SOCWK 6630 Quiz 2 - Diagnosis and Related Treatment for Social Work Practice

Specifiers for voyeristic disorder

-In a controlled environment: This specifier is primarily applicable to individuals living in institutional or other settings where opportunities to engage in voyeuristic behavior are restricted. -In full remission: The individual has not acted on the urges with a nonconsenting person, and there has been no distress or impairment in various areas of functioning for at least 5 months while in an uncontrolled environment.

Specifiers for Enuresis

-Nocturnal: Passage of urine only during nighttime sleep. -Diurnal: Passage of urine during waking hours. -Nocturnal and diurnal: A combination of the two subtypes above.

Treatments for PTSD

-Prolonged Exposure Therapy -EMDR -SSRI's (antidepressants) -SRI's (sertraline)

Encopresis specifiers

-With constipation and overflow incontinence: There is evidence of constipation on physical examination or by history. -Without constipation and overflow incontinence: There is no evidence of constipation on physical examination or by history.

Autism Spectrum Disorder specifiers

-With or without accompanying intellectual impairment -With or without accompanying language impairment -Associated with a known medical or genetic condition or environmental factor (Coding note: Use additional code to identify the associated medical or genetic condition.) -Associated with another neurodevelopmental, mental, or behavioral disorder (Coding note: Use additional code[s] to identify the associated neurodevelopmental, mental, or behavioral disorder[s].) -With catatonia (refer to the criteria for catatonia associated with another mental disorder, pp. 119-120, for definition) (Coding note: Use additional code 293.89 [F06.1] catatonia associated with autism spectrum disorder to indicate the presence of the comorbid catatonia.)

What percentage of those diagnosed with substance dependence commit suicide?

10%

Other Paraphilic Disorders

302.89 (F65.89) Other Specified Paraphilic Disorder p. 705 302.9 (F65.9) Unspecified Paraphilic Disorder

Specified Learning Disorder

315.00 (F81.0) With impairment in reading: Word reading accuracy Reading rate or fluency Reading comprehension 315.2 (F81.81) With impairment in written expression Spelling accuracy Grammar and punctuation accuracy Clarity or organization of written expression 315.1 (F81.2) With impairment in mathematics Number sense Memorization of arithmetic facts Accurate or fluent calculation Accurate math reasoning

Motor Disorders

315.4 (F82) Developmental Coordination Disorder 307.3 (F98.4) Stereotypic Movement Disorder Tic Disorders 307.23 (F95.2) Tourette's Disorder 307.22 (F95.1) Persistent (Chronic) Motor or Vocal Tic Disorder 307.21 (F95.0) Provisional Tic Disorder 307.20 (F95.8) Other Specified Tic Disorder 307.20 (F95.9) Unspecified Tic Disorder

Disinhibited Social Engagement Disorder

A.A pattern of behavior in which a child actively approaches and interacts with unfamiliar adults and exhibits at least two of the following: 1.Reduced or absent reticence in approaching and interacting with unfamiliar adults. 2.Overly familiar verbal or physical behavior. 3.Diminished or absent checking back with adult caregiver after venturing away, even in unfamiliar settings. 4.Willingness to go off with an unfamiliar adult with minimal or no hesitation. B.The behaviors in Criterion A are not limited impulsivity (as in ADHD) but include socially disinhibted behavior.

Reactive Attachment Disorder

A.A consistent pattern of inhibited, emotionally withdrawn behavior toward adult caregivers, manifested by both of the following: 1.The child rarely or minimally seeks comfort when distressed. 2.The child rarely or minimally responds to comfort when distressed. B.A persistent social and emotional disturbance characterized by at least two of the following: 1.Minimal social and emotional responsiveness to others. 2.Limited positive affect. 3.Episodes of unexplained irritability, sadness, or fearfulness that are evident even during nonthreatening interactions with adult caregivers.

Fetishistic Disorder

A.Over a period of at least 6 months, recurrent and intense sexual arousal from either the use of nonliving objects or a highly specified focus on nongenital body part(s), as manifested by fantasies, urges, or behaviors. B.The fantasies, sexual urges, or behaviors cause clinically significant distress or impairment in various levels of functioning. C.The fetish objects are not limited to articles of clothing used in cross-dress (as in transvestic disorder) or devices specifically designed for the purpose of tactile genital stimulation (e.g., vibrator)

Avoidant/Restrictive Food Intake Disorder

A.An eating or feeding disturbance as manifested by persistent failure to meet appropriate nutritional and/or energy needs associated with one (or more) of the following: 1.Significant weight loss (or failure to achieve expected weight gain or faltering growth in children). 2.Significant nutritional deficiency. 3.Dependence on enteral feeding (tube feeding) or oral nutritional supplements. 4.Marked interference with psychosocial functioning. B.The disturbance is not better explained by lack of available food or by an associated culturally sanctioned practice.

Dissociative Amnesia

A.An inability to recall important autobiographical information, usually of a traumatic or stressful nature, that is inconsistent with ordinary forgetting. Note: Dissociative amnesia most often consists of localized or selective amnesia for a specific event or events; or generalized amnesia for identity and life history. B.The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. C.The disturbance is not better attributed to substances or a neurological or other medical condition. D.The disturbance is not better explained by DID, PTSD, acute stress disorder, somatic symptom disorder, or major or mild neurocognitive disorder. Coding Note: -300.12 (F44.0) Dissociative amnesia without dissociative fugue -300.13 (F44.1) Dissociative amnesia with dissociative fugue

Dissociative Identity Disorder

A.Disruption of identity characterized by two or more distinct personality states, which may be described in some cultures as an experience of possession. The disruption in identity involves marked discontinuity in sense of self and sense of agency, accompanied by related alterations in affect, behavior, consciousness, memory, perception, cognition, and/or sensory-motor functioning. These signs and symptoms may be observed by others or reported by the individual. B.Recurrent gaps in the recall of everyday events, important personal information, and/or traumatic events that are inconsistent with ordinary forgetting. C.The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. D.The disturbance is not a normal part of a broadly accepted cultural or religious practice. Note: In children, the symptoms are not better explained by imaginary playmates or fantasy play. E.The symptoms are not attributed to substances or medical conditions.

