Diagnostics 6051 midterm

Midterm Diagnostics 6051 SPRING 2021 Tareq Mohamad Fill in the blanks: The four domains of client experience include: Mood Cognitions Behavior Physiology The five most frequently diagnosed classes of DSM disorders are Bipolar and Related Disorders Depressive Disorders Anxiety Disorders Obsessive-Compulsive and Related Disorders Trauma and Stressor-Related Disorders The process of excluding diagnoses based on dimensions that the client is not experiencing is called: Ruling out How do you decide between a diagnosis of brief psychotic disorder, schizophreniform disorder, and schizophrenia? A brief psychotic disorder is a condition in which psychotic symptoms appear, including hallucinations, disorganized behavior, delusions, or strange speech or language. It is distinguished from schizophreniform disorder, schizophrenia, and other psychotic disorders by its sudden appearance in its short duration that appears between at least one day and one month at most where the patient usually recovers completely. Rarely, a brief psychotic disorder may occur more than once in the same person. If the above-mentioned symptoms were associated with diminished range of emotional expressions (not a must) and the duration was more than 1 month and less than 6 months, then the patient will be diagnosed with schizophreniform disorder in which 1/3 recover within 6 month and 2/3 of people will go on to develop schizophrenia. Along with the previously mentioned symptoms, If the duration stayed 6 months or longer, then the patient will be diagnosed with the uncurable schizophrenia where the client will be needing a lifelong psychosocial therapy and medications. Explain the difference between bizarre and non-bizarre delusions Non-bizarre delusions are fixed false beliefs that involve situations that occur in real life, such as being harmed or poisoned, although these thoughts are false, they are technically possible. Bizarre delusion is when a person believes he or she is mentally controlled by another, if the delusions are clearly implausible and not understandable to same-culture peers and do not derive from the ordinary life experience, then we call it bizarre delusions. What is the difference between a delusion and a hallucination? While hallucinations are based in the senses, delusions revolve around concepts, ideas and beliefs that are strongly held in the mind. Delusions - fixed beliefs not open to change even when evidence contradicts them. Hallucinations - involuntary sensory experiences not related to external stimuli. Visual Auditory (most common) Olfactory (may indicate a medical problem) Gustatory (may indicate a medical problem) Tactile (often linked to substance withdrawal or intoxication) The DSM 5 contains both the ICD 9 code and the ICD 10 code. In the following example, highlight the ICD 10 Code 296.22 (F32.2) Major Depressive Disorder, Single Episode, Moderate Multiple Choice What kinds of problems would counselors not diagnose: Those that cause clinically significant distress Those that produce an increased risk of harm to self or others Conflicts between the individual and society We would diagnose all of the above What is the ICD? Insanity Classification Dictionary The Insanity Criteria and Diagnosis The International Catalog of Disorders The International Classification of Diseases Which of the following is it particularly important to assess when making a differential diagnosis? A clients level of acculturation the clients past history of psychological disorders the extent to which the symptoms are interfering with daily functioning how the client copes with his or her symptoms Which terms are used to determine severity of a DSM diagnosis? Low, Medium, High Mild, Moderate, Severe Superficial, Typical, Intense Level I, Level II, Level III Joshua was given a diagnosis of ADHD and major depressive disorder. ADHD is the diagnosis that underlies his challenges in completing work assignments and is the reason for his ongoing vocational therapy. Therefore, ADHD is considered the Principle diagnosis Provisional diagnosis Ancillary diagnosis Deferred diagnosis Which of the following is not a method to define psychopathology? Measuring the intelligence quotient Assessing for distress or impairment Observing maladaptive behavior Determining deviation from the statistical norm The DSM 5 criteria for a disorder include all of the following EXCEPT: What features must be seen What features are essential How many criteria must be met The preferred method of treating the disorder DSM 5 Specifiers include descriptions of all of the following EXCEPT: Course of the disorder Features of the disorder Subtypes of the disorder Current severity Differential Diagnoses includes: Alternate diagnosis that should be considered before making the final diagnosis Additional risks and vulnerabilities associated with the disorder Clinical features known to frequently occur in association with the disorder Frequent, co-occurring mental disorders or medical conditions Severe impairment and delays in social skills, communication and behavior in a four-year-old, would likely lead to a diagnosis in which category? Learning