COUN 5111

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How many classes of drugs must you be familiar with to work effectively with the DSM-5's Substance-Related and Addictive Disorders?

10

What is the ICD-9-CM code for the diagnosis Major Depressive Disorder, recurrent, severe, with psychotic features?

296.34

The "Severe" severity in substance use disorders means that there exists the presence of

6 or more symptoms

Which of the following diagnostic groups was part of the DSM-IV-TR, but is not a part of the DSM-5 system?

A Sexual and Gender Identity Disorders

Based upon your readings and work with the DSM-5, which of the following is NOT a feature of any given diagnosis?

A The success rate for treatment of the diagnosis

The prevalence of psychiatric diagnoses is compelling; the National Comorbidity Survey Replication (2005) surveyed the prevalence, severity, and comorbidity of twelve-month duration DSM-IV disorders, and estimates that ____________ of the population presents with psychiatric diagnoses in any given year, and ___________ will have a psychiatric diagnosis within their lifetime; _____________ of those diagnosed will likely have more than one psychiatric diagnosis.

About 25%; almost 60%; nearly half

Which statement best describes the relationship between Activity and Participation within the International Classification of Functioning, Disability and Health (ICF) conceptual framework?

Activity represents one's potential, and Participation reflects one's actual functioning within a current context

Chris developed a severe case of rheumatoid arthritis that is very painful, and is changing the appearance of the joints in his hands and feet. He has been in constant pain for the past 3 months, and has developed significant symptoms of depression and anxiety as a result. What might his diagnosis be?

Adjustment disorder with mixed anxiety and depressed mood

Which of the following side effects from antipsychotic medications relates to extremely uncomfortable restlessness in body movement?

Akethesia

The most commonly occurring perception-like experience that occurs without an external stimulus that is vivid, clear, with the full force of normal perceptions, but not under voluntary control, is referred to in the DSM-5 as

An auditory hallucination

Which of the following diagnoses is best represented by the symptom of intense fear of gaining weight or becoming fat

Anorexia nervosa

I have tremendous difficulty organizing tasks and activities in my life, and often make careless mistakes because of my lack of attention to detail. Sometimes I avoid trying new things because I do not want to screw them up! People often say I am disrespectful and that I only ever think of myself in a conversation. I am forever misplacing things, and very forgetful if I do not write things down. My mom said I've always been like this, even as a child. Over the past year I have been more aware of these problems, and they are causing a lot of difficulty both at home and in my work. What is going on with me?

Attention-Deficit/Hyperactivity Disorder, Predominately Inattentive Presentation

Which choice best describes the key difference between Bipolar I and Bipolar II disorders?

Bipolar I does not require a Major Depressive Episode, while Bipolar II does require it

Gwendolyn is a medical expert for the federal courts, and she has come to see you due to some difficulties she is having at her work site. She describes her life historically as a series of very intense but unstable relationships with a great deal of turmoil and conflict. This continues to manifest within her workplace as she idealizes some colleagues, and vilifies others, resulting in relationships that are at times very close and at other times very critical and disrespectful. She also shared with you her difficulty with binge eating and her related obesity; she reports she over eats to tremendous feelings of emptiness in her life. When things do not go her way she exhibits extreme irritability and reactivity, resulting in frequent displays of temper that alienate her from others. Because of her life long history she tends to be paranoid about what others are thinking, which increases when she is under stress. What might be her diagnosis?

Borderline personality disorder

Everyone is telling me that I have been depressed for a very long time, for years now, and it has affected people's willingness to socialize with me. I tend to eat too much, and sleep too much in my free time. I always seem to have trouble making up my mind about things, and that gets me into trouble at work. I went to a counselor and she asked whether I saw things that were not there, or felt a very elevated mood in between feeling so depressed, but none of that ever happened to me. What is wrong with me?

