DSM-5-TR Diagnosis Flashcards

Question

Disruptive Mood Dysregulation Disorder

Answer 1

Chronic, severe and persistent **irritability** with: * severe temper **outbursts** that are verbal or behavioral * mood switches between **irritability** and temper outbursts * temper outbursts occur **3 or > times per week** * Symptoms are present for **12 or > months** in at least 2 or 3 settings * Dx btw age 6-18 yrs but symptoms present **before age 10** ## Footnote **For children 6-18 years old ONLY**

Answer 2

A period of **at least 2 weeks** where there is a change from the previous level of functioning and either **depressed or irritable mood** and **loss of interest or pleasure** in nearly all activities. **5 or more** of the following symptoms (happen nearly every day): 1. depressed mood most of the day 2. diminished interest or pleasure in all activities most of the day 3. significant weight loss or weight gain 4. insomnia or hypersomnia 5. psychomotor agitation or retardation 6. fatigue or loss of energy 7. feelings of worthlessness or excessive or inappropriate guilt 8. diminished ability to think or concentrate, or indecisiveness 9. recurrent thoughts of death, recurrent suicidal ideation without a specific plan, a specific suicide plan, or a suicide attempt ## Footnote 3 severity levels: * mild * moderate * severe

Answer 3

* Chronic major depressive disorder AND the previous dysthymic disorder * Emphasizes **chronicity** rather than severity and allows for the presence of major depressive episode * **During the 2 yr** (1 yr children and adolescents) * Has not been w/o symptoms for >2 months at a time ## Footnote 3 severity levels: * mild * moderate * severe

Answer 4

* Clinically significant distress or interference with work, school, usual social activities or relationships with others * Symptoms: * mood lability * irritability or anger * depressed mood, hopelessness, or self-deprecating thoughts * anxiety * Symptoms present **in the final week before menses**, improve within a few days after onset and become **minimal or absent** in the week post-menses

Answer 5

* Separation Anxiety Disorder * Selective Mutism * Specific Phobia * Social Anxiety Disorder * Panic Disorder (+ Panic Attack Specifier) * Agoraphobia * Generalized Anxiety Disorder

Answer 6

**Fearful or anxious** about separation from attachment figures to a degree that is **developmentally inappropriate** ## Footnote **6 months or >** in adults; **at least 4 weeks** in children and adolescents

Answer 7

Consistent **failure to speak** in social situations in which there is an expectation to speak (school) even though the individual speaks in other situations. ## Footnote At least **1 month** (not limited to the 1st month of school).

Answer 8

* Excessive anxiety and **worry** about a number of real life events and activities * Very difficult to **control** the worry * At least **3 of the following symptoms** (only 1 for children) must be present: 1. restlessness 2. easily fatigued 3. difficulty concentrating 4. irritability 5. muscle tension 6. sleep disturbance 7. it interferes with functioning ## Footnote At least 6 months

Answer 9

* **Fearful or anxious** about a specific object or situation (flying, heights, animals, receiving an injection). This fear or anxiety are **out of proportion** to the actual danger * Individual actively **avoids** these objects or situations * Causes clinically significant **distress or impairment** ## Footnote 6 months or more

Answer 10

* Fear or anxiety about 1 or more **social situations** involving possible scrutiny by others due to fear of **negative evaluation**. * May include **social interactions** (having a conversation, meeting unfamiliar people), *being observed* (eating or drinking), *performing in front of others* (giving a speech). * In children should occur in **peer settings** and not just during interactions with adults. ## Footnote 6 months or more

Answer 11

Recurrent **unexpected panic attacks**. **4 or more** Symptoms occur: 1. palpitations, pounding heart or accelerated heart rate 2. sweating 3. trembling or shaking 4. 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. numbness or tingling sensations 11. derealization or depersonalization 12. fear of losing control or "going crazy" 13. fear of dying ## Footnote At least 1 attack has been **followed by 1 month** of persistent concern or **worry** about having more panic attacks or **changes in person's behavior** in maladaptive ways because of the panic attacks.

