Adult Psychopathology Test A

Criterion A for schizoaffective disorder requires an uninterrupted period of illness during which Criterion A for schizophrenia is met. Which of the following additional symptoms must be present to fulfill diagnostic criteria for schizoaffective disorder?

How common is schizoaffective disorder relative to schizophrenia?

Substance/medication-induced psychotic disorder cannot be diagnosed if the disturbance is better explained by an independent psychotic disorder that is not induced by a substance/medication. Which of the following psychotic symptom presentations would not be evidence of an independent psychotic disorder?

A 65-year-old man with systemic lupus erythematosus who is being treated with corticosteroids witnesses a serious motor vehicle accident. He begins to have disorganized speech, which lasts for several days before resolving. What diagnosis best fits this clinical picture?

Which of the following statements accurately describes a change in DSM-5 from the DSM-IV criteria for bipolar disorders?

Approximately what percentage of individuals who experience a single manic episode will go on to have recurrent mood episodes?

A patient with a history of bipolar I disorder presents with a new-onset manic episode and is successfully treated with medication adjustment. He notes chronic depressive symptoms that, on reflection, long preceded his manic episodes. He describes these symptoms as “feeling down,” having decreased energy, and more often than not having no motivation. He denies other depressive symptoms but feels that these alone have been sufficient to negatively affect his marriage. Which diagnosis best fits this presentation?

A 25-year-old graduate student presents to a psychiatrist complaining of feeling down and “not enjoying anything.” Her symptoms began about a month ago, along with insomnia and poor appetite. She has little interest in activities and is having difficulty attending to her schoolwork. She recalls a similar episode 1 year ago that lasted about 2 months before improving without treatment. She also reports several episodes of increased energy in the past 2 years; these episodes usually last 1–2 weeks, during which time she is very productive, feels more social and outgoing, and tends to sleep less, although she feels energetic during the day. Friends tell her that she speaks more rapidly during these episodes but that they do not see it as off-putting and in fact think she seems more outgoing and clever. She has no medical problems and does not take any medications or abuse drugs or alcohol. What is the most likely diagnosis?

How does DSM-5 differ from DSM-IV in its classification of mood disorders?

Which of the following statements about how grief differs from a major depressive episode (MDE) is false?

A 45-year-old man with classic features of schizophrenia has always experienced co-occurring symptoms of depression—including feeling “down in the dumps,” having a poor appetite, feeling hopeless, and suffering from insomnia— during his episodes of active psychosis. These depressive symptoms occurred only during his psychotic episodes and only during the 2-year period when the patient was experiencing active symptoms of schizophrenia. After his psychotic episodes were successfully controlled by medication, no further symptoms of depression were present. The patient has never met full criteria for major depressive disorder at any time. What is the appropriate DSM-5 diagnosis?

A 39-year-old woman reports that she became quite depressed in the winter last year when her company closed for the season, but she felt completely normal in the spring. She recalls experiencing several other episodes of depression over the past 5 years (for which she cannot identify a seasonal pattern) that would have met criteria for major depressive disorder. Which of the following correctly summarizes this patient’s eligibility for a diagnosis of “major depressive disorder, with seasonal pattern”?

Which of the following disorders is included in the “Anxiety Disorders” chapter of DSM-5?

Which of the following statements best describes how panic attacks differ from panic disorder?

A 32-year-old woman reports sudden, unexpected episodes of intense anxiety, accompanied by headaches, a rapid pulse, nausea, and shortness of breath. During the episodes she fears that she is dying, and she has presented several times to emergency departments. Each time she has been told that she is medically healthy; she is usually reassured for a time, but on the occurrence of a new episode she again becomes concerned that she has some severe medical problem. She was given lorazepam once but disliked the sedating effect and has not taken it again. She abstains from all medications and alcohol in an attempt to minimize potential causes for her attacks. What is the most likely explanation for her symptoms?

A 35-year-old man is in danger of losing his job because it requires frequent long-range traveling and for the past year he has avoided flying. Two years earlier he was on a particularly turbulent flight, and although he was not in any real danger, he was convinced that the pilot minimized the risk and that the plane almost crashed. He flew again 1 month later and, despite having a smooth flight, the anticipation of turbulence was so distressing that he experienced a panic attack during the flight; he has not flown since. What is the most appropriate diagnosis?

Which of the following statements about compulsive behaviors in obsessivecompulsive disorder (OCD) is true?

A 63-year-old woman has been saving financial documents and records for many years, placing papers in piles throughout her apartment to the point where it has become unsafe. She acknowledges that the piles are a concern; however, she says that the papers include important documents and she is afraid to throw them away. She recalls several instances in which her taxes were audited and she needed certain documents to avoid a penalty. She is concerned because her landlord is threatening to evict her unless she removes the piles of papers. What is the most likely diagnosis?

How does DSM-5 differ from DSM-IV in its classification of posttraumatic stress disorder (PTSD)?

A 25-year-old woman, new to your practice, tells you that a little more than 3 months ago she was accosted on her way home. The attacker told her he had a gun, was going to rape her, and would shoot her if she resisted. He walked her toward an alley. She was sure he would kill her afterward no matter what she did, and therefore she pushed away from him, aware that she might be shot. She was able to escape unharmed. She describes not being able to fall asleep for the first 2 nights after the attack and of avoiding that particular street in her neighborhood for 2 days following the event. She thinks that the attacker might have touched her breasts but cannot remember for sure. She has recently started feeling anxious all of the time and is tearful, and she has stopped going to work. She fears that something about her makes her “look like a victim.” What is the most likely diagnosis?

Somatoform Disorders in DSM-IV are referred to as Somatic Symptom and Related Disorders in DSM-5. Which of the following features characterizes the major diagnosis in this class, somatic symptom disorder?

After an airplane flight, a 60-year-old woman with a history of chronic anxiety develops deep vein thrombophlebitis and a subsequent pulmonary embolism. Over the next year, she focuses relentlessly on sensations of pleuritic chest pain and repeatedly seeks medical attention for this symptom, which she worries is due to recurrent pulmonary emboli, despite negative test results. Review of systems reveals that she also has chronic back pain and that she has consulted many physicians for symptoms of culture-negative cystitis. What diagnosis best fits this clinical picture?

What is the minimum average frequency of binge eating required for a diagnosis of DSM-5 binge-eating disorder?

What are the subtypes of bulimia nervosa?

A 45-year-old man with a long-standing history of heavy alcohol use is referred for psychiatric evaluation after his recent admission to the hospital for acute hepatitis. The patient reports that he drank almost daily in college. Over the past 10 years, he has gradually increased his nightly alcohol intake from a single 6-pack to two 12-packs of beer, and this nightly drinking habit has resulted in his frequently oversleeping and missing work. He has tried to moderate his alcohol use on numerous occasions with little success, particularly after developing complications associated with alcoholic cirrhosis. The patient admits that he becomes anxious and gets hand tremors when he doesn’t drink. This patient meets the criteria for which of the following diagnoses?