Selection of Categories of Psychological Disorders

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AP Psychology › Selection of Categories of Psychological Disorders

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1

A child has severe temper outbursts three times weekly and persistently irritable mood between outbursts for 12 months. Diagnosis?

Oppositional Defiant Disorder, involving defiance and vindictiveness, not necessarily severe recurrent outbursts with chronic irritability.

Intermittent Explosive Disorder, involving discrete outbursts without persistent irritable mood between episodes in children.

Bipolar I Disorder, involving episodic mania; chronic irritability without discrete manic episodes is not sufficient for bipolar I.

Disruptive Mood Dysregulation Disorder, with frequent severe temper outbursts and persistent irritability for at least 12 months.

Explanation

This describes Disruptive Mood Dysregulation Disorder (DMDD), characterized by severe recurrent temper outbursts (verbal or behavioral) that are grossly out of proportion to the situation, occurring three or more times per week for at least 12 months with no more than three consecutive months without symptoms. The mood between outbursts is persistently irritable or angry most of the day, nearly every day. Onset must be before age 10. ODD involves defiance and vindictiveness but not necessarily the severe recurrent outbursts with chronic irritability. Bipolar I requires discrete manic episodes with elevated mood and increased activity; chronic irritability alone isn't sufficient. Intermittent Explosive Disorder doesn't typically involve persistent irritable mood between episodes in children.

2

A person has chronic worry about many topics, restlessness, muscle tension, and sleep problems for over six months. Diagnosis?

Generalized Anxiety Disorder, defined by excessive anxiety and worry across domains with associated symptoms for at least six months.

Panic Disorder, defined by unexpected panic attacks and concern about attacks, not persistent broad worry across topics.

Obsessive-Compulsive Disorder, involving obsessions and compulsions, not primarily generalized worry with tension and insomnia.

Posttraumatic Stress Disorder, requiring trauma exposure and intrusion/avoidance symptoms, not generalized worry without a trauma trigger.

Explanation

This describes Generalized Anxiety Disorder (GAD), characterized by excessive anxiety and worry about multiple events or activities occurring more days than not for at least six months. The worry is difficult to control and associated with at least three additional symptoms (restlessness, fatigue, concentration problems, irritability, muscle tension, sleep disturbance). The key features are the generalized nature across multiple domains, chronicity (six months), and associated physical/cognitive symptoms. Panic Disorder involves discrete panic attacks and worry about future attacks. OCD involves specific obsessions and compulsions. PTSD requires trauma exposure and specific trauma-related symptom clusters including intrusion and avoidance symptoms.

3

A person repeatedly violates others’ rights, lies, is impulsive, and shows lack of remorse since age 15. Which diagnosis fits?

Narcissistic Personality Disorder, involving grandiosity and need for admiration, not a consistent pattern of unlawful behavior and remorse deficits.

Antisocial Personality Disorder, requiring pervasive disregard for others’ rights since age 15 and evidence of Conduct Disorder before age 15.

Intermittent Explosive Disorder, involving discrete aggressive outbursts, not pervasive deceit, exploitation, and longstanding violation of rights.

Borderline Personality Disorder, involving abandonment fears and affective instability, not primarily chronic rights violations and deceitfulness.

Explanation

This describes Antisocial Personality Disorder, which requires a pervasive pattern of disregard for and violation of others' rights occurring since age 15, evidence of Conduct Disorder before age 15, and the individual must be at least 18 years old. Key features include repeated unlawful acts, deceitfulness, impulsivity, irritability and aggressiveness, disregard for safety, consistent irresponsibility, and lack of remorse. The pattern must be pervasive and longstanding, not limited to discrete episodes. Narcissistic Personality Disorder involves grandiosity but not necessarily criminal behavior or lack of remorse. Borderline Personality Disorder involves emotional instability and abandonment fears. Intermittent Explosive Disorder involves discrete aggressive outbursts, not a pervasive pattern of rights violations.

4

A teen has inattention and hyperactivity across home and school for 8 months, impairing grades. Which disorder fits best?

Autism Spectrum Disorder, defined by social-communication deficits and restricted, repetitive behaviors, not primarily by cross-setting hyperactivity and distractibility.

Oppositional Defiant Disorder, characterized by angry/irritable mood and defiant behavior toward authority, without primary attention and hyperactivity symptoms.

Attention-Deficit/Hyperactivity Disorder, Combined Presentation, with persistent inattention and hyperactivity-impulsivity across settings causing functional impairment.

Generalized Anxiety Disorder, involving excessive worry and tension; concentration problems may occur but hyperactivity across settings is not central.

Explanation

This case presents classic symptoms of Attention-Deficit/Hyperactivity Disorder (ADHD), Combined Presentation. The key diagnostic features include persistent inattention and hyperactivity occurring across multiple settings (both home and school) for at least 6 months, causing functional impairment in academic performance. ADHD requires symptoms to be present before age 12 and to interfere with functioning in two or more settings. While Oppositional Defiant Disorder involves defiant behavior, it lacks the core attention and hyperactivity symptoms. Autism Spectrum Disorder is characterized by social-communication deficits and repetitive behaviors rather than hyperactivity as the primary concern. Generalized Anxiety Disorder may include concentration difficulties but does not feature the pervasive hyperactivity across settings that defines ADHD.

5

A child has multiple motor and vocal tics for over one year, starting before age 18. Which diagnosis fits best?

Tourette’s Disorder, defined by multiple motor tics and at least one vocal tic persisting over one year with onset before 18.

Obsessive-Compulsive Disorder, involving compulsions driven by obsessions, not involuntary motor and vocal tics.

