, the indvidual has performed repecitive behaviars (eg, inor checking excessive gooming sion picking, reassurance seeking) or mental acts (eg, comparing his or her appearance with that of ochers) in response to the appearance concems
C. The preoccupation causes dinically significant distress or impairment in social, occupationa, or ather important areas of functioning.
D. The appearance preoccupation is not better explined by concerns with body fat or weight in an individual whase symptoms meet diagnostic critena far an earing disorder.
Body Dysmorphic Disorder
149
Specify if BDD if the indivdualis preoccupied with the ides thar his or her body build is too small or insufficiency muscular This specifier is used even if the indiidual is preccoupied with ather body areas which is often the case.
BDD with muscle dysmorphia
150
Specify if the BDD of the indvidual recognizes that the body dysmarphic disorder beliefs are definitely ar probably not true ar chat they may ar may nơt be true.
With good or fair insight
151
Specify if body dysmorphic disorder of the individual recognizes that the body dysmarphic disarder beliefs are definitely ar probaly not true or that they may or may not be true.
With good or fair insight
152
Specify if the body dysmorphic disorder of the individual thinks that the body dysmarphic disorder beliefs are probably true
With poor insight
153
Specify if body dysmorphic disorder of the individual is completely convinced that the body dysmorphic disorder beices are true
With absent insight/delusional beliefs
154
A. Recurrent skin picking resulting in skin lesions.
B .Repeated attempts to decrease or stop skin picking.
C .The skin picking causes clinically signiticant distress or impairment in social, occupational, or other important areas of functioning.
D. The skin picking Is not attributable to the physiological ettects of a substanoe (e.g., cocane) or another medical condion (e.g., scables).
E. The skin picking is not better explained by symptoms of another mental disorder (e.g., delusions or tacite hallucinations in a psychotic disorder, attempts to improve a percelved defect or flaw in appearance in body dysmorphic disorder. stereotypies in stereotypic movement of disorder, or intention to harm oneself in nonsuicidal self-injury)-
Excoriation (skin-picking) criteria
155
A Recurrent pulling out of one's hair, resulting in hair loss.
B. Repeated attempts to decrease or stop hair pulling.
C. The hair pulling causes clinically significant distress or Impalent in social, cocupational, or other Important areas of functioning.
D. The hair pulling or hair loss is not atinbutable to another medical condition (e.g..
E. The hair pulling is not better explained by the symptoms of another mental disorder (e.g., attempts to improve a perceived detect or flaw in appearance in body dysmorphic disorder):
Trichotillomania (hair-pulling disorder)
156
A Persistent difficulty discarding or parting with possessions, regardless of their
actual value.
B. This dificulty is due to a perceived need to save the items and to distress associated with discarding them.
C. The difficulty discarding possessions results in the accumulation of possessions that congest and clutter active living areas and substandally compromises their ntended use. I living areas are unclutered, it Is only because of the interventions of third parties (e.g., family members, cleaners, authorties)
D. The hoarding causes clinically significant distress or Impairment in social, occupational, or other important areas of functioning (including maintaining a sate environment for self and others).
E. The hoarding is not attributable to another medical condition (e.g., brain injury. cerebrovascular disease, Prader-Willi syndrome).
F. The hoarding is not better explained by the symptoms of another mental disorder (eg., obsessions in obsessive-compulsive disorder, decreased energy in major depressive disorder, delusions in schizophrenia or another psychotic disorder. cognitive deficits in major neurocognitive disorder, restricted interests in autism spectrum disorder).
Hoarding disorder
157
Specify if the hoarding disorder have difficulty discarding possessions is accompanied by excessive acquisition of items that are not needed or for which there is no available space.
With execessive acquisition
158
The individual recognizes that hoarding-related bellets and behaviors (pertaining to difficulty discarding items, clutter, or excessive acquisition) are problematic. (Hoarding disorder)
With good or fair insight
159
The individual is mostly convinced that hoarding-related beliefs and behaviors (pertaining to difficulty discarding items, clutter, ar excessive acquisition) are not problematic despite evidence to the contrary. (Hoarding Disorder)
With poor insight
160
The indvidual is completely convinced that hoarding related bellets and behaviors (pertaining to difficulty discarding items, clutter, or excessive acquisition) are not problematic despite evidence to the contrary.
With absent insight/delusional beliefs
161
Phobias develop through classical conditioning (learning fear from a threatening experience) and are maintained through operant conditioning (avoidance reduces fear, reinforcing the behavior)
Two-factor model (mower) (behavioral model of phobia)
162
Experiencing a frightening event.
