DSM (Practice LMSW Questions)
What changes were made to the diagnosis of paraphilias and paraphilic disorders in DSM-5? A. A distinction has been made between paraphilias and paraphilic disorders B. Three specifiers have been added to paraphilic disorders: "in a controlled environment," "in remission," and "benign." C. Transvestic disorder has been eliminated D. Paraphilic disorders are grouped in a chapter with sexual disorders
A. A distinction has been made between paraphilias and paraphilic disorders
A 42-year-old man reports 1 week of increased activity associated with an elevated mood, a decreased need for sleep, and inflated self-esteem. Although the man does not object to his current state ("I'm getting a lot of work done!"), he is concerned because he recalls a similar episode 10 years ago during which he began to make imprudent business decisions. A physical examination and laboratory work are unrevealing for any medical cause of his symptoms. He had taken fluoxetine for a depressive episode but self-discontinued it 3 months ago because he felt that his mood was stable. Which diagnosis BEST fits this clinical picture? A. Bipolar I Disorder B. Bipolar II Disorder C. Cyclothymic Disorder D. Substance/medication induced bipolar disorder
A. Bipolar I Disorder
A 12-year-old boy begins to have new episodes of temper outbursts that are out of proportion to the situation. Which of the following is NOT a diagnostic possibility for this patient? A. Disruptive mood dysregulation disorder B. Bipolar disorder C. Oppositional defiant disorder D. ADHD
A. Disruptive mood dysregulation disorder
Which of the following is the only non-substance-related disorder to be included in the DSM-5 chapter "Substance-Related and Addictive Disorders?" A. Gambling disorder B. Internet gaming disorder C. Compulsive computer use disorder D. Compulsive shopping
A. Gambling disorder
What is the gender ratio of attention-deficit/hyperactivity disorder (ADHD) in children? A. Male to female ratio of 2 to 1 B. Male to female ratio of 1 to 1 C. Male to female ratio of 5 to 1 D. Male to female ratio of 1 to 2
A. Male to female ration of 2 to 1
A 32-year-old man reports 1 week of feeling unusually irritable. During this time, he has increased energy and activity, sleeps less, and finds it difficult to sit still. He also is more talkative than usual and is easily distracted, to the point of finding it difficult to complete his work assignments. A physical examination and laboratory workup are negative for any medical cause of his symptoms and he takes no medications. What diagnosis BEST fits this clinical picture? A. Manic episode B. Hypomanic episode C. Bipolar I disorder, with mixed features D. Cyclothymic disorder
A. Manic episode
Which of the following symptoms MUST be present for a woman to meet criteria for premenstrual dysphoric disorder? A. Marked affective lability B. Decreased interest in usual activities C. Marked change in appetite D. A sense of feeling overwhelmed or out of control
A. Marked affective lability
Which of the following statements about diagnostic markers for major depressive disorder (MDD) is TRUE? A. No laboratory test has demonstrated sufficient sensitivity and specificity to be used as a diagnostic tool for MDD. B. Several diagnostic laboratory tests exist, but no commercial enterprise will offer them to the public. C. Diagnostic laboratory tests have been withheld for fear that people testing positive for MDD may attempt suicide. D. Tests that exist are adequate diagnostically but are not covered by health insurance.
A. No laboratory test has demonstrated sufficient sensitivity and specificity to be used as a diagnostic tool for MDD
What is the minimum average frequency of binge eating required for a diagnosis of DSM-5 binge-eating disorder? A. Once weekly for the last 3 months B. Once weekly for the last 4 months C. Every other week for the last 3 months D. Once a month for the last 3 months
A. Once weekly for the last 3 months
Which of the following statements about reactive attachment disorder (RAD) is TRUE? A. RAD occurs only in children who lack healthy attachments B. RAD occurs only in children who have impaired communication C. RAD occurs in children without a history of severe social neglect
A. RAD occurs only in children who lack healthy attachments
What are the three essential diagnostic features of bulimia nervosa? A. Recurrent episodes of binge eating; recurrent inappropriate compensatory behaviors to prevent weight gain; self-evaluation that is unduly influenced by body shape and weight. B. Delusions regarding body habitus; obsessional focus on food; recurrent purging. C. Hypomanic symptoms for 1 month; mood instability; self-evaluation that is unduly influenced by body shape and weight. D. Recurrent restriction of food; self-evaluation that is unduly influenced by body shape and weight; mood instability.
A. Recurrent episodes of binge eating; recurrent inappropriate compensatory behaviors to prevent weight gain; self-evaluation that is unduly influenced by body shape and weight.
