dissociative, elimination, sleep wake ,gender dysphoria disorders

Which of the following is not a way in which DSM-5 classification of dissocia tive disorders differs from DSM-IV?

A. In DSM-IV, derealization occurring without depersonalization was classi fied under dissociative disorder not otherwise specified (NOS), whereas in DSM-5 it is classified as depersonalization/derealization disorder.

B. In DSM-IV, dissociative fugue was a separate diagnosis, whereas in DSM-5, it is a subtype of dissociative amnesia.

C. In DSM-IV, experiences of possession could not be part of the diagnosis of dissociative identity disorder (DID); in DSM-5, they can be.

D. In keeping with the empirical basis of DSM-5, DID can be diagnosed only if the clinician or a reliable family member witnesses the claimed disruption of identity; in DSM-IV, this restriction did not apply.

E. The criteria for DID have been changed to indicate that gaps in the recall of events may occur for everyday events and not just traumatic events.

D. In keeping with the empirical basis of DSM-5, DID can be diagnosed only if the clinician or a reliable family member witnesses the claimed disruption of identity; in DSM-IV, this restriction did not apply.

Dissociative disorders involve disruptions or discontinuities in the operation and integration of many areas of psychological functioning. Which of the fol lowing is not a functional area affected in dissociative disorders?

A. Memory.

B. Consciousness.

C. Perception.

D. Delusional beliefs.

E. Emotional responses.

D. Delusional beliefs.

Which of the following statements correctly describes the meanings of the ad jectives positive and negative when applied to dissociative symptoms?

A. When applied to dissociative disorder symptoms, the adjectives positive and negative have the same meanings as they do in schizophrenia.

B. “Positive” dissociative symptoms refer to those accompanied by euphoric moods.

C. “Negative” dissociative symptoms refer to inability to access mental con tent or to control mental functions in a normal fashion.

D. “Negative” dissociative symptoms refer to the belief that one has ceased to exist.

E. The adjectives positive and negative are not appropriately applied to disso ciative symptoms because these symptoms are value neutral.

C. “Negative” dissociative symptoms refer to inability to access mental con tent or to control mental functions in a normal fashion.

Which of the following statements about depersonalization/derealization dis order is true?

A. Although transient symptoms of depersonalization/derealization are common in the general population, symptomatology that meets full criteria for depersonalization/derealization disorder is markedly less common.

B. Women are 1.5 times more likely than men to develop depersonalization/ derealization disorder.

C. Age at onset of the disorder is most commonly between 25 and 35 years.

D. During episodes of depersonalization/derealization, individuals may feel that they are “going crazy” and typically lose reality testing.

E. The most common childhood traumatic experience in persons with deper sonalization/derealization disorder is sexual abuse.

A. Although transient symptoms of depersonalization/derealization are common in the general population, symptomatology that meets full criteria for depersonalization/derealization disorder is markedly less common.

Criterion A for the diagnosis of dissociative identity disorder (DID) requires the presence of two or more distinct personality states or an experience of pos session. Which of the following symptom presentations would not qualify as a manifestation of an alternate identity?

A. An intrusive but nonhallucinatory voice that is not recognized as being part of one’s own normal thought flow.

B. Suddenly emergent strong impulses or emotions.

C. Acute changes in personal preferences in areas such as food, clothing, or even political convictions.

D. An acute sense of being in a different body, such as an adult feeling like he or she is in a child’s body.

E. A religious experience of being reborn into a new spiritual state that affects multiple domains of the individual’s behavior

E. A religious experience of being reborn into a new spiritual state that affects multiple domains of the individual’s behavior

Criterion B for the diagnosis of dissociative identity disorder (DID) requires re current gaps in the recall of everyday events, important personal information, and/or traumatic events that are inconsistent with ordinary forgetting. Which of the following statements about Criterion B–qualifying amnesia is false?

