Simplified DSM-5 Study Guide – Vocabulary Flashcards

Anxiety Disorders

• Core features

  • Excessive fear and anxiety with related behavioral and physiological disturbances
  • Fear = emotional response to real/perceived imminent threat → arousal for fight/flight, thoughts of immediate danger, escape behaviors
  • Anxiety = anticipation of future threat → muscle tension, vigilance, cautious/avoidant behaviors
  • Panic attack = discrete surge of intense fear/discomfort; can be expected (trigger-bound) or unexpected (no clear trigger)
  • Disorders distinguished by content of fear/avoidance and associated cognitions
  • Transient anxiety vs. disorder: persistence \ge 6\,\text{months}, excessiveness, functional impairment
  • Sex ratio ≈ \text{Female} : \text{Male} = 2:1

• Diagnostic entities (key criteria only)

  • Generalized Anxiety Disorder (GAD)
  • Persistent, excessive worry across multiple domains, difficulty controlling the worry
  • Somatic symptoms: restlessness, fatigue, concentration problems, irritability, muscle tension, sleep disturbance
  • Panic Disorder
  • Recurrent unexpected panic attacks
  • Persistent concern/worry about additional attacks or consequences and/or maladaptive behavior change
  • Agoraphobia
  • Marked fear/avoidance of ≥2 “unsafe” situations (public transport, open/enclosed spaces, crowds, outside home alone) where escape/help may be difficult
  • Specific Phobia
  • Circumscribed fear/avoidance out of proportion to actual risk
  • Sub-types: animal, natural-environment, blood-injection-injury, situational, other
  • Social Anxiety Disorder (Social Phobia)
  • Fear/avoidance of social interactions/performances with potential scrutiny; cognitive theme = negative evaluation/offending others
  • Separation Anxiety Disorder
  • Developmentally inappropriate anxiety regarding separation from attachment figures; nightmares, somatic complaints possible
  • Selective Mutism
  • Consistent failure to speak in certain social situations despite speaking in others; impacts achievement/social communication
  • Substance/Medication-Induced Anxiety Disorder
  • Anxiety symptoms attributable to intoxication, withdrawal, or med exposure
  • Anxiety Disorder Due to Another Medical Condition
  • Other Specified / Unspecified Anxiety Disorder (limited-symptom, insufficient info, etc.)

Trauma- and Stressor-Related Disorders

• Shared requirement: exposure to traumatic or stressful event → prominent anhedonic/dysphoric, aggressive or dissociative symptoms

• Greater prevalence in females; social neglect in childhood = risk for cognitive/language delays, stereotypies, attachment problems

• Disorders

  • Reactive Attachment Disorder (RAD)
  • Emotionally withdrawn behavior toward caregivers; depressive sx; stems from extreme neglect
  • Disinhibited Social Engagement Disorder (DSED)
  • Culturally inappropriate, overly familiar approach to strangers; neglect etiology
  • Post-Traumatic Stress Disorder (PTSD)
  • After trauma: clusters of intrusion, avoidance, negative mood/cognition, arousal/reactivity
  • Acute Stress Disorder
  • PTSD-like sx 3\,\text{days} – 1\,\text{month} post-trauma
  • Adjustment Disorders
  • Emotional/behavioral sx in response to identifiable stressor; onset within 3\,\text{months}
  • Other Specified / Unspecified Trauma & Stressor Disorders (e.g., persistent complex bereavement, ataque de nervios)

Obsessive-Compulsive & Related Disorders

• Core: obsessions (intrusive thoughts/urges/images) and/or compulsions (repetitive behaviors/mental acts aimed at reducing anxiety)

• Disorders

  • Obsessive-Compulsive Disorder (OCD): common dimensions—cleaning, symmetry, forbidden thoughts, harm
  • Body Dysmorphic Disorder: preoccupation with imagined defects; repetitive checking, grooming
  • Hoarding Disorder: perceived need to save items, distress with discarding
  • Trichotillomania: recurrent hair pulling → hair loss
  • Excoriation (Skin-Picking) Disorder: recurrent skin picking → lesions
  • Substance/Medication-Induced OCD-Like Disorder
  • OCD & Related Disorder Due to Medical Condition
  • Other Specified / Unspecified OCD-Related Disorder (e.g., obsessional jealousy)

Somatic Symptom & Related Disorders

• Focus on positive somatic symptoms + maladaptive thoughts/feelings/behaviors

• Common in primary care; high comorbidity with depression/anxiety

• Disorders

  • Somatic Symptom Disorder: multiple distressing sx ± medical explanation; high health anxiety, checking
  • Illness Anxiety Disorder: preoccupation with serious illness, minimal somatic sx
  • Conversion Disorder (Functional Neurological): neurological deficits incompatible with known pathology
  • Factitious Disorder: falsification of illness for sick-role without external incentives
  • Psychological Factors Affecting Other Medical Conditions
  • Other Specified / Unspecified Somatic Symptom Disorders (brief forms, pseudocyesis, etc.)

