MCAT Social and Behavioral Sciences : Classifying Disorders
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Example Questions
Example Question #1 : Classifying Disorders
The American Psychiatric Association uses the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) to __________.
uniformly classify and describe mental disorders
provide physicians with medication administration information
provide guidelines for International Classification of Disease (ICD) coding
establish legal terms for severe mental illnesses
coordinate disease symptoms and treatment
uniformly classify and describe mental disorders
The American Psychiatric Association developed the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) to uniformly classify and describe mental disorders. The DSM-IV provides a detailed description of the symptoms seen in psychiatric disorders. "Insanity" is a legal term for severe mental illness present at the time a crime was committed. It is not a mental diagnosis. The International Classification of Disease is used to assign codes to medical diagnoses that are used for reimbursement purposes. The Physician Desk Reference (PDR) provides detailed information on medication administration. The DSM-IV does not provide information about treatment.
Example Question #2 : Classifying Disorders
Normal neurodevelopment in children is typically characterized by the acquisition of personal, social, academic, and occupational functioning. These functions are often learned and developed before the child begins primary education. During this period, the child learns social skills and how to control executive functions. Neurodevelopmental disorders involve developmental deficits that are manifested as impairments in normal neurodevelopment. Impairments in intelligence and social skills are often associated with neurodevelopmental disorders, and they frequently occur together.
A child and adolescent psychiatrist wanted to further characterize children with neurodevelopmental disorders according to several protocols. The psychiatrist observed all children with any identified impairments of social skills and any associated intellectual disability The psychiatrist noted the following: communication disorder, impairment in attention, impairment in organization, motor disorder, repetitive behaviors, restricted behaviors, or other interests.
The child and adolescent psychiatrist concluded that children with repetitive and restricted interests or patterns of behavior often demonstrate impairments in social skills. Some of the children who had restricted interests, repetitive patterns of behavior, and impairments in social skills also had intellectual impairments, language impairments, associated medical conditions, or other associated mental or behavioral disorders. It was found that specifying the individual characteristics of the neurodevelopmental disorders provided the child and adolescent psychiatrist the ability to better describe the diagnosis and associated symptoms to patients and their families.
If impairments in social skills are caused by specific deficits in social communication, what is the most likely diagnosis in 5-year-old child who has difficulty taking turns in conversation and does not change speech when in the classroom as when on the playground?
Social (pragmatic) communication disorder
Attention-deficit/hyperactivity disorder
Intellectual disability
Autism spectrum disorder
Social anxiety disorder
Social (pragmatic) communication disorder
Social (pragmatic) communication disorder is the correct answer. This patient possesses specific deficits in social communication. The history is notable for difficulties following rules for conversation and impairment of ability to change speech to match context. The prognosis for pragmatics is highly variable with some children having substantial improvement over time and others having persistent difficulties that may continue into adulthood.
Example Question #3 : Classifying Disorders
Normal neurodevelopment in children is typically characterized by the acquisition of personal, social, academic, and occupational functioning. These functions are often learned and developed before the child begins primary education. During this period, the child learns social skills and how to control executive functions. Neurodevelopmental disorders involve developmental deficits that are manifested as impairments in normal neurodevelopment. Impairments in intelligence and social skills are often associated with neurodevelopmental disorders, and they frequently occur together.
A child and adolescent psychiatrist wanted to further characterize children with neurodevelopmental disorders according to several protocols. The psychiatrist observed all children with any identified impairments of social skills and any associated intellectual disability The psychiatrist noted the following: communication disorder, impairment in attention, impairment in organization, motor disorder, repetitive behaviors, restricted behaviors, or other interests.
The child and adolescent psychiatrist concluded that children with repetitive and restricted interests or patterns of behavior often demonstrate impairments in social skills. Some of the children who had restricted interests, repetitive patterns of behavior, and impairments in social skills also had intellectual impairments, language impairments, associated medical conditions, or other associated mental or behavioral disorders. It was found that specifying the individual characteristics of the neurodevelopmental disorders provided the child and adolescent psychiatrist the ability to better describe the diagnosis and associated symptoms to patients and their families.