disorders pervasive developmental disorders personality disorders conduct disorders The parents of a 15-year-old tenth grader believe that she should be doing better in high school, given how bright she seems and the fact that she received mostly A’s through eighth grade. During evaluation, the student reports a long history of failing to give close attention to details, difficulty sustaining attention while in class or doing homework, failing to finish chores and tasks, and significant difficulties with time management, planning, and organization. She is forgetful, often loses things, and is easily distracted. She has no history of restlessness or impulsivity. She is liked by her peers. The most likely diagnosis would be: Specific Learning Disorder Attention-deficit/hyperactivity disorder, predominately inattentive Major depressive disorder Adjustment disorder with anxiety Which of the following is not associated with attention-deficit/hyperactivity disorder (ADHD). Reduced School performance Poorer Occupational performance and attendance Reduced risk of substance use disorders Elevated interpersonal conflict A 5-year old boys is constantly moody, irritable, and intolerant of frustration. In addition, he is pervasively and chronically restless, impulsive, and inattentive. What diagnosis best fits his clinical picture? ADHD ADHD and Disruptive Mood Dysregulation Disorder (DMDD) Bipolar Disorder Major Depressive Disorder Someone who experiences delusions, hallucinations, and disorganized speech or behavior for a least one day, but less than one month, might be diagnosed with: Schizoaffective disorder Schizophreniform disorder Delusional disorder Brief psychotic disorder False beliefs that do not change even with proof that the beliefs are not true,: Hallucinations Obsessions Delusions Compulsions In order to separate schizoaffective disorder from depressive or bipolar disorder with psychotic features, which one of the following symptoms must be present for at least two weeks in the absence of a major mood episode at some point during the lifetime duration of the illness? Delusions or hallucinations Regressed behavior Projective identification Binge eating A false belief in which an individual believes that they are being watched or tormented by agencies are persons in authority with whom they have never interacted is known as a Grandiose delusion Delusion of thought control Delusion of reference Delusion of persecution Which of the following is not a commonly recognized type of delusion? Persecutory Erotomaniac Alien Abduction Grandiose A 19-year-old college student is brought by ambulance to the emergency room. His college roommate, who called the ambulance, reports that the student was isolating himself, was pacing in his room, and was not responding to questions. In the emergency room, the patient gets down in a crouching position and begins making barking noises at seemingly random times. Toxicology screens are negative and all labs are within normal range. What is the best description of these symptoms? An animal delusion Intermittent explosive rage Paranoia Catatonic Behavior Which does not represent a negative symptom of schizophrenia Hallucinations Decreased motivation Affective flattening Social disinterest Which of the following are the most common kinds of hallucinations experienced by an individual with schizophrenia? Olfactory Tactile Auditory Visual During the clinical interview a 25-year-old law student reports to you that he has uncovered the truth about JFK’s assassination and that CIA agents have been dispatched to follow him and monitor his internet communications. You would consider this assertion to be: A non-bizarre delusion A bizarre delusion A nondelusion A hallucination. A 30-year-old single woman reports having experienced auditory and persecutory delusions for 2 months, followed by a full major depressive episode with sad mood, anhedonia, and suicidal ideation lasting 3 months. Although the depressive episode resolves with pharmacotherapy and psychotherapy, the psychotic symptoms persist for another month before resolving. What diagnosis best fits this clinical picture? Brief Psychotic Disorder Schizoaffective Disorder Major Depressive Disorder Bipolar I disorder Marshall is suffered from several symptoms that indicate a schizophrenia-related condition, but his symptoms have only been present for four months. Which of the following would be an appropriate diagnosis? Brief psychotic disorder Delusional disorder Schizoaffective disorder Schizophreniform disorder Which of the following is a characteristic of the grandiose type of delusional disorder? Believing one is loved by an important person or celebrity Falsely believing that one’s sexual partner is unfaithful Believing one has some great (but unrecognized talent or insight or having made some important discovery Believing one has been malevolently treated in some way Effective treatment for schizophrenia would include all of the following except: Psychodynamic therapy Behavioral therapy Social and living skills training Medication management training A behavioral disturbance in which one appears to be in a trancelike state, and