Diagnostics Final Exam Study Guide

Which of the following statements about depersonalization/derealization disorder is true? A. Although transient symptoms of depersonalization/derealization are common in the general population, symptomatology that meets full criteria for depersonalization/derealization disorder is markedly less common B. Women are 1.5 times more likely than men to develop depersonalization/ derealization disorder. C. Age at onset of the disorder is most commonly between 25 and 35 years. D. During episodes of depersonalization/derealization, individuals may feel that they are "going crazy" and typically lose reality testing. E. The most common childhood traumatic experience in persons with depersonalization/derealization disorder is sexual abuse.

A. Although transient symptoms of depersonalization/derealization are common in the general population, symptomatology that meets full criteria for depersonalization/derealization disorder is markedly less common

Which of the following statement about gender is true? A. An individual's gender cannot always be predicted from his or her biological indicators. B. An individual's gender is determined by cultural factors C. An individual's gender is determined by assignment at birth (natal gender) D. An individual's gender is determined by psychological factors E. An individual's gender cannot be determined when there is a cocurrent disorder of sexual development

A. An individual's gender cannot always be predicted from his or her biological indicators.

Which substance or class of substances in the Substance-Related and Addictive chapter of DSM-5 is not associated with a substance use disorder? A. Caffeine B. Hallucinogens C. Inhalants D. Stimulants E. Tobacco

A. Caffeine

The diagnostic criteria for neurocognitive disorder (NCD) due to HIV infection include fulfillment of criteria for major or mild NCD and documented infection with human immunodeficiency virus (as confirmed by established by laboratory methods). Which of the following is a prominent feature of NCD due to HIV infection? A. Impairment in executive functioning B. Conspicuous aphasia C. Significant delusions and hallucinations at onset of the disorder D. Marked difficulty with recall to learn information E. Rapid progression to profound neurocognitive development

A. Impairment in executive functioning

Depression, irritability, anxiety, obsessive-compulsive symptoms, and apathy are frequently associated with Huntington's disease and often precede the onset of major symptoms. Psychosis more rarely precedes the onset of motor symptoms. Which of the following is a core feature of major or mild neurocognitive disorder due to Huntington's disease. A. Progressive cognitive impairment with early changes in executive function B. Prominent early memory impairment, mostly affecting short term memory C. Psychosis in the early stages, with marked olfactory hallucinations D. Voluntary jerking movements E. Diminished hearing and smell

A. Progressive cognitive impairment with early changes in executive function

In addition to preoccupations with a perceived body flaw, which of the following behaviors would be most suggestive of a diagnosis of body dysmorphic disorder (BDD)? A. Repetitive mirror checking in response to preoccupation B. Consulting a psychiatrist because of the distress caused by the preoccupation C. Losing an unhealthy amount of weight in order to improve one's appearance D. Having a related pre occupant with having or acquiring a disfiguring illness E. Experiencing discomfort with one's primary or secondary sex characteristics

A. Repetitive mirror checking in response to preoccupation

A 10-year-old boy demonstrates hand-flapping and finger flicking, and he repetitively flips coins and lines up his trucks. He tends to "echo" the last several words of a question posed to him before answering, mixes up his pronouns (refers to himself in the second person), tends to repeat phrases in a perseverative fashion, and is quite fixated on routines related to dress, eating, travel, and play. He spends hours in his garage playing with his father's tools. What do these behaviors represent? A. Restricted, repetitive patterns of behaviors, interests, or activities characteristic of autism spectrum disorder. B. Symptoms of obsessive-compulsive disorder C. Prototypical manifestations of obsessive-compulsive personality. D. Symptoms of pediatric acute-onset neuropsychiatric syndrome (FANS). E. Complex tics.