A child and adolescent psychiatrist examined a 7-year-old boy and gave diagnoses of both intellectual disability and neurocognitive disorder. Which of the following clinical and study findings would be inconsistent with giving both diagnoses?
Loss of previously acquired cognitive skills following head injury
Increased level of adaptive function deficits following meningitis
Stable intellectual disability with Down syndrome
Delayed language milestones in the first 24 months of life
Acute intracranial hemorrhage overlying gray matter heterotopia on computed tomography scan
Stable intellectual disability with Down syndrome
The neurocognitive disorders are characterized by a loss of intellectual function. Intellectual disability is typically not progressive, but a diagnosis of neurocognitive disorder may be made with intellectual disability when further cognitive disability develops or is lost, e.g. such as may follow infections ("increased level of adaptive function deficits following meningitis" is consistent and can be eliminated) and traumatic brain injury (both "loss of previously acquired cognitive skills following head injury" and "acute intracranial hemorrhage overlying gray matter heterotopia on computed tomography scan" are consistent and can be eliminated). Thus, "stable intellectual disability with Down syndrome" is inconsistent with giving diagnoses of both intellectual disability and neurocognitive disorder and is the correct answer choice. All other choices are consistent with the diagnoses of intellectual disability and neurocognitive disorder. Delayed milestones may be seen as early as within the first 2 years of life in children with severe intellectual disability ("delayed language milestones in the first 24 months of life" is consistent and can be eliminated).
Example Question #4 : Classifying Disorders
Normal neurodevelopment in children is typically characterized by the acquisition of personal, social, academic, and occupational functioning. These functions are often learned and developed before the child begins primary education. During this period, the child learns social skills and how to control executive functions. Neurodevelopmental disorders involve developmental deficits that are manifested as impairments in normal neurodevelopment. Impairments in intelligence and social skills are often associated with neurodevelopmental disorders, and they frequently occur together.
A child and adolescent psychiatrist wanted to further characterize children with neurodevelopmental disorders according to several protocols. The psychiatrist observed all children with any identified impairments of social skills and any associated intellectual disability The psychiatrist noted the following: communication disorder, impairment in attention, impairment in organization, motor disorder, repetitive behaviors, restricted behaviors, or other interests.
The child and adolescent psychiatrist concluded that children with repetitive and restricted interests or patterns of behavior often demonstrate impairments in social skills. Some of the children who had restricted interests, repetitive patterns of behavior, and impairments in social skills also had intellectual impairments, language impairments, associated medical conditions, or other associated mental or behavioral disorders. It was found that specifying the individual characteristics of the neurodevelopmental disorders provided the child and adolescent psychiatrist the ability to better describe the diagnosis and associated symptoms to patients and their families.
In addition to deficits in social skills, excessive restricted, repetitive behaviors are also seen in autism spectrum disorder. Which of the following best describes a pattern of behavior that would most likely not be seen?
Lining up toys
Finger flicking
Use of "you" only when not referring to self
Spending hours writing out division tables
Pacing a perimeter
Use of "you" only when not referring to self
The use of "you" when referring to self includes repetitive speech that may be seen in autism spectrum disorder. This repetitive speech (i.e. echolalia) may be delayed or immediate following words heard. Therefore, patients with autism spectrum disorder with symptoms of repetitive speech may use "you" when referring to self, and "use of 'you' only when not referring to self" would be the pattern of behavior least likely seen in autism spectrum disorder of the available choices and is the correct choice. In addition to repetitive speech that may be seen in autism spectrum disorder, other restricted, repetitive behaviors include patterns of nonverbal behavior ("pacing a perimeter" is wrong), abnormal intense focus ("spending hours writing out division tables" is wrong), repetitive use of object ("lining up toys" is wrong), as well as simple motor stereotypes ("finger flicking" is wrong).