Childhood-Onset Fluency Disorder (Stuttering)

A.Disturbances in the normal fluency and time patterning of speech that are inappropriate for the individual's age and language skills, persist over time, and are characterized by frequent and marked occurrences of one (or more) of the following: 1.Sound and syllable repetitions. 2.Sound prolongations of consonants as well as vowels. 3.Broken words (e.g., pauses within a word). 4.Audible or silent blocking (filled or unfilled pauses in speech). 5.Circumlocutions (word substitutions to avoid problematic words). 6.Words produced with an excess of physical tension. 7.Monosyllabic whole-word repetitions (e.g., "I-I-I-I see him"). B.The disturbance causes anxiety about speaking or limitations in effective communication, social participation, or academic or occupational performance, individually or in any combination. C.The onset of symptoms is in early developmental period. (Note: Later-onset cases are diagnosed as 307.0 [F98.5] adult-onset fluency disorder). D.The disturbance is not attributable to a speech-motor or sensory deficit, dysfulency associated with neurological insult (e.g., stroke, etc.), or another medical condition and is not better explained by another mental disorder.

Histrionic Personality Disorder

A.Excessive emotionality; attention seeking, as indicated by five (or more) of the following: 1.Uncomfortable when not center of attention 2.Inappropriate sexually seductive or provocative behavior 3.Rapidly shifting and shallow expression of emotions 4.Uses physical appearance to draw attention to self 5.Has a style of speech that is excessively lacking in detail 6.Self-dramatization 7.Highly suggestible 8.Considers relationships more intimate than they actually are

Acute Stress Disorder

A.Exposure to actual or threatened death, serious injury, or sexual violation in 1 (or more) of the following ways: 1.Directly experiencing the traumatic events(s) 2.Witnessing, in person, the event(s) happening to others 3.Learning that the event(s) occurred to a close family member or close friend. Note: In cases of actual or threatened death of a family member or friend, the event(s) must have been violent or accidental. 4.Experiencing repeated or extreme exposure to aversive details of the traumatic event(s) (e.g., first responders collecting human remains or police officers repeatedly exposed to details of child abuse). Note: This does not apply to exposure through electronic media, television, movies, or pictures, unless this exposure is work related.

Avoidant Personality Disorder

A.Inhibited, feels inadequate, and is hypersensitive to negative evaluation, beginning by early adulthood, as indicated by four (or more) of the following: 1.Avoids meaningful relationships with others 2.Unwilling to get involved unless "guaranteed" they will be liked 3.Shows restraint because they fear shame or ridicule 4.Preoccupied with criticism or rejection 5.Inhibited in new interpersonal situations because of feeling inadequate 6.Views self as inept, inferior 7.Reluctant to take risks, might be embarrassed

Dependent Personality Disorder

A.Needs to be taken care of; clinging behavior with others, beginning by early adulthood, as indicated by five (or more) of the following: 1.Difficulty making everyday decisions 2.Desires others to assume responsibility 3.Difficulty expressing disagreement with others because of fear of loss of support or approval 4.Lacks initiative 5.Goes to excessive lengths to obtain support 6.Feels uncomfortable or helpless 7.Urgently seeks another relationship 8.Preoccupied with fears of being left alone

Obsessive-Compulsive Personality Disorder

A.Orderly, perfectionistic, inflexible, as indicated by four (or more) of the following: 1.Preoccupied with rules, regulations 2.Quest for perfection interferes with completion 3.Excessively devoted to work 4.Overly conscientious, scrupulous, and inflexible 5.Hoards objects 6.Reluctant to delegate tasks 7.Adopts a miserly spending style 8.Rigid and stubborn

Transvestic Disorder

A.Over a period of at least 6 months, recurrent and intense sexual arousal from cross-dressing, as manifested by fantasies, urges, or behaviors. B.The fantasies, sexual urges, or behaviors cause clinically significant distress or impairment in various levels of functioning.

Voyeuristic Disorder

A.Over a period of at least 6 months, recurrent and intense sexual arousal from observing an unsuspecting person who is naked, in the process of disrobing, or engaging in sexual activity, as manifested by fantasies, urges, or behaviors. B.The individual has acted on these sexual urges with a nonconsenting person, or the sexual urges or fantasies cause clinically significant distress or impairment in various areas of functioning. C.The individual experiencing the arousal and/or acting on the urges is at least 18 years of age.

Sexual Masochism Disorder

A.Over a period of at least 6 months, recurrent and intense sexual arousal from the act of being humiliated, beaten, bound, or otherwise made to suffer, as manifested by fantasies, urges, or behaviors. B.The fantasies, sexual urges, or behaviors cause clinically significant distress or impairment in various areas of functioning. Specify if: With asphyxiophilia: If the individual engages in the practice of achieving sexual arousal related to restriction of breathing.

Exhibitionistic Disorder

A.Over a period of at least 6 months, recurrent and intense sexual arousal from the exposure of one's genitals to an unsuspecting person, as manifested by fantasies, urges, or behaviors. B.The individual has acted on these sexual urges with a nonconsenting person, or the sexual urges or fantasies cause clinically significant distress or impairment in various areas of functioning. Specify whether: -Sexually aroused by exposing genitals to prepubertal children -Sexually aroused by exposing genitals to physically mature individuals -Sexually aroused by exposing genitals to prepubertal children and to physically mature individuals

Sexual Sadism Disorder

A.Over a period of at least 6 months, recurrent and intense sexual arousal from the physical or psychological suffering of another person, as manifested by fantasies, urges, or behaviors. B.The individual has acted on these sexual urges with a nonconsenting person, or the sexual urges or fantasies cause clinically significant distress or impairment in various areas of functioning.

Frotteuristic Disorder

A.Over a period of at least 6 months, recurrent and intense sexual arousal from touching or rubbing against a nonconsenting person, as manifested by fantasies, urges, or behaviors. B.The individual has acted on these sexual urges with a nonconsenting person, or the sexual urges or fantasies cause clinically significant distress or impairment in various areas of functioning.

Pedophilic Disorder

A.Over a period of at least 6 months, recurrent, intense sexually arousing fantasies, sexual urges, or behaviors involving sexual activity with a prepubescent child or children (generally age 13 years or younger). B.The individual has acted on these urges, or the sexual urges or fantasies cause marked distress or interpersonal difficulty. C.The individual is at least age 16 years and at least 5 years older than the child or children in Criterion A. Note: Do not include an individual in late adolescents involved in an ongoing sexual relationship with a 12- or 13-year-old.