Answer 12

* **Avoiding certain situations** because there is fear that one might not be able to **escape** the situation if they develop panic-like/ incapacitating/ embarrassing symptoms. * **Fear or anxiety** about 2 or more of the situations: 1. Using public transport 2. Being in open spaces 3. Being in enclosed spaces 4. Standing in line or being in a crowd 5. Being outside of home alone ## Footnote 6 months or more

Answer 13

* Obsessive-Compulsive Disorder * Body Dysmorphic Disorder * Hoarding Disorder * Trichotillomania & Excoriation

Answer 14

* Presence of obsessions, compulsions or both * Time consuming (take more than 1 hour per day) or cause clinically significant distress or impairment

Answer 15

* **Preoccupation** with perceived body defects. * **Repetitive behaviors** (mirror checking, skin picking) or **mental acts** (comparing appearance with others) in response to the appearance concerns

Answer 16

* **Difficulty discarding** or parting with possessions * Feel the need to save **everything** * Possessions **congest and clutter active living area** * Causes clinically significant **distress** or impairment

Answer 17

* Trichotillomania = Hair-Pulling disorder. Results in hair loss * Excoriation = Skin picking disorder. Results in skin lesions ## Footnote Tries to stop, can't -> distress

Answer 18

* Reactive Attachment Disorder * Disinhibited Social Engagement Disorder * PTSD: Posttraumatic Stress Disorder * Acute stress disorder * Adjustment disorders * Prolonged Grief Disorder

Answer 19

* The child is emotionally **withdrawn**/ inhibited toward adult caregiver * Persistent social and emotional **disturbance** * History of **extreme insufficient care/neglect** * The criteria are not met for Autism Spectrum Disorder ## Footnote The child is **at least 9 months**. The disturbance is evident **before age 5 yrs**.

Answer 20

* A pattern of behavior where a child actively approaches and interacts with unfamiliar adults * At least 2 of the following symptoms 1. Reduced or absent reticence with strangers 2. Overly familiar behavior 3. Diminished checking back with caregiver 4. Willingness to go off with unfamiliar adults * A child has experienced extremes of **insufficient care** ## Footnote The child is **at least 9 months**

Answer 21

Exposure to actual or threatened death, serious injury or sexual violence. **Intrusion symptoms** (at least 1 should be present): 1. recurrent, involuntary, and intrusive distressing memories of the traumatic event (s) 2. recurrent distressing dreams 3. dissociative reactions (flashbacks) when the individual feels or acts as if the traumatic event is recurring 4. intense **psychological** distress when exposed to the cues of traumatic events 5. marked **physiological** reactions when exposed to the cues of traumatic events **Persistant avoidance** of stimuli associated with the traumatic event (1 or both are present): 1. Avoidance of distressing memories, thoughts or feelings 2. Avoidance of external reminders (people, places, conversations, activities, objects, situations) **Negative alterations in cognitions and mood** (2 or more of the following): 1. Inability to remember an important aspect of the traumatic event 2. Persistent and exaggerated negative beliefs or expectations about oneself, others or the world 3. Dirsorted cognitions about the cause or consequences of traumatic event 4. negative emotional state 5. diminished interest or participation in significant activities 6. feelings of detachment or estrangement from others 7. persistent inability to experience positive emotions Marked **alterations in arousal or reactivity** (2 or more of the following): 1. Irritable behavior and angry outbursts 2. reckless or self-destructive behavior 3. hypervigilance 4. exaggerated startle response 5. problems with concentration 6. sleep disturbance ## Footnote Duration of the disturbance is **>1 month**

Answer 22

Exposure to actual or threatened death, serious injury or sexual violence. **Intrusion symptoms** (at least 1 should be present): 1. recurrent, involuntary, and intrusive distressing memories of the traumatic event (s) 2. recurrent distressing dreams 3. dissociative reactions (flashbacks) when the individual feels or acts as if the traumatic event is recurring 4. intense **psychological** distress when exposed to the cues of traumatic events 5. marked **physiological** reactions when exposed to the cues of traumatic events **At least 1 symptom** of persistent avoidance of stimuli OR negative alterations in cognitions and mood. Marked **alterations in arousal or reactivity** (2 or more of the following): 1. Irritable behavior and angry outbursts 2. hypervigilance 3. exaggerated startle response 4. problems with concentration 5. sleep disturbance ## Footnote Duration of the disturbance is **>1 month**

Answer 23

* Exposure to a traumatic **stressor** (actual or threatened death, serious injury, sexual violence) * Presence of 9 or more **PTSD-like symptoms** (intrusion, negative mood, dissociation, avoidance and arousal) * Duration of the disturbance is **at least 3 days and up to 30 days**