one’s muscles assume a waxy rigidity such that one tends to remain in any position in which one is placed, is known as: Catalepsy Catatonia Apraxia Psychomotor Retardation A person who alternates between episodes of hypomania and of moderate depression chronically for at least two years would be diagnosed as having: Bipolar I disorder Bipolar II disorder Rapid cycling bipolar disorder Cyclothymic disorder A 32-year-old man reports 1 week of feeling unusually irritable. During this time, he has increased energy and activity, sleeps less, and finds it difficult to sit still. He also is more talkative than usual and is easily distractible, to the point of finding it difficult to complete his work assignments. A physical examination and laboratory workup are negative for any medical cause of his symptoms and he takes no medications. What description fits best? Cyclothymic disorder Major Depressive Episode Manic Episode Bipolar II Disorder A 50-year-old man with a history of a prior depressive episode is given an antidepressant by his family doctor to help with his depressive symptoms. Two weeks later, his doctor contacts you for a consultation because the patient is now euphoric, has increased energy, racing thoughts, psychomotor agitation, poor concentration and attention, pressured speech, and a decreased need to sleep. These symptoms began with the initiation of the patient’s new medication. However, the patient stopped the medication after two days because he no longer felt depressed, but the newer symptoms persist. Your diagnosis is: Substance/medication-induced bipolar and related disorder Bipolar disorder Cyclothymic disorder Major depressive disorder. In ______________, people experience more severe depressions and milder periods of mania Depression with atypical features Bipolar I disorder Bipolar II disorder Cyclothymic disorder Freda shared that she was hospitalized for homicidal and suicidal thoughts last month and comes to you with symptoms of a major depressive episode. Records from the hospital document a history of both depressive and hypomanic episodes. What diagnosis will Freda most likely have? Bipolar II Disorder, most recent episode depressed Bipolar I Disorder, most recent episode hypomanic Bipolar I Disorder, most recent episode depressed Bipolar II disorder, most recent episode hypomanic Lithium is most often used to treat: Depression Bipolar Disorder Schizophrenia Neurodevelopmental Disorders Which of the following is NOT TRUE about a hypomanic episode? Is it not necessarily problematic It does not contribute to the definition of several mood disorders It causes marked impairment in social or occupational functioning It need last only 4 days At various times, Cynthia, a 20-year-old college student, has been considered by her family and/or friends to be moody, high-strung, explosive, or hyperactive. She never fails to take care of her responsibilities, but the fact that she seems to experience mood swings that are outside the norm has been noticed by those around her. Knowing the criteria for mood disorders, you would diagnose Cynthia with ___________. major depressive disorder panic disorder persistent depressive disorder cyclothymic disorder A 45-year-old man presents with persistently depressed mood for several weeks that interferes with his ability to work. He has insomnia and fatigue, feels guilty, has thoughts he would be better off dead, and has thoughts about how he could die without anyone knowing it was a suicide. His wife informs you that he requests sex several times a day and that she thinks he may be going to “massage parlors” regularly, both of which are changes from his typical behavior. He has told her of his ideas for a “better Internet,” and has invested thousands of dollars in software programs that he cannot use. She notes that he complains of fatigue but sleeps only 1 or 2 hours each night and seems to have tremendous energy during the day. Your diagnosis is: Manic Episode Bipolar I disorder Major Depressive Episode, with mixed features Cyclothymic disorder A 12-year-old boy begins to have new episodes of temper outbursts that are out of proportion to the situation. Which of the following is not a diagnostic possibility for this client? Disruptive mood dysregulation disorder Bipolar disorder Oppositional defiant disorder Conduct disorder Children with DMDD (Disruptive mood dysregulation disorder) are most likely to develop which of the following disorders in adulthood? Bipolar I disorder Schizophrenia Bipolar II disorder Unipolar Depressive Disorders Richard, a 30-year old businessman, has experienced anhedonia for about the past month. He frequently wakes up very early in the morning during which time his symptoms are especially debilitating. He feels extremely guilty about many things and has lost a significant amount of weight since the onset of his symptoms. Richard would be diagnosed with Depression with catatonic features Depression with melancholic features Depression with psychotic features Depression with atypical features For the past two weeks, John has experienced a loss of interest in his usual activities, psychomotor agitation, increased appetite, insomnia, and