A. Gaps in recall of remote life events do not meet Criterion B definitions for amnesia.

B. It is common for individuals with DID to minimize their amnesia symp toms. C. Individuals with DID may discover evidence of their past actions or expe riences, such as finding clothing in the closet they do not recall buying, or seeing a photo of a trip they don’t recall taking.

D. Forgetting of skills such as those involved in playing a musical instrument would count as amnesia for the purposes of Criterion B.

E. Dissociative fugues in which an individual finds him- or herself in a loca tion with no memory of having traveled there are common in DID and rep resent a form of amnesia.

A. Gaps in recall of remote life events do not meet Criterion B definitions for amnesia.

Dissociative amnesia most often involves which of the following types of am nesia?

A. Continuous amnesia.

B. Permanent, irreversible amnesia.

C. Localized or selective amnesia for specific events.

D. Generalized amnesia similar to that seen in neurological toxicity.

E. Systematized amnesia.

E. Systematized amnesia.

How does DSM-5 differ from DSM-IV in its classification of dissociative fugue?

A. Unlike DSM-IV, DSM-5 allows a fugue event to be diagnosed as dissociative identity disorder (DID) if it takes place in conjunction with the symptoms of DID.

B. Unlike DSM-IV, DSM-5 allows a fugue event secondary to temporal lobe epilepsy to be diagnosed as dissociative fugue.

C. Whereas dissociative fugue was a separate diagnosis in DSM-IV, it is a spec ifier of dissociative amnesia in DSM-5 (i.e., dissociative amnesia with disso ciative fugue).

D. Unlike DSM-IV, DSM-5 recognizes that fugue states are more common in dissociative amnesia than in dissociative identity disorder.

E. Whereas DSM-IV treated dissociative fugue as an independent diagnostic entity, DSM-5 recognizes that fugue states most commonly present in the context of identity pathology.

E. Whereas DSM-IV treated dissociative fugue as an independent diagnostic entity, DSM-5 recognizes that fugue states most commonly present in the context of identity pathology.

A 7-year-old boy with mild to moderate developmental delay presents with a chronic history of wetting his clothes during the day about once weekly, even during school. He is now refusing to go to school for fear of wetting his pants and being ridiculed by his classmates. Which of the following statements accu rately describes the diagnostic options regarding enuresis in this case?

A. He should not be diagnosed with enuresis because the frequency is less than twice per week.

B. He should be diagnosed with enuresis because the incontinence is resulting in impairment of age-appropriate role functioning.

C. He should not be diagnosed with enuresis because his mental age is likely less than 5 years old.

D. He should be diagnosed with enuresis, diurnal only subtype.

E. He should not be diagnosed with enuresis because the events are restricted to the daytime.

C. He should not be diagnosed with enuresis because his mental age is likely less than 5 years old.

Which of the following statements about enuresis is true?

A. Over 60% of children diagnosed with enuresis have a comorbid DSM-5 dis order.

B. Developmental delays are no more common in children with enuresis than in other children.

C. Urinary tract infections are more common in children with enuresis.

D. While embarrassing, enuresis has no effect on children’s self-esteem.

E. Prevalence rates for enuresis at age 10 are similar to those at age 5.

C. Urinary tract infections are more common in children with enuresis.

Which of the following statements about the diurnal-only subtype of enuresis is true?

A. This subtype is more common in males.

B. This subtype is more common after age 9 years.

C. This subtype is sometimes referred to as monosymptomatic enuresis.

D. This subtype is more common than the nocturnal-only subtype.

E. This subtype includes a subgroup of individuals with “voiding postponement,” in which micturition is consciously deferred because of a social reluctance to use the bathroom or to interrupt a play activity

E. This subtype includes a subgroup of individuals with “voiding postponement,” in which micturition is consciously deferred because of a social reluctance to use the bathroom or to interrupt a play activity

Which of the following statements correctly identifies a distinction between primary enuresis and secondary enuresis?

