Lesson 11: Mental Disorders Part I

Which match of the following DSM5 (a system of categorizing mental illnesses) illness categories with its description is incorrect? (A) Anxiety Disorders - distress caused by only phobias (B) Neurodevelopmental - distress is caused by improper development of the nervous system (C) Neurocognitive - nervous system developed then lost function afterwards, causing distress (D) Bipolar disorders - distress caused by both depressive moods and mania

(A) Anxiety disorders - distress caused by only phobias Anxiety disorders can be general too, not only caused by specific stimuli like phobias.

Which of the following would fall under the "Other/Unspecified" subcategory for Neurodevelopmental Disorders, meaning it meets some but not all of the criteria? (A) Down's Syndrome Disorder (B) Autism Spectrum disorders (C) ADHD (Attention Defecit Hyperactivity Disorder) (D) What formerly was called "mental retardation"

(A) Down's Syndrome Disorder Autism Spectrum Disorders, ADHD and what was formerly called "Mental Retardation" fully meet the criteria for Neurodevelopmental Disorders. Down's Syndrome meets some of the criteria, but not all, for this category, so it falls under the "other/unspecified" subcategory.

If a doctor has diagnosed Schizophrenia in a patient, which medications are they most likely taking to treat it? (A) Drugs targeting dopamine levels and receptors (B) Drugs targeting epigenetic markers (C) Drugs targeting synapse pruning (D) None of the above.

(A) Drugs targeting dopamine levels and receptors Most of the medications used for treating Schizophrenia target dopamine levels and receptors.

Which of the following has been noticed in studies of patients with depression? I. Decreased Frontal Lobe activity II. Increased Temporal lobe activity III. Decreased Occipital lobe activity (A) I only (B) III only (C) I and II only (D) I and III only

(A) I only Studies have noted decreased frontal lobe activity and increased limbic system activity.

*CRB* Which of the following terms describe the two types of symptoms patients suffering from Psychosis endure? They are often described as either adding or taking away something. (A) Positive and Negative (B) Presenting and Subordinate (C) Emergence and Submergence (D) Addition and Subtraction

(A) Positive and Negative In Psychosis, there are two main classifications of symptoms: Positive symptoms are when something has been added. Negative symptoms are when something has been taken away.

Which of the following is not a category of symptoms often expressed in schizophrenics? (A) Psychotic (B) Cognitive (C) Negative (D) Positive

(A) Psychotic Schizophrenia is a subset of psychotic disorders, not the other way around. Symptoms expressed in Schizophrenia fall under the subcategories of Cognitive, Negative and Positive

*CRB* A very common phobia is a fear of public speaking or presenting in front of a large crowd. Which of the four types of phobias would this best fit under? (A) Situational (B) Animal (C) Natural Environment (D) Blood-Injection-Injury

(A) Situational Because this phobia is directly linked to a situation, it is most definitely a situational phobia.

Which of the following statements about classification of mental disorders is incorrect? (A) The ICD and DSM rarely change, and only change if new research demands that disorders must be reclassified. (B) There are two main systems for classifying mental disorders: the ICD and DSM. (C) The American Psychiatric Association and World Health Organization group mental disorders differently (D) The DSM-5 has more top-level categories, meaning it breaks down mental disorders into more categories.

(A) The ICD (international classification of diseases) and DSM ( diagnostic statistical manual of mental disorders) rarely change, and only change if new research demands that disorders must be reclassified. The ICD and DSM are updated regularly, for a variety of reasons!

About ______% of adults meet the criteria of at least one mental illness, and ____% of adults meet the criteria for at least one serious mental illness causing distress or disability. (A) 25, 10 (B) 25, 6 (C) 10, 6 (D) 35, 10

(B) 25, 6 About 25% of adults meet the criteria of at least one mental illness, and 6% of adults meet the criteria for at least one serious mental illness.