Which of the following is NOT associated with attention-deficit hyperactivity disorder (ADHD)? A. Reduced risk of substance abuse B. Reduced school performance C. Poorer occupational performance and attendance D. Elevated interpersonal conflict
A. Reduced risk of substance abuse
In addition to preoccupations with a perceived body flaw, which of the following behaviors would be most suggestive of a diagnosis of body dysmorphic disorder (BDD)? A. Repetitive mirror checking in response to the preoccupation B. Consulting a psychiatrist because of the distress caused by the preoccupation C. Losing an unhealthy amount of weight in order to improve one's appearance D. Having a related preoccupation with having or acquiring a disfiguring illness
A. Repetitive mirror checking in response to the preoccupation
What are the two subtypes of anorexia nervosa? A. Restricting type and binge-eating/ purging type B. Energy-sparing type and binge-eating/purging type C. Low-calorie/low carbohydrate type and restricting type D. Restricting type and low-weight type
A. Restricting type and binge-eating/purging type
What is the most common site of hair pulling in trichotillomania? A. Scalp B. Axillary area C. Facial area D. Pubic area
A. Scalp
A 3-year-old boy has rather severe temper tantrums that have occurred at least weekly for a 6-week period. Although the tantrums can sometimes be associated with defiant behavior, they often result from a change in routine, fatigue, or hunger, and he only rarely does anything destructive. He is generally well behaved in nursery school and during periods between his tantrums. Which of the following conclusions best fits this child's presentation? A. The boy does not meet criteria for Oppositional Defiant Disorder (ODD) B. The boy meets criteria for ODD because of the presence of tantrums and defiant behavior C. The boy could be diagnosed with ODD as long as it does not appear that his home environment is harsh, neglectful, or inconsistent D. The boy's symptoms more likely represent intermittent explosive disorder than ODD
A. The boy does not meet criteria for Oppositional Defiant Disorder (ODD)
Trans-sexual
An individual who seeks, or has undergone, a social transition from male to female or female to male
Transgender
An individual who transiently or persistently identifies with a gender different from his or her natural gender
Gender
An individual's lived role in society as boy or girl, man or woman
In order for a child to meet criteria for a diagnosis of gender dysphoria, which of the following must be present? A. A co-occurring disorder of sex development B. A strong desire to be of the other gender or an insistence that one is the other gender C. A strong dislike of one's sexual anatomy D. A stated wish to change gender
B. A strong desire to be of the other gender or an insistence that one is the other gender
Which of the following is more common in MEN with bipolar I disorder than in women with the disorder? A. Rapid cycling B. Alcohol abuse C. Eating disorders D. Anxiety disorders
B. Alcohol abuse
A patient with a history of bipolar I disorder presents with a new-onset manic episode and is successfully treated with medication adjustment. He notes chronic depressive symptoms that, on reflection, long preceded his manic episodes. He describes these symptoms as "feeling down," having decreased energy, and more often than not having no motivation. He denies other depressive symptoms but feels that these alone have been sufficient to negatively affect his marriage. Which diagnosis BEST fits this presentation? A. Other specified bipolar and related disorder B. Bipolar I disorder and persistent depressive disorder (dysthymia) C. Cyclothymic disorder D. Bipolar II disorder
B. Bipolar I disorder and persistent depressive disorder (dysthymia)
A 25-year-old graduate student presents to a psychiatrist complaining of feeling down and "not enjoying anything." Her symptoms began about a month ago, along with insomnia and poor appetite. She has little interest in activities and is having difficulty attending to her schoolwork. She recalls a similar episode 1 year ago that lasted about 2 months before improving without treatment. She also reports several episodes of increased energy in the past 2 years; these episodes usually last 1-2 weeks, during which time she is very productive, feels more social and outgoing, and tends to sleep less, although she feels energetic during the day. Friends tell her that she speaks more rapidly during these episodes but that they do not see it as off-putting and in fact think she seems more outgoing and clever. She has no medical problems and does not take any medications or abuse drugs or alcohol. What is the MOST LIKELY diagnosis? A. Bipolar I disorder, current episode depressed B. Bipolar II disorder, current episode depressed C. Cyclothymic disorder D. Major depressive disorder
B. Bipolar II disorder, current episode depressed
A 16-year-old boy with a long history of defiant behavior toward authority figures also has a history of aggression toward peers (gets into fights at school), toward his parents, and toward objects (punching holes in walls, breaking doors). He frequently lies, and he has recently begun to steal merchandise from stores and money and jewelry from his parents. He does not seem pervasively irritable or depressed, and he has no sleep disturbance or psychotic symptoms. What is the MOST LIKELY diagnosis? A. Oppositional Defiant Disorder (ODD) B. Conduct Disorder C. Attention Deficit/Hyperactivity Disorder (ADHD) D. Major Depressive Disorder