A. Secondary enuresis is due to an identified medical condition; primary en uresis has no known etiology.

B. Children with secondary enuresis have higher rates of psychiatric comor bidity than do children with primary enuresis.

C. Primary enuresis has a typical onset at age 10, much later than the onset of secondary enuresis.

D. Primary enuresis is never preceded by a period of continence, whereas secondary enuresis is always preceded by a period of continence.

E. Unlike primary enuresis, secondary enuresis tends to persist into late ado lescence.

D. Primary enuresis is never preceded by a period of continence, whereas secondary enuresis is always preceded by a period of continence.

Which of the following statements correctly describes factors related to the eti ology and/or onset of enuresis?

A. Enuresis has been shown to be heritable, with a child being twice as likely to have the diagnosis if either parent has had it.

B. Mode of toilet training or its neglect can affect rates of enuresis, as shown by high rates seen in orphanages.

C. In girls with enuresis, nocturnal enuresis is the more common form.

D. Rates of enuresis are much higher in European countries than in developing countries.

E. The development of modern diapers is believed to speed toilet training and reduce enuresis.

B. Mode of toilet training or its neglect can affect rates of enuresis, as shown by high rates seen in orphanages.

A 6-year-old boy with mild to moderate developmental delay presents with a history of passing feces into his underwear during the day about once every 2 weeks, even during school. He is now refusing to go to school for fear of soil ing his pants and being ridiculed by his classmates. Which of the following statements accurately describes the diagnostic options regarding encopresis in this case?

A. He should not be diagnosed with encopresis because the frequency is less than twice per week.

B. He should be diagnosed with encopresis because the incontinence is result ing in impairment of age-appropriate role functioning.

C. He should not be diagnosed with encopresis because his mental age is likely less than 4 years old.

D. He should be diagnosed with encopresis.

E. He should not be diagnosed with encopresis because the events are re stricted to the daytime.

C. He should not be diagnosed with encopresis because his mental age is likely less than 4 years old.

Which of the following statements about encopresis is true?

A. When oppositional defiant disorder or conduct disorder is present, one can not diagnose encopresis.

B. When constipation is present, one cannot diagnose encopresis.

C. Urinary tract infections can be comorbid with encopresis and are more common in girls.

D. Although it is embarrassing, encopresis has no effect on children’s self esteem.

E. Prevalence rates for encopresis at age 5 are estimated to be 5%

C. Urinary tract infections can be comorbid with encopresis and are more common in girls.

Which of the following statements correctly describes clinical aspects of the di agnosis of encopresis?

A. Encopresis with constipation and overflow incontinence is often involuntary.

B. Encopresis with constipation and overflow incontinence always involves well-formed stool.

C. Encopresis with constipation and overflow incontinence cannot be diagnosed if the behavior results from avoidance of defecation that develops for psychological reasons.

D. In encopresis with constipation and overflow incontinence, leakage usually occurs during sleep.

E. Encopresis with constipation and overflow incontinence rarely resolves af ter treatment of the constipation.

E. Encopresis with constipation and overflow incontinence rarely resolves af ter treatment of the constipation.

Which of the following is a core feature of insomnia disorder?

A. Depressed mood.

B. Dissatisfaction with sleep quantity or quality.

C. Cognitive impairment.

D. Abnormal behaviors during sleep.

E. Daytime fatigue.

B. Dissatisfaction with sleep quantity or quality.

Which of the following is necessary to make a diagnosis of insomnia disorder?