Answer 24

* Emotional or behavioral symptoms in response to an **identifiable stressor** * Marked distress **out of proportion** to stressor * Significant **impairment** in functioning * Symptoms or behaviors do not meet the full criteria for another mental disorder * The symptoms do NOT represent **normal bereavement** and are NOT better explained by prolonged grief disorder * Occurs within **3 months** of stressor and lasts **no longer than 6 months** after stressor or its consequences terminated

Answer 25

* The death of a person who was **close** (at least 12 months ago for adults and 6 months - for children and adolescents). **Intense yearning/ longing** for the deceased person and/or preoccupation with thoughts and memories about them. **Symptoms** (at least 3 are present): 1. identity disruption 2. sense of disbelief about the death 3. avoidance of reminders that the person is dead 4. intense emotional pain related to the death 5. difficulty reintegrating into relationships and activities 6. emotional numbness 7. feeling that life is meaningless as a result of the death 8. intense loneliness as a result of the death ## Footnote Symptoms have occurred nearly every day for **at least the last month**.

Answer 26

* Dissociative Identity Disorder * Dissociative Amnesia * Depersonalization/Derealization Disorder

Answer 27

* Two or more **distinct personalities** * Discontinuity in sense of **self** and sense of agency * **Alterations** in affect, behavior, consciousness, memory, perception, cognition and/ or sensory-motor functioning * Recurrent **gaps in the recall of everyday events**, important personal information and/ or traumatic events * In children the symptoms are **NOT** better explained by imaginary playmates or other fantasy play

Answer 28

**Inability to recall** important autobiographical information, usually **traumatic or stressful**. ## Footnote **Localized**: an event or period of time **Selective**: specific aspect of an event **Generalized**: identity and life history

Answer 29

Experiences of unreality or detachment from * one's mind, body or self (**depersonalization**) * one's surroundings (**derealization**) ## Footnote During these experiences **reality testing remains intact.**

Answer 30

* Somatic Symptom Disorder * Illness Anxiety Disorder * Conversion Disorder (Functional Neurological Symptom Disorder) * Factitious Disorder

Answer 31

* One or more somatic symptoms that are distressing or result in significant **disruption in daily life**. * **Excessive** thoughts, feelings or behaviors related to the somatic symptoms or associated health concerns ## Footnote **Persistent** if more than **6 months** 3 severity levels: * mild * moderate * severe

Answer 32

* preoccupation with **having or acquiring a serious illness** * **somatic** symptoms are not present or only mild in intensity * high level of **anxiety** about health * excessive health-related **behaviors** (care-seeking type) or maladaptive **avoidance** (care-avoidant type) ## Footnote at least **6 months** (feared illness may change)

Answer 33

* **Altered voluntary motor or sensory function** not explained by medical tests * Evidence of **incompatibility** between symptom and neurological or medical conditions ## Footnote Acute (<6 months) or persistent

Answer 34

* **Falsification of physical or psychological symptoms** (imposed on self or other) or induction of injury or disease, involving deception * Absence of obvious **external reward** ## Footnote Types: * Imposed on self * Imposed on another

Answer 35

* Pica Disorder * Rumination Disorder * Avoidant/Restrictive Food Intake Disorder Anorexia Nervosa * Bulimia Nervosa * Binge-Eating Disorder

Answer 36

Eating **nonnutritive**, nonfood substances. ## Footnote At least **1 month**

Answer 37

* Previously swallowed food that may be partially digested is brought up into the mouth without apparent nausea, involuntary retching or disgust. * Regurgitated food may be re-chewed, re-swallowed or spit out ## Footnote At least **1 month**

Answer 38

An **eating or feeding disturbance** (1 or more of the following): 1. significant weight loss 2. significant nutritional deficiency 3. dependence on enteral feeding or oral nutritional supplements 4. marked interference with psychosocial functioning ## Footnote * NOT driven by body image disturbance * No fear of weight gain (distinguishes from anorexia)

Answer 39

3 key features: 1. persistent energy intake **restriction**, which leads to a **significantly low body weight** 2. intense **fear of gaining weight** or becoming fat or persistent behavior that interferes with weight gain 3. **disturbance** in self-perceived weight or shape | Subtypes: * Restricting type * Binge-eating/purging type ## Footnote 4 levels of severity: * Mild * Moderate * Severe * Extreme

Answer 40

* 3 key features: 1. recurrent episodes of **binge eating** 2. recurrent inappropriate **compensatory behaviors** to prevent weight gain (self-induced vomiting, misuse of medications, fasting or excessive exercise) 3. self-evaluation that is unduly influenced by **body shape and weight gain** * The binge-eating and compensatory behaviors occur **at least once a week for 3 months** | Does not occur exclusively during anorexia ## Footnote levels of severity: * Mild * Moderate * Severe * Extreme

