Abnormal

Premature Ejaculation

Persistent or recurrent ejaculation within about one minute of vaginal penetration (or before desired), present for ≥ 6 months on almost all occasions, causing distress; often treated with start-stop or squeeze techniques.

Prognosis for Schizophrenia

More favorable when there is good premorbid adjustment, acute and later onset, female gender, precipitating event, brief active-phase duration, insight, family history of mood disorder, and no family history of schizophrenia.

Reactive Attachment Disorder

Inhibited, emotionally withdrawn behavior toward caregivers with minimal comfort-seeking, linked to extreme insufficient care; symptoms evident before age 5 and developmental age ≥ 9 months.

Risk Factors for Suicide

Warning signs, prior attempts, lethal plan, male gender, divorced/separated/widowed status, hopelessness; highest rates in Whites (except AI/AN ages 15-34), and with Major Depression or Bipolar Disorder; attempters more often female.

Schizoid Personality Disorder

Pervasive detachment and restricted emotion, with ≥ 4 features such as preferring solitude, little interest in sex, few pleasures, no close friends, indifference to praise/criticism, emotional coldness.

Schizophrenia

At least two active-phase symptoms (e.g., delusions, hallucinations, disorganized speech) for ≥ 1 month, continuous disturbance ≥ 6 months, functional impairment; treatment includes antipsychotics, CBT, psychoeducation, social skills, supported employment, family interventions.

Schizophreniform Disorder

Same symptom criteria as schizophrenia but duration ≥ 1 month and < 6 months; functional impairment may occur but is not required.

Schizotypal Personality Disorder

Social/interpersonal deficits with acute discomfort and reduced capacity for close relationships plus ≥ 5 eccentric features (ideas of reference, magical thinking, odd perceptions, constricted affect, no close friends, suspicions, inappropriate affect, social anxiety).

Separation Anxiety Disorder

Developmentally inappropriate, excessive fear of separation from home or attachment figures with ≥ 3 symptoms; lasts ≥ 4 weeks in youth or ≥ 6 months in adults and causes distress/impairment.

Social Anxiety Disorder

Intense fear of social scrutiny; fears negative evaluation of anxiety symptoms, leads to avoidance or endured distress; disproportionate to threat, persistent, and impairing; exposure with response prevention (plus social skills or cognitive restructuring) is effective.

Specific Learning Disorder

Persistent (≥ 6 months) difficulties in academic skills below age expectations despite interventions, interfering with daily life, began during school years, and not better explained by other conditions.

Specific Phobia

Marked fear or anxiety about a specific object/situation, avoided or endured with distress, disproportionate to threat, lasting ≥ 6 months and impairing; in-vivo exposure with response prevention is treatment of choice.

Substance-Induced Disorders

Substance Intoxication, Withdrawal, or Substance/Medication-Induced Mental Disorders—temporary but sometimes persistent CNS syndromes caused by substances, medications, or toxins (e.g., induced psychotic, depressive, neurocognitive disorders).

Substance Use Disorders

Maladaptive pattern of substance use with ≥ 2 symptoms (e.g., larger amounts, failed cut-down attempts, craving, continued use despite problems, risky use, tolerance, withdrawal) occurring within 12 months.

Tobacco Use Disorder / Smoking Cessation Interventions

Long-term abstinence most likely when treatment combines nicotine replacement, multicomponent behavioral therapy (skills training, relapse prevention, stimulus control, rapid smoking), and clinician support.

Tobacco Withdrawal

Within 24 hrs of stopping/reducing tobacco use, ≥ 4 symptoms appear: irritability/anger, anxiety, impaired concentration, increased appetite, restlessness, depressed mood, insomnia.

Tourette's Disorder

Multiple motor tics and at least one vocal tic present for > 1 year (waxing and waning) with onset before age 18.

Uncomplicated Bereavement

Normal reaction to loss of a loved one; may mimic depressive symptoms but perceived as normal by the individual, who may seek help for associated issues like insomnia or anorexia.

Vascular Neurocognitive Disorder

Major or Mild Neurocognitive Disorder due to cerebrovascular disease, evident via history, exam, or imaging; course may involve acute onset with partial recovery, stepwise decline, or fluctuating progression.

Acute Stress Disorder

At least nine stress-related symptoms (intrusion, negative mood, dissociation, avoidance, arousal) lasting 3 days–1 month after exposure to a traumatic event and causing distress/impairment.

Adjustment Disorders

Emotional or behavioral symptoms within 3 months of an identifiable stressor; out of proportion distress or impairment; resolve within 6 months after stressor ends.

Agoraphobia

Marked fear/anxiety about ≥2 situations (public transport, open/enclosed spaces, crowds, being outside alone) because escape/help may be difficult; situations avoided or endured with intense fear; causes distress/impairment.

Alcohol Withdrawal

≥2 symptoms (e.g., autonomic hyperactivity, tremor, insomnia, nausea, hallucinations, seizures) within hours–days after reducing/ceasing heavy alcohol use.