Dissociative Disorders

• Disruption in integration of consciousness, memory, identity, perception

• Positive symptoms: fragmentation, depersonalization, derealization; Negative: amnesia

• Disorders

  • Depersonalization/Derealization Disorder: persistent experiences with intact reality testing
  • Dissociative Amnesia: inability to recall autobiographical info; may include fugue
  • Dissociative Identity Disorder: ≥2 distinct personality states + amnesia
  • Other Specified / Unspecified Dissociative Disorders

Depressive Disorders

• Core mood = sad/empty/irritable + cognitive & somatic changes

• Grief vs. depression distinction (emptiness vs. persistent depressed mood)

• Disorders

  • Disruptive Mood Dysregulation Disorder: chronic severe irritability, temper outbursts
  • Major Depressive Disorder: ≥2 weeks depressed mood/ anhedonia + 4 other sx
  • Persistent Depressive Disorder (Dysthymia): depressed mood ≥ 2\,\text{years}, no break >2\,\text{months}
  • Premenstrual Dysphoric Disorder: cyclical mood & physical sx in luteal phase
  • Substance/Medication-Induced Depressive Disorder
  • Depressive Disorder Due to Medical Condition
  • Other Specified / Unspecified Depressive Disorder

• Specifiers: anxious distress, mixed, melancholic, atypical, psychotic, catatonia, peripartum, seasonal; remission & severity qualifiers

Bipolar & Related Disorders

• Episode definitions

  • Manic: ≥1\,\text{week} elevated/irritable mood + ↑ energy + 3 additional sx (any duration if hospitalized)
  • Hypomanic: ≥4\,\text{days} similar but less severe; no marked impairment/hospitalization
  • Major Depressive: as above

• 75% comorbidity with anxiety

• Disorders

  • Bipolar I: ≥1 manic episode (MDE or hypomania optional)
  • Bipolar II: ≥1 hypomanic + ≥1 MDE, no mania
  • Cyclothymic: ≥2\,\text{years} of sub-threshold hypomanic & depressive sx present ≥50% of time
  • Substance/Medication-Induced Bipolar Disorder (watch for treatment-emergent mania)
  • Bipolar Due to Medical Condition (e.g., Cushing’s, MS, TBI)
  • Other Specified / Unspecified Bipolar Disorders

• Specifiers: anxious distress, mixed, rapid-cycling, melancholic, atypical, psychotic, catatonia, peripartum, seasonal; remission & severity

Schizophrenia Spectrum & Other Psychotic Disorders

• 5 symptom domains

  • Delusions (persecutory, grandiose, somatic, bizarre …)
  • Hallucinations (auditory > visual, clear sensorium)
  • Disorganized thinking/speech (derailment, tangentiality, incoherence)
  • Grossly disorganized or catatonic behavior
  • Negative symptoms (diminished expression, avolition, etc.)

• High substance & anxiety comorbidity

• Disorders

  • Schizotypal Personality Disorder (listed here & in personality cluster A)
  • Delusional Disorder: ≥1 month delusions only
  • Brief Psychotic Disorder: 1 day–<1\,\text{month} positive sx
  • Schizophreniform: 1–<6\,\text{months} schizophrenia-like; no decline required
  • Schizophrenia: ≥6\,\text{months} with ≥1 month active-phase, functional decline
  • Schizoaffective: mood episode + psychosis with ≥2 weeks psychosis alone
  • Substance/Medication-Induced Psychotic Disorder
  • Psychotic Disorder Due to Medical Condition
  • Catatonia (specifier, due to medical condition, unspecified)
  • Other Specified / Unspecified Psychotic Disorders

Personality Disorders

• General: pervasive, inflexible patterns starting by adolescence/early adulthood, across contexts, distress/impairment, not due to another disorder/condition
• Cluster A (odd/eccentric): Paranoid, Schizoid, Schizotypal (≥4 criteria each except Paranoid =4, Schizoid=4, Schizotypal=4)
• Cluster B (dramatic): Antisocial (≥3), Borderline (≥5), Histrionic (≥5), Narcissistic (≥5)
• Cluster C (anxious): Avoidant (≥4), Dependent (≥5), Obsessive-Compulsive (≥4)
• Personality Change Due to Medical Condition
• Other Specified / Unspecified Personality Disorder (mixed, passive-aggressive, etc.)