Direct trauma
163
Observing other’s fearful responses
Modeling
164
Being told something is dangerous
Verbal instruction
165
Not everyone developed phobias after threatening experiences
Diathesis stress perspective
166
(genetic vulnerability, neuroticism, negative cognition, sensitivity to conditioning) act as a diatheses influencing who develops phobias
Risk factors
167
Phobia cluster around evolutionarily dangerous stimuli (snakes, spiders, blood heights in angry faces) not neutral, stimuli like flowers or lamps. They suggest human or biologically prepared to learn here or life-threatening stimuli.
Prepared learning( evolutionary perspective)
168
Shows that fear of neutral objects fade quickly, but fears of dangerous stimuli like snakes are sustained
Prepared learning (evolutionary perspective)
169
Two-factor conditioning model: this may develop through:
◦ Direct negative social experiences.
◦ Modeling (observing others’ negative experiences).
◦ Verbal instruction (being told social situations are dangerous).
◦ These experiences lead to classical conditioning of fear
SAD Social Anxiety Disorder
170
Fear is maintained because avoiding social situations society
Avoidance behaviors (operant conditioning)
171
Avoiding eye contact, disengaging from conversation, standing apart
Safety behaviors (smaller avoidant strategies)
172
Individuals believe social mistakes (e.g., blushing, pausing) will lead to rejection
Negative self-beliefs
173
More attention on internal sensations (e.g., “He must think I’m an idiot”) rather than on conversation partners
Self-focused attention
174
Vivid images of how others might react negatively increase anxiety
Negative imagery
175
Anxiety → social awkwardness → poor performance → reinforces negative beliefs.
Vicious cycle
176
Some individuals have a biological tendency toward anxiety when meeting new people
Inherited vulnerability
177
may hinder development of social skills and self-confidence.
Anxiety
178
Fear of others’ opinions + negative self-thoughts → avoidance of social situations → fewer opportunities to practice social skills → increased anxiety over time.
Vicious cycle
179
reflect a misfire of the fear circuit, with a surge in sympathetic nervous system activity (neurobiological factor)
Panic attack
180
Major source of norepinephrine, which triggers sympathetic activation
Locus coeruleus
181
When Electrically stimulated, in monkeys produces panic-like reactions
Locus coeruleus
182
Drugs that increase this part of the brain activity can trigger panic; those that decrease it (e.g., clonidine, antidepressants) reduce panic risk.
Locus coerleus
183
panic attacks become conditioned responses to internal bodily sensations of arousal
Interoceptive conditioning
184
Can be triggered by both external situations and internal cues.
Panic
185
Central idea: catastrophic misinterpretation of bodily sensations. This misinterpretation fuels anxiety → increases physical symptoms → creates a vicious cycle.
Cognitive factors
186
is maintained by a fear of experiencing anxiety in public
Agoraphobia
187
Individuals hold this beliefs about the consequences of anxiety symptoms in public, such as:
◦“I might go crazy.”
◦“I’ll lose control.”
◦“Others will judge me negatively.”
catastrophic beliefs
188
Worry distracts from more powerful negative emotions and images, making it reinforcing despite being unpleasant
Worry as avoidance
189
Worry reduces this, preventing individuals from fully experiencing and extinguishing deeper anxiety
Psychological arousal 
190
People with GAD have difficulty identifying and labeling feelings as well as regulating negative emotions which causes them this type of deficit.
Emotional process deficit 
191
So people with GAD, have difficulty of:
Identifying and labeling feelings
Regulating negative emotions
192
Individuals who find ambiguity intolerable are more prone to worry and developed GAD
Intolerance of uncertainty
193
Individuals who find ambiguity intolerable (i.e., “something bad might happen”) are more prone to worry and develop
Generalized Anxiety Disorder
194
predicts increases in worry over time
Intolerance of uncertainty
195
has a moderate genetic contribution, with heritability estimates of 30–50%
Obsessive Compulsive Disorder
196
play a role, but cognitive and behavioral factors are also major contributors.
Genetics
197
the internal feeling of completion (“that is enough”)
Yedasentience
198
may lack this signal, leading to difficulty stopping thoughts or behaviors, even when they know logically it’s unnecessary.