Both Persistent Depressive Disorder and Dysthymia

Major Depressive Disorder can be diagnosed when discrete major depressive symptoms occur

Both two weeks duration and with inter-episode remissions

Which of the following diagnoses is best represented by the symptom of recurrent episodes of binge eating

Bulimia Nervosa

Dr. Nelson is experiencing the need to urinate frequently, he has some mild muscle twitching in his cheek muscle, he gets brief periods of tachycardia, and his face is a bit flushed. What might be his diagnosis?

Caffeine intoxication

Cluster C Personality Disorders

Can be described as anxious-fearful

Cluster B Personality Disorders

Can be described as dramatic-emotional

Lisa was released from prison last year and has been a patient of yours at the Parole Outpatient Clinic. She served time for multiple assault and battery charges, for which she showed no remorse. Since her release from prison she recounts stories of her gang involvement, where she boasts regular intimidation of non-gang affiliated neighbors, breaking the nose of a rival gang member with a glass bottle, and regularly beats the family dog when she is angry with anyone in the family. Her behavior prevents her from gainful employment, and from having healthy relationships with her family and community. What diagnosis might she have?

Conduct Disorder

Psychiatric disability within the WHO model of health (ICF) can best be defined as how

D well a person with a disability manages social stigma

Someone who switches from one unrelated topic to another, answers questions in a tangential fashion, or speaks in a manner that resembles receptive aphasia, is demonstrating the symptom of

Disorganized thinking

What class of disorders involves the disruption in normal integration of functions like memory, perception, emotion, and behavior?

Dissociative disorders

Repeated voiding of urine into bed or clothes whether involuntary or intentional, during both the nighttime and waking hours, is

Enuresis, Nocturnal and Diurna

According to the DSM-5, what is the difference between fear and anxiety?

Fear is the emotional response to real or perceived imminent threat, whereas anxiety is anticipation of future threat. Depressive Disorders

Ophelia engaged in various sexual activities about 10 times since she turned 18, she is now 21. In none of her sexual encounters was she able to achieve an orgasm. She thought one time she may have felt something, but it was hard for her to tell. She had no other physical or psychological conditions that she knew of. What might be her diagnosis?

Female orgasmic disorder

Linda is a 19-year-old woman who identifies as a lesbian, but she has come to see you about a conflict she feels inside regarding her gender. She has never felt like a girl or woman inside, she always felt more like a man, portrayed more traditionally masculine qualities, and was very comfortable living that role in her relationships. What diagnosis may apply to her?

Gender dysphoria

Which of the following is NOT a Cluster A Personality Disorder?

Histrionic Personality Disorder

Steve just slept nine hours and does not feel restored. He has trouble staying awake. He has had trouble staying awake during the day for at least the last year. He has no diagnosed sleep condition, but these symptoms are negatively affecting the quality of his life. What diagnosis might he have?

Hypersomnolence disorder

A key difference between a manic and hypomanic episode is

Hypomania is not severe enough to cause marked impairment, while mania does so (e.g., psychosis, hospitalization)

The diagnostic system used most commonly to diagnose mental disorders throughout the world is the

ICD-10-CM

In what year and with what version of the ICD did the WHO propose an international standardized terminology for Mental or Behavioral Disorders (MDBs)?

ICD-9, 1975

The DSM-5 lists the following code or codes for most diagnoses presented:

ICD-9-CM and ICD-10-CM

Trudy became very worried about contracting hepatitis B after she learned that it could be transmitted by heavy kissing. Seven months ago Trudy had an evening of passionate kissing at transmitted by heavy kissing. Seven months ago Trudy had an evening of passionate kissing at a party with a stranger. Ever since then she has been obsessed with whether she was developing symptoms of hepatitis B infection. She reviewed symptoms on line and thought she may have some of them. Most recently she believed that her liver felt large, that she was more fatigued, and both of these developments created even greater concern. She even wondered whether her skin began to have a yellow hue to it, frequently checking herself in the mirror. What diagnosis may she have?