Answer 41

* Recurrent episodes of **binge-eating**. Eating in a discrete period of time (usually 2 hours) an amount of food that is definitely larger than most people would eat in a similar period of time (w/o purge) * **Lack of control** over eating during the episode * **3 or more** of the following: * eating much more rapidly than normal * eating until feeling uncomfortably full * eating large amounts of food when not feeling physically hungry * eating alone because of embarassment * feeling disgusted with oneself, depressed or very guilty * At least **once a week for 3 months** | NO regular compensatory behaviors (distinguishes from bulimia) ## Footnote levels of severity: * Mild * Moderate * Severe * Extreme

Answer 42

* Enuresis * Encopresis

Answer 43

* Repeated **voiding of urine** into bed or clothes, either involuntary or intentional * At least **twice a week for at least 3 consecutive months** ## Footnote Age is **at least 5 years**

Answer 44

* Repeated **passage of feces into inappropriate places** (clothing, floor), either involuntary or intentional * At least one event occurs **each month for at least 3 months** ## Footnote Age is **at least 4 years**

Answer 45

* Delayed Ejaculation * Erectile Disorder * Female Orgasmic Disorder * Female Sexual Interest/Arousal Disorder * Genito-Pelvic Pain/Penetration Disorder * Male Hypoactive Sexual Desire Disorder * Premature (Early) Ejaculation

Answer 46

* Marked **delay** in ejaculation, marked **infrequency** of ejaculation, or **absence** of ejaculation * Occurs during **partnered** sexual activity, without the individual desiring delay. * Present on **most (75–100%)** occasions. * Not better explained by another mental disorder, medical condition, substance, **severe relationship distress** or **significant stressors** * Specifiers: Lifelong vs. acquired. Generalized vs. situational | Specifiers ## Footnote at least **6 months** levels of severity: * Mild * Moderate * Severe

Answer 47

1. Marked **difficulty obtaining or maintaining** an erection 2. Marked **decrease** in erectile rigidity * Present on **most (75–100%)** occasions. * Not better explained by another mental disorder, medical condition, substance, **severe relationship distress** or **significant stressors** * Specifiers: Lifelong vs. acquired. Generalized vs. situational ## Footnote at least **6 months** levels of severity: * Mild * Moderate * Severe

Answer 48

1. Marked **delay in, infrequency of, or absence** of orgasm 2. Markedly **reduced intensity** of orgasmic sensations * Present on **most (75–100%)** occasions. * Not better explained by another mental disorder, medical condition, substance, **severe relationship distress** or **significant stressors** * Specifiers: Lifelong vs. acquired. Generalized vs. situational. Never experienced an orgasm under any situation ## Footnote at least **6 months** levels of severity: * Mild * Moderate * Severe

Answer 49

**Lack of or reduced** sexual interest/arousal, manifested by **at least 3** of the following: 1. interest in sexual activity 2. sexual **thoughts or fantasies** 3. **initiation** of sexual activity 4. sexual **excitement or pleasure** on most (75–100%) occasions 5. interest in sexual cues in response to any internal or external sexual/erotic cues 6. genital or non-genital **sensations** during sexual activity on most (75–100%) occasions * Not better explained by another mental disorder, medical condition, substance, **severe relationship distress** or **significant stressors** * Specifiers: Lifelong vs. acquired. Generalized vs. situational. ## Footnote at least **6 months** levels of severity: * Mild * Moderate * Severe

Answer 50

**Persistent or recurrent difficulties** with 1 or more: 1. Vaginal penetration during intercourse 2. Marked **vulvovaginal or pelvic pain** during penetration attempts 3. Marked **fear or anxiety** about pain 4. Marked **tensing or tightening of pelvic floor muscles** during attempted vaginal penetration * Not better explained by another mental disorder, medical condition, substance, **severe relationship distress** or **significant stressors** * Specifiers: Lifelong vs. acquired. Generalized vs. situational. ## Footnote at least **6 months** levels of severity: * Mild * Moderate * Severe

Answer 51

* Persistently or recurrently **deficient or absent** sexual/erotic thoughts, fantasies and desire for sexual activity * Judged by the clinician, considering age and general+ sociocultural context * Not better explained by another mental disorder, medical condition, substance, **severe relationship distress** or **significant stressors** * Specifiers: Lifelong vs. acquired. Generalized vs. situational. ## Footnote at least **6 months** levels of severity: * Mild * Moderate * Severe