B. Conduct Disorder
A 6-year-old girl has repeatedly approached strangers while in the park with her class. The teacher requests an evaluation of the behavior. The girl has a history of being placed in several different foster homes over the past 3 years. Which diagnosis is suggested from this history? A. Attention-deficit/hyperactivity disorder (ADHD) B. Disinhibited social engagement disorder (DSED) C. Autism spectrum disorder (ASD) D. Borderline personality disorder
B. Disinhibited social engagement disorder (DSED)
A 32-year-old man presents to the emergency department distressed and agitated. He reports that his sister has been killed in a car accident on a trip to South America. When asked how he found out, he says that he and his sister were very close and he "just knows it." After putting him on the phone with his sister, who was comfortably staying with friends while on her trip, the man expressed relief that she was alive. Which of the following descriptions BEST fits this presentation? A. He had a delusional belief, because he believed it was true without good warrant B. He did not have a delusional belief, because it changed in light of new evidence C. He had a grandiose delusion, because he believed he could know things happening far away D. He had a nihilistic delusion, because it involved an untrue, imagined catastrophe
B. He did not have a delusional belief, because it changed in light of new evidence
A 48-year-old man presents to a psychiatrist, stating that he was pressured by his wife to seek help. He explains that he likes to collect wine, and he does not see a problem with this; he claims that many of the wines are quite valuable and a potential investment. On further questioning, he admits that he rarely drinks the wines, because it "never seems the right time." He has never sold or given away any wine because he finds it hard to part with the bottles. He has had to use increasing portions of his house for storage of the wine, which, along with the financial hardship, is his wife's primary concern. He admits that many of the wine bottles have probably spoiled because he cannot afford to properly store the wine and the bottles have sat for years on shelves. What is the most appropriate diagnosis? A. Normal collecting behavior B. Hoarding disorder, excessive acquisition type C. OCD D. Delusional disorder
B. Hoarding disorder, excessive acquisition type
A depressed patient reports that he experiences no pleasure from his normally enjoyable activities. Which of the following additional symptoms would be required for this patient to qualify for a diagnosis of major depressive disorder with melancholic features? A. Despondency, depression that is worse in the morning, and inability to fall asleep. B. Inappropriate guilt, depression that is worse in the morning, and early-morning awakening. C. Significant weight gain, depression that is worse in the evening, and excessive guilt. D. Despondency, significant weight gain, and psychomotor retardation.
B. Inappropriate guilt, depression that is worse in the morning, and early-morning awakening
Children with disruptive mood dysregulation disorder (DMDD) often meet criteria for what additional DSM-5 diagnosis? A. Schizophrenia B. ODD (oppositional defiant disorder) C. Intermittent explosive disorder D. Major depressive disorder
B. ODD (oppositional defiant disorder)
A 52-year-old man with raw, chapped hands is referred to a psychiatrist by his primary care doctor. The man reports that he washes his hands repeatedly, spending up to 4 hours a day, using abrasive cleansers and scalding hot water. Although he admits that his hands are uncomfortable, he is entirely convinced that unless he washes in this manner he will become gravely ill. A medical workup is unrevealing, and the man takes no medications. What is the most appropriate diagnosis? A. Delusional Disorder, somatic type B. Obsessive-compulsive disorder, with absent insight C. Generalized anxiety disorder D. Illness Anxiety Disorder
B. Obsessive-Compulsive Disorder, with absent insight
In most substance/medication-induced mental disorders (with the exception of substance/medication-induced major or mild neurocognitive disorder and hallucinogen persisting perception disorder), if the person abstains from substance use, the disorder will eventually disappear or no longer be clinically relevant even without formal treatment. In what time frame is this LIKELY to happen? A. One hour B. One month C. Three months D. One year
B. One month
A 30-year-old single woman reports having experienced auditory and persecutory delusions for 2 months, followed by a full major depressive episode with sad mood, anhedonia, and suicidal ideation lasting 3 months. Although the depressive episode resolves with pharmacotherapy and psychotherapy, the psychotic symptoms persist for another month before resolving. What diagnosis BEST fits this clinical picture? A. Brief psychotic disorder B. Schizoaffective disorder C. Major depressive disorder D. Bipolar I disorder, current episode manic, with mixed features
B. Schizoaffective disorder
In which of the following aspects does cyclothymic disorder differ from bipolar I disorder? A. Duration B. Severity C. Age of onset D. Pervasiveness
B. Severity
Which of the following statements about risk factors for developing post traumatic stress disorder (PTSD) is TRUE? A. Sustaining personal injury does not affect the risk of developing PTSD B. Severity of the trauma influences the risk of developing PTSD C. Dissociation has no impact on the risk of developing PTSD D. Perceived life threat is the only risk factor for developing PTSD