A. Difficulty being fully awake after awakening.

B. Difficulty with sleep initiation or sleep maintenance, or early-morning awakening with inability to return to sleep.

C. Absence of a coexisting mental disorder.

D. Documented insufficient opportunity for sleep.

E. Persistence of sleep difficulties despite use of sedative-hypnotic agents.

B. Difficulty with sleep initiation or sleep maintenance, or early-morning awakening with inability to return to sleep.

An 80-year-old man has a history of myocardial infarction and had coronary artery bypass graft surgery 8 years ago. He plays tennis three times a week, takes care of his grandchildren 2 afternoons each week, generally enjoys life, and manages all of his activities of daily living independently; however, he complains of excessively early morning awakening. He goes to sleep at 9:00 P.M. and sleeps well, with nocturia once nightly, but wakes at 3:30 A.M. al though he would like to rise at 5:00 A.M. He does not endorse daytime sleepi ness as a problem. His physical examination, mental status, and cognitive function are normal. What is the most likely sleep-wake disorder diagnosis?

A. Insomnia disorder.

B. Rapid eye movement (REM) sleep behavior disorder.

C. Restless legs syndrome.

D. Obstructive sleep apnea hypopnea.

E. The man is a short sleeper, which is not a DSM-5 diagnosis.

E. The man is a short sleeper, which is not a DSM-5 diagnosis.

Which of the following symptoms is most likely to indicate the presence of hy persomnolence disorder?

A. Sleep inertia.

B. Nonrefreshing sleep in main sleep episode.

C. Automatic behavior.

D. Frequent napping.

E. Headache

A. Sleep inertia.

An obese 52-year-old man complains of daytime sleepiness, and his partner confirms that he snores, snorts, and gasps during nighttime sleep. What poly somnographic finding is needed to confirm the diagnosis of obstructive sleep apnea hypopnea?

A. No polysomnography is necessary.

B. Polysomnographic evidence of at least 5 apnea or hypopnea episodes per hour of sleep.

C. Polysomnographic evidence of at least 10 apnea or hypopnea episodes per hour of sleep. D. Polysomnographic evidence of at least 15 apnea or hypopnea episodes per hour of sleep.

E. Polysomnographic evidence of resolution of apneas/hypopneas with ap plication of continuous positive airway pressure.

B. Polysomnographic evidence of at least 5 apnea or hypopnea episodes per hour of sleep.

In addition to requiring recurrent sleep attacks, the diagnostic criteria for nar colepsy require the presence of cataplexy, hypocretin deficiency, or characteris tic abnormalities on sleep polysomnography or multiple sleep latency testing. Which of the following is a defining characteristic of cataplexy?

A. It is sudden.

B. It is induced by suggestion.

C. It occurs unilaterally.

D. It persists for hours.

E. It is accompanied by hypertonia.

A. It is sudden.

In DSM-IV, the diagnosis of breathing-related sleep disorder would be given to an individual complaining of excessive daytime sleepiness, with nocturnal polysomnography demonstrating episodic loss of ventilatory effort and result ing apneic episodes occurring 10–20 times per hour, whose symptoms cannot be attributed to another mental disorder, a medication or substance, or another medical condition. What is the appropriate DSM-5 diagnosis for the same in dividual?

A. Insomnia disorder.

B. Narcolepsy.

C. Obstructive sleep apnea hypopnea.

D. Central sleep apnea.

E. Other specified hypersomnolence disorder

D. Central sleep apnea.

Which of the following metabolic changes is the cardinal feature of sleep related hypoventilation?

A. Insulin resistance.

B. Hypoxia.

C. Hypercapnia.

D. Low arterial hemoglobin oxygen saturation.

E. Elevated vasopressin.

C. Hypercapnia.

A 51-year-old man presents with symptoms of chronic fatigue and excessive worrying about current life stressors. He has a strong family history of depres sion and a past history of a major depressive episode, with some improvement while maintained on antidepressants. On weekday nights, it takes him several hours to fall asleep, and he then has difficulty getting up to go to work in the morning, experiencing sleepiness for the first few hours of awake time. On weekends, he awakens later in the morning and feels less fatigue and sleepi ness. Which of the following diagnoses apply?