Illness anxiety disorder

Which of the following symptoms does NOT address a Manic Episode?

Increased need for sleep due to manic symptoms

Which of the following is not an area of impairment in adaptive functioning for consideration of the diagnosis of intellectual disability?

Intellectual functioning

Toby's mother comes to you very concerned about his behavior, she feels like she can no longer handle his unprovoked, unreasonable outbursts. There is no predictable provocation for his outbursts, and Tory appears to be without any reason for his recurrent aggressive outbursts. The last six months have been very stressful, with four or more weekly instances of Tory's failure to control his aggressive impulses. While quite dramatic, he does not manage to damage anything or hurt anyone during his outbursts. What diagnosis might he have?

Intermittent Explosive Disorder

Chris comes to you with concern about his psychosexual health. For the past year he has noticed a lack of sexual desire in his life. He used to be quite active sexually. He is only 27, and finds this change alarming. He just had a clean bill of physical health from his primary care provider, so he is sure it is something psychological. What diagnosis might he have?

Male hypoactive sexual desire disorder

Ever since Ingrid began a new course of antidepressant medication, she demonstrates a reduced ability to sustain attention in conversations with others, and occasional disorientation to time and place. Her symptoms started three days ago a day following the new medication, and they fluctuate throughout the day. She also demonstrates new deficits in short-term memory. What might her diagnosis be?

Medication Induced Delirium

Intellectual disability, or intellectual developmental disorder, replaced which of the following DMS-IV-TR diagnoses?

Mental retardation

What determines whether Bipolar I Disorder is "with rapid cycling"?

Mood episodes change four or more times per year

The DSM-5 alternative model for personality disorders contains which of the following diagnoses?

Narcissistic personality disorder

A substantial portion of the morbidity associated with schizophrenia manifests as

Negative symptoms

What are the 17 major disorder categories?

Neurodevelopmental Schizophrenia Spectrum and other Psychotic Disorders Bipolar Related Disorders Depressive Disorders Anxiety Disorders Obessive-Compulsive and Related Disorders Trauma-and Stressors Related Disorders Dissociative Disorders Somatic System and Related Disorders Feeding and Eating Disorders Eliminations Disorders Sleep-Wake Disorders Sexual Dysfunction Gender Dysphoria Disruptive, Impulse-Control, and conduct disorder Substance Related and Addictive Disorders Neurocognitive Disorders Personality Disorders Paraphilic Disorders Other Mental Disorders Medication-Induced Movement Disorder and other Adverse Effects of medication

Prior to its inclusion in the Neurodevelopmental Disorders section of the DSM-5, Intellectual Disabilities were

Not referred to as Intellectual Disabilities but rather Mental Retardation

Max presents as a 15-year-old with a lot of anger and irritability that never seems to go away. He constantly argues, defies authority, and loses his temper with family and friends alike. The neighborhood kids don't come around to play with him anymore, and his parents are getting more contacts from the principal's office. What diagnosis might Max have?

Oppositional defiant disorder

Most diagnoses in the DSM-5 have as diagnostic choices within each major diagnostic group

Other specified and unspecified disorder

According to the US Census Bureau's American Community Survey of 2008, ________________ of those seeking rehabilitation services may have a psychiatric diagnoses affecting cognitive functioning.

Over One-third

Sara has been having recurrent, unexpected surges of intense fear and discomfort. Within minutes she has heart palpitations, sweaty palms, a sense of choking, and numbing/tingling sensations. For the past month since she began having these episodes She has been avoiding public places. What is a possible diagnosis?

Panic Disorder

Which of the following diagnoses is best represented by the symptom of persistent eating of nonnutritive, nonfood substances

Pica

Which of the proposed Criterion B Pathological Personality Traits did not match well the Big

Psychoticism

A tall sized brewed Starbucks drip coffee contains 260 mg of caffeine; how does this relate to the DSM-5 diagnosis of Caffeine intoxication?

