Presentation Disorders

Diagnostic Criteria [Adjustment Disorder]

A) development of emotional / behavioural symptoms in response to an identifiable stressor within 3 months of stressor onset

B) symptoms + behaviours cause clinically significant distress (disproportionate to stressory severity / intensity + other contexts / cultural factors) and/or significantly impair functioning 

C) disturbance does not meet criteria for another mental disorder + isn’t an exacerbation of a preexisting mental disorder

D) symptoms don’t represent normal bereavement + aren’t better explained by prolonged grief disorder

E) once stressor / consequences of stressor is over, symptoms resolve within 6 months

Specifiers [Adjustment Disorder]

• w/ depressed mood: predominantly low mood, tearfulness, or hopelessness

• w/ anxiety: predominantly nervous, worried, jittery, or separation anxiety

• w/ mixed anxiety + depressed mood

• w/ disturbance of conduct

• w mixed disturbance of emotions + conduct: emotions can be depressed or anxious

• unspecified: maladaptive reactions that don’t fit one of the other subtypes

Diagnostic Criteria [ADHD]

A) persistent pattern of inattention and/or hyperactivity-impulsivity that interferes w/ functioning / development, lasting at least 6mos

B) several inattentive or hyperactive-impulsive symptoms were present before age 12

C) several inattentive or hyperactive-impulsive symptoms are present in 2+ settings

D) clear evidence that symptoms interfere w/ or reduce the quality of social / academic / occupational functioning

E) symptoms don’t occur exclusively during course of schizophrenia / another psychotic disorder + aren’t better explained by another mental disorder

Inattention Symptoms [ADHD]

6+ symptoms, lasting at least 6mo, at a degree that isn’t consistent w/ developmental level & negatively impacts social + academic / occupational activites. if over 17, only 5+ symptoms required.

1. often fails to pay close attention to details or makes careless mistakes in schoolwork / at work / during other activities

2. often has difficulty keeping attention on tasks / play activities for long periods of time

3. often doesn’t seem to listen when spoken to directly

4. often doesn’t follow through on instructions + fails to finish schoolwork, chores, or workplace tasks

5. often has difficulty organising tasks + activities

6. often avoids, dislikes, or is reluctant to participate in tasks that need sustained mental effort

7. often loses things necessary for tasks / activities

8. often easily distracted by unnecessary stimuli (can include unrelated thoughts)

9. often forgetful in daily activities

Hyperactivity / Impulsivity Symptoms [ADHD]

6+ symptoms, lasting at least 6mo, at a degree that isn’t consistent w/ developmental level & negatively impacts social + academic / occupational activites. if over 17, only 5+ symptoms required.

1. often fidgets, taps hands / feet, or squirms in seat

2. often leaves seat in situations where expected to remain sitting

3. often runs about or climbs in inappropriate situations 

   • in teens / adults, may be limited to feeling restless

4. often unable to play or engage in leisure activities quietly

5. often “on the go”, acting as if “driven by a motor”

6. often talks excessively

7. often blurts out answers before questions are finished

8. often has difficulty waiting their turn

9. often interrupts or intrudes on others

Diagnostic Criteria [Illness Anxiety Disorder]

a) preoccupation with having or acquiring a serious illness

b) somatic symptoms aren’t present or are only mild. if another medical condition is present or there’s a high risk of developing a condition, the preoccupation is excessive / disproportionate

c) individual has high level of anxiety about health + is easily alarmed about their personal health status

d) performance of excessive health-related behaviours or maladaptive avoidance

e) preoccupation has lasted for at least 6 mos — feared illness may have changed during that time

f) not better explained by another mental disorder such as somatic symptom disorder, panic disorder, generalised anxiety disorder, body dysmorphic disorder, obsessive-compulsive disorder, or delusional disorder somatic type

Diagnostic Criteria [Narcissistic Personality Disorder]

pervasive pattern of grandiosity, need for admiration, lack of empathy, + heightened sense of self-importance, beginning by early adulthood + present in a variety of contexts. requires 5+ symptoms

1. grandiose sense of self-importance

2. preoccupation w/ fantasies of unlimited success, power, brilliance, beauty, or ideal love

3. belief that they are “special” + unique, can only be understood by / should associate w/ other special or high-status people / institutions