A. Restricted, repetitive patterns of behaviors, interests, or activities characteristic of autism spectrum disorder.

Which of the following symptoms is most likely to indicate the presence of hypersomnolence disorder? A. Sleep inertia B. Nonrefreshing sleep in main sleep episode C. Automatic behavior D. Frequent napping E. Headache

A. Sleep inertia

Which of the following statements about the diagnosis of gender dysphoria in adolescent and adults is true? A. The "post transition" specifier is used to indicate that the individual has undergone or is pursuing treatment procedures to support the new gender assignment. B. To qualify for the diagnosis, the individual must be pursing some kind of sex reassignment treatment C. To qualify for the diagnosis, the individual must have a strong desire to be the other gender or must insist that he or she is the other gender D. To qualify for the diagnosis, the individual must have an associated disorder of sex development E. To qualify for the diagnosis, the individual must engage in cross-dressing behavior

A. The "post transition" specifier is used to indicate that the individual has undergone or is pursuing treatment procedures to support the new gender assignment

Which of the following presentations is characteristic of dependent personality disorder? A. A pattern of acute discomfort in close relationships, cognitive or perceptual distortions, and eccentricities of behavior B. A pattern of submissive and clinging behavior related to an excessive need to be taken care of. C. A pattern of instability in interpersonal relationships, self-image, and affects, and marked impulsivity, D. A pattern of grandiosity, need for admiration, and lack of empathy. E. A pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation.

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

Female sexual interest/arousal disorder requires a lack of, or significantly reduced, sexual interest/arousal, as manifested by at least three of six possible indicators. Which of the following is not one of these six indicators? A. No/reduced initiation of sexual activity, and typically unreceptive to a partner's attempt to initiate B. Absent/reduced sexual excitement/pleasure during sexual activity with the opposite sex. C. Absent/reduced genital or nongenital sensations during sexual activity in almost all or all sexual encounters D. Absent/reduced interest in sexual activity E. Absent/reduced sexual/erotic thoughts or fantasies

B. Absent/reduced sexual excitement/pleasure during sexual activity with the opposite sex.

A 7 year-old girl presents with a history of normal language skills (vocabulary and grammar intact) but is unable to use language in a socially pragmatic manner to share ideas and feelings. She has never made good eye contact, and she has she has difficulty reading social cues. Consequently, she has had difficulty making friends, which is further complicated by her being somewhat obsessed with cartoon characters, which she repetitively scripts. She tends to excessively smell objects. Because she insists on wearing the same shirt and shorts everyday, regardless of the season, getting dressed is a difficult activity. These symptoms date from early childhood and cause significant impairment in her functioning. What diagnosis best fits this child's presentation. A. Asperger's disorder. B. Autism spectrum disorder. C. Pervasive developmental disorder not otherwise specified (NOS). D. Social (pragmatic) communication disorder. E. Rett syndrome.

B. Autism spectrum disorder.

Which of the following statements about compulsive behaviors in obsessive-compulsive disorder (OCD) is true? A. Compulsions in OCD are best understood as a form of addictive behavior B. Compulsive behaviors in OCD are aimed at reducing the distress triggered by obsessions C. Examples of compulsive behaviors include paraphilias in (sexual compulsions), gambling, and substance use D. Compulsions involve repetitive persistent thoughts (e.g., of contamination), images (e.g., violent or horrific scenes), or urges (e.g., stab someone) E. Compulsive behaviors in OCD are typically goal directed, fulfilling a realistic purpose

B. Compulsive behaviors in OCD are aimed at reducing the distress triggered by obsessions

A 16-year old boy with a long history of defiant behavior toward authority figures also has a history of aggression toward peers (gets into fights at school), toward his parents, and toward objects (punching holes in walls, breaking doors). He frequently lies and he has recently begun to steal merchandise from stores and money and jewelry from his parents. He does not seem pervasively irritable or depressed and he has not sleep disturbance or psychotic symptoms. What is the most likely diagnosis? A. Oppositional defiant disorder (ODD) B. Conduct disorder C. Attention-deficit/hyperactivity disorder (ADHD) D. Major depressive disorder E. Disruptive mood dysregulation disorder