B. Severity of the trauma influences the risk of developing PTSD
To fulfill diagnostic criteria for excoriation (skin-picking) disorder, the picking must be severe enough to result in which of the following? A. Itching B. Skin Lesions C. An infection D. Medical attention
B. Skin Lesions
Which of the following statements about the development and course of autism spectrum (ASD) is FALSE? a. Symptoms of ASD are typically recognized during the second year of life (12-24 months of age) b. Symptoms of ASD are usually noticeable until 5 to 6 years of age c. First symptoms frequently involve delayed language development, often accompanied by lack of social interest or unusual social interactions d. ASD is not a degenerative disorder, and it is typical for learning and compensation to continue throughout life
B. Symptoms of ASD are usually not noticeable until 5 to 6 years of age
Which of the following statements about gender differences in the risk of developing post traumatic stress disorder (PTSD) is TRUE? A. The risk is lower in females in preschool-age populations B. The risk is higher in females across the lifespan C. The risk is higher in males in elderly populations D. The risk is higher in males across the lifespan
B. The risk is higher in females across the lifespan
Which of the following is NOT a specifier included in the diagnostic criteria for autism spectrum disorder? A. With or without accompanying intellectual impairment B. With or without associated dementia C. With or without accompanying language impairment D. Associate with a known medical or genetic condition or environmental factor
B. With or without associated dementia
Because opioid withdrawal and sedative, hypnotic, or anxiolytic withdrawal can involve very similar symptoms, distinguishing between the two can be difficult. Which of the following presenting symptoms would aid in making the correct diagnosis? A. Nausea or vomiting B. Yawning C. Insomnia D. Anxiety
B. Yawning
Which of the following statements about pedophilic disorder is TRUE? A. Pedophilic disorder is found in 10%-12% of the male population B. There is no evidence that neurodevelopmental perturbation in utero increases the probability of development of a pedophilic orientation C. Adult males with pedophilia often report that they were sexually abused as children D. To meet criteria for the diagnosis, the individual must experience sexually arousing fantasies, sexual urges, or behaviors involving sexual activity with children age 8 years or younger
C. Adult males with pedophilia often report that they were sexually abused as children
A 45-year-old man with a long-standing history of heavy alcohol use is referred for psychiatric evaluation after his recent admission to the hospital for acute hepatitis. The patient reports that he drank almost daily in college. Over the past 10 years, he has gradually increased his nightly alcohol intake from a single 6-pack to two 12-packs of beer, and this nightly drinking habit has resulted in his frequently oversleeping and missing work. He has tried to moderate his alcohol use on numerous occasions with little success, particularly after developing complications associated with alcoholic cirrhosis. The patient admits that he becomes anxious and gets hand tremors when he doesn't drink. This patient meets the criteria for which of the following diagnoses? A. Alcohol abuse B. Alcohol dependence C. Alcohol use disorder, severe D. Alcohol use disorder, mild
C. Alcohol use disorder, severe
Which of the following is NOT a commonly recognized type of delusion? A. Persecutory B. Erotomanic C. Alien abduction D. Grandiose
C. Alien abduction
Which mental disorder or disorder class has the highest prevalence among individuals with cannabis use disorder? A. Major depressive disorder B. Conduct disorder C. Anxiety disorders D. Bipolar I disorder
C. Anxiety disorders
A 45-year-old woman had a choking episode 3 years ago after eating salad. Since that time she has been afraid to eat a wide range of foods, fearing that she will choke. This fear has affected her functionality and her ability to eat out with friends and has contributed to weight loss. Which diagnosis best fits this clinical picture? A. Bulimia Nervosa B. Schizophrenia C. Avoidant/ restrictive food intake disorder D. Binge-eating disorder
C. Avoidant/restrictive food intake disorder
Schizophrenia spectrum and other psychotic disorders are defined by abnormalities in one or more of five domains, four of which are also considered psychotic symptoms. Which of the following is NOT considered a psychotic symptom? A. Delusions B. Hallucinations C. Avolition D. Disorganized thinking
C. Avolition
In excoriation (skin-picking) disorder, which of the following is the most typical motivation for the skin-picking behavior? A. Inflicting pain that brings relief by reaffirming one's ability to feel B. Appearance concerns C. Boredom D. Fear of infection
C. Boredom
A 25-year-old medical student presents to the student health service at 7 A.M. complaining of having a "panic attack." He reports that he stayed up all night studying for his final gross anatomy exam, which starts in an hour, but he feels too anxious to go. He reports vomiting twice. The patient is restless and appears flushed, with visible muscle twitching. He is urinating excessively, has tachycardia, and his electrocardiogram shows premature ventricular complexes. His thoughts and speech appear to be rambling in nature. His urine toxicology screen is negative. What is the MOST LIKELY diagnosis? A. Panic disorder B. Amphetamine intoxication, amphetamine-like substance C. Caffeine intoxication D. Alcohol withdrawal