Recent consumption of caffeine (a dose well in excess of 250 mg.)

Which of the following diagnoses is best represented by the symptom of repeated regurgitation of food

Rumination disorder

Fritz, a 23-year-old man immigrated from Germany was referred to you by his host family, with whom he stays while he completes his college studies. Fritz presented as a peculiar young man, with a rather constricted affect. He appeared socially uncomfortable and very suspicious of you as you begin your interview. Fritz shares that both here and in Germany he did not have many acquaintances, as he did not trust people. As he spoke he tended to use very elaborate phrases to say very simple things. At the end of your session when he was a bit more comfortable with you, he shared with you his belief that when someone hurts his feelings sufficiently, something bad happens to that person, as if the universe pays them back for the wrong they have done. What is Fritz's diagnosis?

Schizotypal personality disorder

In the case of antisocial personality disorder, one must

Select one: a. All of this must be true for antisocial personality disorder b. Establish a diagnosis of conduct disorder prior to age 15. c. Use collateral sources of information to gather accurate information given the tendency toward deceit and/or manipulation d. Be over 18 years of age ANSWER: A All of this must be true for antisocial personality disorder

With respect to Bipolar I Disorder,

Select one: a. Hypomania is common but not required for the diagnosis b. A major depressive episode frequently follows a manic episode, but is not required for the diagnosis of Bipolar I Disorder. c. Both b and d are true d. Neither of these are true about Bipolar I disorder ANSWER: Both b and d are true

When are symptoms NOT indicative of a mental disorder?

Select one: a. In an expectable or culturally approved response to a common stressor or loss b. Socially deviant behavior reflecting a conflict between an individual and society (not resulting from a mental disorder) c. When there is not sufficiently severe impairment in social, occupational, or other important activities d. A transient response to stressor. e. All of these are examples of when symptoms do not indicate the presence of a mental disorder. ANSWER:E All of these are examples of when symptoms do not indicate the presence of a mental disorder.

What happened to the NOS or "not otherwise specified" qualifier for diagnoses within the DSM-IV-TR within the DSM-5?

Select one: a. It was carried over to the DSM-5 for further development as it was underutilized in clinical practice b. It was changed because it was over-utilized in the IV-TR c. It was replaced with "other specified" and "unspecified" disorder qualifiers to allow opportunity to use clinical judgment whether to highlight the specific reason a set of symptoms do not meet diagnostic criteria d. Both a and c are correct ANSWER: D It was carried over to the DSM-5 for further development as it was underutilized in clinical practice/ It was replaced with "other specified" and "unspecified" disorder qualifiers to allow opportunity to use clinical judgment whether to highlight the specific reason a set of symptoms do not meet diagnostic criteria

In order to accurately diagnose Bipolar I Disorder, one needs to know the definition of a:

Select one: a. Manic Episode b. Hypomanic Episode c. Major Depressive Episode d. All of these ANSWER: D All of these

Which of the following is NOT a part of the thematic content of delusions as defined in the DSM-5?

Select one: a. Religious b. Referential c. Persecutory d. Erotomanic e. All of these are thematic content of delusions ANSWER: E All of these are thematic content of delusions

What are the common features of all depressive disorders?

Select one: a. Sad, empty, or irritable mood b. Somatic and cognitive changes c. Significant impact on functioning d. All of these are common features of depressive disorders ANSWER: D All of these are common features of depressive disorders

Within the conceptual framework of the International Classification of Functioning, Disability & Health (ICF), body structure related to psychological functioning most closely relates to:

Select one: a. The brain b. The central nervous system c. A change in the brain's neurochemistry d. None of these relate to structures of the body proper e. a, b, and c all represent body structures affecting psychological functioning ANSWER: E --a, b, and c all represent body structures affecting psychological functioning

What does it mean that the ICF is etiologically neutral?