B. Conduct disorder

A 5-year-old boy has difficulty making friends and problems with initiating and sustaining back-and-forth conversation; reading social cues; and sharing his feelings with others. He makes good eye contact, has normal speech intonation, displays facial gestures, and has a range of affect that generally seems appropriate to the situation. He demonstrates an interest in trains that seems abnormal in intensity and focus, and he engages in little imaginative or symbolic play. Which of the following diagnostic requirements for autism spectrum disorder are not met in this case? A. Deficits in social-emotional reciprocity B. Deficits in nonverbal communicative behaviors used for social interaction C. Deficits in developing and maintaining relationships D. Restricted, repetitive patterns of behavior, interests, or activities as manifested by symptoms in two of the specified four categories E. Symptoms with onset in early childhood that cause clinically significant impairment

B. Deficits in nonverbal communicative behaviors used for social interaction

Which of the following is necessary to make a diagnosis of insomnia disorder? A. Difficulty being fully awake after awakening B. Difficulty with sleep initiation or sleep maintenance, or early-morning awakening with inability to return to sleep C. Absence of co-existing mental disorder D. Documented insufficient opportunity for sleep E. Persistence of sleep difficulties despite use of sedative-hypnotic agents

B. Difficulty with sleep initiation or sleep maintenance, or early-morning awakening with inability to return to sleep

Which of the following is a core feature of insomnia disorder? A. Depressed mood B. Dissatisfaction with sleep quantity or quality C. Cognitive impairment D. Abnormal behaviors during sleep E. Daytime fatigue

B. Dissatisfaction with sleep quantity or quality

A 35-year-old with new-onset diabetes presents with a 6-month history of inability to maintain an erection. His erectile dysfunction had a sudden onset: he was fired from his job a month before the symptoms began. His serum glucose is well controlled with oral hypoglycemic medication. What is the appropriate DSM-5 diagnosis? A. Sexual dysfunction due to general medication B. Erectile disorder C. Adjustment disorder D. Unspecified sexual dysfunction E. No diagnosis

B. Erectile disorder

A 32-year-old man presents to the emergency department distressed and agitated. He reports that his sister has been killed in a car accident on a trip to South America. When asked how he found out, he says that he and his sister were very close and he, "just knows it" After putting him on the phone with his sister, who was comfortably staying with friends while on her trip, the man expressed relief that she was alive. Which of the following best fits this presentation? A. He had a delusional belief because he believed it was true without warrant B. He did not have a delusional belief because it changed in the light of new evidence C. He had a grandiose delusion, because he believed he could know things happening far away D. H had a nihilistic delusion, because it involved untrue, imagined catastrophe E. He did not have a delusion because in some cultures people believe they know things about family members outside of ordinary communications

B. He did not have a delusional belief because it changed in the light of new evidence

Over a period of several years, a 50-year old woman visits her dermatologists office every few weeks to be evaluated for skin cancer, showing the dermatologist various freckles, nevi, and patches of dry skin about which she has become concerned. None of the skin findings have ever been abnormal and the dermatologist has repeatedly reassured her. The woman does not have pan, itching, bleeding, or other somatic symptoms. She does have a history of occasional panic attacks. What is the most likely diagnosis? A. Unspecified anxiety disorder B. Illness anxiety disorder C. Hypochondriasis D. Somatic symptom disorder E. Factitious disorder

B. Illness anxiety disorder

A 25-year-old woman, new to your practice, tells you that a little more than 3 months ago she was accosted on her way home. The attacker told her she had a gun, was going to rape her, and would shoot her if she resisted. He walked her toward an alley. She was sure he would kill her afterward no matter what she did, and therefore she pushed away from him, aware that she might be shot. She was able to escape unharmed. She describes not being able to fall asleep for the first 2 nights after the attack and of avoiding that particular street in her neighborhood for 2 days following the event. She thinks the attacker might have touched her breasts, but cannot remember for sure. She has recently started feeling anxious all of the time and is tearful, and she has stopped going to work. She fears that something about her makes her, "look like a victim." What is the most likely diagnosis? A. Post-traumatic stress disorder B. Acute stress disorder C. Adjustment disorder D. Dissociative amnesia E. Personality disorder