Answer 52

A persistent or recurrent pattern of ejaculation occurring during **partnered** sexual activity * within approximately **1 minute** following vaginal penetration * before the individual wishes it Occurs on **most (75–100%)** occasions * Not better explained by another mental disorder, medical condition, substance, **severe relationship distress** or **significant stressors** * Specifiers: Lifelong vs. acquired. Generalized vs. situational. ## Footnote at least **6 months** levels of severity: * Mild * Moderate * Severe

Answer 53

* A marked **incongruence** between **experienced/expressed** gender and **assigned** gender * Manifested by **at least 2** of the following: 1. **Incongruence** between gender identity and primary/ secondary sex characteristics 2. Strong desire **to be rid of** primary/ secondary sex characteristics 3. Strong desire for the primary/ secondary sex characteristics **of another gender** 4. Strong desire **to be of another gender** (different from assigned) 5. Strong desire **to be treated as another gender** (different from assigned) 6. Strong **conviction** of having typical **feelings/reactions** of another gender (different from assigned) ## Footnote at least **6 months**

Answer 54

* A marked **incongruence** between **experienced/expressed** gender and **assigned** gender * Manifested by **at least 6** of the following: 1. Strong **desire to be of another gender** or insistence that one is another gender (MUST be for a diagnosis!) 2. Strong preference for **cross-dressing** 3. Strong preference for **cross-gender roles** in play or fantasy 4. Strong preference for **toys/activities** stereotypically used by another gender 5. Strong preference for **playmates of another gender** 6. Strong rejection of toys/activities typical of assigned gender 7. Strong **dislike of one’s sexual anatomy** 8. Strong **desire for physical sex characteristics** matching experienced gender ## Footnote at least **6 months**

Answer 55

* Voyeuristic * Exhibitionistic * Frotteuristic * Sexual Masochism * Sexual Sadism * Pedophilic * Fetishistic * Transvestic

Answer 56

For every paraphilic disorder **BOTH** criteria must be present Criterion A * Recurrent and intense **sexual arousal from atypical focus** (e.g., objects, suffering, non-consenting others) * Manifested by **fantasies, urges, or behaviors** Criterion B * Individual has acted on these sexual urges with a **nonconsenting person** OR * Sexual urges or fantasies cause **clinically significant distress or impairment** ## Footnote **6+ months** for ALL

Answer 57

Sexual arousal from **observing** an unsuspecting person who is * Naked * Disrobing * Engaging in sexual activity Individual is **18+** years old Specifiers * In a controlled environment (individual lives in institutional or other setting) * In full remission (for 5+ years in uncontrolled environment) ## Footnote **6+ months**

Answer 58

Sexual arousal from **exposing one’s genitals** to an unsuspecting person Specifiers 1.Aroused by exposing genitals to * Prepubescent children * Physically mature individuals * Both 2.In a controlled environment VS In full remission ## Footnote **6+ months**

Answer 59

Sexual arousal from **touching or rubbing against a non-consenting person** Specifiers: * In a controlled environment * In full remission ## Footnote **6+ months**

Answer 60

Sexual arousal from **being humiliated, beaten, bound, or made to suffer** Specifiers: * With **asphyxiophilia** (arousal involving restriction of breathing) * In a controlled environment VS In full remission ## Footnote **6+ months**

Answer 61

Sexual arousal from **physical or psychological suffering of another person** Specifiers: * In a controlled environment * In full remission ## Footnote **6+ months**

Answer 62

* Sexual arousal involving **sexual activity with a prepubescent child** (generally ≤ 13 years) * Individual is **16+ years old** * At least **5 years older** than the child Specifiers: 1.Sexually attracted to: * Males * Females * Both 2.Limited to **incest** 3.**Exclusive** (attracted ONLY to children) vs **nonexclusive** ## Footnote **6+ months**

Answer 63

Sexual arousal from * The use of **nonliving** objects, OR * Highly specific focus on **non-genital body parts** Arousal is NOT limited to * Articles of clothing used in cross-dressing (as in transvestic disorder) * Devices designed for tactile genital stimulation (vibrator) **Specifiers** * Body part(s) * Nonliving object(s) * Other * In a controlled environment VS In full remission ## Footnote **6+ months**