Select one: a. The etiological or environmental factors are not influential b. The focus shifts from cause of disability to manifestation of function c. Manifestations of impairment in function may be similar across various conditions d. Both a and b related to the ICF's etiological neutrality ANSWER: D Both a and b relate to the ICF's etiological neutrality

Bipolar & Related Disorders were located between Schizophrenia Spectrum & Other Psychotic Disorders and Depressive Disorders because

Select one: a. They all share psychotic symptoms b. They all share major depressive episodes c. They all share hypomanic episodes d. None of these are true ANSWER: D None of these are true

Why is it essential that counselors understand psychiatric diagnoses?

Select one: a. To reduce social stigma associated with psychiatric diagnosesb. For the amelioration or elimination of problematic symptoms that negatively impact health and functioning c. The counselor may be the first clinical contact to identify a diagnosable mental health condition d. To make appropriate referrals to psychiatric treatment or psychotherapy e. All of these are reasons why it is essential for counselors to understand psychiatric diagnoses ANSWER: E All of these are reasons why it is essential for counselors to understand psychiatric diagnoses

What must counselors understand in order to maximize the health and functioning of people with psychiatric diagnoses?

Select one: a. factors that predispose one to mental disorders b. events that may precipitate mental disorders c. dynamics that perpetuate psychiatric impairment d. resources that protect and preserve mental health e. all of the above must be understood, and within the individual's social and cultural context ANSWER: E all of the above must be understood, and within the individual's social and cultural context

Catatonia can best be described as

Select one: a. purposeless and excessive motor activity b. staring grimacing, echoing speech c. complete lack of verbal & motor response d. occurring in schizophrenia as well as with other mental and physical conditions e. All of these choices apply to catatonia ANSWER: E All of these choices apply to catatonia

The American Psychiatric Association, within the DSM-5, defines a mental disorder as a

Select one: a. syndrome or syndrome combination. b. clinically significant disturbance in cognition, emotion regulation, or behavior. c. dysfunction in psychological, biological, or developmental processes underlying mental functioning. d. All of these are part of the APA's definition of mental disorder. ANSWER: D All of these are part of the APA's definition of mental disorder

Persistent Depressive Disorder

Select one: a.Is also known as dysthymia b. Is a more chronic form of depression c. Requires 2 years duration for adults d. Requires 1 year duration for children e. Involves all of these choices ANSWER: E Involves all of these choices

___________ is a traditional biological indicator, while ____________ is a public and usually legally recognized lived role

Sex, gender

Somatic Symptom and Related Disorders in the DSM-5 used to be referred to in the DSM-IV-TR as

Somatoform Disorders

According to the NIMH study (2007), which of the following represent, in the order of frequency form highest to lowest, the diagnostic categories with the highest lifetime prevalence of all DSM diagnoses?

Substance use disorders, anxiety disorders (including PTSD), and mood disorders (combining depressive and bipolar disorders)

What major change occurred in revising the DSM-IV-TR to the DSM-5 with respect to the diagnosis of schizophrenia?

Subtypes of schizophrenia have been removed due to their lack of clinical utility

For sustained remission to be a qualifier on a substance use disorder,

The full criteria for substance use disorder must have previously been met, and none of the criteria have been met at any time during a period of 12 months or longer (apart from craving)

Anxiety disorders differ from each other with respect to

The types of objects or situations that induce fear, anxiety, or avoidance behavior, and the associated cognitive ideation.

Which of the following statements relating obsessive-compulsive disorders and anxiety disorders is MOST true?

There are close relationships between the anxiety disorders and some of the obsessive-compulsive disorders.

In Bipolar II Disorder

There must be a hypomanic episode and at least one major depressive episode

How many diagnostic categories are there in the DSM-5 in comparison with the DSM-IV-TR?

