Quiz 1 DSM-5: Neurodevelopmental Disorders/Schizophrenia spectrum

Neurodevelopmental Disorders

ONSET early childhood. Characterized by deficits that produce impairments of personal, social, academic or occupational functioning.

Attention-Deficit/Hyperactivity Disorder definition:

A persistent pattern of inattention and/ or hyperactivity-impulsivity that interferes with functioning or development

ADHD is characterized by one or both of what two criteria

Inattention and/or Hyperactivity and Impulsivity

What is a screening question for ADHD if the client is a child?

Is your child restless, always on the go, impulsive and or unable to focus on the task at hand?

What is the screening question for ADHD if the client is an adult?

Have hyperactivity and distractibility been problems for you, going as far back as you can remember?

T or F

Comorbidity is uncommon with ADHD

False- it is very frequent with clients whose symptoms meet criteria for ADHD

ADHD co occurs in about 50 percent of clients that are diagnosed with which disorder?

Oppositional defiant disorder

T or F

ADHD is more frequent in females than in males in the general population at a 2:1 ratio.

False- It is more frequent in males

T or F

ADHD is most often identified in elementary school years.

True

Provisional Tic Disorder

A. Single or multiple and/or vocal tics

Example:

A child has significant problems understanding words and ideas and has a slow reading speed.

Intellectual Disability/ Intellectual Developmental Disorder

Example:

A 9 year old girl is often distracted, forgetful, often late to class, and is very disorganized even for her age.

Attention-Deficit Disorder (inattention)

Example:

A 10 year old boy does not make eye contact in social settings, inflexible and ritualized in his playtime and avoids the other children around him.

Autism Spectrum Disorder

Example:

A 4-year old girl is very behind from the development of her peers, does not walk well, and speaks very little. She also cannot control her own emotions well.

Global Developmental Delay Disorder

(because she is under the age of 5 and cannot be tested for other disorders)

Mild Intellectual Development Disorder

Example:

A 14-year old boy has difficulty in school with all of his classes, enjoys social time but often does not understand social settings and often is made fun of because of his gullibility. He is also very forgetful with hygiene and personal care.

Example:

A 12-year old boy will only talk about elevators and trains with his peers or adults; any other topic and he will walk away without saying anything to the person.

Autism Spectrum Disorder

Example:

A 10-year old boy has difficulty writing down his name or numbers, and walks with difficulty, very wobbly. However, all of his verbal responses are correct when he answers problems in math class. He does not like playing sports or games with balls during recess.

Developmental Coordination Disorder

Example:

A 12 year old boy avoids answering questions in class. When he does, he stumbles with his words, blinks rapidly, his head shakes, and he often repeats the last word he speaks.

Tic Disorder, Tourette's Disorder

Example:

A 9 year old girl rocks back and forth in her chair or the ground at the beginning of class, and before she begins any new activity in class. It happens so often that the other children often make fun of her or expect her to do this.

Stereotypic Movement Disorder

(without self-injurious behavior)

Example:

A 14 year old girl does not understand jokes or humor of her peer group, still takes literal meanings from metaphors, makes good grades in school, desires friends and relationships, but has difficulty following social rules of conversation.

Social (Pragmatic) Communication Disorder

Example:

Joanne is 28 years old and has had a history of hospitalization due to schizophrenic symptoms. Recently, she has had a suicide attempt due to a very deep depressive episode on top of hearing voices. Very few people can understand her because her speech does not make sense.

Schizoaffective Disorder

Example:

A 30 year old male patient is very distressed because he believes a doctor last night has gone in and taken all of his organs and replaced them with someone else's organs. When asked where the scars are he is positive the doctor has powers to do so without causing scarring. This patient's therapist has heard many other irrational beliefs and complex stories that causes the patient distress in the last few weeks. Besides these beliefs, there are no other abnormal symptoms.

Delusional Disorder

Example:

Jon (23) is very distressed that his girlfriend is trying to poison him anytime she cooks for him. Even when they eat at restaurants, he believes she has the cooks there in on her secret. When asking him how he knows she is poisoning him he says that his friends tell him every time something is poisoned before he eats. These friends no one else can see, but Jon can see and hear them. The girlfriend is particularly upset because their relationship was just great, and he was acting totally normal until a couple months ago. Now he won't eat anything when they are together.