C. Caffeine intoxication
A 27-year-old woman presents for psychiatric evaluation after almost hitting someone with her car while driving under the influence of marijuana. She reports that she was prompted to seek treatment by her husband, with whom she has had several conflicts over the past year about her ongoing marijuana use. She has continued to smoke two joints daily and drive while under the influence of marijuana since this event. What is the appropriate diagnosis? A. Cannabis abuse B. Cannabis dependence C. Cannabis use disorder D. Cannabis intoxication
C. Cannabis use disorder
A 19-year-old college student is brought by ambulance to the emergency department. His college dorm supervisor, who called the ambulance, reports that the student was isolating himself, was pacing in his room, and was not responding to questions. In the emergency department, the patient gets down in a crouching position and begins making barking noises at seemingly random times. His urine toxicology report is negative, and all labs are within normal limits. What is the BEST description of these symptoms? A. An animal delusion- the patient believes he is a dog B. Intermittent explosive rage C. Catatonic behavior D. Formal thought disorder
C. Catatonic behavior
Criterion B for acute stress disorder requires the presence of nine (or more) symptoms from any of five categories of response. Which of the following is NOT one of these five categories? A. Intrusion B. Disassociation C. Confusion D. Avoidance
C. Confusion
A 45-year-old woman with multiple sclerosis was treated with interferon beta-1a a year ago, which resolved her physical symptoms. She now presents with depressed mood (experienced daily for the past several months), middle insomnia (of recent onset), poor appetite, trouble concentrating, and lack of interest in sex. Although she has no physical symptoms, she is frequently absent from work. She denies any active plans to commit suicide but admits that she often thinks about it, as her mood has worsened. What is the MOST likely diagnosis? A. Major depressive disorder B. Persistent depressive disorder (dysthymia) C. Depressive disorder due to another medical condition D. Substance/medication induced depressive disorder
C. Depressive disorder due to another medical condition
Which of the following DSM-5 diagnosis has replaced the former DSM-IV diagnosis of gender identity disorder? A. Gender aversion disorder B. Gender dysmorphic disorder C. Gender dysphoria D. Gender incongruence
C. Gender dysphoria
Which of the following statements about the course of hoarding disorder is true? A. Hoarding behavior tends to wax and wane in severity throughout an individual's life B. Hoarding behavior peaks in young adulthood and subsequently lessens in severity C. Hoarding behavior tends to become more severe with increasing age D. Hoarding disorder begins in childhood, is chronic, and tends to not change in severity
C. Hoarding behavior tends to become more severe with increasing age
A patient with a history of bipolar disorder reports experiencing 1 week of elevated and expansive mood. Evidence of which of the following would suggest that the patient is experiencing a hypomanic, rather than manic, episode? A. Irritability B. Decreased need for sleep C. Increased productivity at work D. Good insight into the illness
C. Increased productivity at work
Which of the following is NOT associated with attention-deficit/hyperactivity disorder (ADHD)? A. Social rejection B. Increased risk of developing conduct disorder in childhood C. Increased risk of Alzheimer's Disease D. Increased frequency of traffic accidents and violations
C. Increased risk of Alzheimer's Disease
A 15-year-old boy has a history of episodic violent behavior that is out of proportion to the precipitant. During a typical episode, which will escalate rapidly, he will become extremely angry, punching holes in walls or destroying furniture in the home. There seems to be no specific purpose or gain associated with the outbursts, and within 30 minutes he is calm and "back to himself," a state that is not associated with any predominant mood disturbance. What diagnosis best fits this clinical picture? A. Bipolar Disorder B. Disruptive Mood Dysregulation Disorder C. Intermittent Explosive Disorder (IED) D. Conduct Disorder
C. Intermittent Explosive Disorder (IED)
A 9-year-old boy is brought in for evaluation because of explosive outbursts when he is frustrated with schoolwork. The parents report that their son is well behaved and pleasant at other times. Which diagnosis best fits this clinical picture? A. Disruptive mood dysregulation disorder B. Major depressive disorder C. Intermittent explosive disorder D. Persistent depressive disorder (dysthymia)
C. Intermittent explosive disorder
Which of the following substances is most likely to be associated with poly-drug use? A. Cannabis B. Tobacco C. MDMA (ecstasy) D. Alcohol
C. MDMA (ecstasy)