Schizotypal Personality Disorder

A.Perceptual disturbances; interpersonal deficits, as indicated by five (or more) of the following: 1.Ideas of reference 2.Odd beliefs or magical thinking 3.Unusual perceptions 4.Odd thinking and speech 5.Suspicious and paranoid ideation 6.Inappropriate or constricted affect 7.Behavior appears odd and eccentric 8.Lack of close friends 9.Excessive social anxiety B.Does not occur exclusively during the course of a mental illness or medical condition. Note: If criteria are met prior to the onset of schizophrenia, add "premorbid," i.e., "schizotypal personality disorder (premorbid).

Autism Spectrum Disorder

A.Persistent deficits in social communication and social interaction across multiple contexts, as manifested by the following, currently or by history (examples are illustrative, not exhaustive, see text): 1.Deficits in social-emotional reciprocity, ranging, for example, from abnormal social approach and failure of normal back-and-forth conversation; to reduced sharing of interests, emotions, or affect; to failure to initiate or respond to social interactions. 2.Deficits in nonverbal communicative behaviors used for social interaction, ranging, for example, from poorly integrated verbal and nonverbal communication; to abnormalities in eye contact and body language or deficits in understanding and use of gestures; to a total lack of facial expressions and nonverbal communication. 3.Deficits in developing, maintaining, and understanding relationships, ranging, for example, from difficulties adjusting behavior to suit various social contexts; to difficulties in sharing imaginative play or in making friends; to absence of interest in peers.

Language Disorder

A.Persistent difficulties in the acquisition and use of language across modalities due to deficits in comprehension or production that include the following: 1.Reduced vocabulary. 2.Limited sentence structure. 3.Impairments in discourse (ability to use vocabulary and connect sentences for explanations). B.Language abilities are substantially and quantifiably below those expected for age, resulting in functioning limitations in effective communication, social participation, academic achievement, or occupational performance, individually or in any combination. C.Onset of symptoms is in the early developmental period. D.The difficulties are not attributed to hearing or other sensory impairment, motor dysfunction, other medical or neurological conditions, or intellectual disability.

Social (Pragmatic) Communication Disorder

A.Persistent difficulties in the social use of verbal and nonverbal communication as manifested by all of the following: 1.Deficits in using communication for social purposes, such as greeting and sharing information, in a manner that is appropriate for the social context. 2.Impairment of the ability to change communication to match context or the needs of the listener, such as speaking differently in a classroom than on the playground, talking differently to a child than to an adult, and avoiding use of overly formal language. 3.Difficulties following rules for conversation and storytelling, such as taking turns in conversation, rephrasing when misunderstood, and knowing how to use verbal and nonverbal signals to regulate interaction. 4.Difficulties understanding what is not explicitly stated (e.g., making inferences) and nonliteral or ambiguous meanings of language (e.g., idioms, humor, metaphors, multiple meanings that depend on the context for interpretation).

Pica

A.Persistent eating of nonnutritive, nonfood substances over a period of at least 1 month. B.The eating of nonnutritive, nonfood substances is inappropriate to the developmental level of the individual. C.The eating behavior is not part of a culturally supported or socially normative practice. D.If the eating behavior occurs in the context of another mental disorder (e.g., intellectual disability, autism spectrum disorder, schizophrenia) or medical condition (including pregnancy), it is sufficiently severe to warrant additional clinical attention.

Bulimia Nervosa

A.Recurrent episodes of binge eating characterized by the following: 1.Eating, in a discrete period of time (e.g., within any 2-hour period), an amount of food that is definitely larger than what most individuals would eat in a similar period of time under similar circumstances. 2.A sense of lack of control over eating during the episode. B.Recurrent inappropriate compensatory behaviors in order to prevent weight gain, such as self-induced vomiting; misuse of laxatives, diuretics, or other medications; fasting; or excessive exercise. C.The binge eating and inappropriate compensatory behaviors both occur, on average, at least once a week for 3 months. D.Self-evaluation is unduly influenced by body shape and weight. E.The disturbance does not occur exclusively during episodes of anorexia nervosa.

Binge-Eating Disorder

A.Recurrent episodes of binge eating characterized by the following: 1.Eating, in a discrete period of time (e.g., within any 2-hour period), an amount of food that is definitely larger than what most individuals would eat in a similar period of time under similar circumstances. 2.A sense of lack of control over eating during the episode. B.The binge-eating episodes are associated with three (or more) of the following: 1.Eating much more rapidly than usual. 2.Eating until feeling uncomfortably full. 3.Eating large amounts of food when not feeling physically hungry. 4.Eating alone because of feeling embarrassed by how much is eaten. 5.Feeling disgusted with oneself, depressed, or very guilty afterward.

Encopresis

A.Repeated passage of feces into inappropriate places (e.g., clothing, floor), whether involuntary or intentional. B.At least one such event occurs each month for at least 3 months. C.Chronological age is at least 4 years (or equivalent developmental level). D.The behavior is not attributed to the physiological affects of substances or a medical condition.

Rumination Disorder

A.Repeated regurgitation of food over a period of at least 1 month. Regurgitated food may be re-chewed, re-swallowed, or spit out. B.The repeated regurgitation is not attributable to associated gastrointestinal or other medical conditions. C.The eating disturbance does not occur exclusively during the course of another feeding and eating disorder. D.If the symptoms occur in the context of another mental disorder they are sufficiently severe to warrant additional clinical attention. Specify if: In remission: After full criteria for rumination disorder were previously met, the criteria have not been met for a sustained period of time.

Enuresis

A.Repeated voiding of urine into bed or clothes, whether involuntary or intentional. B.The behavior is clinically significant as manifested by either a frequency of at least twice a week for at least 3 consecutive months or the presence of clinically significant distress or impairment in social, academic (occupational), or other areas of functioning. C.Chronological age is at least 5 years (or equivalent developmental level). D.The behavior is not attributed to the physiological effects of a substance or another medical condition.

Narcissistic Personality Disorder

A.Requires excessive admiration, is grandiose, and lacks empathy; beginning by early adulthood and as indicated by five (or more) of the following: 1.Grandiose 2.Fantasizes about unlimited success, power 3.Believes (s)he is "special" and unique and can only be understood by special or high-status people 4.Requires excessive admiration 5.Striking sense of entitlement and feeling special 6.Interpersonal relationships exploited; others manipulated 7.Lacks empathy 8.Envious of others and thinks others are jealous of them 9.Arrogant

Anorexia Nervosa

A.Restriction of energy intake relative to requirements, leading to a significantly low body weight. B.Intense fear of gaining weight or of becoming fat, or persistent behavior that interferes with weight gain, even though at a significantly low weight. C.Disturbance in the way in which one's body weight or shape is experienced, undue influence of body weight or shape on self-evaluation, or persistent lack of recognition of the seriousness of the current low body weight.

