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Abnormal Psychology
– Part I
1
DSM-5
• The DSM-5 provides a nonaxial assessment system. All psychiatric
and medical diagnoses are listed together, with the principal
diagnosis listed first and any other disorders listed in order of focus
and treatment.
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• The DSM-5 uses a categorical classification system. To account for
diagnostic heterogeneity, most diagnoses include a polythetic
criteria set.
• Diagnostic uncertainty is indicated using one of the following:
other specified disorder or unspecified disorder.
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Intellectual Disability
• Deficits in reasoning, problem-solving, abstract thinking, and other
areas of intellectual functioning.
• Onset of deficits during the developmental period.
Severity (mild, moderate, severe, profound) based on adaptive
functioning in conceptual, social, and practical domains.
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• Deficits in adaptive functioning in multiple environments and in at
least one cognitive domain (conceptual, social, practical).
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Autism Spectrum Disorder
• Persistent deficits in social communication and interaction across
multiple contexts.
• Symptoms present in the early developmental period.
Etiology: Has been linked to heredity, irregularities in the structure
and function of the cerebellum and amygdala, and elevated serotonin.
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• Restricted, repetitive patterns of behavior, interests, and activities.
Prognosis: Better outcomes associated with communication skills by
age 5 or 6, an IQ over 70, and a later onset of symptoms.
Differential Diagnosis: Social (Pragmatic) Communication Disorder
4
Attention Deficit/Hyperactivity
Disorder (p. 1)
• Onset age 17 or older: at least five symptoms of inattention
and/or hyperactivity-impulsivity.
• Significant impairment in at least two settings.
• Duration of symptoms for at least six months.
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• Onset before age 12: at least six symptoms of inattention and/or
hyperactivity-impulsivity.
Subtypes: predominantly inattention presentation, predominantly
hyperactive/impulsive presentation, combined presentation
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Attention Deficit/Hyperactivity
Disorder (p. 2)
Treatment: CNS stimulant and parent- and teacher-administered
behavioral management.
Prognosis: Up to 60% of children diagnosed with ADHD have some
symptoms in adulthood with inattention predominating the symptom
profile.
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Etiology: Has been linked to heredity and lower-than-normal activity
in the frontal lobes and basal ganglia.
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Specific Learning Disorder: Difficulties related to academic skills as
indicated by the presence of at least one symptom that lasts for at
least six months despite provision of appropriate interventions.
Subtypes: with impairment in reading, with impairment in written
expression, with impairment in mathematics.
Childhood-Onset Fluency Disorder (Stuttering): Disturbance in the
normal fluency and time patterning of speech that is inappropriate for
the person’s age. Treatment: Habit reversal training (awareness
training, competing response training, and social support).
Tourette’s Disorder: Multiple motor tics and one or more vocal tics
with a duration of at least one year and onset before age 18. Most
common co-occurring disorders are OCD and ADHD.
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Other Neurodevelopmental
Disorders
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Schizophrenia (p. 1)
• Continuous signs of the disturbance for at least six months.
• For a significant portion of the time since the onset of symptoms,
level of functioning has been below the level achieved prior to
onset.
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• At least two active phase symptoms for at least one month with at
least one symptom being delusions, hallucinations, or disorganized
speech. Active phase symptoms are delusions, hallucinations,
disorganized speech, grossly disorganized or catatonic behavior,
and negative symptoms (e.g., affective flattening, avolition).
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Schizophrenia (p. 2)
Etiology: Has been linked to heredity, excessive levels of or
oversensitivity to dopamine and other neurotransmitter
abnormalities, and several brain abnormalities including enlarged
ventricles and hypofrontality.
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Course and Prognosis: Better prognosis is associated with good
premorbid adjustment, an abrupt and later onset, a precipitating
stressor, female gender, insight into the illness, and no family history of
Schizophrenia.
Treatment: Traditional or newer antipsychotic, social skills training
and cognitive-behavioral therapy, and family interventions (e.g., to
reduce expressed emotion).
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Schizophrenia Spectrum
Disorders (p. 1)
• Brief Psychotic Disorder: One or more characteristic symptoms
(delusions, hallucinations, disorganized speech, grossly disorganized
or catatonic behavior) with at least one symptom being delusions,
hallucinations, or disorganized speech and a duration of one day to
less than one month.
• Schizoaffective Disorder: Concurrent symptoms of Schizophrenia
and a major depressive or manic episode except for a period of at
least two weeks without mood symptoms.
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• Schizophreniform Disorder: Two or more active phase symptoms
for at least one month with at least one being delusions,
hallucinations, or disorganized speech and a duration of symptoms
for at least one month but less than six months.
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Schizophrenia Spectrum Disorders (p.
2)
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• Delusional Disorder: One or more delusions for one month or
longer; apart from the impact of delusions or their effects,
functioning is not markedly impaired and behavior is not obviously
bizarre or odd.
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Mood Episodes (p. 1)
• Abnormally and persistent elevated, expansive, or irritable mood
and goal-directed activity or energy for at least one week with at
least three symptoms (e.g., inflated self-esteem or grandiosity,
increased talkativeness, flight of ideas).