There was an increase in the number categories based upon the developmental framework and new research; 22 in the DSM-5 in comparison with 17 in the DSM-IV-TR

Your patient arrives in your office wearing a cap, with a worried look on his face. He wants to show you something, so you ask what it is he'd like to show. He removes his hat and across his scalp he has six 2-inch round bald spots. What diagnosis might this be?

Trichotillomania

Where would one find the diagnosis "Borderline Intellectual Functioning" within the DSM-5?

Under Other Conditions that May Be a Focus of Clinical Attention

Which of the following facts are true about the DSM-5?

Uses the WHODAS 2.0 as a standardized measure of disability

A 45-year-old man immigrated from India comes to your office seeking your assistance. He describes with some discomfort his strong desire to observe unsuspecting people who are changing clothing in a retail store, young lovers kissing in the park, and even peeking into windows at night looking for intimate activity. He has been engaging in more frequent behavior of this type over the past 7 months. What might his diagnosis be?

Voyeuristic disorder

Which of the following is NOT one of the causes of Major or Mild Neurocognitive Disorders?

a. Alzheimer's disease b. Traumatic Brain Injury c. Vasculard. Frontotemporale. With Lewy Bodies f. All of these are causes of neurocognitive disorders ANSWER: F All of these are causes of neurocognitive disorders

Cluster A Personality Disorders

a. Can be described as odd-eccentric b. Includes schizotypal personality disorders c. All of the above are true about Cluster A Personality Disorders d. Includes paranoid and schizoid personality disorders ANSWER: C All of the above are true about Cluster A Personality Disorders

Which of the following is NOT one of the cognitive domains addressed in determining major versus mild neurocognitive disorders?

a. Complex attention b. All of these are domains for neurocognitive disorders c. Executive functioning d. Social cognition e. Learning and memory ANSWER: B All of these are domains for neurocognitive disorders

Sue comes to you describing several months of worsening fatigue, daytime sleepiness, and generally "not feeling well." She has to force herself to do the things she enjoys. She has nodded off several times driving home from work and school. She sleeps 8-10 hours each night, but reports frequent awakenings, trips to the bathroom, and often woke with a choking sensation and sometimes with a headache. She comes from a family of snorers, she herself snores up a storm. Physically she has been struggling with heart burn and obesity. The mental status exam you administered was not suggestive of depression, psychosis, or cognitive decline. What diagnosis should be ruled out by further evaluation?

a. Obstructive sleep apnea hypoapnea b. Sleep related hypoventilationc. All of these should be ruled out by further evaluation d. Central sleep apnea e. Primary snoring disorder ANSWER: C All of these should be ruled out by further evaluation

General Personality Disorder reflects

a. Personality traits that are maladaptive b. Significant functional impairment or subjective distress c. Behavior that markedly departs from cultural expectations d. Personality traits that are inflexible e. All of these are reflected in General Personality Disorder ANSWER: E All of these are reflected in General Personality Disorder

Why were the paraphilic disorders included in the DSM selected?

a.All of these are reasons the list of paraphilic disorders exist as it is in the DSM-5 b. Because they are classed as criminal offenses c. Due to their noxiousness and potential harm to others d. They are relatively common ANSWER: A All of these are reasons the list of paraphilic disorders exist as it is in the DSM-5

The primary reason the diagnosis Disruptive Mood Regulation Disorder was created was to

address the over-diagnosis of children with bipolar and related disorders

With respect to a Major Depressive Episode (MDE) and bereavement,

clinical judgment is essential and it is important to distinguish from grief

The Neurocognitive Disorders category is a group of conditions where the primary clinical deficit is in

cognitive functioning that is acquired, not developmental

Linda learned that her husband had been held up at gunpoint, and after he was robbed an accomplice slashed his throat and he bled to death. A week later, Betty has nightmares with vivid details of the murder, and at times during the day she will think about is and feel like it is happening now and she has to get up and stop it. Lind has been afraid to go out at night ever since. What diagnosis might she have?

d. Acute stress disorder


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