A. Major depressive disorder, in partial remission.

B. Generalized anxiety disorder.

C. Insomnia disorder.

D. Major depressive disorder in partial remission and circadian rhythm sleep wake disorder, delayed sleep phase type.

E. Major depressive disorder in partial remission; generalized anxiety disor der; circadian rhythm sleep-wake disorder, delayed sleep phase type; and insomnia disorder

D. Major depressive disorder in partial remission and circadian rhythm sleep wake disorder, delayed sleep phase type.

A 67-year-old woman complains of insomnia. She does not have trouble falling asleep between 10 and 11 P.M., but after 1–2 hours she awakens for several hours in the middle of the night, sleeps again for 2–4 hours in the early morn ing, and then naps three or four times during the day for 1–3 hours at a time. She has a family history of dementia. On exam she appears fatigued and has deficits in short-term memory, calculation, and abstraction. What is the most likely diagnosis?

A. Major neurocognitive disorder (NCD).

B. Circadian rhythm sleep-wake disorder, irregular sleep-wake type, and un specified NCD.

C. Narcolepsy.

D. Insomnia disorder.

E. Major depressive disorder.

B. Circadian rhythm sleep-wake disorder, irregular sleep-wake type, and un specified NCD.

Following a traumatic brain injury resulting in blindness, a 50-year-old man develops waxing and waning daytime sleepiness interfering with daytime ac tivity. Serial actigraphy (a method of measuring human activity/rest cycles) demonstrates that the time of onset of the major sleep period occurs progressively later day after day, with a normal duration of the major sleep period. What is the most likely diagnosis?

A. Circadian rhythm sleep-wake disorder, unspecified type.

B. Circadian rhythm sleep-wake disorder, delayed sleep phase type.

C. Circadian rhythm sleep-wake disorder, non-24-hour sleep-wake type.

D. Pineal gland injury.

E. Malingering.

C. Circadian rhythm sleep-wake disorder, non-24-hour sleep-wake type.

A 50-year-old emergency department nurse complains of sleepiness at work interfering with her ability to function. She recently switched from the 7 A.M. 4 P.M. day shift to the 11 P.M.–8 A.M. night shift in order to have her afternoons free. Even with this schedule change, she finds it difficult to sleep in the morn ings at home, has little energy for recreational activities or household chores in the afternoon, and feels exhausted by the middle of her overnight shift. What is the most likely diagnosis?

A. Normal variation in sleep secondary to shift work.

B. Circadian rhythm sleep-wake disorder, shift work type.

C. Bipolar disorder.

D. Insomnia disorder.

E. Hypersomnolence disorder

B. Circadian rhythm sleep-wake disorder, shift work type.

A 14-year-old girl frequently wakes in the morning with clear recollection of very frightening dreams. Once she awakens, she is normally alert and ori ented, but the dreams are a persistent source of distress. Her mother reports that the girl sometimes murmurs or groans but does not talk or move during the period before waking. Her history is otherwise notable for having been homeless and living with her mother in a series of temporary shelter accom modations for 1 year when she was 10 years old. What is the most likely diag nosis?

A. Unspecified anxiety disorder.

B. Rapid eye movement (REM) sleep behavior disorder.

C. Non–rapid eye movement sleep arousal disorders.

D. Posttraumatic stress disorder.

E. Nightmare disorder.

E. Nightmare disorder.

Which of the following is a type of non–rapid eye movement (REM) sleep arousal disorder in DSM-5?

A. REM sleep behavior disorder.

B. Sleep terrors.

C. Nightmare disorder.

D. Fugue.

E. Obstructive sleep apnea hypopnea

B. Sleep terrors.

Which of the following is a specific subtype of non–rapid eye movement sleep arousal disorder, sleepwalking type?

A. Rapid eye movement (REM) sleep behavior disorder.

B. Sleep-related seizure disorder.

C. Sleep-related sexual behavior (sexsomnia).

D. Complex motor behavior during alcoholic blackout.

E. Nocturnal panic attack.

C. Sleep-related sexual behavior (sexsomnia).

What is the difference between sleep terrors and nightmare disorder?