Schizoid Personality Disorder

A.Socially restrictive, as indicated by four (or more) of the following: 1.No desire for close friendships 2.Chooses solitary activities 3.No interest in sex 4.Takes little pleasure in activities 5.Lacks friends 6.Indifferent to praise or criticism 7.Cold, detached, or flat affect B.Does not occur exclusively during the course of a mental illness or medical condition. Note: If criteria are met prior to the onset of schizophrenia, add "premorbid," i.e., "schizoid personality disorder (premorbid).

Paranoid Personality Disorder

A.Suspicious and distrustful of others' motives as malevolent, as indicated by four (or more) of the following: 1.Believes that others seek to harm them 2.Preoccupied with unjust doubts about others' 3.Reluctant to confide in others 4.Reads hidden meanings to communication 5.Bears grudges 6.Counterattacks or reacts angrily 7.Has recurrent suspicious about fidelity of partner B.Does not occur exclusively during the course of a mental illness or medical condition. Note: If criteria are met prior to the onset of schizophrenia, add "premorbid," i.e., "paranoid personality disorder (premorbid).

Adjustment Disorders

A.The development of emotional or behavioral symptoms in response to an identifiable stressor(s) occurring within 3 months of the onset of the stressor(s). B.These symptoms or behaviors are clinically significant, as evidenced by one or both of the following: 1.Marked distress that is out of proportion to the severity or intensity of the stressor, taking into account the external context and the cultural factors that might influence symptom severity and presentation. 2.Significant impairment in social, occupational, or other important areas of functioning. C.The stress-related disturbance does not meet the criteria for another mental disorder and is not merely an exacerbation of a preexisting mental disorder. D.The symptoms do not represent normal bereavement. E.Once the stressor or its consequences have terminated, the symptoms do not persist for more than an additional 6 months.

Depersonalization/Derealization Disorder

A.The presence of persistent or recurrent experiences of one or both: 1.Depersonalization: Experiences of unreality, detachment, or being an outside observer with respect to one's thoughts, feelings, sensations, body, or actions (e.g., perceptual alterations, distorted sense of time, unreal or absent self, emotional and/or physical numbing). 2.Derealization: Experiences of unreality or detachment with respect to surroundings (e.g., individuals or objects are experienced as unreal, dreamlike, foggy, lifeless, or visually distorted) B.During the depersonalization or derealization experiences, reality testing remains intact. C.The symptoms cause clinically significant distress or impairment in various areas of life. D.The disturbance is not attributed to the physiological effects of a substance or a medical condition. E.The disturbance is not better explained by another mental disorder.

Borderline Personality Disorder

A.Unstable relationships; poor self-image, marked impulsivity, as indicated by five (or more) of the following: 1.Frantic efforts to avoid being abandoned 2.A pattern of unstable, chaotic relationships 3.Identity disturbance 4.Impulsive spending, sex, substance abuse 5.Recurrent suicidal behaviors, gestures, threats, or self-mutilating behaviors 6.Affective instability due to a marked reactivity of mood 7.Chronic feelings of emptiness 8.Inappropriate, intense behavior, or difficulty controlling anger 9.Transient, stress-related paranoid ideation or severe dissociative symptoms

Antisocial Personality Disorder

A.Violent; blatant disregard for others; behavior present before 15 years old; must be 18 before diagnosed. 1.Failure to conform to social norms 2.Dishonest for own profit and purposes 3.Impulsivity 4.Irritability and/or aggressiveness 5.Reckless disregard for self or others 6.Irresponsible 7.Lack of remorse B.The individual is at least age 18 years. C.There is evidence of conduct disorder with onset before age 15 years. D.The occurrence of antisocial behavior is not exclusively during the course of schizophrenia or bipolar disorder.

Classes of substances

Alcohol Amphetamine Caffeine Cannabis Cocaine Hallucinogens Inhalants Nicotine Opioids Phencyclidine (PCP) Sedatives Hypnotics Anxiolytics

Cluster C

Anxious, fearful -Avoidant -Obsessive-compusive -Dependent

Attention-Deficit/Hyperactivity Disorder

Attention-Deficit/Hyperactivity Disorder 314.01 (F90.2) Combined presentation 314.00 (F90.0) Predominantly inattentive presentation 314.01 (F90.1) Predominantly hyperactive/impulsive presentation 314.01 (F90.8) Other Specified Attention-Deficit/Hyperactivity Disorder 314.01 (F90.9) Unspecified Attention-Deficit/Hyperactivity Disorder

Acute Stress Disorder pt. 2

B.Presence of at least 9 of 14 symptoms from any of 5 categories—intrusion, negative mood, dissociation, avoidance, and arousal—beginning or worsening after the traumatic event(s) occurred. Intrusion symptoms 1.Recurrent, involuntary, and intrusive distressing memories of the traumatic event(s). Note: Children may engage in repetitive play during which themes or aspects of the traumatic event(s) are expressed. 2.Recurrent distressing dreams in which the content or affect of the dream is related to the event(s). Note: Children may experience frightening dreams without recognizable content. 3.Dissociative reactions (e.g., flashbacks) in which the individual feels or acts as if the traumatic event(s) were recurring. Note: In children, trauma-specific reenactment may occur in play. 4.Intense or prolonged psychological distress or marked physiologic reactions in response to internal or external cues that symbolize or resemble an aspect of the traumatic event(s).