• Symptoms cause impaired functioning, require hospitalization,
and/or include psychotic features.
Hypomanic Episode:
• Abnormally and persistent elevated, expansive, or irritable mood
and increased activity or energy for at least four days with at least
three symptoms of mania.
• Symptoms are not severe enough to cause impaired functioning or
require hospitalization and do not include psychotic features.
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Manic Episode:
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Mood Episodes (p. 2)
• Five or more characteristic symptoms with at least one symptom
being depressed mood or loss of interest or pleasure. Symptoms
include insomnia or hypersomnia, fatigue, feelings of worthlessness,
and impaired ability to think or concentrate.
• Symptoms last for at least two weeks and cause significant distress
or impaired functioning.
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Major Depressive Episode:
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Bipolar and Related Disorders
Bipolar II Disorder: At least one hypomanic episode and at least one
major depressive episode.
Cyclothymic Disorder: Numerous periods of hypomanic symptoms
and depressive symptoms for at least two years in adults or one year in
children and adolescents.
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Bipolar I Disorder: At least one manic episode that may or may not
have been preceded or followed by major depressive or hypomanic
episodes.
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Depressive Disorders (p. 1)
• With peripartum onset: Onset of symptoms during pregnancy or
the four weeks following delivery. Up to 80% of women experience
“baby blues” and 10 to 20% have symptoms sufficiently severe for a
diagnosis of Major Depressive Disorder.
• With seasonal pattern (seasonal affective disorder): Presence of a
temporal relationship between mood episodes and time of year.
Symptoms include hypersomnia, overeating, weight gain, and
carbohydrate craving.
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Major Depressive Disorder: At least one major depressive episode.
Specifiers include the following:
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Depressive Disorders (p. 2)
Persistent Depressive Disorder: Depressed mood for at least two
years in adults or one year in children and adolescents.
• Biological Theories: Heredity and neurotransmitter abnormalities
(e.g., catecholamine hypothesis).
• Cognitive-Behavioral Theories: Learned helplessness model and
Beck’s cognitive triad.
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Etiology of Major Depressive Disorder:
Treatment of Major Depressive Disorder: Antidepressant and
psychotherapy (cognitive-behavioral therapy or interpersonal
therapy).
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Disruptive Mood Dysregulation Disorder: Severe recurrent temper
outbursts manifested verbally and/or behaviorally that are out of
proportion in intensity or duration to the provocation; are inconsistent
with developmental level; occur, on average, three or more times a
week; with a persistent irritable or angry mood between temper
outbursts most of the day and nearly every day.
• Differential Diagnosis: Disruptive, Impulse-Control, and Conduct
Disorders (Oppositional Defiant Disorder, Conduct Disorder)
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Disruptive Impulse Control and
Conduct Disorders
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Suicide Risk (p. 1)
• A previous suicide attempt is one of the best predictors of a future
• Early warning signs include threatening self-harm or suicide, writing
or talking about death or suicide, seeking a means to commit
suicide, and making preparations for dying.
• Beck and colleagues found that hopelessness is a better predictor of
suicide than is severity of depression.
• Historically, the rate of completed suicide has increased with
increasing age, with those over age 65 having the highest rate.
However, beginning in 2004, the rate for individuals ages 25 to 64
began to surpass the rate for individuals ages 65 and older.
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attempt.
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Suicide Risk (p. 2)
• For most age groups, suicide rates are highest for Whites. The
exception is American Indians/Alaskan Natives ages 15 to 34 who
have a suicide rate 2.5 times higher than the national average for
that age group.
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• The rate of completed suicide is four times higher for males than
females, while the rate of attempted suicide is two to three times
higher for females.
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Anxiety Disorders (p. 1)
Specific Phobia: Intense fear of or anxiety about a specific object or
situation, with the individual avoiding the object or situation or
enduring it with marked distress. Treatment: In vivo exposure with
response prevention.
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Separation Anxiety Disorder: Developmentally inappropriate and
excessive fear or anxiety related to separation from home or
attachment figures. Duration must be at least four weeks in children
and adolescents or six months in adults. Treatment: Cognitivebehavioral interventions (e.g., systematic desensitization).
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Social Anxiety Disorder: Intense fear of or anxiety about one or more
social situations in which the individual may be exposed to scrutiny by
others, with the individual avoiding the situations or enduring them
with marked distress. Treatment: Cognitive-behavioral therapy that
combines exposure, applied relaxation, cognitive restructuring, and
other techniques.
Panic Disorder: Recurrent unexpected panic attacks with at least one
attack being followed by persistent concern about having additional
attacks or their consequences and/or a significant maladaptive
behavior change related to the attacks. Treatment: Cognitivebehavioral therapy that includes exposure with response prevention.
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Anxiety Disorders (p. 2)
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Anxiety Disorders (p. 3)
Generalized Anxiety Disorder: Excessive anxiety and worry about
multiple events or activities. Treatment: Cognitive-behavioral therapy
and medication (SSRI, benzodiazepine, anxiolytic).