*CRB* One type of somatoform disorder is a Conversion disorder, where there is a change in sensory or motor function without a discernable psychologcial or physical cause. Which of the following is most likely to be a Conversion Disorder? (A) Jamaal feels a new devotion to his religion and starts frequently attending church ceremonies. (B) Aqib woke up the day of his mother's funeral and literally could not lift himself out of bed. (C) After slipping on a patch of ice, Sammy couldn't walk for a while. (D) Jay quit attending trivia night entirely after losing on a hotly-contested tiebreaker.

(B) Aqib woke up the day of his mother's funeral and literally could not lift himself out of bed. It is clear that Aqib is going through an emotional struggle, but there is still no discernable cause for not being able to lift himself out of bed. This emotional struggle is also a common trigger for Somatoform disorders in general.

Which subcategory of Schizophrenia symptoms involves issues with attention, organizing, or planning abilities? (A) None of the following (B) Cognitive (C) Negative (D) Positive

(B) Cognitive The Cognitive subcategory of Schizophrenia symptoms involves issues with attention, organizing and planning abilities.

Which of the following is not a diagnostic tool for diagnosing schizophrenia? (A) Checking for elevated levels of Dopamine (B) Hearing voices (C) Brain scans (D) Patient History

(B) Hearing voices Hearing voices is a common symptom of schizophrenia, not a diagnostic tool.

Which of the pathways potentially involved in depression has an incorrect description of its function? I. The Raphe System is responsible for serotonin secretion II. Locus coeruleus responsible for dopamine and serotonin secretion. III. The VTA supplies much of the dopamine of the brain (A) I Only (B) II Only (C) I and II Only (D) II and III Only

(B) II Only The Locus Coeruleus is responsible for norepinephrine secretion.

*CRB* Which of the following is not one of the four types of Specific Phobias? (A) Situational (B) Learning Environment (C) Natural Environment (D) Blood-Injection-Injury

(B) Learning Environment The four types of specific phobias are: 1. Situational 2. Animal 3. Natural Environment 4. Blood-Injection-Injury

*CRB* Which of the following would best describe Cyclothymic Disorder? (A) Dual episodes are lasting months at a time, severe enough to impair functioning. (B) Similar to Bipolar Disorder, but with less extreme mood swings. (C) Cycling between the Manic and Depressive episodes quickly, but with similar severity. (D) Similar to Bipolar Disorder, but typically caused by an autoimmune attack on the brain caused by a Thymus tumor.

(B) Similar to Bipolar Disorder, but with less extreme mood swings. Cyclothymic Disorder is similar to Bipolar Disorder, but with less extreme mood swings.

Which of the following does "Psychosis" include? (A) Hallucinations (B) Delusions (C) Both A and B (D) Neither

(C) Both A and B Psychosis includes both Hallucinations and Delusions.

Which of the following symptom groups are NOT characteristic of depression? (A) Feeling helpless and low self esteem (B) Lack of energy and change in weight (C) Decreased self-awareness and increased interests (D) Low mood and Decreased focus

(C) Decreased self-awareness and increased interests

*CRB* There are also some episodes where a person meets the symptoms of both Major Depressive and Manic Episodes almost daily for over a week. What type of episode would this be called? (A) Extreme Episode (B) Polarized Episode (C) Mixed Episode (D) Cyclothymic Episode

(C) Mixed Episode In a Mixed Episode, symptoms of both Major Depressive and Manic Episodes are met almost daily for over a week, and the symptoms can combine in strange ways. For example, a person may be crying uncontrollably and inconsolable, but still be fixated on finishing a task.

Which subcategory of Schizophrenia symptoms involves blunted emotions and loss of interest in activities? (A) None of the following (B) Cognitive (C) Negative (D) Positive

(C) Negative The Negative subcategory of Schizophrenia symptoms includes blunted emotions and loss of interest in activities.