C. Adjustment disorder

After a routine chest X-ray, a 53-year old man with a history of heavy cigarette use is told that he has a suspicious lesion in his lung. A bronchoscopy confirms the diagnosis of adenocarcinoma. The man delays scheduling a follow-up appointment with the oncologist for more than 2 weeks, describes feeling as is, "all of this is not real," is having nightly dreams of seeing his own tombstone, and is experiencing intrusive flashbacks to the moment when he heard the physician saying, "The tests strongly suggest that you have cancer of the lung." He is tearful and is convinced he will die. He also feels intense guilt that his smoking caused the cancer and expresses the thought that he "deserves" to have cancer. What diagnosis best fits this clinical picture? A. Acute stress disorder B. Post-traumatic stress disorder. C. Adjustment disorder. D. Major depressive disorder. E. Generalized anxiety disorder

C. Adjustment disorder

Six months after the death of her husband, a 70-year-old woman is seen for symptoms of overwhelming sadness, anger regarding her husband's unexpected death from a heart attack, intense yearning for him to come back, and repeated unsuccessful attempts to begin moving out of her large home (which she can no longer afford) due to inability to sort through and dispose of her husband's belongings. What is the most appropriate diagnosis? A. Major depressive disorder B. Post-traumatic stress disorder C. Adjustment disorder, with depressed mood D. Other specified trauma- and stressor-related disorder (persistent complex bereavement disorder) E. Normative stress reaction

C. Adjustment disorder, with depressed mood

Which of the following is not a commonly recognized type of delusion? A. Persecutory B. Erotomanic C. Alien abduction D. Somatic E. Grandiose

C. Alien abduction

A 7-year-old boy is having behavioral and social difficulties in his second-grade class. Although he seems to be able to attend and is doing, "well" from an academic standpoint (though seemingly not what he is capable of), he is constantly interrupting, fidgeting, talking excessively, and getting out of his seat. He has friends, but he sometimes annoys peers because of his difficulty sharing and taking turns and the fact that he is constantly talking over them. Although he seeks out play dates, his friends tire of him because he wants to play sports nonstop. At home, he can barely stay in his seat for a meal and is unable to play quietly. Although he shows remorse when the consequences of his behavior are pointed out to him, he can become angry in response and seems nevertheless unable to inhibit himself. What is the most likely diagnosis? A. Bipolar disorder B. Autism spectrum disorder C. Attention-deficit/hyperactivity disorder, predominantly hyperactive/impulsive D. Generalized anxiety disorder E.. Specific learning disorder

C. Attention-deficit/hyperactivity disorder, predominantly hyperactive/impulsive

The parents of a 15-year-old female 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. Her papers are handed in late, and she makes careless mistakes on examinations. They have her tested and the WAIS-IV results are as follows: Verbal IQ 125; Perceptual Reasoning Index, 122; Full-Scale IQ, 123; Working Memory Index 55th percentile; Processing Speed Index, 50th percentile. Weakness in executive functioning are noted. During a psychiatric evaluation, she 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 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, and she is well liked by her peers. What is the most likely diagnosis? A. Adjustment disorder with anxiety. B. Specific learning disorder. C. Attention-deficit/hyperactivity disorder, predominantly inattentive D. Developmental coordination disorder E. Major depressive disorder

C. Attention-deficit/hyperactivity disorder, predominantly inattentive

A 45-year-old woman had a choking episode 3 years ago after eating salad. Since that time she has been afraid to eat a wide range of foods, fearing that she will choke, This fear has affected her functionality and her ability to eat out with friends and has contributed to weight loss Which diagnosis best fits this clinical picture? A. Bulimia nervosa. B. Schizophrenia. C. Avoidant/restrictive food intake disorder. D. Binge—eating disorder. E. Adjustment disorder.

