DSM 5 Test 1 Questions and
Answers
Rumination disorder - Answer-Involves the repeated regurgitation of food for at least
one month. Food maybe re-chewed, re-swallowed, or spit out. Not attributable to a
medical disorder. Age of onset is usually between 3-12 months. Neglect, stressful life
situations, and parent-child problem may be predisposing factors.
Avoidant/Restrictive Food Intake Disorder - Answer-Characterized by a failure to eat
adequately with one or more: significant weight loss or failure to achieve expected
weight gain, significant nutritional deficiency, dependence on a feeding tube or
nutritional supplements, or marked interference with psychosocial functioning. Only
diagnosed when there is no medical condition that accounts for the symptoms. Is
associated with failure to thrive syndrome.
Anorexia Nervosa - Answer-Characterized by a restriction of food intake, leading to a
significantly low body weight. Intense fear of gaining weight or behavior that interferes
with weight gain. There must be distortions in self image, undue influence given to body
weight or shape in self-evaluation, or a denial of the seriousness of the problem. Two
subtypes: restricting type and binge eating/purging type. Additional specifiers: in partial
remission or in full remission. Current severity also specified: mild (BMI of 17+),
moderate (BMI 16-16.99), severe (BMI 15-15.99) or extreme (BMI <15). Typically
begins during adolescence or down without her. Earlier age of onset is associated with
shorter duration of illness. Find more common in females associate it with cultures,
settings, occupations,etc. suicide risk is increased. Bipolar, depressive, and anxiety
disorders commonly cooccur. Alcohol use and other substance use disorders may also
be comorbid. Treatment generally requires a multidisciplinary approach, overall family
treatment is the most well-established approach. Structural family therapy most well
known. CBT has modest research support
Bulimia Nervosa - Answer-Characterized by recurrent episodes of binge eating followed
by inappropriate compensatory behavior to prevent weight gain. Episodes occur at least
once a week for three months. Binge eating is eating an amount definitely larger than
most would within a discrete time period or a sense of lack of control over eating during
the episode. The specifiers in partial remission or in full should be used. Current
severity is based on the average number of episodes each week mild (1-3), moderate
(4-7), severe (8-13), or extreme (14+). Commonly begins in adolescence or young
adulthood far more common in females associated with childhood obesity and early
pubertal maturation, low self-esteem, and childhood sexual or physical abuse. Suicide
risk is increased. Bipolar, depressive, anxiety, and personality disorders (especially
BPD) commonly cooccur. Alcohol use disorder and stimulant use disorder may also be
comorbid. Treatment includes CBT and interpersonal therapy antidepressants are also
highly effective as serotonin is believed to be the primary neurotransmitter involved.
,Binge eating disorder - Answer-Recurrent episodes of binge eating associated with
three or more: eating much more rapidly than normal, eating until feeling uncomfortably
full, eating large amounts of food when not hungry, eating alone out of embarrassment
by the amount one is eating, or feeling disgusted or guilty afterwards. The binge on
average last at least once a week for three months.(no compensatory behaviors as
seen in bulimia nervosa). The specifiers in partial remission or in full should be used.
Current severity is based on the average number of episodes each week mild (1-3),
moderate (4-7), severe (8-13), or extreme (14+)
Other specified/unspecified feeding or eating disorder - Answer-Examples include
atypical anorexia (criteria for anorexia met but no significant weight loss or weight is
within or above normal range), bulimia nervosa of low frequency and/or limited duration,
purging disorder (absence of binge eating), and night eating syndrome (recurrent
episodes of night eating either after awakening from sleep or after the evening meal)
Elimination disorders - Answer-Involve inappropriate elimination of urine or feces;
usually first diagnosed in childhood.
Enuresis - Answer-Diagnosed when there is repeated voiding of urine into the bed or
clothes, whether intentionally or involuntarily. Considered clinically significant either
when it occurs twice a week for at least three months or results in significant distress or
impairment in functioning. Minimum chronological and mental age is five years. Not
diagnosed if due to a medical disorder. subtypes: nocturnal only, diurnal only, or
nocturnal and diurnal. Characterized as either primary, in which the child is age 5 and
has never established continence, or secondary in which the disturbance develops after
a period of continence. Usually remits by adulthood. Most effective treatment for primary
is the urine alarm (aka bell & pad technique; based on principles of classical
conditioning), medication (high relapse rate once stopped). Family and/or individual
therapy is often used to treat secondary associated with the stressor
Encopresis - Answer-Dx when there is repeated passage of feces into inappropriate
places, intentionally or involuntarily. Must occur at least once a month got a minimum of
3 months. Child must be chronologically & mentally age 4. Specifiers: with constipation
and overflow incontinence and without constipation and overflow incontinence. Can be
primary in which person has never established continence or secondary in which the
problem develops after a period of continence. No evidence-based treatments. Medical
management is often used successfully when constipation is the underlying problem.
When clearly deliberate, features of ODD and/or CD may also be present. Treatment
typically involves a behavioral approach in order to promote appropriate continent.
Family therapy may be indicated especially if the symptoms are secondary to family
conflict.
Other specified/unspecified elimination disorder - Answer-An example is low-frequency
enuresis
,Sleep-Wake Disorders - Answer-Typically complain of dissatisfaction with the quality,
timing, and amount of sleep, resulting in daytime distress and impairment. Include
difficulties getting enough sleep, problems with excessive sleepiness in spite of sleeping
adequate hours, sleep intrusion, breathing related sleep disorders, and parasomnias.