Feeding & Eating Disorders

• Persistent disturbances in eating/food absorption impacting health or psychosocial fxn; obesity not mental disorder but correlated

• Disorders: Pica, Rumination, Avoidant/Restrictive Food Intake Disorder, Anorexia Nervosa (restricting vs. binge/purge), Bulimia Nervosa, Binge-Eating Disorder, Other Specified / Unspecified Feeding or Eating Disorders

Elimination Disorders

• Enuresis: urine voiding ≥2×/week for 3\,\text{months}, age ≥5
• Encopresis: feces passage 1×/month for 3\,\text{months}, age ≥4
• Other Specified / Unspecified Elimination Disorder

Sleep-Wake Disorders

• Dissatisfaction with sleep quantity/quality; includes dyssomnias & parasomnias
• Insomnia, Hypersomnolence, Narcolepsy, Breathing-related (Obstructive & Central Apnea, Hypoventilation), Circadian Rhythm Disorders, NREM Arousal, Nightmare, REM Behavior, Restless Legs, Substance/Medication-Induced and residual categories (Other Specified/Unspecified)

Sexual Dysfunctions

• Disturbance in sexual response/pleasure ≥6\,\text{months}; Lifelong vs. Acquired; Generalized vs. Situational
• Disorders: Delayed Ejaculation, Erectile Disorder, Female Orgasmic, Female Sexual Interest/Arousal, Genito-Pelvic Pain/Penetration, Male Hypoactive Sexual Desire, Premature Ejaculation, Substance/Medication-Induced, Other Specified/Unspecified

Gender Dysphoria

• Key concepts: sex vs. gender, assignment, identity, nonconformity, reassignment, transgender, transsexual
• Gender Dysphoria: distress from incongruence between experienced vs. assigned gender (≥6 sx in children; ≥2 in adults, duration ≥6\,\text{months})
• Other Specified / Unspecified Gender Dysphoria

Paraphilic Disorders

• Paraphilia = intense persistent non-normative sexual interest; becomes disorder if distress/impairment or harm risk
• Shared criteria: recurring arousal + fantasies/urges/behaviors for ≥6\,\text{months} + acted on w/ nonconsenting person or distress
• Disorders: Voyeuristic, Exhibitionistic, Frotteuristic, Sexual Masochism (specifier: asphyxiophilia), Sexual Sadism, Pedophilic, Fetishistic, Transvestic, Other Specified / Unspecified Paraphilic Disorders

Feeding/Eating, Elimination and Personality material duplicated on p10-11 (see above)

Disruptive, Impulse-Control & Conduct Disorders

• Problems in emotional/behavioral self-control violating rights/norms; onset typically childhood/adolescence
• Oppositional Defiant Disorder: ≥4 sx anger/irritable, argumentative/defiant, vindictiveness ≥1×/week for 6\,\text{months}
• Intermittent Explosive Disorder: verbal/physical aggression 2×/week for 3\,\text{months} or ≥3 serious outbursts/12 months
• Conduct Disorder: pattern ≥3 criteria in past year aggression, property destruction, deceit/theft, rule violation
• Antisocial Personality Disorder (after age 18)
• Pyromania, Kleptomania
• Other Specified / Unspecified Disruptive, Impulse-Control & Conduct Disorders

Substance-Related & Addictive Disorders

• Core = continued use despite problems; activation of brain reward; craving, tolerance, withdrawal; includes gambling
• Shared criteria clusters: impaired control, social impairment, risky use, pharmacological criteria
• Substance Use Disorders: Alcohol, Caffeine (no SUD but intox/withdrawal), Cannabis, Phencyclidine, Other Hallucinogen, Inhalant, Opioid, Sedative/Hypnotic/Anxiolytic, Stimulant, Tobacco, Other/Unknown
• Each substance: Use Disorder (≥2/12mos), Intoxication (syndrome), Withdrawal (criteria), Induced Mental Disorders, Unspecified categories
• Gambling Disorder: ≥4 criteria/12 months

Neurocognitive Disorders (NCD)