C. Avoidant/restrictive food intake disorder.

A 79-year-old woman with a history of depression is being evaluated at a nursing home for a suspected urinary tract infection. She is easily distracted, perseverates on answers and questions, asks the same question repeatedly, is unable to focus, and cannot answer questions regarding orientation. The mental status changes evolved over a single day. Her family reports that they thought she, "wasn't herself" when they saw her the previous evening, but the nursing report this morning indicates that the patient was cordial and appropriate. What is the most likely diagnosis? A. Major depressive disorder, recurrent episode B. Depressive disorder due to another mental condition C. Delirium D. Major depressive disorder, with anxious distress E. Obsessive-compulsive disorder

C. Delirium

Which of the following combinations, if present for 1 month, would meet Criterion A for schizophrenia? A. Prominent auditory and visual hallucinations B. Grossly disorganized speech and diminished emotional expression C. Disorganized speech and emotional expression D. Paranoid and grandios delusions E. Avolition and diminished emotional expression

C. Disorganized speech and emotional expression

A 6-year-old boy with mild to moderate developmental delay presents with a history of passing feces into his underwear during the day about once every 2 weeks, even during school. He is now refusing to go to school for fear of soiling his pants and being ridiculed by his classmates. Which of the following statements accurately describes the diagnostic options regarding encopresis in this case? A. He should not be diagnosed with encopresis because the frequency is less than twice per week B. He should be diagnosed with encopresis because the incontinence is resulting in impairment of age appropriate functioning C. He should not be diagnosed with encopresis because his mental age is likely less than 4 years old. D. He should be diagnosed with encopresis E. He should not be diagnosed with encopresis because the events are restricted to the daytime.

C. He should not be diagnosed with encopresis because his mental age is likely less than 4 years old

A 7-year-old boy with mild to moderate developmental delay presents with a chronic history of wetting his clothes during the day about once weekly, even during school. He is now refusing to go to school for fear of wetting his pants and being ridiculed by his classmates. Which of the following statements accurately describes the diagnostic options regarding enuresis in this case? A. He should not be diagnosed with enuresis because the frequency is less than twice per week. B. He should be diagnosed with enuresis because the incontinence is resulting in impairment of age appropriate role functioning C. He should not be diagnosed with enuresis because his mental age is likely less than 5 years old D. He should be diagnosed with enuresis, diurnal subtype only. E. He should not be diagnosed with enuresis because the events are restricted to daytime.

C. He should not be diagnosed with enuresis because his mental age is likely less than 5 years old

A 45-year old man with a family history of early-onset coronary artery disease avoids climbing stairs, eschews exercise, and abstains from sexual activity for a fear of provoking a heart attack. He frequently checks his pulse, reads extensively about preventive cardiology, and tried many health food supplements alleged to be good for the heart. When he experiences an occasional twinge of chest discomfort, he rests in bed for 24 hours; however, he does not go to doctors because he fears hearing bad news about his heart from them. What diagnosis best fits this clinical picture? A. Persistent complex bereavement disorder B. Adjustment disorder C. Illness anxiety disorder D. Unspecified somatic symptom disorder E. Somatic symptom disorder

C. Illness anxiety disorder

Dissociative amnesia most often includes which of the following types of amnesia? A. Continuous amnesia B. Permanent, irreversible amnesia C. Localized or selective amnesia D. Generalized amnesia similar to that seen in neurological toxicity E. Systematized amnesia

C. Localized or selective amnesia

A 52 year old man with raw, chapped hands is referred to a psychiatrists by his primary care doctor. The man reports that he washes his hands repeatedly, spending up to 4 hours a day using abrasive cleansers and scalding hot water. Although he admits that his hands are uncomfortable, he is entirely convinced that unless he washes in this manner he will become gravely ill. A medical workup is unrevealing, and the make takes no medications. What is the most appropriate diagnosis? A. Delusional disorder, somatic type B. Illness anxiety disorder C. Obsessive-compulsive disorder, with absent insight D. Obsessive-compulsive personality disorder E. Generalized anxiety disorder

C. Obsessive-compulsive disorder, with absent insight

A previously well-behaved 13-year old girl begins to display extremely defiant and oppositional behavior, with vindictiveness. She is angry, argumentative, and refuses to accept responsibility for her behavior, which is affecting both her home life and school life in a significant way. Which is the least likely diagnosis? A. Major depressive disorder B. Bipolar disorder C. Oppositional defiant disorder D. Adjustment disorder E. Substance use disorder