Insomnia disorder - Answer-Predominant complaint of dissatisfaction with sleep quality
or quantity associated with one or more: difficulty initiating sweet, difficulty maintaining
sleep, or early-morning awakening with inability to go back to sleep. Occurs at least
three nights each week for at least three months. Specifiers with a non-sleep disorder
mental comorbidity, with other medical comorbidity, and with other sleep disorder.
Additional specifiers: episodic (symptoms last at least one month for less than three
months), persistent (symptoms last three months or longer), and recurrent (two or more
episodes within one year). CBT is most effective, component techniques there also use
independently to successfully treat including sleep restriction therapy, stimulus control
therapy, and relaxation training. Dx when this is the focus of tx.
Hypersomnolence disorder - Answer-Characterized by excessive sleepiness in spite of
sleeping at least seven hours with at least one of the following: recurrent daytime sleep
episodes, prolonged sleep for more than nine hours that is non-restorative, or difficulty
being fully awake after abrupt awakening. Occurs at least three times a week for at least
three months. Specifiers: with mental comorbidity, with medical condition, and with
another sleep disorder. Additional specifiers: acute, subacute, and persistent. Severity
is specified based on the frequency of difficulty maintaining daytime alertness: mild
moderate and severe.
Narcolepsy - Answer-Recurrent periods of an irresistible need to sleep, lapsing into
sleep, or napping occurring within a given day, at least three times per week, for at least
a three-month duration. Involves at least one: cataplexy (either brief episodes of sudden
bilateral loss of muscle tone, typically precipitated by laughter are joking, or grimaces
our job opening with tongue thrusting, without obvious emotional triggers),hypocretin
deficiency, or REM indicators. Severity a specified is mild moderate or severe.
Individuals commonly experience recurrent intrusion of REM sleep into the transition
between sleep and wakefulness. Manifested as hypnagogic hallucinations at the onset
of sleep, as hypnopompic hallucinations on awakening, or sleep paralysis at the
beginning or end of sleep episodes.
Breathing related sleep disorders - Answer-Include three distinct disorders: obstructive
sleep apnea hypopnea (characterized by snoring, snorting/gasping, or breathing pauses
during sleep); central sleep apnea (no evidence of obstruction); sleep related
hypoventilation (decreased respiration associated with elevated carbon dioxide levels).
Obstructive sleep apnea hypopnea is the most common. Apnea refers to a temporary
cessation of breathing; hypopnea is abnormally slow or shallow breathing.
Circadian rhythm sleep wake disorder - Answer-Characterized by a recurrent pattern of
sleep disruption caused by an alteration of the circadian system, or a mismatch in the
sleep wake schedule required by the person's environment and circadian sleep wake
, cycle. The mismatch results in insomnia or excessive sleepiness. Specifiers: delayed
sleep phase type, advanced sleep phase type, irregular sleep wake type, non-24 hour
sleep wake type, shiftwork type, and unspecified type. Also episodic, persistent, or
recurrent
Non-Rapid Eye Movement (NREM) Sleep Arousal Disorders - Answer-Involve recurrent
episodes of incomplete awakening from sleep, usually during the first third of the night
accompanied by either sleepwalking or sleep terrors. There's total amnesia for the event
and no dream recollection.
Schizophrenia Spectrum & Psychotic Other Disorders - Answer-Characterized by
abnormalities of one or more: delusions,hallucinations, disorganized thinking (speech),
disorganized or abnormal motor (including catatonia) & negative symptoms. Severity is
rated by assessing the primary symptoms of psychosis on a 5point scale for each so
based on presence & strength of the screen from 0 (not present) to 4 (present &
severe). Disorders presented in order of severity.
Delusions (thinking) - Answer-Fixed, false beliefs that are unchangeable. Content varies
and can be bizarre or non-bizarre. Non-bizarre are situations that are possible and
bizarre are those that are clearly implausible
Hallucinations (perception) - Answer-Vivid & clear perceptions that occur w/out external
stimuli. May occur in any sensory modality. Auditory experiences are the most common
and tend to be experienced as voices that are distinct from one's own thoughts
Disorganized Thinking - Answer-Usually inferred from speech - person switches from
topic to topic (derailment or loose associations) or provides answers that diverge from
questions asked (tangentiality)
Grossly Disorganized or Abnormal Motor Behavior (including catatonia) - Answer-May
range from childlike silliness to unexpected agitation, typically interfering with goal-
directed behaviors and activities of daily living. Catatonia is a marked decrease in
reactivity that ranges from resistance to instructions (negativism), to maintaining odd
posture,to lack of verbal or motor response (mutism and stupor). Can also involve
excessive motor activity (catatonic excitement) repeated stereotype movement,
grimacing, and echoing of speech.
Negative Symptoms - Answer-Include diminished emotional expression and avolition
(decrease in self-initiated purposeful activities), alogia (reduced speech output),
anhedonia (diminished pleasure) & asociality (lack of interest in social interactions)
Specifier w/catatonia - Answer-Can be coded for any of the disorders. Criteria involve a
clinical picture that is dominated by 3 or more: stupor (no psychomotor activity),
catalepsy (posture is held passively, against gravity), waxy flexibility (resistance to
positioning by another), mutism (no verbal response), negativism (no response
instructions or external stimuli), posturing (actively maintaining a posture against