• Primary deficit in acquired cognitive function; domains: complex attention, executive, learning/memory, language, perceptual-motor, social cognition
• Delirium: acute disturbance in attention/awareness + cognition, due to medical/substance/toxin
• Major NCD: significant decline interfering with independence
• Mild NCD: modest decline, independence preserved with effort
• Etiological specifiers: Alzheimer’s, Frontotemporal, Lewy Body, Vascular, TBI, Substance/Medication, HIV, Prion, Parkinson’s, Huntington’s, Other, Multiple, Unspecified

Neurodevelopmental Disorders

• Onset during developmental period; deficits from specific (learning) to global (intellectual)
• Intellectual Disability (severity based on adaptive functioning)
• Global Developmental Delay (
• Communication Disorders: Language, Speech Sound, Childhood-Onset Fluency (Stuttering), Social (Pragmatic) Communication, Unspecified
• Autism Spectrum Disorder: social communication deficits + restricted/repetitive patterns
• Attention-Deficit/Hyperactivity Disorder (ADHD): inattention and/or hyperactivity-impulsivity ≥6 sx (children) across settings
• Specific Learning Disorder: difficulties with reading, writing, math
• Motor Disorders: Developmental Coordination, Stereotypic Movement, Tic Disorders (Tourette’s, Persistent motor/vocal, Specified, Unspecified)
• Other Specified / Unspecified Neurodevelopmental Disorder (e.g., prenatal alcohol exposure)

Residual / Other Categories

• Mental disorders due to another medical condition (specified/unspecified)
• Other Specified / Unspecified mental disorders when criteria not fully met but distress/impairment present

Catatonia (key features)

• ≥3 of 12 psychomotor signs: stupor, catalepsy, waxy flexibility, mutism, negativism, posturing, mannerism, stereotypy, agitation, grimacing, echolalia, echopraxia
• Occurs as specifier to neurodevelopmental, psychotic, mood disorders; or due to medical condition; or unspecified

Key Numerical Thresholds & Time Frames (quick sheet)

• Persistent anxiety diagnosis: \ge 6\,\text{months}
• Acute Stress Disorder: 3\,\text{days} – 1\,\text{month}
• Brief Psychotic Disorder: 1\,\text{day} – <1\,\text{month}
• Schizophreniform: 1 – <6\,\text{months}
• Schizophrenia: \ge 6\,\text{months} (1 month active)
• Dysthymia: \ge 2\,\text{years}
• Cyclothymia: \ge 2\,\text{years} sx half the time, no >2-month break
• Personality diagnosis: onset by adolescence/early adulthood
• Sexual dysfunction minimum duration: 6\,\text{months}
• Substance Use Disorder window: 12\,\text{months} for ≥2 criteria

Ethical / Practical Considerations & Real-World Links

• Accurate differentiation prevents misdiagnosis (e.g., GAD vs. normal stress)
• Substance-induced categories underline importance of medical/toxicology work-up
• Childhood neglect’s impact on attachment disorders emphasizes societal responsibility for early care
• Catatonia recognition critical for benzodiazepine or ECT responsiveness
• Understanding specifiers guides treatment (e.g., depression with psychotic features → antidepressant + antipsychotic or ECT)
• Cultural syndromes (ataque de nervios) included via “Other Specified” to enhance diagnostic flexibility

Study Tips & Mnemonics

• "SIGECAPS" for MDD (Sleep, Interest, Guilt, Energy, Concentration, Appetite, Psychomotor, Suicidality)
• "DIG FAST" for mania (Distractibility, Indiscretion, Grandiosity, Flight of ideas, Activity ↑, Sleep ↓, Talkative)
• "SAD PERSONS" suicide risk, relevant across disorders
• For PTSD criteria: "TRAUMA" (Trauma, Re-experience, Avoidance, Unable to function, Month or more, Arousal)
• OCD common themes: "WASH" (Washing, Arranging, Symmetry, Harm)

Hypothetical Scenario Example

• A 23-year-old develops panic attacks on crowded trains, begins avoiding subway, fears escape impossible → meets Agoraphobia criteria; if panic attacks also occur randomly, evaluate for concurrent Panic Disorder.

Connections to Previous/Foundation Principles

• Classical conditioning conceptualizes acquisition of specific phobias
• Operant conditioning (negative reinforcement) maintains compulsions in OCD
• Neurotransmitter systems: serotonin dysregulation implicated in anxiety & mood; dopamine hyperactivity in psychosis
• Neurodevelopmental trajectory: early speech/language disorders may precede later academic learning disorders

Key Formulas / Stats

• No intricate equations; remember prevalence differentials (e.g., anxiety disorders lifetime prevalence ≈ \sim 30\%; female > male)
• Catatonia criteria: \text{Signs} \ge 3 out of 12

End of Notes