Posttraumatic Stress Disorder pt. 2

B.Presence of one (or more) of the following intrusion symptoms associated with the traumatic event(s), beginning after the traumatic event(s) occurred: 1.Recurrent, involuntary, and intrusive distressing memories of the traumatic event(s). Note: In children older than 6 years, repetitive play may occur in which themes or aspects of the traumatic event(s) are expressed. 2.Recurrent distressing dreams in which the content and/or affect of the dream are related to the traumatic event(s). Note: In children, there may be frightening dreams without recognizable content. 3.Dissociative reactions (e.g., flashbacks) in which the individual feels or acts as if the traumatic event(s) are recurring. (Such reactions may occur on a continuum, with the most extreme expression being a complete loss of awareness of present surroundings.) Note: In children, trauma-specific reenactment may occur in play. 4.Intense or prolonged psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event(s). 5.Marked physiological reactions to internal or external cues that symbolize or resemble an aspect of the traumatic event(s) reminders of the traumatic event(s)

Autism Spectrum Disorder pt. 2

B.Restricted, repetitive patterns of behavior, interests, or activities, as manifested by at least two of the following, currently or by history (examples are illustrative, not exhaustive; see text): 1.Stereotyped or repetitive motor movements, use of objects, or speech (e.g., simple motor stereotypes, lining up toys or flipping objects, echolalia, idiosyncratic phrases). 2.Insistence on sameness, inflexible adherence to routines, or ritualized patterns or verbal nonverbal behavior (e.g., extreme distress at small changes, difficulties with transitions, rigid thinking patterns, greeting rituals, need to take same route or eat food every day). 3.Highly restricted, fixated interests that are abnormal in intensity or focus (e.g., strong attachment to or preoccupation with unusual objects, excessively circumscribed or preservative interest). 4.Hyper- or hypo reactivity to sensory input or unusual interests in sensory aspects of the environment (e.g., apparent indifference to pain/temperature, adverse response to specific sounds or textures, excessive smelling or touching of objects, visual fascination with lights or movement).

Social (Pragmatic) Communication Disorder cont.

B.The deficits result in functional limitations in effective communication, social participation, social relationships, academic achievement, or occupational performance, individually or in combination. C.The onset of the symptoms is in the early developmental period (but deficits may not become fully manifest until social communication demands exceed limited capacities). D.The symptoms are not attributable to another medical or neurological condition or to low abilities in the domains or word structure and grammar, and are not better explained by autism spectrum disorder, intellectual disability (intellectual developmental disorder), global developmental delay, or another mental disorder.

Binge-Eating Disorder cont.

C.Marked distress regarding binge eating present. D.The binge eating occurs, on average, at least once a week for 3 months. E.The binge eating is not associated with the recurrent use of inappropriate compensatory behavior as in bulimia nervosa and does not occur exclusively during the course of bulimia or anorexia nervosa. Specify if: -In partial remission (less than one episode per week for a sustained period of time) -In full remission Specify if: -Mild: An average of 1-3 episodes per week. -Moderate: An average of 4-7 episodes per week. -Severe: An average of 8-13 episodes per week. -Extreme: An average of 14 or more episodes per week.

Posttraumatic Stress Disorder pt. 3

C.Persistent avoidance of stimuli associated with the traumatic event(s), beginning after the traumatic event(s) occurred, as evidenced by one or both of the following: 1.Avoidance of or efforts to avoid distressing memories, thoughts, or feelings about or closely associated with the traumatic event(s). 2.Avoidance of or efforts to avoid external reminders (people, places, conversations, activities, objects, situations) that arouse distressing memories, thoughts, or feelings about or closely associated with the traumatic event(s).

Autism Spectrum Disorder pt. 3

C.Symptoms must be present in the early developmental period (but may not become fully manifest until social demands exceed limited capacities, or may be masked by learned strategies in later life). D.Symptoms cause clinically significant impairment in social, occupational, or other important areas of current functioning. E.These disturbances are not better explained by intellectual disability (intellectual developmental disorder) or global developmental delay. Intellectual disability and autism spectrum disorder frequently co-occur; to make comorbid diagnoses of autism spectrum disorder and intellectual disability, social communication should be below that expected for general developmental level

Disinhibited Social Engagement Disorder cont.

C.The child has experienced a pattern of extremes of insufficient care as evidenced by at least one of the following: 1.Social neglect or deprivation in the form of persistent lack of having basic emotional needs for comfort, stimulation, and affection met by caregiving adults. 2.Repeated changes of primary caregivers that limit opportunities to form stable attachments. 3.Rearing in unusual settings that severely limit opportunities to form selective attachments. D.The care in Criterion C is presumed to be responsible for the disturbed behavior in Criterion A. E.The child has a developmental age of at least 9 months.

Reactive Attachment Disorder cont.

C.The child has experienced a pattern of extremes of insufficient care as evidenced by at least one of the following: 1.Social neglect or deprivation in the form of persistent lack of having basic emotional needs for comfort, stimulation, and affection met by caregiving adults. 2.Repeated changes of primary caregivers that limit opportunities to form stable attachments. 3.Rearing in unusual settings that severely limit opportunities to form selective attachments. D.The care in Criterion C is presumed to be responsible for the disturbed behavior in Criterion A. E.The criteria are not met for autism spectrum disorder. F.The disturbance is evident before age 5 years. G.The child has a developmental age of at least 9 months.

Avoidant/Restrictive Food Intake Disorder cont.

C.The eating disturbance does not occur exclusively during the course of anorexia nervosa or bulimia nervosa, and there is no evidence of a disturbance in the way in which one's body weight or shape is experienced. D.The eating disturbance is not attributable to a concurrent medical condition or not better explained by another mental disorder. When the eating disturbance occurs in the context of another condition or disorder, the severity of the eating disturbance exceeds that routinely associated with the condition or disorder and warrants additional clinical attention. Specify if: In remission: After full criteria for avoidant/restrictive food intake disorder were previously met, the criteria have not been met for sustained period of time.

Substance Use Withdrawal

Cessation or reduction of substance use that has been heavy or prolonged Signs or symptoms developing within hours or days after the cessation or reduction The signs or symptoms cause clinically significant distress in various areas of life Signs or symptoms are not otherwise attributed to a medical condition, mental disorder, or intoxication with another substance

Substance Use Severity

Coding is often determined by level of severity, e.g., 305.1 (Z72.0) Tobacco Use Disorder, Mild Mild: Presence of 2-3 symptoms Moderate: Presence of 4-5 symptoms Severe: Presence of 6 or more symptoms

Culture, age, and gender features of substance dependence

Cultural factors should be taken into consideration when diagnosing substance use Some groups forbid the use of alcohol while others might encourage use of substance to enhance mood, visual experiences, etc. 18-24 year olds have a higher prevalence rate for the use of virtually ever substance Intoxication can begin as early as teens, but the initial onset for abuse ranges from 20's to 40's If a Substance-Related Disorder develops in adolescence, it is often associated with Conduct Disorder and linked to failure to complete school. Substance-Related Disorders are most often diagnosed in males, but diagnostics may vary depending on the class of the substance.