Korsakoff Syndrome

Amnestic-confabulatory alcohol-induced major neurocognitive disorder linked to thiamine deficiency with anterograde and retrograde amnesia plus confabulation.

Alcohol-Induced Sleep Disorder

Usually insomnia type, due to alcohol intoxication or withdrawal.

Anorexia Nervosa

Restriction leading to significantly low weight, intense fear of gaining weight, and body-image disturbance or lack of recognition of seriousness.

Antisocial Personality Disorder

Pattern of disregard for and violation of others’ rights since age 15 with ≥3 symptoms (law-breaking, deceit, impulsivity, reckless disregard, lack of remorse); diagnosis at age ≥18 and history of Conduct Disorder before 15.

Attention-Deficit/Hyperactivity Disorder (ADHD)

≥6 inattention and/or ≥6 hyperactivity-impulsivity symptoms before age 12, present in ≥2 settings, causing social/academic/occupational impairment; in adults, inattention predominates.

Autism Spectrum Disorder

Persistent social communication/interaction deficits plus restricted/repetitive behaviors; onset in early development; impairment; best prognosis with speech by age 5–6, IQ > 70, later onset.

Avoidant Personality Disorder

Pervasive social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation; ≥4 symptoms such as avoiding interpersonal work tasks, unwillingness to get involved unless liked, viewing self as socially inept.

Behavioral Pediatrics (Hospitalization)

Children 1–4 show most negative reactions to hospitalization; chronic illness linked to school problems; adolescents often noncompliant with medical regimens.

Behavioral Theory of Depression (Lewinsohn)

Depression results from a low rate of response-contingent reinforcement.

Bipolar I Disorder

At least one 1-week manic episode with ≥3 manic symptoms causing marked impairment/hospitalization/psychosis; may include hypomanic or depressive episodes; treated with lithium/antiseizure meds and CBT.

Bipolar II Disorder

At least one hypomanic episode (≥4 days, ≥3 manic symptoms, no marked impairment) and one major depressive episode (≥2 weeks, ≥5 symptoms with depressed mood or anhedonia).

Borderline Personality Disorder

Pervasive instability of relationships, self-image, affect, plus impulsivity; ≥5 symptoms such as frantic avoidance of abandonment, unstable intense relationships, identity disturbance, self-harm threats.

Brief Psychotic Disorder

Delusions, hallucinations, disorganized speech, and/or catatonic/disorganized behavior for ≥1 day but <1 month with return to premorbid functioning.

Bulimia Nervosa

Recurrent binge eating with loss of control, inappropriate compensatory behaviors, and self-evaluation overly influenced by weight/shape.

Concordance Rates for Schizophrenia

Genetic similarity correlates with risk: ~10 % for siblings, 48 % for monozygotic twins.

Conduct Disorder

Persistent behavior violating others’ rights/social norms with ≥3 symptoms in past 12 months (aggression, property destruction, deceit/theft, rule violations); not diagnosed if criteria met for Antisocial PD and age > 18.

Conversion Disorder

Motor or sensory symptoms incompatible with recognized medical/neurological conditions (e.g., paralysis, seizures, blindness).

Cyclothymic Disorder

≥2 years (1 year in youth) of fluctuating hypomanic symptoms and depressive symptoms that never meet full episode criteria; causes distress/impairment.

Delirium

Acute fluctuating disturbance in attention/awareness plus cognitive deficit due to medical condition, substance, or toxin; not during coma.

Delusional Disorder

One or more delusions ≥1 month; overall functioning not markedly impaired; subtypes include erotomanic, grandiose, jealous, persecutory, somatic, mixed.

Dependent Personality Disorder

Excessive need to be taken care of leading to submissive, clinging behavior and separation fear; ≥5 symptoms (difficulty making decisions, fears disagreement, goes to extremes for support, etc.).

Depressive Cognitive Triad (Beck)

Negative views of self, world, and future characteristic of depression.

Dialectical Behavior Therapy (DBT)

Linehan’s treatment for Borderline PD combining group skills training, individual therapy, and phone coaching to reduce self-harm and improve emotion regulation.

Diagnostic Uncertainty (DSM-5)

Code Other Specified Disorder when giving reason symptoms don’t meet criteria; Unspecified Disorder when not specifying reason.

Dissociative Amnesia

Inability to recall important personal info (often trauma-related) beyond normal forgetting; causes distress/impairment; localized and selective are common forms.

Dopamine Hypothesis

Schizophrenia attributed to excess dopamine or receptor sensitivity.

DSM-5 Features

Categorical, polythetic criteria sets; nonaxial listing of mental and medical diagnoses with primary diagnosis first.

Enuresis

Involuntary/intentional urine voiding ≥2 ×/week for 3 months in age ≥5; treated commonly with bell-and-pad urine alarm.

Erectile Disorder

Difficulty obtaining, maintaining, or rigidity of erection on most occasions; at least one symptom consistently.

Expressed Emotion (EE) and Schizophrenia

High family EE (criticism, hostility, overinvolvement) predicts higher relapse risk in schizophrenia.