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Agoraphobia: Marked fear or anxiety about at least two of five
situations (e.g., using public transportation, being in enclosed spaces)
due to concern that escape might be difficult or help unavailable in
case of panic-like, incapacitating, or embarrassing symptoms.
Treatment: In vivo exposure with response prevention.
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Obsessive-Compulsive and
Related Disorders
Body Dysmorphic Disorder: Preoccupation with a defect or flaw in
appearance that appears minor or is unobservable to others. At some
time during the course of the disorder, the person has performed
repetitive behaviors or mental acts because of the defect or flaw.
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Obsessive-Compulsive Disorder: Recurrent obsessions and/or
compulsions that are time-consuming or cause significant distress or
impaired functioning. Treatment: Exposure with response prevention
and the tricyclic clomipramine or an SSRI.
Trichotillomania (Hair-Pulling Disorder): Recurrent hair pulling
resulting in hair loss.
Excoriation (Skin-Picking) Disorder: Recurrent skin picking resulting in
skin lesions.
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Practice Questions
a)
b)
c)
d)
no or minimal delays in motor development
an ability to communicate verbally by age five or six
a brief period of active-phase symptoms
strong family support
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1. For individuals with Autism Spectrum Disorder, a better prognosis
has been linked to which of the following?
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Practice Questions
a)
It is not an effective treatment for most individuals with this
disorder.
b) It is an effective treatment and exerts its strongest effects on
inattention and impulsivity.
c) It is an effective treatment and exerts its strongest effects on
hyperactivity.
d) It is an effective treatment only when used in conjunction with
a central nervous system stimulant.
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2. Research investigating the effectiveness of neurofeedback as a
treatment for ADHD has generally found which of the following?
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Practice Questions
a) at lower risk for ADHD and other mental disorders.
b) at about the same risk for ADHD and other mental disorders.
c) at about the same risk for ADHD and other mental disorders
but at higher risk for more severe symptoms.
d) at higher risk for ADHD and other mental disorders.
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3. Compared to children in the general population, children with a
Specific Learning Disorder are:
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Practice Questions
a)
b)
c)
d)
1 to 3 years.
5 to 7 years.
9 to 11 years.
12 to 14 years.
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4. The mean age of onset of motor tics in Tourette’s Disorder is:
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Practice Questions
a)
b)
c)
d)
enlarged hippocampus
enlarged frontal lobes
enlarged temporal lobes
enlarged ventricles
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5. Of the brain abnormalities associated with Schizophrenia, which of
the following has been found in the largest proportion of patients?
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Practice Questions
a)
b)
c)
d)
two
five
ten
twenty
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6. The biological brother of a person who has received a diagnosis of
times more likely to develop the disorder
Schizophrenia is
than a member of the general population.
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Practice Questions
a)
b)
c)
d)
cortisol
glutamate
melatonin
GABA
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7. Seasonal affective disorder (SAD) has been most consistently linked
abnormalities.
to
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Practice Questions
a)
b)
c)
d)
is the opposite of what is found in prepubertal children.
is the same as what is found in prepubertal children.
does not become evident until early adulthood.
does not become evident until mid-adolescence.
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8. In adults, the rate of Major Depressive Disorder for women is about
1.5 to 3 times the rate for men. This gender difference:
31
Practice Questions
a)
b)
c)
d)
American Indian/Alaskan Natives.
Blacks.
Hispanics.
Whites.
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9. In the United States, the highest rates of suicide for individuals ages
15 to 34 are for:
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10. The DSM-5 diagnosis of Panic Disorder requires at least two
panic attacks, with at least one attack being followed by
or more
of persistent concern or worry about having another attack or the
consequences of an attack and/or a significant maladaptive change in
behavior that is related to the attacks.
a)
b)
c)
d)
expected or unexpected; one month
expected or unexpected; three months
unexpected; one month
unexpected; two months
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Practice Questions
33
11. Mary Ann, age 29, seems very nervous during her first therapy
session with you. When she speaks, her hands shake and she blushes.
She tells you that, while she isn’t afraid to be around people, she gets
anxious and flustered whenever she has to speak to people she
doesn’t know. Mary Ann also says she has trouble talking to her
supervisor at work because he’s condescending and critical. Based on
these symptoms, the most likely diagnosis for Mary Ann is which of the
following?
a)
b)
c)
d)
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Practice Questions
Specific Phobia
Social Anxiety Disorder
Panic Disorder
Generalized Anxiety Disorder
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Practice Questions
a)
b)
c)
d)
flooding
systematic desensitization
stress inoculation
cognitive-behavioral therapy
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12. Studies suggest that which of the following is the most effective
intervention for Generalized Anxiety Disorder?
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Practice Questions
a)
In both children and adults, the rates are higher for males than
for females.
b) In both children and adults, the rates are higher for females
than for males.
c) In children, the rates are higher for males; in adults, the rates
are about equal for males and females.
d) In children, the rates are higher for females; in adults, the rates
are about equal for males and females.
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13. Which of the following is true about the rates of ObsessiveCompulsive Disorder for males and females?
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