4. requires excessive admiration

5. sense of entitlement

6. interpersonally exploitative

7. lack of empathy: unwilling to recognise / identify w/ the feelings + needs of others

8. envious of others or believes that others are envious of them

9. arrogant, haughty behaviours or attitudes

Diagnostic Criteria [Brief Psychotic Disorder]

A) includes 1+ psychotic symptoms, one of which must be delusions, hallucinations, or disorganised speech:

1. delusions

2. hallucinations

3. disorganised speech (eg: derailment, incoherence)

4. grossly disorganised or catatonic behaviour

B) episode must last at least 1 day but less than 1 month

C) individual returns fully to their baseline level of functioning afterward

D) episode is not better explained by mood disorder with psychotic features, another psychotic disorder, catatonia as a primary disorder, substances / medications, or another medical condition

Diagnostic Criteria [Dependent Personality Disorder]

Pervasive and excessive need to be taken care of that leads to submissive and clinging behaviour and fears of separation, beginning by early adulthood and present in a variety of contexts. Indicated by 5+ symptoms.

1. has difficulty making everyday decisions without an excessive amount of advice + reassurance from others

2. needs others to assume responsibility for most major areas of their life

3. has difficulty expressing disagreement with others because of fear of loss of support or approval (not including realistic fears)

4. has difficulty starting projects or doing things on their own bc of a lack of confidence in their judgement or abilities

5. goes to excessive lengths to get nurturance and support from others, to the point of volunteering to do unpleasant things

6. feels uncomfortable or helpless when alone because of exaggerated fears of being unable to care for themself

7. urgently seeks another relationship as a source of care and support when a close relationship ends

8. is unrealistically preoccupied w/ fears of being left to take care of themself

Diagnostic Criteria [Oppositional Defiant Disorder]

A) a pattern of angry / irritable mood, argumentative / defiant behaviour, or vindictiveness lasting 6+ months, evidenced by 4+ symptoms, and exhibited during interaction w/ at least one person who’s not a sibling. persistence + frequency of behaviours should be used to distinguish behaviour WNL + symptomatic behaviour (eg: for kids <5, behaviour should occur most days; for kids 5+, behaviour should occur at least once a week), + other factors should be considered (eg: if behaviour is normative for developmental level, gender, or culture)

1. often loses temper

2. often touchy / easily annoyed

3. often angry + resentful

4. often argues w/ authority figures (or adults, if child / adolescent)

5. often actively defies / refuses to comply w/ requests from authority figures or w/ rules

6. often deliberately annoys others

7. often blames others for their mistakes or misbehaviour

8. has been spiteful or vindictive within the last 6 months

B) disturbance in behaviour is associated w/ distress in client or others in their immediate social context, or negatively impacts functioning

C) behaviours don’t happen exclusively during course of psychotic, substance use, depressive, or bipolar disorders. criter aren’t met for disruptive mood regulation disorder.

Diagnostic Criteria [Histrionic Personality Disorder]

Pervasive and excessive emotionality + attention seeking, beginning by early adulthood & present in a variety of contexts. Indicated by 5+ symptoms.

1. uncomfortable in situations in which they’re not the center of attention

2. interactions w/ others often characterised by inappropriate sexually seductive / provocative behaviour

3. displays rapidly shifting + shallow emotional expression

4. consistently uses physical appearance to draw attention to self

5. has a style of speech that’s excessively impressionistic + lacking in detail

6. shows self-dramatisation, theatricality, & exaggerated expression of emotion

7. is suggestible (easily influenced by others / circumstances)

8. considers relationships to be more intimate than they actually are

Diagnostic Criteria in Children [Gender Dysphoria]

A) a marked incongruence between experienced / expressed gender + assigned gender, lasting 6+ months, shown by 6+ symptoms.

1. strong desire to be of another gender or insistence that they are another gender [required]

2. in AMABs, a strong preference for cross-dressing or simulating female attire; in AFABs, a strong preference for wearing only typically masc clothing + a strong resistance to the wearing of typical fem clothing

3. strong preference for cross-gender roles in make-believe or fantasy play

4. strong preference for toys, games, or activities stereotypically used / engaged in by other gender

5. strong preference for playmates of other gender

6. in AMABs, a strong rejection of typically masc toys, games, & activities + strong avoidance of rough-and-tumble play; in AFABs, a strong rejection of typically fem toys, games, & activities

7. a strong dislike of their sexual anatomy

8. a strong desire for the primary and/or secondary sex characteristics matching their experienced gender

B) assoc. w/ clinically significant distress or impaired functioning

Diagnostic Criteria in Adolescents + Adults [Gender Dysphoria]

A) a marked incongruence between experienced / expressed gender + assigned gender, lasting 6+ months, shown by 2+ symptoms.