C. Oppositional defiant disorder - because onset unlikely in adolescence

Which of the following is not a criterion for the DSM-5 diagnosis of attention-deficit/hyperactivity disorder (ADHD)? A. Onset of several inattentive or hyperactive-impulsive symptoms prior to age 12 years. B. Manifestation of several inattentive or hyperactive-impulsive symptoms in two or more settings (e.g., at home, school, or work; with friends or relatives; in other activities). C. Persistence of symptoms for at least 12 months. D. Clear evidence that symptoms interfere with, or reduce the quality of, social, academic or occupational functioning E. Inability to explain symptoms as manifestation of another mental disorder (ex: mood disorder, anxiety disorder, dissociative disorder, personality disorder, substance intoxication withdrawal)

C. Persistence of symptoms for at least 12 months.

A 35-year-old woman tells her therapist that she has recently become intensely aroused while watching movies in which people are tortured and that she regularly fantasizes about torturing people while masterbating. She is not distressed by these thoughts and denies ever having acting on these new fantasies, though she fantasizes about these activities several times a day. Which of the following best summarizes the diagnostic implications of this patient's presentation? A. She does not meet the criteria of sexual sadism disorder B. She does not meet the criteria for sexual sadism disorder because the fantasies are not sexual in nature C. She does not meet the criteria for sexual sadism disorder because she has never acted on fantasies D. She does not meet the criteria for sexual sadism disorder because the interest and arousal began after age 35 E. She does not meet the criteria for sexual sadism disorder as the diagnosis is only made in men

C. She does not meet the criteria for sexual sadism disorder because she has never acted on fantasies

The essential feature of the DSM-5 diagnosis of delirium is a disturbance in attention/awareness and in cognition that develops over a short period of time, represents a change from baseline, and tends to fluctuate in severity during the course of a day. Which of the following additional conditions must apply? A. There myst be laboratory evidence of an evolving dementia B. The disturbance must be associated with a disruption of the sleep-wake cycle C. The disturbance must not occur in the context of a severely reduced level of arousal, such as a coma D. The disturbance must be a direct physiological consequence of a substance use disorder E. The disturbance must not be superimposed on a preexisting neurocognitive disorder

C. The disturbance must not occur in the context of a severely reduced level of arousal, such as a coma

Criterion A4 of post traumatic stress disorder requires, "Experiencing repeated or extreme exposure to aversive details of the traumatic event." Which of the following would not qualify as an experiencing trauma under this criterion? A. A police officer reviewing surveillance videotapes of homicides to identify perpetrators B. A social worker interviewing children who have been sexually abused and obtaining the details of the abuse C. A soldier sifting through the rubble of a collapsed building to retrieve remains of comrades D. A college student at a film festival watching a series of violent movies that contain graphic rape scenes E. A psychologist working with victims of torture who are seeking political asylum in the United States

D. A college student at a film festival watching a series of violent movies that contain graphic rape scenes

While intoxicated at a Mardi Gars celebration, a 19-year-old woman lifts her blouse and bra as a float goes by to get beads. The event appears on a cable news program watched by friends of her parents, who inform her parents. They insist that she get a psychiatric evaluation. She denies any other similar events in her life but admits that the experience was, "sort of sexy." She is currently extremely anxious and distressed - to the point of attend parties or go away on vacation. What is the most appropriate diagnosis? A. Exhibitionistic disorder B. Frotteuristic disorder C. Voyeuristic disorder D. Adjustment disorder E. Antisocial personality disorder

D. Adjustment disorder

A 25-year old man is concerned that he looks, "weak" and "puny" despite the fact that to neutral observers he appears very muscular. When confronted about his belief he believes he is being humored and that people are in fact making fun of his small size behind his back. He has tried a number of strategies to increase muscle mass, including exercising excessively and using anabolic steroids; however, he remains dissatisfied with his appearance. What is the most likely diagnosis? A. Delusional disorder, somatic type B. Narcissistic personality disorder C. Body identity integrity disorder D. Body dysmorphic disorder, with muscle dysmorphia E. Koro