A 50-year-old man presents with persistently depressed mood for several weeks that interferes with his ability to work. He has insomnia and fatigue, feels guilty, has thoughts he would be better off dead, and has thought about how he could die without anyone knowing it was a suicide. His wife informs you that he requests sex several times a day and that she thinks he may be going to "massage parlors" regularly, both of which are changes from his typical behavior. He has told her he has ideas for a "better Internet," and he has invested thousands of dollars in software programs that he cannot use. She notes that he complains of fatigue but sleeps only 1 or 2 hours each night and seems to have tremendous energy during the day. Which diagnosis best fits this patient? A. Manic episode B. Major depressive episode C. Major depressive episode with mixed features D. Major depressive episode with atypical features
C. Major depressive episode with mixed features
A 63-year-old woman has been saving financial documents and records for many years, placing papers in piles throughout her apartment to the point where it has become unsafe. She acknowledges that the piles are a concern; however, she says that the papers include important documents and she is afraid to throw them away. She recalls several instances in which her taxes were audited and she needed certain documents to avoid a penalty. She is concerned because her landlord is threatening to evict her unless she removes the piles of papers. What is the most likely diagnosis? A. Delusional Disorder B. Hoarding Disorder C. Obsessive-Compulsive Disorder D. Nonpathological Collecting Behavior
C. Obsessive-Compulsive Disorder
How common is schizoaffective disorder relative to schizophrenia? A. Much more common B. Twice as common C. One-third as common D. Equally common
C. One-third as common
In order to be considered a symptom of conduct disorder, running away must have occurred with what frequency? A. At least three times B. At least five times C. Only once if the individual did not return for a lengthy period D. Six times over a three month period
C. Only once if the individual did not return for a lengthy period
A previously well-behaved 13-year-old girl begins to display extremely defiant and oppositional behavior, with vindictiveness. She is angry, argumentative, and refuses to accept responsibility for her behavior, which is affecting both her home life and school life in a significant way. What is the LEAST likely diagnosis? A. Major Depressive Disorder B. Bipolar Disorder C. Oppositional Defiant Disorder D. Adjustment Disorder
C. Oppositional Defiant Disorder
A 14-year-old boy describes himself as feeling "down" all of the time for the past year. He remembers feeling better while he was at camp for 4 weeks during the summer; however, the depressed mood returned when he came home. He reports poor concentration, feelings of hopelessness, and low self-esteem but denies suicidal ideation or changes in his appetite or sleep. What is the MOST likely diagnosis? A. Major depressive disorder B. Disruptive mood dysregulation disorder C. Persistent depressive disorder (dysthymia), with early onset D. Depressive episodes with short duration hypomania
C. Persistent depressive disorder (dysthymia), with early onset
What are the three essential diagnostic features of anorexia nervosa? A. Persistently low self-confidence, intense fear of becoming fat, and disturbance in motivation. B. Low self-esteem, disturbance in self-perceived weight or shape, and persistent energy restriction. C. Persistent restriction of energy intake, intense fear of becoming fat, and disturbance in self-perceived weight or shape. D. Persistent lack of weight gain, disturbance in motivation, and restricted affect.
C. Persistent restriction of energy intake, intense fear of becoming fat, and disturbance in self-perceived weight or shape.
Which of the following features confers a WORSE prognosis for a patient with bipolar II disorder? A. Younger age B. Higher educational level C. Rapid cycling pattern D. Married marital status
C. Rapid cycling pattern
A 35-year-old woman tells her therapist that she has recently become intensely aroused while watching movies in which people are tortured and that she regularly fantasizes about torturing people while masturbating. She is not distressed by these thoughts and denies ever having acted on these new fantasies, though she fantasizes about these activities several times a day. Which of the following best summarizes the diagnostic implications of this patient's presentation? A. She meets all of the criteria for sexual sadism disorder B. She does not meet the criteria for sexual sadism disorder because the fantasies are not sexual in nature C. She does not meet the criteria for sexual sadism disorder because she has never acted on the fantasies D. She does not meet the criteria for sexual sadism disorder as the diagnosis is only made in men
C. She does not meet the criteria for sexual sadism disorder because the fantasies are not sexual in nature
A 25-year-old woman is brought to the emergency department by her friends after a party. They report that the woman had been seen ingesting some unknown pills earlier in the evening. She became increasingly confused throughout the course of the night. She eventually had a witnessed seizure on the street, prompting activation of emergency medical services. Vital signs indicate that the patient is tachycardic and hypertensive. On evaluation, the patient is observed to be thin with dilated pupils. She is smiling to herself, is fidgety, and is oriented to self, place, and date. When queried about auditory hallucinations, the patient admits that she is hearing voices but is unconcerned, stating, "I only hear them while I'm partying, Doc." Which diagnosis best fits this clinical presentation? A. Stimulant-induced manic episode B. Stimulant-induced psychotic disorder C. Stimulant intoxication, with perpetual disturbances D. Other hallucinogen-induced psychotic disorder