*CRB* Which of the following diseases is estimated to occur in LESS than 10% of US residents? (A) Anxiety Disorders (B) Mood Disorders (C) Psychotic Disorders (D) Dissociative disorders

(C) Psychotic Disorders Despite all of this media attention that Schizophrenia receives, its class of disorders (Psychotic Disorders) are only in about 1% of US residents. That's an order of magnitude less than the other three groups listed!

Which of the following is NOT one of the most common focuses of obsessions in OCD? (A) Dirt and Toxins (B) Symmetry (C) Tapping in multiples of a number (D) Accidents and extreme scenarios

(C) Tapping in multiples of a number Option (C) is a compulsion, because it is an action performed. Common Obsessions in OCD are Dirt and Toxins, Symmetry, and Worrying over Accidents and unlikely scenarios.

Which of the following is NOT a theory on the psychologial factors/causes of depression? (A) Learned Helplessness (B) Cognitive Distortions (C) Internal, stable and global attributions (D) Decreased coping abilities

(D) Decreased coping abilities Theories of psychological causes/factors of depression include Learned Helplessness, Cognitive Distortions and Internal, stable and global attributions.

Which match of the following DSM5 (a system of categorizing mental illnesses) illness categories with its description is incorrect? (A) Personality disorders involve distress related to long term behavioral features considered characteristic, and is broken into smaller clusters of diseases (B) Somatic symptom disorders involve having symptoms that are derived psychologically, similar to an illness but without anything wrong at tissues (C) Dissociative disorders involve distress from issues of identity or memory (D) Gender dysphoria is never recognized as an illness by the DSM5

(D) Gender dysphoria is never recognized as an illness by the DSM5 Gender dysphoria is a mental disorder if the person feels distress or disability regarding their gender identity. If there is no distress or disability, it is not considered a mental illness.

Which of the following are potential characteristics of Mania? I. Delusions of grandeur II. Poor Judgment III. Risky behaviors influenced by increased optimism (A) I Only (B) I and III Only (C) II and III Only (D) I, II and III

(D) I, II and III Characteristics of Mania include Delusions of grandeur, Risky Behaviors, Poor Judgment, and dangerously increased Self-esteem and Optimism.

*CRB* Which of the following would mimic the symptoms of an anxiety disorder? I. Medication use or withdrawal II. General medical conditions III. Alcohol (A) I only (B) I and II only (C) I and III only (D) I, II and III

(D) I, II and III Medication use or withdrawal, general medical conditions, alcohol, or other drug use could all lead to symptoms that present similarly to anxiety disorders.

Which of the following are abnormalities seen in the nervous system of schizophrenics? I. Diminished tissue size leading to larger ventricles in brain II. Cortical layers of cerebral cortex are disorganized III. The mesocorticolimbic pathway that carries dopamine from VTA to other cortex and limbic system acts irregularly. (A) I only (B) III only (C) I and III (D) I, II, and III

(D) I, II, and III Abnormalities often seen in Schizophrenic patients are larger than normal ventricles in the brain, cortical layers are disorganized, and the mesocorticolimbic pathway that carries dopamine from VTA to other cortex and limbic system acts irregularly.

Compare and contrast Anorexia Nervosa and Bulimia Nervosa.

Both Anorexia and Bulimia are Feeding and Eating Disorders that lead to underweight patients. In Anorexia, the person consumes too little food consistently, whereas in bulimia, a person will binge eat and then purge it out (throw up the food).

Which of the following are appropriate uses of the word "mood" according to the DSM-5? I. A short-term emotional state, directly driven by emotions II. A long-term emotional state, related to emotions III. The subjective experience of emotions, similar to affect (A) I only (B) I and II only (C) I and III only (D) II and III only

(D) II and III only Appropriate uses of "mood" include Long-term emotional states (compared to short-term emotions) and the subjective experience of emotions, similar to affect.

A researcher is looking at blood samples of clinically depressed patients. Which of the following are they most likely to find? (A) Decreased blood glucose levels (B) Increased cytokines (C) Increased dopamine (D) Increased cortisol levels

(D) Increased cortisol levels In a blood sample of clinically depressed patients, increased cortisol and other stress-related hormones are likely.