D. Body dysmorphic disorder, with muscle dysmorphia

A 27-year old woman presents for psychiatric evaluation after almost hitting someone with her car while driving under the influence of marijuana. She reports that she was prompted to seek treatment by her husband, with whom she has had several conflicts over the past year about her ongoing marijuana use. She has continued to smoke two joints daily and drive while under the influence or marijuana since this event. What is the appropriate diagnosis? A. Cannabis use B. Cannabis dependence C. Cannabis intoxication D. Cannabis use disorder E. Unspecified cannabis-related disorder

D. Cannabis use disorder

A 19-year-old college student is brought by ambulance to the emergency department. His college dorm supervisor, 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 department, the patient gets down in a crouching position and begins making barking noises at seemingly random times. His urine toxicology report is negative, and all labs are within normal limits. What is the best description of these symptoms? A. An animal delusion - the patient believes he is a dog B.Intermittent explosive rage C. A paranoid stance leading to self-protective aggression D. Catatonic behavior E. A formal thought disorder

D. Catatonic behavior

A 25-year old woman is hospitalized for evaluation of episodes in which she appears to lose consciousness, rocks her head from side to side, moves her arms and legs in non synchronous bicycling pattern. The episode does occur a few times per day for 2-5 minutes. Electroencephalography during the episodes does not reveal any ictal activity. Immediately after a fit, her sensorium appears clear. What is the most likely diagnosis? A. Epilepsy B. Malingering C. Somatic symptom disorder D. Conversion disorder (functional neurological symptom disorder) with attacks or seizures E. Factitious disorder

D. Conversion disorder (functional neurological symptom disorder) with attacks or seizures

A 31-year-old man narrowly escapes (without injury) from a house fire caused when he dropped the lighter while trying to light his crack pipe. Six weeks later, while smoking crack he thinks he smells smoke and tuns from the building in a panic shouting, "It's on fire!" Which of the following symptoms or circumstances would rule out a diagnosis of post traumatic stress disorder (PTSD) for this patient? A. Having difficulty falling asleep B. Being uninterested in going back to work C. Inappropriately getting angry at family members D. Experiencing symptoms when smoking crack cocaine E. Concluding that, "the world is completely dangerous"

D. Experiencing symptoms when smoking crack cocaine

A 15-year old girl with a history of cruelty to animals, stealing, school truancy, and running away from home shows no remorse when caught, or when she is confronted with how her behavior is affecting the rest of her family. She disregards the feelings of others and seems to not care that her conduct is compromising her school performance. The behavior has been present for over a year and in multiple relationships and settings. Which of the following components of the "With limited prosocial emotions" specifier is absent in this clinical picture? A. Lack of remorse or guilt B. Callous - lack of empathy C. Lack of concern about performance D. Shallow or deficient affect E. The required time duration

D. Shallow or deficient affect

Criterion A for the diagnosis of dissociative identity disorder (DID) requires the presence of two or more distinct personality states or an experience of possession. Which of the following symptom presentations would not qualify as a manifestation of an alternate identity? A. An intrusive but nonhallucinatory voice that is not recognized as being part of one's own normal thought flow. B. Suddenly emergent strong impulses or emotions. C. Acute changes in personal preferences in areas such as food, clothing, or even political convictions D. An acute sense of being in a different body, such as an adult feeling like he or she is in a child's body. E. A religious experience of being reborn into a new spiritual state that affects multiple domains of the individual's behavior.

E. A religious experience of being reborn into a new spiritual state that affects multiple domains of the individual's behavior.