C. Stimulant intoxication, with perpetual disturbances
A 5-year-old child was present when her babysitter was sexually assaulted. Which of the following symptoms would be MOST suggestive of post traumatic stress disorder (PTSD) in this child? A. Playing normally with toys B. Having dreams about princesses and castles C. Taking the clothing off her dolls while playing D. Expressing no fear when talking about the event
C. Taking the clothing off her dolls while playing
Which of the following is a DSM-5 diagnostic criteria for Tourette's Disorder? A. Tics occur throughout a period of more than 1 year, and during this period there was never a tic-free period of more than three consecutive months B. Onset is before the age of 5 years C. The tics may wax and wane in frequency but has persisted for more than one year since first tic onset D. Motor tics must precede vocal tics
C. The tics may wax and wane in frequency but has persisted for more than one year since first tic onset
Which of the following is not a paraphilic disorder? A. Sexual masochism disorder B. Transvestic disorder C. Transsexual disorder D. Voyeuristic disorder
C. Transsexual disorder
In which of the following disorders can psychotic symptoms occur? A. Bipolar and depressive disorders B. Substance use disorders C. Post traumatic stress disorder D. All of the above
D. All of the above
Which of the following comorbid disorders is associated with pyromania? A. Antisocial Personality Disorder B. Substance Use Disorders C. Mood Disorders D. All of the above
D. All of the above
A 7-year old boy is having behavioral and social difficulties in his second-grade class. Although he seems to be able to attend and is doing "well" from an academic standpoint (though seemingly not what he is capable of), he is constantly interrupting, fidgeting, talking excessively, and getting out of his seat. He has friends, but he sometimes annoys his peers because of his difficulty sharing and taking turns and the fact that he is constantly talking over them. Although he seeks out play dates, his friends tire of him because he wants to play sports nonstop. At home, he care barely stay in his seat for a meal and is unable to play quietly. Although he shows remorse when the consequences of his behavior are pointed out to him, he can become angry in response and nevertheless unable to inhibit himself. What is the most likely diagnosis? A. Bipolar Disorder B. Autism Spectrum Disorder C. Specific Learning Disorder D. Attention deficit/hyperactivity disorder, predominantly hyperactive/impulsive
D. Attention deficit/hyperactivity disorder, predominantly hyperactive/impulsive
The parents of a 15-year-old female tenth grader believe that she should be doing better in high school, given how bright she seems and the fact that she received mostly A's through eighth grade. Her papers are handed in late, and she makes careless mistakes on examinations. They have her tested, and the WAIS-IV results are as follows: Verbal IQ-125, Perceptual Reasoning Index - 122, Full-Scale IQ-123, Working memory index 55th percentile, processing speed index 50th percentile. Weaknesses in executive functioning are noted. During a psychiatric evaluation, she reports a long history of failing to give close attending to details, difficulty sustaining attention while in class or doing homework, failing to finish chores an tasks, and significant difficulties with time management, planning, and organization. She is forgetful, often loses things, and is easily distracted. She has no history of restlessness or impulsivity, and she is well liked by her peers. What is the most likely diagnosis? a. Adjustment disorder with anxiety b. Specific learning disorder c. Major depressive disorder d. Attention-deficit/hyperactivity disorder, predominantly inattentive
D. Attention-deficit/hyperactivity disorder, predominantly inattentive
Which of the following stressful situations would meet Criterion A for the diagnosis of acute stress disorder (ASD)? A. Finding out that one's spouse has been fired B. Failing an important final examination C. Receiving a serious medical condition D. Being in the cross fire of a police shootout but not being harmed
D. Being in the cross fire of a police shootout but not being harmed
A 25-year-old man is concerned that he looks "weak" and "puny" despite the fact that to neutral observers he appears very muscular. When confronted about his belief he believes he is being humored and that people are in fact making fun of his small size behind his back. He has tried a number of strategies to increase muscle mass, including exercising excessively and using anabolic steroids; however, he remains dissatisfied with his appearance. What is the most likely diagnosis? A. Delusional disorder, somatic type B. Narcissistic personality disorder C. Anxiety disorder D. Body dysmorphic disorder, with muscle dysmorphia
D. Body dysmorphic disorder, with muscle dysmorphia
Which of the following substances, when abused, is most likely to cause symptoms mimicking obsessive-compulsive disorder? A. Heroin B. Marijuana C. LSD D. Cocaine
D. Cocaine
A 31-year-old man narrowly escapes (without injury) from a house fire caused when he dropped the lighter while trying to light his crack pipe. Six weeks later, while smoking crack, he thinks he smells smoke and runs from the building in a panic, shouting, "It's on fire!" Which of the following symptoms or circumstances would rule out a diagnosis of post traumatic stress disorder (PTSD) for this patient? A. Having difficulty falling asleep B. Being uninterested in going back to work C. Inappropriately getting angry at family members D. Experiencing symptoms only when smoking crack cocaine