Dawn's therapist recommmended that she try cognitive behavioral therapy to cope with her agoraphobia. The therapist hopes that she will become conditioned to these situations with increased exposure, and her fight or flight response will decrease. Which of the following experiments is the therapist hoping to emulate? (A) B.F. Skinner shaping birds' actions to spin around by gradually reinforcing similar behavior. (B) A dog trainer using chaining to teach the dog a 3-minute "dance" routine slowly over time (C) Pavlov's dogs being conditioned to salivate when a bell is rung, since it signals food. (D) Pavlov's dogs, over time, becoming habituated with the bell ringing and salivating less than when first conditioned.

(D) Pavlov's dogs, over time, becoming habituated with the bell ringing and salivating less than when first conditioned. The key idea of this form of cognitive behavioral therapy recommended to Dawn was habituation of the response when faced with the unfamiliar situation.

Which subcategory of Schizophrenia symptoms involves issues with hallucinations and delusions? (A) None of the following (B) Cognitive (C) Negative (D) Positive

(D) Positive The Positive subcategory of Schizophrenia symptoms includes hallucinations and delusions.

Which of the following is NOT a Sleep-Wake Disorder? (A) Insomnia (B) Somnambulism (sleep walking) (C) Sleep Apnea (D) REM Deficiency

(D) REM Deficiency Insomnia, Somnambulism and Sleep Apnea are all Sleep-Wake Disorders.

A week after his house was broken into in the night, James has a panic attack while trying to fall asleep in his bed his first night back home. Could he be diagnosed with a panic disorder?

Based on this information, no. James had an isolated panic attack that was somewhat justified by the situation, not a history of panic attacks for less warranted reasons.

After living with a depressed roommate for months and not scoring well on the LSAT, Jamarcus starts to develop depression himself. Could co-rumination have been a factor? If so, how?

Co-rumination is definitely a possible factor. Living with a depressed roommate, and after failing, Jamarcus and his roommate both may have sulked, and Jamarcus could have adopted some of his roommate's tendencies and attributions.

Compare delirium versus dementia.

Delirium is for reversible episodes of neurocognitive malfunctions due to drugs, improper blood concentrations, or even infection. Dementia is a major neurocognitive disorder that can lead to loss of functions

Compare the terms delusion and hallucination.

Delusions are fixed false beliefs not explained by a cultural background. Hallucinations are sensory perceptions without stimuli.

In what ways is comparing Depression and a common cold appropriate? In which ways is it inappropriate?

Depression is by far the #1 reason for reaching out to mental health services, so its prevalence in the mental health community is similar to a cold's prevalence. However, this comparison can trivialize depression, since common colds are often recovered from without outside help.

True or False? Mania is similar to Action Potentials in the sense that it is an all-or-nothing occurrence.

False. Hypomania is when more mild versions of symptoms of Mania are exhibited, and the symptoms never develop into full-blown Mania.

True or False? In animal models of major depressive disorders, an increase in neuroplasticity has been noticed.

False. In animal models of major depressive disorders, a DECREASE in neuroplasticity has been noticed.

*CRB* True or false? Psychological disorders must include BOTH behavioral and psychological symptoms that go against cultural norms and are severe enough to cause significant distress and/or impairment to functioning.

False. Psychological disorders must include behavioral and/OR psychological symptoms that go against cultural norms and are severe enough to cause significant distress and/or impairment to functioning.

True or False? Schizophrenia is the diagnosis if a patient exhibits multiple personalities.

False. Schizophrenia is the diagnosis if a patient has delusions and/or hallucinations that affect the way they act, including isolation, disorganization and a flat affect.

True or False? Symptoms can still be considered a mental disorder if the symptoms are being caused by drug usage.

False. Symptoms CANNOT be considered a mental disorder if the symptoms are being caused by drug usage.