A. In nightmare disorder, arousal or awakening from the nightmare is incom plete, whereas sleep terrors result in complete awakening.

B. In sleep terrors, episodes are concentrated in the final hours of the sleep pe riod, whereas nightmares occur mostly early in the sleep period.

C. Sleep terrors are characterized by clear recall of vivid dreams with frighten ing content, whereas nightmares are not recalled.

D. Sleep terrors occur during rapid eye movement (REM) sleep, whereas nightmares occur in non-REM sleep.

E. Sleep terrors are precipitous but incomplete awakenings from sleep begin ning with a panicky scream or cry, with little recall, whereas nightmares are characterized by full arousal and vivid recall.

E. Sleep terrors are precipitous but incomplete awakenings from sleep begin ning with a panicky scream or cry, with little recall, whereas nightmares are characterized by full arousal and vivid recall.

What is the key abnormality in sleep physiology in rapid eye movement (REM) sleep behavior disorder?

A. REM starts earlier than normal in the sleep cycle.

B. There is more REM sleep than normal.

C. Delta wave activity is increased.

D. Skeletal muscle tone is preserved during REM sleep.

E. Total sleep time is greater than normal

D. Skeletal muscle tone is preserved during REM sleep.

Which of the following conditions is commonly associated with rapid eye movement (REM) sleep behavior disorder?

A. Attention-deficit/hyperactivity disorder.

B. Synucleinopathies.

C. Tourette’s syndrome.

D. Sleep terrors.

E. Epilepsy.

B. Synucleinopathies.

Which of the following classes of psychotropic drugs may result in rapid eye movement (REM) sleep without atonia and REM sleep behavior disorder?

A. Selective serotonin reuptake inhibitors.

B. Benzodiazepines.

C. Phenothiazines.

D. Second-generation antipsychotics.

E. Monoamine oxidase inhibitors

A. Selective serotonin reuptake inhibitors.

A 10-year-old boy is referred by his teacher for evaluation of his difficulty sit ting still in school, which is interfering with his academic performance. The boy complains of an unpleasant “creepy-crawly” sensation in his legs and an urge to move them when sitting still that is relieved by movement. This symp tom bothers him most of the day, but less when playing sports after school or watching television in the evening, and it generally does not bother him in bed at night. What aspect of his clinical presentation rules out a diagnosis of rest less legs syndrome (RLS)?

A. He is too young for a diagnosis of RLS.

B. He does not have a sleep complaint.

C. He does not complain of daytime fatigue or sleepiness.

D. His symptoms occur in the daytime as much as or more than in the evening or at night.

E. He does not have impaired social functioning.

D. His symptoms occur in the daytime as much as or more than in the evening or at night.

A 28-year-old woman who is in her thirty-fourth week of pregnancy reports that for the past few weeks she has experienced restlessness and difficulty fall ing asleep at the onset of the sleep period, as well as daytime fatigue. She works during the day and has not changed her schedule. She states that as she becomes increasingly tired, she feels more irritable and depressed. What sleep disorder is suggested by the onset of these symptoms in the third trimester of pregnancy?

A. Circadian rhythm sleep-wake disorder, delayed sleep phase type.

B. Insomnia disorder.

C. Rapid eye movement (REM) sleep behavior disorder.

D. Restless legs syndrome.

E. Hypersomnolence disorder.

D. Restless legs syndrome.

Which of the following sleep disturbances or disorders occurs during rapid eye movement (REM) sleep?

A. Nightmare disorder.

B. Confusional arousals.

C. Sleep terrors.

D. Obstructive sleep apnea hypopnea.

E. Central sleep apnea.

A. Nightmare disorder.

Which of the following sleep disturbances is associated with chronic opiate use?

A. Excessive daytime sleepiness.

B. Insomnia.

. Periodic limb movements in sleep.

D. Obstructive sleep apnea hypopnea.

E. Parasomnias.

B. Insomnia.

Which of the following substances is associated with parasomnias?