thoughts of committing suicide. John would be diagnosed as having: Double depression Bipolar II disorder Major depression Cyclothymic disorder A 14-year-old boy describes himself as feeling “down” all of the time for the past year. He remembers feeling better while he was at camp for 4 weeks during the summer; however, the depressed mood returned when he came home. He reports poor concentration, feelings of hopelessness, and low self-esteem but denies suicidal ideation or changes in his appetite or sleep. What is the most likely diagnosis? Major depressive disorder Disruptive mood dysregulation disorder Persistent depressive disorder, with early onset Schizoaffective disorder A common characteristic of depression in children and teens is ________________ Aggression and irritability Passiveness Shyness Coping behavior A 9-year-old boy cannot go to sleep without having a parent in his room. While falling asleep, he frequently awakens to check that a parent is still there. One parent usually stays until the boy falls asleep. If he wakes up alone during the night, he starts to panic and gets up to find his parents. He also reports frequent nightmares in which he or his parents are harmed. He occasionally calls out that he saw a strange figure peering into his dark room. The parents usually wake in the morning to find the boy asleep on the floor of their room. They once tried to leave him with a relative so they could go on a vacation; however, he became so distressed in anticipation of this that the canceled their plans. The most likely diagnosis is Specific Phobia Nightmare disorder Separation anxiety disorder Agoraphobia Randy presents little or no shyness in approaching and interacting with unknown adults and is willing to go off with an unknown adult with little or no caution. The diagnosis in this case might be: Reactive attachment disorder Disinhibited Social Engagement Disorder Negative reluctance disorder Uncharacteristic inhibition disorder At home and school, Elvin presents with severe outbursts which occur three or more times per week. Between outbursts he appears irritable and angry. You suspect: Conduct Disorder Oppositional Defiant Disorder Disruptive Mood Dysregulation Disorder Bipolar Disorder Laura presents with complaints of heart pounding, shortness of breath, sweating, and the fear that she is going to die. She has experienced five such attacks during the last three months, at home, at work, and while driving her car. Laura would probably be diagnosed with Anxiety disorder Panic Disorder Acute stress disorder Generalized anxiety disorder A 34-year-old man tells a social worker that in the last few years he has been afraid to be apart from his wife. He fears she might be injured or killed and he would never see her again. His nightmares often include that exact scenario. What would be the most likely diagnosis for this client? Reactive Attachment Disorder Dependent Personality Disorder Separation Anxiety Disorder Specific Phobia A 35-year-old man is in danger of losing his job because it requires frequent long-range traveling and for the past year he has avoid flying. Two years earlier he was on a particularly turbulent flight, and although he was not in any real danger, he was convinced that the pilot minimized the risk and that the plane almost crashed. He flew again 1 month later and, despite having a smooth flight, the anticipation of turbulence was so distressing that he experienced a panic attack during the flight; he has not flown since. What is the most appropriate diagnosis? Agoraphobia Specific Phobia, Situational type Social Anxiety Disorder Acute Stress Disorder Which of the following is the most accurate description of people with specific phobias? The average individual fears only one object or situation The fear is generally quite mild in intensity The fear is exactly the same intensity each time the situation or object is encountered The fear occurs almost every time the person encounters the object or situation Although onset of a specific phobia can occur at any age, specific phobia most typically develops during which age period? Childhood Adolescence Early Adulthood Middle Age In social phobia (social anxiety disorder), the object of the individual’s fear is the potential for which of the following? Harm to self or others Separation from objects of attachment Embarrassment Social or occupational impairment Tom avoids using public transportation or being in a crowd because of concern that escape might be hard or help not readily available in the event of embarrassing health or panic symptoms. This condition has persisted for 6 months. Tom would probably be diagnosed with: Agoraphobia PTSD Panic dysfunction Obsessive-compulsive disorder When called on at school, a 7-year-old boy will only nod or write in response. The family of the child is surprised to hear this from the teacher, because the boy speaks normally when at home with his parents. The child has achieved appropriate developmental milestones, and a medical evaluation indicates that he is healthy. The boy is unable to give any explanation for his behavior, but the parents are concerned that it will affect