D. Experiencing symptoms only when smoking crack cocaine
Which of the following symptoms is a recognized consequence of the abrupt termination of daily or near-daily cannabis use? A. Hallucinations B. Delusions C. Hunger D. Irritability
D. Irritability
Which of the following statements about paraphilias is FALSE? A. The presence of a paraphilia does not always justify clinical intervention B. Most paraphilias can be divided into those that involve an unusual activity and those that involve an unusual target C. Paraphilias may coexist with normophilic sexual interests D. It is rare for an individual to manifest more than one paraphilia
D. It is rare for an individual to manifest more than one paraphilia
A 10-year-old boy with a history of dyslexia, who is otherwise developmentally normal, is in a skateboarding accident in which he experiences severe traumatic brain injury. This results in significant global intellectual impairment (with a persistent reading deficit that is more pronounced than his other newly acquired but stable deficits, along with a full-scale IQ of 75). There is mild impairment in his adaptive functioning such that he requires support in some areas of functioning. He is also displaying anxious and depressive symptoms in response to his accident and hospitalization. What is the least likely diagnosis? a. Intellectual disability (intellectual developmental disorder) b. Traumatic brain injury c. Specific learning disorder d. Major neurocognitive disorder due to traumatic brain injury
D. Major neurocognitive disorder due to traumatic brain injury
What is the most common type of delusion? A. Somatic delusion of distorted body appearance B. Grandiose delusion C. Thought insertion D. Persecutory delusion
D. Persecutory delusion
Which of the following DOES NOT represent a negative symptom of schizophrenia? A. Affective flattening B. Decreased motivation C. Impoverished thought processes D. Sadness over loss of functionality
D. Sadness over loss of functionality
A 17-year-old boy with a history of bullying and initiating fights using bats and knives has also stolen from others, set fires, destroyed property, broken into homes, and "conned" others. This pattern of disturbed conduct covers all of the Criterion A behavior categories EXCEPT: A. Aggression to people and animals B. Destruction of property C. Deceitfulness or theft D. Serious violations of rules
D. Serious violations of rules
A 15-year-old girl with a history of cruelty to animals, stealing, school truancy, and running away from home shows no remorse when caught, or when she is confronted with how her behavior is affecting the rest of her family. She disregards the feelings of others and seems to not care that her conduct is compromising her school performance. The behavior has been present for over a year and in multiple relationships and settings. Which of the following components of the "With limited prosocial emotions" specifier is ABSENT in this clinical picture? A. Lack of remorse or guilt B. Callous- lack of empathy C. Lack of concern about performance D. Shallow or deficient affect
D. Shallow or deficient affect
A 31-year-old woman with no history of mood symptoms reports that she experiences distressing mood lability and irritability starting about 4 days before the onset of menses. She feels "on edge," cannot concentrate, has little enjoyment from any of her activities, and experiences bloating and swelling of her breasts. The patient reports that these symptoms started 6 months ago when she began taking oral contraceptives for the first time. If she stops the oral contraceptives and her symptoms remit, what would the diagnosis be? A. Premenstrual dysphoric disorder B. Dysthymia C. Major depressive disorder D. Substance/medication induced depressive disorder
D. Substance/medication induced depressive disorder
Which of the following characteristics is generally NOT associated with autism spectrum disorder? A. Anxiety, depression, and isolation as an adult B. Catatonia C. Poor psychosocial functioning D. Successful adaptation in regular school settings
D. Successful adaptation in regular school settings
For a child diagnosed with reactive attachment disorder, which of the following situations would qualify for a disorder specifier of "severe"? A. The child has been in five foster homes B. The child never expresses positive emotions when interacting with caregivers C. The disorder has been present for 18 months D. The child meets all symptoms of the disorder, with each symptom manifesting at relatively high levels
D. The child meets all symptoms of the disorder, with each symptom manifesting at relatively high levels
Sex
The biological indicators of male or female seen in an individual
Gender dysphoria
The distress that may accompany the incongruence between one's experienced or expressed gender and one's assigned gender
Which of the following is NOT required for a DSM-5 diagnosis of intellectual disability (intellectual developmental disorder)? a. Full-scale IQ below 70 b. Deficits in intellectual functions confirmed by clinical assessment c. Deficits in adaptive functioning that result in failure to meet developmental and sociocultural standards for personal independence and social responsibility d. Deficits in intellectual functions confirmed by individualized, standardized intelligence testing
a. Full-scale IQ below 70