A. Cannabis.

B. Zolpidem.

C. Methadone.

D. Cocaine.

E. Mescaline.

B. Zolpidem.

A psychiatric consultation is requested for evaluation and help with manage ment of severe insomnia in a 65-year-old man, beginning the day after elective hip replacement surgery and continuing for 2 days. On evaluation the patient acknowledges heavy drinking until the day before surgery, and he appears to be in alcohol withdrawal, with autonomic instability, confusion, and tremor. Why would a diagnosis of substance/medication-induced sleep disorder be inappropriate in this situation?

A. The insomnia is an understandable emotional reaction to the anxiety pro voked by having surgery.

B. The insomnia is not causing functional impairment.

C. The insomnia has not been documented with polysomnography or actigra phy.

D. The insomnia is occurring during acute alcohol withdrawal.

E. The insomnia might be related to postoperative pain

D. The insomnia is occurring during acute alcohol withdrawal.

A 56-year-old college professor complains of having difficulty sleeping for more than 5 hours per night over the past few weeks, leaving her feeling tired in the daytime. She awakens an hour or two before her intended waking time in the morning, experiencing restless sleep with frequent awakenings until it is time to get up. She does not have initial insomnia and is not depressed. The pa tient attributes the sleep trouble to intrusive thoughts that arise, after she ini tially awakens momentarily, about the need to complete an overdue academic project. What is the most appropriate diagnosis?

A. Adjustment disorder with anxious mood.

B. Obsessive-compulsive personality disorder.

C. Insomnia disorder.

D. Other specified insomnia disorder (brief insomnia disorder).

E. Unspecified insomnia disorder.

D. Other specified insomnia disorder (brief insomnia disorder).

A 74-year-old woman has a history of daytime sleepiness interfering with her ability to carry out her daily routine. She reports that it has become progres sively worse over the past year. Polysomnography reveals sleep apnea without evidence of airway obstruction with two or three apneic episodes per hour. What is the most appropriate diagnosis?

A. Central sleep apnea.

B. Other specified sleep-wake disorder (atypical central sleep apnea).

C. Unspecified sleep-wake disorder.

D. Rapid eye movement (REM) sleep behavior disorder.

E. Circadian rhythm sleep-wake disorder.

B. Other specified sleep-wake disorder (atypical central sleep apnea).

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.

E. A strong desire for the primary and/or secondary sex characteristics that match one’s experienced gender

B. A strong desire to be of the other gender or an insistence that one is the other gender.

Which of the following statements about the diagnosis of gender dysphoria in adolescents and adults is true?

A. The “posttransition” specifier is used to indicate that the individual has undergone or is pursuing treatment procedures to support the new gender assignment.

B. To qualify for the diagnosis, the individual must be pursuing some kind of sex reassignment treatment.

C. To qualify for the diagnosis, the individual must have a strong desire to be the other gender or must insist that he or she is the other gender.

D. To qualify for the diagnosis, the individual must have an associated disor der of sex development.

E. To qualify for the diagnosis, the individual must engage in cross-dressing behavior

A. The “posttransition” specifier is used to indicate that the individual has undergone or is pursuing treatment procedures to support the new gender assignment.

Which of the following statements about gender is true?

A. An individual’s gender cannot always be predicted from his or her biological indicators.

B. An individual’s gender is determined by cultural factors.

C. An individual’s gender is determined by assignment at birth (natal gender).

D. An individual’s gender is determined by psychological factors.

E. An individual’s gender cannot be determined when there is a concurrent disorder of sexual development.

A. An individual’s gender cannot always be predicted from his or her biological indicators.

What new DSM-5 diagnosis has re placed the former DSM-IV diagnosis of gen der identity disorder?

A. Gender aversion disorder.

B. Gender dysmorphic disorder.

C. Gender dysphoria.

D. Cross-gender identity disorder.

E. Gender incongruence.

C. Gender dysphoria.