Acute Stress Disorder pt. 5

D.Disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning. E.The disturbance is not attributed to the physiological effects of a substance (e.g., a medication or alcohol) or another medical condition (e.g., mild traumatic brain injury) and is not better explained by brief psychotic disorder.

Posttraumatic Stress Disorder pt. 4

D.Negative alterations in cognitions and mood associated with the traumatic event(s), beginning or worsening after the traumatic event(s) occurred, as evidenced by two (or more) of the following: 1.Inability to remember an important aspect of the traumatic event(s) (typically due to dissociative amnesia and not to other factors such as head injury, alcohol, or drugs) 2.Persistent and exaggerated negative beliefs or expectations about oneself, others, or the world (e.g., "I am bad," "No one can be trusted," "The world is completely dangerous," "My whole nervous system is permanently ruined"). 3.Persistent, distorted cognitions about the cause or consequences of the traumatic event(s) that lead the individual to blame himself/herself or others. 4.Persistent negative emotional state (fear, horror, anger, guilt, or shame). 5.Markedly diminished interest or participation in significant activities. 6.Feelings of detachment or estrangement from others. 7.Persistent inability to experience positive emotions (inability to experience happiness, satisfaction, or loving feelings).

What is the best treatment for borderline personality disorder?

Dialectic behavioral therapy, wise mind - mix of rational and emotional thinking

Posttraumatic Stress Disorder pt. 5

E.Marked alterations in arousal and reactivity associated with the traumatic event(s), beginning or worsening after the traumatic event(s) occurred, as evidenced by two (or more) of the following: 1.Irritable behavior and angry outbursts (with little or no provocation) typically expressed as verbal or physical aggression toward people or objects. 2.Reckless or self-destructive behavior. 3.Hypervigilance. 4.Exaggerated startle response. 5.Problems with concentration. 6.Sleep disturbance (e.g., difficulty falling or staying asleep or restless sleep).

Cluster B

Emotional, dramatic, or erratic -Antisocial -Borderline -Histrionic -Narcissistic

Posttraumatic Stress Disorder pt. 6

F.Duration of the disturbance (Criteria B, C, D, and E) is more than 1 month. G.The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning. H.The disturbance is not attributable to the physiological effects of a substance (e.g., medication, alcohol) or another medical condition.

Stimulants withdrawal

Fatigue Vivid, unpleasant dreams Insomnia or hypersmonia Increased appetite Psychomotor retardation or agitation

Caffeine intoxication

Five (or more) of the following: Restlessness Nervousness Excitement Insomnia Flushed face Diuresis (increased urination) Gastrointestinal issues Muscle twitching Rambling flow of thought and speech Tachycardia or arythmia Periods of inexhaustibility Psychomotor agitation

Other personality disorders

General Personality Disorder pp. 646-649 310.1 (F07.0) Personality Change Due to Another Medical Condition pp.632-684 301.89 (F60.89) Other Specified Personality Disorder p.684 301.9 (F60.9) Unspecified Personality Disorder p.684

Intellectual Disability characteristics

Intellectual disability has a prevalence of 1%, and prevalence varies by age. Severe intellectual disability is approximately 6 per 1,000 people. Delayed motor, language, and social milestones may be identifiable within the first 2 years of life among those with more severe intellectual disability, while mild levels may not be until school age. When associated with a genetic syndrome, there may be a characteristic physical appearance. Co-occurring mental, neurodevelopmental, medical, and physical conditions are frequent in intellectual disability. Co-occurring mental and neurodevelopmental disorders are ADHD; depressive and bipolar disorders; anxiety disorders; autism spectrum disorder; stereotypic movement disorder; impulse-control disorders; and major neurocognitive disorder. 315.8 (F88) Global Developmental Delay reserved for those under the age of 5 who cannot be reliably assessed at time of diagnosis. 319 (F79) Unspecified Intellectual Disability reserved for those over the age of 5 when assessment is difficult, and should only be used under exceptional circumstances and requires reassessment after a period of time.

Tobacco withdrawal

Irritability, frustration, or anger Anxiety Difficulty concentrating Increased appetite Restlessness Depressed mood Insomnia

Why are personality disorders less identified?

It is harder to identify details of personality disorders

Acute Stress Disorder pt. 4

Negative Mood 10.Sleep disturbance (e.g., difficulty falling or staying asleep or restlessness during sleep) 11.Irritable behavior and angry outbursts (with little or no provocation), typically expressed as verbal or physical aggression toward people or objects 12.Hypervigilance 13.Problems with concentration 14.Exaggerated startle response C.Duration of the disturbance (symptoms in Criterion B) is 3 days to 1 month after trauma exposure. Note: Symptoms typically begin immediately after the trauma, but persistence for at least 3 days and up to a month is needed to meet disorder criteria.

Acute Stress Disorder pt. 3

Negative Mood 5.Persistent inability to experience positive emotions (e.g., inability to experience happiness, satisfaction, or loving feelings). Dissociative symptoms 6.Altered sense of the reality of one's surroundings or oneself (e.g., seeing oneself from another's perspective, being in a daze, or feeling that time is slowing). 7.Inability to remember an important aspect of the traumatic event(s) (typically due to dissociative amnesia and not to other factors such as head injury, alcohol, or drugs). Avoidance Symptoms 8.Efforts to avoid distressing memories, thoughts, or feelings about or closely associated with the traumatic event(s). 9.Efforts to avoid external reminders (e.g., people, places, conversations, activities, objects, or situations) that arouse distressing memories, thoughts, or feelings about or closely associated with the traumatic event(s).

Posttraumatic Stress Disorder

Note: The following criteria apply to adults, adolescents, & children older than 6 years. A.Exposure to actual or threatened death, serious injury, or sexual violence, in one (or more) of the following ways: 1.Directly experiencing the traumatic event(s). 2.Witnessing, in person, the traumatic event(s) as it occurred to others. 3.Learning that the traumatic event(s) occurred to a close family member or close friend; cases of actual or threatened death must have been violent or accidental. 4.Experiencing repeated or extreme exposure to aversive details of the traumatic event(s) (e.g., first responders collecting human remains; police officers repeatedly exposed to details of child abuse); this does not apply to exposure through electronic media, television, movies, or pictures, unless this exposure is work-related.

Cluster A

Odd and eccentric -Paranoid -Schizoid -Schizotypal

Sedatives, Hypnotics, or Anxiolytics intoxication

One (or more) of the following: Slurred speech Poor coordination Unsteady gait Nystagmus Impairment in cognition Stupor or coma

Alcohol intoxication

One (or more) of the following: Slurred speech Poor coordination Unsteady gait Nystagmus (reduced vision from repetitive/uncontrolled eye movement) Impairment in attention or memory Stupor or coma

Withdrawals are not known to occur with what substances?