Answer 64

Sexual arousal from **cross-dressing** Arousal is NOT limited to * Articles of clothing used in cross-dressing (as in transvestic disorder) * Devices designed for tactile genital stimulation (vibrator) **Specifiers** * With **fetishism** (if sexually aroused by fabrics, materials or garments) * With **autogynephilia** (aroused by thoughts/images of oneself as a woman) * In a controlled environment VS In full remission ## Footnote **6+ months**

Answer 65

* Oppositional Defiant Disorder (ODD) * Intermittent Explosive Disorder * Conduct Disorder * Pyromania * Kleptomania

Answer 66

* A pattern of angry/irritable mood, argumentative/defiant behavior, or vindictiveness * 4+ symptoms from the following 3 categories **1.Angry/Irritable Mood** * Loses temper * Touchy or easily annoyed * Angry and resentful **2.Argumentative/Defiant Behavior** * Argues with authority figures (for children – argues with adults) * Actively defies or refuses to comply with requests from authority figures or rules * Deliberately annoys others * Blames others for their own mistakes or misbehavior **3.Vindictiveness** * Spiteful or vindictive at least twice within the past 6 months **Qualifiers** * For children **under 5**, the behavior must occur on most days for 6+ months * For children **5 and older**, the behavior must occur at least once per week * Behaviors must occur with at least 1 individual who is NOT a sibling ## Footnote 6+ months Severity * Mild (1 setting) * Moderate (2+ settings) * Severe (3+ settings)

Answer 67

Recurrent outbursts representing a failure to control aggressive impulses as evidenced by EITHER of the following: * Verbal and/or physical aggression WITHOUT damage or injury **2x/week for 3 months** OR * Outburst WITH damage to property and/or physical assault **3x/year** ## Footnote Person is **at least 6 years old** (or equivalent developmental level)

Answer 68

A repetitive and persistent pattern of behavior in which the **basic rights** of others or major age-appropriate societal norms or **rules** are **violated**. These behaviors fall into **4 main groupings:** 1. Aggression to people and animals 2. Destruction of property 3. Deceitfulness or Theft 4. Serious Violations of Rules ## Footnote 3+ behaviors in the last 12 mo (1 being in last 6 mo) Specifiers * Childhood-Onset Type (at least 1 criterion characteristic of CD BEFORE age 10) * Adolescent-Onset Type (absence of any criteria before age 10) * Unspecified Onset Severity * Mild * Moderate * Severe

Answer 69

* Deliberate and purposeful **fire setting** on more than one occasion * Tension or affective arousal **before** the act * Fascination with, interest in, curiosity about, or attraction to fire and its situational contexts * **Pleasure, gratification, or relief when setting fires** or when witnessing or participating in their aftermath

Answer 70

* Recurrent failure to resist i**mpulses to steal objects** that are not needed for personal use or for their monetary value * Increasing **sense of tension before** committing the theft * **Pleasure, gratification, or relief** at the time of committing the theft

Answer 71

1. alcohol 2. caffeine 3. cannabis 4. hallucinogens 5. inhalants 6. opioids 7. sedatives, hypnotics, and anxiolytics 8. stimulants (amphetamine-type substances, cocaine, and other stimulants) 9. tobacco 10. other (or unknown) substances * 11 Diagnostic Criteria (from 4 domains) Specifiers * In early remission * In sustained remission * In a controlled environment * On maintenance therapy ## Footnote All (except caffeine) >12 mo Severity * Mild: 2-3 criteria (most similar to former substance abuse) * Moderate: 4-5 criteria * Severe: 6+ criteria (most similar to former substance dependence)

Answer 72

* Persistent and recurrent **problematic gambling behavior** that disrupts personal, family, and/or vocational pursuits * The gambling behavior is NOT better explained by a manic episode * 9 diagnostic criteria Specifiers * Episodic (symptoms subside between periods for at least several months) * Persistent (continuous symptoms for multiple years) * In early remission (has NOT met criteria for at least 3 months but for less than 12 months) * In sustained remission (has NOT met any criteria for 12+ months) ## Footnote 12 months Severity * Mild: 4-5 criteria * Moderate: 6-7 criteria * Severe: 8-9 criteria