Example Question #5 : Classifying Disorders
Normal neurodevelopment in children is typically characterized by the acquisition of personal, social, academic, and occupational functioning. These functions are often learned and developed before the child begins primary education. During this period, the child learns social skills and how to control executive functions. Neurodevelopmental disorders involve developmental deficits that are manifested as impairments in normal neurodevelopment. Impairments in intelligence and social skills are often associated with neurodevelopmental disorders, and they frequently occur together.
A child and adolescent psychiatrist wanted to further characterize children with neurodevelopmental disorders according to several protocols. The psychiatrist observed all children with any identified impairments of social skills and any associated intellectual disability The psychiatrist noted the following: communication disorder, impairment in attention, impairment in organization, motor disorder, repetitive behaviors, restricted behaviors, or other interests.
The child and adolescent psychiatrist concluded that children with repetitive and restricted interests or patterns of behavior often demonstrate impairments in social skills. Some of the children who had restricted interests, repetitive patterns of behavior, and impairments in social skills also had intellectual impairments, language impairments, associated medical conditions, or other associated mental or behavioral disorders. It was found that specifying the individual characteristics of the neurodevelopmental disorders provided the child and adolescent psychiatrist the ability to better describe the diagnosis and associated symptoms to patients and their families.
In concluding that children with repetitive, restricted interests and patterns of behavior often demonstrate impairments in social skills, the child and adolescent psychiatrist assumed that impairments in social skills are considered to be which of the following?
Deficits in social communication and social interaction across many contexts
Masked by compensatory mechanisms
Nonverbal behaviors used for social interactions
Cause of significant impairment
Symptoms that may not be accompanied by excessively repetitive behaviors
Symptoms that may not be accompanied by excessively repetitive behaviors
Symptoms that may not be accompanied by excessively repetitive behaviors is the best choice because it directly addresses that impairments in social skills may be seen in the presence or absence of restricted, repetitive behaviors. Autism spectrum disorder is characterized by social communication impairments and restricted, repetitive patterns of behavior, often in the first 2 years of life. None of the other choices discuss the association that impairments in social skills may have with restricted interests and repetitive behaviors.
Example Question #6 : Classifying Disorders
Normal neurodevelopment in children is typically characterized by the acquisition of personal, social, academic, and occupational functioning. These functions are often learned and developed before the child begins primary education. During this period, the child learns social skills and how to control executive functions. Neurodevelopmental disorders involve developmental deficits that are manifested as impairments in normal neurodevelopment. Impairments in intelligence and social skills are often associated with neurodevelopmental disorders, and they frequently occur together.
A child and adolescent psychiatrist wanted to further characterize children with neurodevelopmental disorders according to several protocols. The psychiatrist observed all children with any identified impairments of social skills and any associated intellectual disability The psychiatrist noted the following: communication disorder, impairment in attention, impairment in organization, motor disorder, repetitive behaviors, restricted behaviors, or other interests.
The child and adolescent psychiatrist concluded that children with repetitive and restricted interests or patterns of behavior often demonstrate impairments in social skills. Some of the children who had restricted interests, repetitive patterns of behavior, and impairments in social skills also had intellectual impairments, language impairments, associated medical conditions, or other associated mental or behavioral disorders. It was found that specifying the individual characteristics of the neurodevelopmental disorders provided the child and adolescent psychiatrist the ability to better describe the diagnosis and associated symptoms to patients and their families.
Impairments in intelligence and social skills seen in the neurodevelopmental disorders indicate which of the following?
Communication disorders may produce lifelong functional impairments
Symptoms may change with development
Range of developmental deficits varies
A neurocognitive disorder may also be diagnosed in case of global developmental delay
Specific learning disorder may occur in children identified as intellectually gifted
Range of developmental deficits varies
Symptoms of developmental deficits may vary from specific learning disorders to gross limitations in learning intellectual and social skills. The "range of developmental deficits varies" describes the variability that may be seen in the neurodevelopmental disorders. The other choices can be eliminated because they describe specific disorders or prognosis and do not describe the range of limitations that may be seen.