PCP, inhalants, or other hallucinogens

Gambling Disorder

Persistent and recurrent maladaptive gambling behavior as indicated by four (or more) of the following in a 12-month period: 1.Needs to gamble regardless of money to obtain desired result 2.Restless or irritable when attempting to do the aforementioned 3.Repeated unsuccessful attempts to control, cut back, or stop gambling 4.Preoccupation with gambling 5.After losing money, will return the next day to get even 6.Gambles as an escape from problems or dysphoric mood 7.Lies to family members and others 8.Has jeopardized or lost a significant relationship, job, etc. 9.Relies on others to provide money to relieve financial burden Gambling is not accounted for by a Manic Episode Specify if: -Episodic or Persistent -In early remission or In sustained remission Mild: 4-5 criteria met; Moderate: 6-7 criteria met; Severe: 8-9 criteria met

Speech Sound Disorder

Persistent difficulty with speech sound production that interferes with speech intelligibility or prevents verbal communication. The disturbance causes limitations in effective communication that interfere with social participation, academic achievement, or occupational performance, individually or in combination. Onset of symptoms is in the early developmental period. The difficulties cannot be attributed to congenital or acquired conditions, such as cerebral palsy, cleft palate, deafness or hearing loss, traumatic brain injury, other medical or neurological conditions.

What medication treats nightmares?

Prazosin

Opioid intoxication

Pupillary constriction or dilation due to anoxia (lack of oxygen) from overdose and one (or more) of the following: Drowsiness or coma Slurred speech Impairment in attention or memory

Substance Use Intoxication

Recent substance use Medical or Mental signs or symptoms of use Significant impairment in various areas of life Signs or symptoms are not otherwise attributed to a medical condition, mental disorder, or intoxication with another substance

Substance use disorders:

Significant impairment or distress, as manifested by at least two of the following, occurring within a 12 month period: 1.Compulsive drug use over a longer period of time 2.Unsuccessful attempts at quitting or lowering dose 3.A lot of time spent obtaining and using the substance or recovering 4.Recurrent substance use that can impede major obligations 5.Continued use despite social and interpersonal problems 6.Inhibits social, occupational, and recreational activities 7.Recurrent use in physically hazardous situations 8.Continued use despite known threat of physical and psychological harm 9.Continued use despite known threat of physical and psychological harm 10.High tolerance 11.Pattern of Withdrawal (not present in all substances)

Impairments and Complications for substance dependence

Social, interpersonal, occupational impairments, etc. Health problems such as sudden death, respiratory arrest, HIV infection, Hepatitis infection, complications with pregnancy, etc. Impairment in judgment, which may lead to fights, criminal activity, automobile or other accidents, etc.

Is there a familial pattern of substance dependence

Some evidence of genetics in the role of Alcohol Intoxication More often associated with other diagnoses that may predispose individuals to substance use, such as ASPD Children of individuals with Alcohol Dependence are not predisposed to developing other substance abuse dependences, but are at high risk for ETOH Dependence.

Specifiers for exhibitionist disorder

Specify if: -In a controlled environment: This specifier is primarily applicable to individuals living in institutional or other settings where opportunities to engage in voyeuristic behavior are restricted. -In full remission: The individual has not acted on the urges with a nonconsenting person, and there has been no distress or impairment in various areas of functioning for at least 5 years while in an uncontrolled environment.

Specifiers for frotteuristic disorder

Specify if: -In a controlled environment: This specifier is primarily applicable to individuals living in institutional or other settings where opportunities to engage in voyeuristic behavior are restricted. -In full remission: The individual has not acted on the urges with a nonconsenting person, and there has been no distress or impairment in various areas of functioning for at least 5 years while in an uncontrolled environment.

Specifiers for sexual masochism disorder

Specify if: -In a controlled environment: This specifier is primarily applicable to individuals living in institutional or other settings where opportunities to engage in voyeuristic behavior are restricted. -In full remission: The individual has not acted on the urges with a nonconsenting person, and there has been no distress or impairment in various areas of functioning for at least 5 years while in an uncontrolled environment.

Bulimia Nervosa specifiers

Specify if: -In partial remission -In full remission Specify if: -Mild: An average of 1-3 episodes per week. -Moderate: An average of 4-7 episodes per week. -Severe: An average of 8-13 episodes per week. -Extreme: An average of 14 or more episodes per week.

Disinhibited Social Engagement Disorder specifiers

Specify if: -Persistent: The disorder has been present for 12 months or more. Specify current severity: -Reactive attachment disorder is specified as severe when a child exhibits all symptoms of the disorder, with each symptom manifesting at relatively high levels.

Reactive Attachment Disorder specifiers

Specify if: -Persistent: The disorder has been present for 12 months or more. Specify current severity: -Reactive attachment disorder is specified as severe when a child exhibits all symptoms of the disorder, with each symptom manifesting at relatively high levels.

Specifiers for transvestic disorder

Specify if: -With fetishism: If sexually aroused by fabrics, material, or garments. -With autogynephilia: If sexually aroused by thoughts or images of self as female. Specify if: -In a controlled environment: This specifier is primarily applicable to individuals living in institutional or other settings where opportunities to engage in voyeuristic behavior are restricted. -In full remission: The individual has not acted on the urges with a nonconsenting person, and there has been no distress or impairment in various areas of functioning for at least 5 years while in an uncontrolled environment.