Answer 73

* Delirium * Major Neurocognitive Disorder * Mild Neurocognitive Disorder

Answer 74

* Acute **disturbance in attention, awareness, and cognition**, with a fluctuating course * Develops over a **short period of time** (hours to days) * Represents a change from baseline * Fluctuates in severity throughout the day Always **the result of** * physiological consequence of another medical condition * substance intoxication or withdrawal * exposure to a toxin * or multiple etiologies **By duration** * Acute * Persistent **By level of psychomotor activity** * Hyperactive * Hypoactive * Mixed level of activity **Subtypes by Etiology** * Substance intoxication * Substance withdrawal * Medication-induced * Due to another medical condition * Due to multiple etiologies

Answer 75

* **Modest cognitive decline** from a previous level of performance * **Does NOT interfere with independence** in everyday activities * Does NOT occur exclusively in the context of delirium * NOT better explained by another mental disorder (major depressive disorder, schizophrenia)

Answer 76

* Cognitive **decline** from a previous level of performance **in 1+ **of the 6 cognitive domains * **Interferes with independence** in everyday activities * Cognitive deficits do NOT occur exclusively in the context of delirium * NOT better explained by another mental disorder (major depressive disorder, schizophrenia) **Specifiers** * With agitation * With anxiety * With mood symptoms * With psychotic disturbance * With other behavioral or psychological disturbance * Without behavioral or psychological disturbance ## Footnote Severity * **Mild**: Difficulties with instrumental daily activities (managing finances, medications) * **Moderate**: Difficulties with basic daily activities (feeding, dressing, bathing) * **Severe**: Fully dependent; requires extensive assistance for all daily activities

Answer 77

**Cluster A** * Paranoid * Schizoid * Schizotypal **Cluster B** * Antisocial * Borderline * Histrionic * Narcissistic **Cluster C** * Avoidant * Dependent * Obsessive-Compulsive

Answer 78

1. Paranoid 2. Schizoid 3. Schizotypal

Answer 79

1. Antisocial 2. Borderline 3. Histrionic 4. Narcissistic

Answer 80

1. Avoidant 2. Dependent 3. Obsessive-compulsive

Answer 81

* A pattern of distrust and suspiciousness such that others' motives are interpreted as malevolent * No psychotic symptoms

Answer 82

A pattern of **detachment from social relationships** and a **restricted range of emotional expression.** ## Footnote More “detached” and “uninterested” in social relations (not as odd) when compared to schizotypal personality disorder. Note: Differentiate from psychotic disorders because NO psychotic symptoms; differentiate from Schizotypal due to no cognitive distortions or eccentricities.

Answer 83

A pattern of **acute** **discomfort** in close **relationships**, cognitive or perceptual **distortions**, and **eccentricities** of behavior. ## Footnote More "odd" than Schizoid PD. Note: Differentiate from psychotic disorders because NO psychotic symptoms; differentiate from Schizoid PD due to HAVING cognitive distortions or eccentricities.

Answer 84

A pattern of **disregard** for and **violation** of the **rights** of others. ## Footnote History of symptoms before age 15. Must be at least 18 years to diagnose.

Answer 85

A pattern of **instability** in interpersonal relationships, self-image, affect, and marked **impulsivity**. Key features include: * frantic efforts to avoid abandonment * unstable and intense relationships * a disturbed sense of self-image * impulsivity in at least two areas * recurrent suicidal behavior or self-harm * affective instability * chronic feelings of emptiness * inappropriate and intense anger * stress-related paranoid thoughts or severe dissociative symptoms

Answer 86

A pattern of excessive **emotionality** and **attention-seeking**.

Answer 87

A pattern of **grandiosity**, need for **admiration**, and lack of **empathy**.

Answer 88

A pattern of social **inhibition**, feelings of **inadequacy**, and **hypersensitivity** to negative evaluation.

Answer 89

A pattern of **submissive** and **clinging** behavior related to an excessive **need to be taken care of**.

Answer 90

A pattern of preoccupation with **orderliness**, **perfectionism**, and **control**. ## Footnote Note: do not confuse with obsessive-compulsive disorder in which there is obsessive thinking and behavioral compulsions.