People with OCD
199
Believe thinking about something increases its likelihood of occurring
People with OCD
200
Feel excessive responsibility for preventing harm
People with OCD
201
Rely heavily on thought suppression, which backfires
People with OCD
202
Trying not to think of something leads to more frequent intrusions
Wetner’s “white bear” study
203
Suppressing thoughts temporarily reduces them, but increases frequency afterward
Rebound effect
204
Suppression led to more intrusive thoughts and greater distress over 4 days.
Trinder (1994) study
205
People who believe bad things happen if you think about them are more likely to suppress thoughts → linked to more
obsessive symptoms.
206
do not necessarily have distorted vision of their features; instead, they are overly focused on appearance-related details
People with ocd
207
do not necessarily have distorted vision of their features; instead, they are overly focused on appearance-related details
People with body dysmorphic disorder and related
208
They are more attuned to features linked to attractiveness (e.g., facial symmetry) compared to those without this disorder
People with BDD
209
They tend to focus on specific details rather than the whole
People with BDD
210
When looking at facial features, they examine one feature at a time rather than considering the overall appearance, increasing preoccupation with perceived flaws
People with BDD (DETAILED ORIENTED PROCESSING)
211
place excessive importance on attractiveness, far more than control groups
People with BDD (APPEARANCE AND SELF-WORTH)
212
Because of this hyper-focus, individuals spend excessive time monitoring their appearance.
Behavioral consequences (people with BDD)
213
They often avoid social situations where their appearance might be judged, interfering with major areas of life functioning.
People with BDD
214
may have evolutionary roots, as storing resources like food and clothing would have been adaptive for survival in prehistoric times
Hoarding disorder (Evolutionary perspective)
215
is linked to poor organizational abilities, unusual beliefs about possessions, and avoidance behaviors
Hoarding Disorder (cognitive-behavioral model)
216
have extreme emotional attachments to objects, often linking them to comfort, identity, and security
Hoarders
217
They fear losing objects and resent others touching or removing them.
Hoarders (unusual beliefs about possession)
218
often view their animals as confidants or family, strengthening attachment
Animal Hoarders
219
have extreme emotional attachments to objects, often linking them to comfort, identity, and security
Hoarders
220
Anxiety about making the wrong decision or losing a valued object leads to avoidance, which prevents discarding and maintains clutter
Hoarders (avoidance behavior)
221
Genetic risk for anxiety disorders
Posttraumatic stress disorder
222
Hyperactivity in the fear circuit, particularly the amygdala
Posttraumatic stress disorder
223
Childhood trauma exposure increases vulnerability. Selective attention to threat cues contributes to symptom onset. Traits of neuroticism and negative affectivity predict this disorders development
Posttraumatic Disorder
224
Initial fear response develops via
Classical conditioning
225
maintains PTSD through avoidance, since avoiding trauma-related cues reduces fear but prevents extinction of fear responses.
Operant Conditioning
226
Higher trauma severity = higher
PTSD LIKELIHOOD
227
strongly linked with psychiatric problems
Combat exposure
228
Human-caused traumas (rape, assault, abuse, combat) more likely to cause this than natural disaster
PTSD
229
This disorder is associated with:
Greater amygdala activation.
Reduced medial prefrontal cortex activation.
Smaller hippocampal volume, impairing memory and emotional regulation
PTSD
230
Avoidance and dissociation predict the development of this disorder
PTSD
231
Dissociation during trauma (e.g., numbness, detachment) linked to later
PTSD
232
High dissociation during rape strongly predicts
PTSD SYMPTOMS
233
may block physiological arousal, preventing emotional processing
Dissociation
234
helps make sense of trauma, reducing PTSD risk
High intelligence
235
reduces PTSD risk by aiding emotional recovery
Strong Social Support
236
Consistent failure to speak in certain social situations despite speaking in others. At least 1 month (not limited to the first month of school)
Selective Mutism
237
Specify whether: If the full diagnostic criteria are not met until at least 6 months after the event (although the onset and expression of some symptoms may be immediate) PTSD
Delayed expression
AbPsych
flashcards
Decks in class (13)
# Cards
-
L172
-
L2158
-
L3237
-
L4137
-
L5111
-
Eating & Sleeping Disorder161
-
Sexual Dysfunction & Paraphilic Disorders189
-
Substance-Related, Addictive, and Impulse-Control Disorders181
-
Inhalant Use Diorder Onwards (DSM 5)29
-
Personality Disorder61
-
Schizophrenia Spectrum and Other Psychotic Disorders93
-
Neurodevelopmental Disorder122
-
Neurocognitive Disorders37