Anorexia Nervosa specifiers

Specify whether: -307.1 (F50.01) Restricting type: During the last 3 months, the individual has not engaged in recurrent episodes of binge eating or purging behavior. Weight loss is accomplished primarily through dieting, fasting, and/or excessive exercise. -301.1 (F50.02) Binge-eating/purging type: During the last 3 months, the individual has engaged in recurrent episodes of binge eating or purging behavior. Specify whether: -In partial remission: Criterion A has not been met for a sustained period, but either Criterion B or C have been met. -In full remission: None of the criteria have been met for a sustained period of time. -Severity is based off BMI percentile: Mild: BMI ≥ 17 kg/m2 Moderate: BMI 16-16.99 kg/m2 Severe: BMI 15-15.99 kg/m2 Extreme: BMI < 15 kg/m2

Specifiers for pedophilic disorder

Specify whether: -Exclusive type (attracted only to children) -Nonexclusive type Specify if: -Sexually attracted to males -Sexually attracted to females -Sexually attracted to both Specify if: -Limited to incest

Acute Stress Disorder specifiers

Specify whether: 309.0 (F43.21) With depressed mood 309.24 (F43.22) With anxiety 309.28 (F43.23) With mixed anxiety and depressed mood 309.3 (F43.24) With disturbance of conduct 309.4 (F43.25) With mixed disturbance of emotions and conduct 309.9 (F43.20) Unspecified

Posttraumatic Stress Disorder specifiers

Specify whether: -With dissociative symptoms: The individual's symptoms meet the criteria for posttraumatic stress disorder, and in addition, in response to the stressor, the individual experiences persistent or recurrent symptoms of either of the following: -1.Depersonalization: Persistent or recurrent experiences of feeling detached from, and as if one were an outside observer of, one's mental processes or body (e.g., feeling as though one were in a dream; feeling a sense of unreality of self or body or of time moving slowly). -2.Derealization: Persistent or recurrent experiences of unreality of surroundings (e.g., the world around the individual is experienced as unreal, dreamlike, distant, or distorted). Note: To use this subtype, the dissociative symptoms must not be attributable to the physiological effects of a substance (e.g., blackouts, behavior during alcohol intoxication) or another medical condition (e.g. complex partial seizures). Specify if: -With delayed expression: If the full diagnostic criteria are not met until at least 6 months after the event (although the onset and expression of some symptoms may be immediate).

Specifiers for fetishistic disorder

Specify: -Body part(s) -Nonliving object(s) -Other Specify if: -In a controlled environment: This specifier is primarily applicable to individuals living in institutional or other settings where opportunities to engage in voyeuristic behavior are restricted. -In full remission: The individual has not acted on the urges with a nonconsenting person, and there has been no distress or impairment in various areas of functioning for at least 5 years while in an uncontrolled environment.

Substance-Induced Mental Disorders

Substance-Induced: Delirium Persisting Dementia Persisting Amnestic Disorder Psychotic Disorder Mood Disorder Anxiety Disorder Sexual Dysfunction Sleep Disorder Hallucinogen Persisting Perception Disorder (Flashbacks)

Stimulants intoxication

Tachycardia or bradycardia Pupillary dilation Elevated or lowered blood pressure Perspiration or chills Nausea or vomiting Evidence of weight loss Psychomotor agitation or retardation Muscular weakness, respiratory depression, etc. Confusion, seizures, dyskinesias, dystonias, or coma

Intellectual Disability (Intellectual Development Disorder)

The following three criteria must be met: A.Deficits in intellectual functions, such as reasoning, problem solving, planning, abstract thinking, judgment, academic learning, and learning from experience, confirmed by both clinical assessment and individualized, standardized intelligence testing. B.Deficits in adaptive functioning that result in failure to meet developmental and sociocultural standards for personal independence and social responsibility. Without ongoing support, the adaptive deficits limit functioning in one or more ADLs, such as communication, social participation, and independent living, across multiple environments, such as home, school, work, and community. C.Onset of intellectual and adaptive deficits during the developmental period.

Other (or Unknown) Substance-Related Disorders

This diagnosis is often related to over-the-counter medications and toxins. Symptoms can manifest with high doses of medication and generally will diminish once the medication is taken as prescribed. These medications can include: Anticonvulsants, antihistamines, antihypertensive and cardiovascular medications, antimicrobial medications, corticosteroids, gastrointestinal medications, muscle relaxants, nonsteroidal anti-inflammatory medications, antidepressants, etc. Toxic substances might include things such as heavy metals (e.g., lead), pesticides, nerve gases, antifreeze, carbon monoxide and carbon dioxide, fuel, paints, etc. Symptoms may include effected mood or thoughts, anxiety, hallucinations, delusions, or seizures.

Ego-dystonic

Those who have them are aware they have a problem and tend to be distressed by their symptoms

Opioid withdrawal

Three (or more) of the following: Dysphoric mood Nausea or vomiting Muscle aches Lacrimation (teary) or rhinorrhea (runny nose) Pupillary dilation, piloerection (hairs standing up), or sweating Diarrhea Yawning Fever Insomnia

Caffeine withdrawal

Three (or more) of the following: Headache Marked fatigue or drowsiness Dysphoric mood, depressed mood, or irritability Difficulty in concentrating Flu-like symptoms (nausea, vomiting, or muscle pain/stiffness)

Cannabis withdrawal

Three (or more) of the following: Irritability, anger, or aggression Nervousness or anxiety Sleep difficulty (e.g., insomnia, disturbing dreams) Decreased appetite or weight loss Restlessness Depressed mood At least one of the following physical symptoms causing significant discomfort: abdominal pain, shakiness/tremors, sweating, fever, chills, or headache

Sedatives, Hypnotics, or Anxiolytics withdrawal

Two (or more) of the following: Autonomic hyperactivity Hand tremor Insomnia Nausea or vomiting Transient visual, tactile, or auditory hallucinations Psychomotor agitation Anxiety Grand mal seizures

Alcohol withdrawal

Two (or more) of the following: Autonomic hyperactivity (e.g., sweating, pulse rater greater than 100 bpm) Increased hand tremor Insomnia Nausea or vomiting Transient visual, tactile, or auditory hallucinations Psychomotor agitation Anxiety Generalized tonic-clonic seizures (grand mal)

Cannabis intoxication

Two (or more) of the following: Conjunctival injection (red eyes) Increased appetite Dry mouth Tachycardia

Inhalants intoxication

Two (or more) of the following: Dizziness Nystagmus Poor coordination Slurred speech Unsteady gait Lethargy Depressed reflexes Psychomotor retardation Tremor Generalized muscle weakness Blurred vision or diplopia (double vision) Stupor or coma Euphoria

Phencyclidine intoxication

Two (or more) of the following: Vertical or horizontal nystagmus Hypertension or tachycardia Numbness or diminished responsiveness to pain Ataxia (loss of body control) Dysarthria (difficult or unclear speech) Muscle rigidity Seizures or coma Hyperacusis (sound sensitivity)

Other hallucinogens intoxication

Two (ore more) of the following: Pupillary dilation Tachycardia Sweating Palpitations Blurring of vision Tremors Poor coordination

Ego-syntonic

the person experiencing them doesn't necessarily think they have a problem