1. marked incongruence between experienced / expressed gender + primary and/or secondary sex characteristics (young adolescents: anticipated secondary sex characteristics)

2. strong desire to be rid of primary and/or secondary sex characteristics bc of marked incongruence w/ experienced / expressed gender (young adolescents: desire to prevent development of anticipated secondary sex characteristics)

3. strong desire for primary and/or secondary sex characteristics of other gender

4. strong desire to be of another gender

5. strong desire to be treated as another gender

6. strong conviction that one has the typical feelings + reactions of another gender

B) assoc. w/ clinically significant distress or impaired functioning

Diagnostic Criteria [Alcohol Use Disorder]

a problematic pattern of alcohol use, leading to clinically significant impairment / distress, shown by 2+ symptoms in a 12-mo period.

1. taken in larger amounts or over longer period than intended

2. persistent desire or unsuccessful attempts to cut down / control use

3. spending a lot of time in activities necessary to get / use alcohol, or to recover from its effects

4. craving, or strong desire / urge to use

5. recurrent use → failure to fulfill work, school, or home obligations

6. continued use despite persistent or recurrent social / interpersonal problems caused or made worse by use

7. giving up / reducing important social, occupational, or recreational activities bc of use

8. recurrent use in situations where it’s physically hazardous

9. continued use despite knowledge of persistent or recurrent physical / psychological problems likely caused or exacerbated by alcohol

10. tolerance, defined as either a) need for markedly increased amounts to achieve intoxication / desired effect, or b) markedly diminished effect w/ continued use of same amount

11. withdrawal, as shown by either a) characteristic withdrawal syndrome for alcohol or b) alcohol (or closely related substance) is taken to avoid / relieve withdrawal symptoms

Diagnostic Criteria [Autism Spectrum Disorder]

A) persistent deficits in social communication + interaction across multiple contexts, manifested by all of the following, currently or in history

• deficits in social-emotional reciprocity (eg: poor back-and-forth conversation, reduced)

• deficits in nonverbal communication used for social interaction (eg: abnormal eye contact, facial features, or gestures)

• deficits in developing, maintaining, & understanding relationships (eg: absence of interest in peers, adjusting to social contexts)

B) restricted, repetitive patterns of behaviour, interests, or activities, as shown by 2+ of following, currently or in history

• stereotyped or repetitive motor movements, use of objects or speech

• insistence of sameness, inflexible adherence to routines, ritualised patterns of verbal / nonverbal behaviours

• highly restricted, fixated interests that are abnormal in intensity / focus

• hyperactivity / hypoactivity to sensory input / unusual interest in sensory aspects of environment

C) symptoms must be present in the early developmental period

D) cause clinically significant impairment in functioning

E) disturbances are not better explained by intellectual disability

Diagnostic Criteria [Delusional Disorder]

A) presence of 1+ delusions, lasting 1+ months

B) criterion A for schizophrenia has never been met

• hallucinations, if present, aren’t prominent + are related to the delusional theme

C) apart from impact of delusion(s) or their ramifications, functioning is not markedly impaired + behaviour is not obviously bizarre / odd

D) if manic or major depressive episodes have happened, they’ve been brief relative to the duration of the delusional periods

E) the disturbance is not attributable to the physiological effects of a substance / other medical condition, & isn’t better explained by another mental disorder

Specifiers [Delusional Disorder]

• erotomanic type: central theme of delusion is that another person is in love with the individual

• grandiose type: central theme of delusion is conviction of having some great (but unrecognised) talent or insight, or having made some important discovery

• jealous type: central theme of delusion is that their spouse / lover is unfaithful

• persecutory type: central theme of delusion involves belief that they’re being conspired against, cheated, spied on, followed, poisoned / drugged, maliciously maligned, harassed, or obstructed in pursuit of long-term goals

• somatic type: central theme of delusion involves bodily functions / sensations

• mixed type: no one delusional theme predominates

• unspecified type: dominant delusional belief can’t be clearly determined or isn’t described in the specific types