his school performance. Your diagnosis would be? Separation Anxiety Disorder Selective mutism Social anxiety disorder Panic disorder Jimmy has been recently experiencing symptoms of anxiety associated with everything he does including activities that should not cause anxiety. Jimmy could be experiencing Schizophrenia Bipolar disorder Major depressive disorder Generalized anxiety disorder A 65-year old woman reports being housebound despite feeling physically healthy. Several years ago, she fell while shopping; although she sustained no injuries, the situation was so upsetting that she became extremely nervous when she had to leave her house unaccompanied. Because she has no children and few friends whom she can ask to accompany her, she is very distressed that she has few opportunities to venture outside her home. You diagnosis would be Specific Phobia Social Anxiety Disorder Agoraphobia Panic disorder Which of the following is not a common symptom of obsessive-compulsive disorder? Compulsions to reduce anxiety Intense stress when objects are not in order Anxiety stemming from traumatic injury A fear of contamination When John leaves his house in the morning, he always has to check multiple times to make sure that he has locked the front door. If John tries to leave his house without checking his door, or after only checking it once, he is filled with such anxiety and dread that he must abandon whatever else he is doing to return home and check is front door again. John is most likely struggling with a(n) __________. Obsession Compulsion Mania Poor memory Brenda feels that she needs to run up and down the stairs exactly 12 times before she leaves school or someone she loves will get hurt. What is the name for this type of intrusive, irrational thought? Obsession Body Dysmorphic Compulsion Paranoia Which of the following is not a common compulsion associated with OCD? Excessively arranging things in a particular order Excessively checking to make sure a loved one is still breathing Excessively checking to make sure the oven is turned off Having flash backs to a past event DIAGNOSE THE FOLLOWING: Case #1: The Case of Joan Joan is a 26-year-old openly gay woman who recently moved to your area to take a job in the publishing business. She comes to your clinic saying she needs medication because she feels "unstable." The history she describes seems to begin about four years ago when she was in college, getting "A's" in most of her classes and having a wide circle of friends. During a particularly stressful period of final exams, she began to feel depressed, had difficulty sleeping and eating, and lost about fifteen pounds. Although she completed her exams satisfactorily, her symptoms continued for about the next two months, during which she became more isolated socially. After she graduated, she felt much better, got a job and felt increasingly energized. She began feeling so energized she didn't seem to need much sleep and would wake up after 3 or 4 hours feeling wide awake and could put in 10 and 11 hour days of work. She would feel her thoughts racing with new ideas and seemed to come up with creative ideas, although she often did not carry through on these, or other people didn't seem to understand them. She was partying and socializing a great deal, and she admitted to excessive use of alcohol. She said that over the next month she found herself preoccupied with sexual thoughts and found sexual implications in whatever people said to her or what she saw on TV. She was also very talkative and felt euphoric except at times when she became extremely irritable and "cranky" towards people. She found herself striking up conversations with complete strangers. She began to feel like she could hear people talking to her that weren't there and began to think that her apartment could be haunted. They would sometimes tell her to do things, like line objects up in a certain order, or take a different route home, or start saying certain words aloud. She also felt like she could read other people's thoughts and was sure they could read hers and they would answer her thoughts even when she didn't say them out loud. "I'm sure I've always been psychic," she said, "but it just really took off. I could sense all kinds of things." She said her friends became concerned and took her to an emergency room. She was hospitalized for several days and put on lithium. Most of her symptoms seemed to abate. Her sleeping pattern improved and appetite increased, although she felt more fatigued and "slowed down." In the course of the move, she had discontinued her use of the medication she'd been given--the prescription had run out and she had lost contact with the prescribing psychiatrist. She says that she has been drinking heavily on a daily basis to calm her nerves but it did not resolve her emotional issues. She has been noticing that she had been having difficulty sleeping, feels "jittery," has been getting concerned about what other people are thinking, and is having difficulty focusing on work projects because her thoughts are racing. Your diagnosis:  Bipolar I Disorder-Sever- with Psychotic Features _ Severe, with Psychotic Features