A 45-year old man with a long-standing history of heavy alcohol use is referred for psychiatric evaluation after his recent admission to the hospital for acute hepatitis. The patient reports that he drank almost daily in college. Over the past 10 years, he has gradually increased his nightly alcohol intake from a single six pack to two 12-packs of beer and this nightly drinking habit has resulted in his frequently oversleeping and missing work. He has tried to moderate his alcohol use on numerous occasions with little success, particularly after developing complications with alcoholic cirrhosis. The patient admits that he becomes anxious and gets hand tremors when he doesn't drink. This patient meets the criteria for which of the following diagnoses? A. Alcohol use B. Alcohol dependence C. Alcohol use disorder, mild D. Alcohol use disorder, moderate E. Alcohol use disorder, severe

E. Alcohol use disorder, severe

In which of the following disorders can psychotic symptoms occur? A. Bipolar and depressive disorders B. Substance use disorders C. Post traumatic stress disorders D. Other medical conditions E. All of the above

E. All of the above

A 15-year—old boy has a long history of nonverbal communication deficits. As an infant he was unable to follow someone else directing his attention by pointing. As a toddler he was not interested in sharing events, feelings, or games with his parents. From school age into adolescence, his speech was odd in tonality and phrasing, and his body language was awkward. What do these symptoms represent? A. Stereotypies. B. Restricted range of interests. C. Developmental regression. D. Prodromal schizophrenime symptoms. E. Deficits in nonverbal communicative behaviors.

E. Deficits in nonverbal communicative behaviors.

A 60-year old man has prostate cancer with bony metastases that cause persistent pain. He is treated with antiandrogen medications that result in hot flashes. He is unable to work because of his symptoms but he is, stoical, hopeful and not anxious. What is the appropriate diagnosis? A. Pain disorder B. Illness anxiety disorder C. Somatic symptom disorder D. Psychological factors affecting other medical conditions E. No diagnosis

E. No diagnosis

Which of the following symptoms or conditions would rule out a diagnosis of erectile disorder? A. Presence of diabetes mellitus B. Marked decreased in erectile rigidity C. Age over 60 years D. Presence of alcohol use disorder E. Presence of symptom for less than 3 months

E. Presence of symptom for less than 3 months

Ater an airplane flight, at 60-year~old woman with a history of chronic anxiety develops deep vein thrombophlebitis and a subsequent pulmonary embolism. Over the next year, she focuses relentlessly on sensations of pleuritic chest pain and repeatedly seeks medical attention for this symptom, which she worries due to recurrent pulmonary emboli, despite negative test results. Review of system reveals that she also has chronic back pain and that she has consulted many physicians for symptoms of culture negative cystitis What diagnosis best fits this clinical picture? A. Post-pulmonary embolism syndrome. ' B. Chart pain syndrome. C. Hypochondriasis D. Pain disorder E. Somatic symtom disorder

E. Somatic symtom disorder

Which of the following symptoms is incompatible with a diagnosis of conversion disorder (functional neurological symptom disorder)? A. Light-headedness upon standing B. Dystonic movements C. Tunnel vision D. Touch and temperature anesthesia with intact pinprick sensation over the left forearm E. Transient leg weakness in a patient with known multiple sclerosis

E. Transient leg weakness in a patient with known multiple sclerosis

Social anxiety disorder (social phobia) differs from normative shyness in that the disorder leads to which of the following? a. social or occupational dysfunction b. marked social reticence c. avoidance of social situations d. derealization or depersonalization e. pervasive social deficits with poor insight

a. social or occupational dysfunction

A 30-year old woman reports 2 years of persistently depressed mood, accompanied by loss of pleasure in all activities, ruminations that she would be better off dead, feelings of guilt about, "bad things" she has done, and thoughts about quitting work because of her inability to make decisions. Although she has never been treated for depression, she feels so distressed at times that she wonders if she should be hospitalized. She experiences an increased need for sleep but still feels fatigued during the day. Her overeating has led to a 12-kg weight gain. She denies drug or alcohol use, and her medical workup is completely normal, including lab test for vitamins. The consultation was prompted by her worsened mood for the past several weeks. What is the most appropriate diagnosis? a. Major depressive disorder (MDD) b. Cyclothymia c. Bipolar II disorder d. Persistent depressive disorder (dysthymia), with persistent major depressive episode e. MDD with melancholic features

b. Persistent depressive disorder (dysthymia), with persistent major depressive episode