Example Question #7 : Classifying Disorders
Normal neurodevelopment in children is typically characterized by the acquisition of personal, social, academic, and occupational functioning. These functions are often learned and developed before the child begins primary education. During this period, the child learns social skills and how to control executive functions. Neurodevelopmental disorders involve developmental deficits that are manifested as impairments in normal neurodevelopment. Impairments in intelligence and social skills are often associated with neurodevelopmental disorders, and they frequently occur together.
A child and adolescent psychiatrist wanted to further characterize children with neurodevelopmental disorders according to several protocols. The psychiatrist observed all children with any identified impairments of social skills and any associated intellectual disability The psychiatrist noted the following: communication disorder, impairment in attention, impairment in organization, motor disorder, repetitive behaviors, restricted behaviors, or other interests.
The child and adolescent psychiatrist concluded that children with repetitive and restricted interests or patterns of behavior often demonstrate impairments in social skills. Some of the children who had restricted interests, repetitive patterns of behavior, and impairments in social skills also had intellectual impairments, language impairments, associated medical conditions, or other associated mental or behavioral disorders. It was found that specifying the individual characteristics of the neurodevelopmental disorders provided the child and adolescent psychiatrist the ability to better describe the diagnosis and associated symptoms to patients and their families.
If a 5-year-old boy who, in comparison to the boy's matched agemates, has severe difficulties in learning skills involving reading, writing, and arithmetic and is without ongoing support, then the child will most likely exhibit which of the following?
Require supervision at all times
Be mature in social interactions
Show much more complex spoken language than that of peers
Need no support
Be able to care for personal needs
Require supervision at all times
The level of severity of intellectual disability is based on adaptive functioning (e.g. personal independence), and adaptive functioning determines the amount of support needed. In the absence of ongoing support, the adaptive deficits in children with severe intellectual disability will limit independence for all activities of daily living ("require supervision at all times"). "Need no support" is wrong since all patients with intellectual disability, dependent on adaptive functioning, require some level of support. "Be able to care for personal needs" can be eliminated since patients with severe intellectual disability require support for all activities of daily living.
Example Question #8 : Classifying Disorders
Normal neurodevelopment in children is typically characterized by the acquisition of personal, social, academic, and occupational functioning. These functions are often learned and developed before the child begins primary education. During this period, the child learns social skills and how to control executive functions. Neurodevelopmental disorders involve developmental deficits that are manifested as impairments in normal neurodevelopment. Impairments in intelligence and social skills are often associated with neurodevelopmental disorders, and they frequently occur together.
A child and adolescent psychiatrist wanted to further characterize children with neurodevelopmental disorders according to several protocols. The psychiatrist observed all children with any identified impairments of social skills and any associated intellectual disability The psychiatrist noted the following: communication disorder, impairment in attention, impairment in organization, motor disorder, repetitive behaviors, restricted behaviors, or other interests.
The child and adolescent psychiatrist concluded that children with repetitive and restricted interests or patterns of behavior often demonstrate impairments in social skills. Some of the children who had restricted interests, repetitive patterns of behavior, and impairments in social skills also had intellectual impairments, language impairments, associated medical conditions, or other associated mental or behavioral disorders. It was found that specifying the individual characteristics of the neurodevelopmental disorders provided the child and adolescent psychiatrist the ability to better describe the diagnosis and associated symptoms to patients and their families.
In order to make the diagnosis of intellectual disability, the intellectual and adaptive functioning deficits must be distinct from those characterized by autism spectrum disorder, communication disorders, specific learning disorder, and the neurocognitive disorders. To make the diagnosis of intellectual disability from the differential diagnoses, then which of the following would be the most logical action to take?
Show deficits specific to the learning domains
Show a loss of cognitive functioning, such as following a head injury
Show onset of disability during developmental period
Link the intellectual disability to a genetic syndrome
Show IQ scores are unstable
Show onset of disability during developmental period
The diagnosis of intellectual disability is made when the onset of intellectual and adaptive function deficits is in the developmental period. The neurocognitive disorders are characterized by a loss of cognitive functioning and may occur with intellectual disability. Specific learning disorder is specific to the learning domains and does not show deficits in intellectual function and adaptive behaviors.
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