Factitious Disorder

Falsification of symptoms (self or another) without external incentives; includes feigning, exaggerating, inducing symptoms.

Gender Dysphoria

Marked incongruence between assigned and experienced gender ≥6 months causing distress; specified criteria differ for children vs. adolescents/adults.

Generalized Anxiety Disorder (GAD)

Excessive, hard-to-control worry most days ≥6 months about various topics with ≥3 physical/cognitive symptoms; CBT ± meds is typical treatment.

Genito-Pelvic Pain/Penetration Disorder

Persistent difficulties with vaginal penetration, pelvic pain, fear/anxiety, or pelvic floor tension during intercourse attempts.

Histrionic Personality Disorder

Pervasive emotionality and attention-seeking with ≥5 symptoms (discomfort when not center, seductive behavior, shallow emotions, uses appearance for attention, perceives intimacy).

Insomnia Disorder

Difficulty initiating/maintaining sleep or early awakening ≥3 nights/week for ≥3 months despite opportunity; causes distress/impairment.

Intellectual Disability

Deficits in intellectual and adaptive functioning with onset during development; severity (mild–profound) based on adaptive functioning domains.

Learned Helplessness Model

Seligman’s theory: exposure to uncontrollable negative events + internal, stable, global attributions leads to depression; reformulated to emphasize hopelessness.

Major Depressive Disorder

≥5 symptoms of major depressive episode (incl. depressed mood or anhedonia) nearly daily ≥2 weeks causing distress/impairment; treated with CBT and antidepressants.

MDD with Peripartum Onset

MDD (or Bipolar I/II) episode beginning during pregnancy or within 4 weeks postpartum; may include anxiety or infant-related psychosis.

MDD with Seasonal Pattern (SAD)

Regular temporal relationship between mood episodes and season (often winter); features include hypersomnia, increased appetite, carb craving.

Major vs. Mild Neurocognitive Disorder

Major: significant cognitive decline interfering with independence; Mild: modest decline not interfering; various etiologies (Alzheimer’s, vascular, etc.).

Malingering

Intentional production/exaggeration of symptoms for external gain (e.g., legal, financial).

Marlatt & Gordon Relapse Prevention

Views addiction as overlearned habit; therapy identifies high-risk situations and teaches cognitive-behavioral coping to prevent/handle lapses.

Narcissistic Personality Disorder

Grandiosity, need for admiration, lack of empathy with ≥5 symptoms (self-importance, fantasies, entitlement, envy, etc.).

Narcolepsy

Irresistible sleep attacks ≥3 ×/week for ≥3 months plus cataplexy, hypocretin deficiency, or short REM latency.

Neurocognitive Disorder due to Alzheimer’s Disease

Major/Mild NCD with insidious onset, gradual progression, Alzheimer’s criteria met; stages: 1 anterograde amnesia, 2 increasing retrograde and behavioral changes, 3 severe decline and incontinence.

Non-REM Sleep Arousal Disorders

Sleepwalking and/or sleep terrors during first third of sleep; limited recall; causes distress/impairment.

Obsessive-Compulsive Disorder (OCD)

Intrusive obsessions and/or compulsions that are time-consuming or cause distress/impairment; best treated with exposure + response prevention and SSRIs/clomipramine.

Obsessive-Compulsive Personality Disorder

Preoccupation with orderliness, perfectionism, control limiting flexibility; ≥4 symptoms (perfectionism interfering with tasks, rigidity, miserly spending, etc.).

Opioid Withdrawal

After stopping/reducing heavy opioid use: ≥3 symptoms (dysphoric mood, nausea, muscle aches, lacrimation, dilated pupils, diarrhea, yawning, fever, insomnia).

Oppositional Defiant Disorder

Angry/irritable mood, argumentative/defiant behavior, or vindictiveness with ≥4 symptoms toward non-sibling lasting ≥6 months.

Outline for Cultural Formulation

DSM-5 guidelines assessing cultural identity, conceptualization of distress, psychosocial stressors/resilience, and client-therapist cultural dynamics.

Panic Disorder

Recurrent unexpected panic attacks plus ≥1 month worry about attacks or maladaptive behavior change; CBT with exposure is treatment-of-choice.

Paranoid Personality Disorder

Pervasive distrust/suspiciousness interpreting others as malevolent; ≥4 symptoms (suspects exploitation, reads hidden threats, holds grudges, unjustified jealousy).

Paraphilic Disorders

Persistent, intense sexual interests other than consensual genital stimulation with adults, causing distress or harm (e.g., voyeuristic, exhibitionistic, pedophilic).

Persistent Depressive Disorder (Dysthymia)

Depressed (or irritable) mood most days ≥2 years (1 year in youth) with ≥2 additional symptoms (low energy, insomnia, low self-esteem, hopelessness, etc.) never absent >2 months.

Posttraumatic Stress Disorder (PTSD)

Trauma exposure plus intrusion, avoidance, negative mood/cognition changes, and arousal alterations >1 month causing distress/impairment; treated with CBT including exposure and cognitive restructuring.