Answer 91

* Insomnia Disorder * Hypersomnolence Disorder * Narcolepsy * Obstructive Sleep Apnea Hypopnea * Central Sleep Apnea * Sleep-Related Hypoventilation * Circadian Rhythm Sleep-Wake Disorders * Non-Rapid Eye Movement Sleep Arousal Disorders * Nightmare Disorder * Rapid-Eye Movement Sleep Behavior Disorder * Restless Legs Syndrome

Answer 92

* **Dissatisfaction with sleep quantity or quality** (1 or more): 1. Difficulty **initiating** sleep 2. Difficulty **maintaining** sleep, frequent awakenings or problems returning to sleep after awakenings 3. **Early-morning awakening** with inability to return to sleep * Occurs **despite adequate opportunity** for sleep **Specifiers:** * With mental disorder (including Substance Use) * With medical condition * With another sleep disorder * **Episodic** (1-3 months), **persistent** (3+ months), **recurrent** (2+ episodes within 1 year) ## Footnote * At least **3 nights per week** * Present for at least **3 months**

Answer 93

* Self-reported **excessive sleepiness** despite a main sleep period 7+ hours * Must include **1+ symptoms**: 1. Recurrent sleep episodes within the same day 2. Prolonged main sleep (9+ hours) that is nonrestorative 3. Difficulty being fully awake after abrupt awakening Specifiers: * With mental disorder (including Substance Use) * With medical condition * With another sleep disorder * **Acute** (less than 1 month), **subacute** (1-3 months), **persistent** (3+ months) ## Footnote Occurs at least **3 times a week**, for at least **3 months** Severity levels: * mild (1-2 days a week) * moderate (3-4 days a week) * severe (5-7 days a week)

Answer 94

Recurrent episodes of **irrepressible need to sleep, lapsing into sleep or napping** occurs within the same day. Must include 1+ symptoms 1. **Cataplexy** a few times a month (sudden loss of muscle tone) 2. **Hypocretin** deficiency 3. **REM sleep** abnormalities ## Footnote Occurs at least **3 times a week** over **3 months** Severity levels: * Mild (need for naps is once or twice per day) * Moderate (need for multiple naps daily) * Severe (constant sleepiness and disturbed nocturnal sleep)

Answer 95

Evidence of obstructive apneas or hypopneas 1. Nocturnal **breathing disturbances**: snoring, snorting/ gasping, or breathing pauses during sleep 2. **Daytime sleepiness, fatigue** or unrefreshing sleep ## Footnote Severity levels: * mild * moderate * severe

Answer 96

* Repeated episodes of **absent respiratory effort** * Polysomnography for diagnosis is **≥ 5 central apneas per hour** of sleep

Answer 97

**Decreased respiration** associated with elevated CO2 levels

Answer 98

* Pattern of **sleep disruption** due to an alteration of the circadian system * The sleep disruption leads to **excessive sleepiness or insomnia, or both** ## Footnote Specifiers * Episodic (1-3 months) * Persistent (3+ months) * Recurrent (2+ episodes within 1 year)

Answer 99

* Recurrent episodes of **incomplete awakening** from sleep, accompanied by either **sleepwalking or sleep terrors** * No or little **dream** imagery is recalled * **Amnesia** for the episodes ## Footnote Specifiers * Sleepwalking type (With sleep-related eating OR With sleep-related sexual behavior (sexsomnia) * Sleep terror type

Answer 100

* **Extended, extremely dysphoric and well-remembered dreams**, usually involve efforts to avoid threats to survival or security, generally occurs during the 2nd half of the major sleep episode * On awakening, the individual rapidly becomes **oriented and alert** Specifiers * Acute (less than 1 month) * Subacute (1-6 months) * Persistent (6+ months) ## Footnote Severity levels: * Mild (less than 1 episode a week) * Moderate (1+ episode a week) * Severe (every night)

Answer 101

* **Arousal during sleep** associated with **vocalization** and/ or complex **motor** behaviors * Behaviors arise during **REM** sleep * Upon awakening, the individual is completely **awake, alert and not confused** or disoriented

Answer 102

**An urge to move the legs**, usually accompanied by or in response to uncomfortable and unpleasant sensations in legs (ALL of the following): 1. The urge to move the legs begins or worsens during periods of rest or inactivity 2. The urge to move legs is partially or totally relieved by movement 3. The urge is worse in the evenings or at night than during the day ## Footnote The symptoms occur at least **3 times per week** for at least **3 months**.

Answer 103

* Suicidal Behavior * Nonsuicidal Self-Injury

Answer 104

* Individuals have engaged in potentially self-injurious behavior with at least some **intent to die** as a result of the act * A suicide attempt may or may not result in actual **self-injury**

Answer 105

Individuals have engaged in **intentional self-inflicted damage to their body** (cutting, burning, stabbing, hitting, excessive rubbing) in the absence of suicidal intent.

DSM-5-TR Diagnosis Flashcards

Learn to recognize and differentiate key DSM-5 diagnoses relevant to marriage and family therapy. (129 cards)