(in another month all the symptoms go away)

Schizophreniform Disorder

Screening Question:

Do you ever hear voices, believe that people mean to harm you, or lose touch with reality?

Schizophrenia

Example:

A 19 year old male is brought into into the campus hospital by his roommates. All they know is that he went to a party with a new friend and he came home acting very strange, screaming, and claiming to see things that were dangerous.

Substance/Medication-Induced Psychotic disorder

Screening Question:

Do you ever hear voices, believe that people mean to harm you, or lose touch with reality? Do you have mood swings?

Schizoaffective disorder

Screening Question::

Do people ever say you have really strange ideas?

Delusional Disorder

Screening Questions:

Do you have strange experiences when you are under the influence of drugs or alcohol?

Substance/Medication-Induced Psychotic disorder

Example:

A client holds themselves for hours depending on the last time they were touched by someone else. They are also unable to speak and rarely blink.

There is no history of bipolar or schizophrenia.

Catatonia Associated with another mental disorder

Example:

Ned's (17) teachers complain of him constantly falling asleep in class for the last semester. When his parents ask him about it, he says he has trouble sleeping because of bad dreams. The people in these dreams wake him up and actually talk with him, but his parents don't know that. Last month he finally was accused of stalking last year's prom queen, convinced that she was in love with him. She filed for a protection order against him and changed schools. His parents have always worried about him because he has an uncle who is institutionalized and they don't want his quirkiness to be misdiagnosed for that.

Schizophrenia

Example:

Molly (29) is 4 months along in her second pregnancy when she is all the sudden unable to speak normally, and is very disturbed by hearing her neighbors who are out of town's voices all through the house. Her husband is freaked out because this has never happened before. Within a week, she is able to speak again and stops hearing these voices.

Brief Psychotic Disorder

Intellectual Disability

Impacts conceptual, social and practical domains (does impact academics but more so impairs everyday functioning); risk of victimization and niavity

Low IQ that impacts all areas

Global Developmental Delay

Under age of 5 years and cannot be tested;

Major developmental milestones delayed

Language Disorder

Reduced vocabulary and sentence structure and lacks ability to write and speak in conversation

Reduced ability to understand and converse

Speech Sound Disorder

Difficulty actually making the speech sounds/ lisping/misarticulation

Difficulty actually physically pronouncing the words

Childhood-Onset Fluency Disorder (stuttering)

Disturbances in normal flow or speaking pattern for their age; sound and syllable repetition or broken words

Difficulty pronouncing words due to stuttering

Social (Pragmatic) Communication Disorder

Deficits in using communication for social purposes with social language/non-verbal rules; doesn't understand metaphors etc.

Difficulty speaking with social skills

Autism Spectrum Disorder

Deficits that impact ability to converse, social interaction, desire for social interaction, fixated interests, inflexibility, ritualized behaviors, hyper sensory, lacking eye contact

Does not understand or desire relationships

Attention-Deficit/Hyperactivity Disorder

Can have both hyperactivity/impulsive symptoms and inattention or either. Must be from childhood and impact negatively life.

Inability to focus/impulsivity or hyperactivity that impacts life

Specific Learning Disorder

Can have high IQ so not intelligence impacted, but specific areas of academics they struggle with. *Dyslexia is common

Dyslexia is an example

Developmental Coordination Disorder

Poor coordination for age level; bad handwriting, poor sports skills, weird walking that impacts self-care, leisure and social

Walking, handwriting and all general motor skills impacted

Stereotypic Movement Disorder

Repetitive, purposeless motor behavior (shaking, body rocking, biting, head banging etc.)

Repetitive purposeless movement that can injure or not

Tourette's Disorder

Before 18

Both motor and vocal tics for more than a yea

Persistent Chronic Motor or Vocal Tic Disorder

Before 18

Either motor or vocal, not both; for more than a year

Provisional Tic Disorder

Before 18

Either motor or vocal or both; less than a year

Delusional Disorder

Only delusions

Brief Psychotic Disorder

All symptoms besides negative (anhedonia/lack of emotion express/avolition) less than 1 month

Schizophreniform Disorder

All symptoms AND negative symptoms

More than 1 month, less than 6 months

Schizophrenia

All symptoms AND negative symptoms

More than 6 months

Schizoaffective Disorder

mood disorder (bipolar or MDD) + schizophrenia symptoms