True or False? The potential causes of Schizophrenia are Genes and Physical Stress only.

False. The potential causes of Schizophrenia are Genes and Physical Stress and Psychosocial factors, like family interaction styles in childhood.

Can a phobia be considered an anxiety disorder?

If the phobia is causing distress or disability, then yes. It will be focused anxiety presenting with a specific pattern.

*CRB* Compare obsessions and compulsions. What differentiates the two?

Obsessions would be repeated and uncontrollable thoughts or impulses that can cause distress or anxiety. A Compulsion would be a repeated Behavior, physical or mental (like counting), that is done to an obsession to reduce the distress.

What mechanistically differentiates PTSD from other anxiety disorders?

PTSD can have a clear trigger that causes the onset of the disorder, while others have more ambiguous or trivial beginnings.

Compare and contrast the biomedical and biopsychosocial approaches to mental disorders.

The biomedical approach mainly focuses on the biological reasons for the disease. The biopsychosocial approach considers the biology, but also includes psychological and cultural factors.

In the context of schizophrenia, define the term Prodrome.

Prodrome is the period before symptoms are fully present, but there is a deterioration in their work and relationships and they start to exhibit symptoms.

John knows that his family has a history of depression, and he has the disease version of the 5-HTTLPR gene (associated with depression in some cases). Knowing this, John avoids long-term stressors when possible and never develops depression. How can this be explained?

The 5-HTTLPR gene is only associated with depression if the person is in stressful situations often.

*CRB* If a medical researcher says "There are much higher rates of eating disorders in well-developed countries (like the USA) than in other countries" and are studying why, would this fit better in the biological or biopsychosocial approach? Explain why.

This is clearly the biopsychosocial approach. This researcher is clearly looking at the social and cultural factors these eating disorder patients face. This goes beyond the biological reasons for disease.

True or False? At the tissue level, there have been no consistent findings that are "typical" of depression sufferers.

True. At the tissue level, there has been no consistent findings that are "typical" of depression sufferers. However, some studies suggest hippocampal atrophy is a common feature after a long history of depression.

*CRB* True or false? One goal of the Biopsychosocial Approach is to use both direct therapies, which would act directly on the patient, and indirect therapy, which would increase social support for the patient, to treat Psychological Disorders.

True. One goal of the Biopsychosocial Approach is to use both direct therapies, which would act directly on the patient, and indirect therapy, which would increase social support for the patient, to treat Psychological Disorders.

*CRB* True or false? Seasonal Affective Disorder is best classified as a major depressive disorder with seasonal (temporal) onset.

True. Seasonal Affective Disorder is best classified as a major depressive disorder with seasonal (temporal) onset.

With Obsessive Compulsive Disorder (OCD), where does the distress or disability come into play?

With OCD, distress comes into their everyday life when their compulsions interfere with daily activities.

For months, Alterrique appeared to be depressed. However, this episode ends and Alterrique has extreme self-esteem and optimism, but also shows risky behaviors. Could Alterrique have been misdiagnosed and suffer from Bipolar Disorder?

Yes, Alterrique's behaviors after the depressive episode are characteristic of mania. Displaying both manic and depressive episodes is characteristic of bipolar disorder.

According to the DSM-5, is Sexual Dysfunction considered a mental disorder?

Yes, Sexual Dysfunction is considered a mental disorder because it involves Distress and Disabilities from abnormalities or performance of sexual acts.

In an autopsy of someone who committed suicide, fewer than normal serotonin and norepinephrine receptors have been found in tissue staining. Is this characteristic of clinical depression?

Yes, studies have shown fewer than average NE and serotonin receptors in patients with depression.

Crystal spent the last calendar year noticeably tense and it was affecting her schoolwork. She often had twitching eyelids and a furrowed brow. Could she have been suffering from General Anxiety disorder (GAD)?

Yes. Since Crystal has had a deficit in her work and her symptoms for over six months from an unclear source, this could be diagnosed as General Anxiety Disorder.