Stereotypic Movement Disorder, involving repetitive nonfunctional movements, not sudden, rapid, recurrent tics with vocal components.

Persistent (Chronic) Motor Tic Disorder, involving motor tics only without vocal tics, persisting over one year.

Explanation

This describes Tourette's Disorder, which requires both multiple motor tics and one or more vocal tics present at some time during the illness, occurring many times a day nearly every day or intermittently for more than one year, with onset before age 18. Tics are sudden, rapid, recurrent, nonrhythmic motor movements or vocalizations. The combination of multiple motor tics AND vocal tics persisting over one year distinguishes Tourette's from other tic disorders. Persistent Motor Tic Disorder involves only motor tics without vocal tics. Stereotypic Movement Disorder involves repetitive nonfunctional movements that are more rhythmic and purposeless than tics. OCD involves obsessions and compulsions, not involuntary tics.

6

A person persistently believes they are severely overweight despite being underweight and restricts intake intensely. Which disorder fits?

Binge-Eating Disorder, involving binge episodes without compensatory behaviors, not persistent restriction leading to low weight.

Anorexia Nervosa, involving restriction leading to significantly low weight plus intense fear of weight gain and body image disturbance.

Bulimia Nervosa, involving recurrent binge eating with compensatory behaviors, typically without significantly low body weight.

Avoidant/Restrictive Food Intake Disorder, involving restriction without body image disturbance or fear of gaining weight.

Explanation

This case describes Anorexia Nervosa, which has three core features: restriction of energy intake leading to significantly low body weight, intense fear of gaining weight or becoming fat (or persistent behavior that interferes with weight gain), and disturbance in the way body weight or shape is experienced. The persistent belief of being severely overweight despite being underweight demonstrates the required body image disturbance. Bulimia Nervosa involves binge eating with compensatory behaviors and typically occurs at normal or above-normal weight. Binge-Eating Disorder involves recurrent binges without restriction leading to low weight. ARFID involves food restriction but without the body image disturbance or fear of weight gain.

7

A child shows limited eye contact, social reciprocity difficulties, and repetitive behaviors beginning in early development. Best category?

Personality Disorders, because enduring maladaptive traits begin by early adulthood and are stable across many contexts.

Disruptive, Impulse-Control, and Conduct Disorders, because aggression and rule violations are required for diagnosis.

Neurodevelopmental Disorders, because early-onset social communication differences and restricted, repetitive behaviors define this category.

Anxiety Disorders, because social avoidance is driven by fear of judgment rather than developmental social-communication differences.

Explanation

Limited eye contact, difficulties with social reciprocity, and repetitive behaviors beginning in early development are core features of Autism Spectrum Disorder, which falls under Neurodevelopmental Disorders. ASD is characterized by persistent deficits in social communication and social interaction across contexts, plus restricted, repetitive patterns of behavior, interests, or activities, with symptoms present in early developmental period. Personality Disorders don't typically begin until adolescence or early adulthood. Anxiety Disorders might cause social avoidance but don't include the developmental social-communication deficits or repetitive behaviors. Disruptive disorders focus on aggression and rule-breaking rather than social-communication differences.

8

An adult has 3 weeks of elevated mood, decreased need for sleep, grandiosity, and risky spending causing hospitalization. Which diagnosis fits best?

Cyclothymic Disorder, involving numerous hypomanic and depressive symptoms for at least 2 years without full manic episodes or hospitalization.

Bipolar I Disorder, defined by at least one manic episode with marked impairment, possible hospitalization, and elevated or irritable mood.

Schizoaffective Disorder, requiring mood episodes plus psychotic symptoms persisting independently; mania alone with hospitalization is insufficient.

Major Depressive Disorder, requiring at least 2 weeks of depressed mood or anhedonia, not sustained elevated mood with grandiosity.

Explanation

This presentation clearly describes a manic episode characteristic of Bipolar I Disorder. The patient exhibits the classic triad of mania: elevated mood, decreased need for sleep, and grandiosity, along with risky behavior (excessive spending) severe enough to require hospitalization. A single manic episode lasting at least one week (or any duration if hospitalization is required) is sufficient for a Bipolar I diagnosis. Cyclothymic Disorder involves milder hypomanic symptoms without full manic episodes or hospitalization. Major Depressive Disorder involves depressed mood and anhedonia, not the elevated mood and grandiosity seen here. Schizoaffective Disorder requires both mood episodes and psychotic symptoms that occur independently of mood episodes, which is not described in this case.

9

A person has multiple distinct identities and recurrent gaps in recall for everyday events. Which diagnosis is most consistent?

Delusional Disorder, because fixed false beliefs occur without prominent identity disruption or recurrent amnesia.

Depersonalization/Derealization Disorder, because identity remains intact while experiences of unreality or detachment are primary.

Dissociative Identity Disorder, because distinct identity states plus recurrent amnesia for daily events are defining features.

Schizophrenia, because hallucinations and delusions are required and best explain identity changes and memory problems.

Explanation

Multiple distinct identity states (previously called personalities) combined with recurrent gaps in recall for everyday events are the two required features for Dissociative Identity Disorder (DID). This disorder involves disruption of identity characterized by two or more distinct personality states, with recurrent gaps in recall that are inconsistent with ordinary forgetting. Depersonalization/Derealization Disorder involves feelings of detachment or unreality but maintains a single, intact identity. Schizophrenia might involve identity confusion but centers on psychotic symptoms like hallucinations and delusions. Delusional Disorder involves fixed false beliefs without the identity fragmentation seen in DID.

10

After a car crash, an adult has nightmares, avoidance, hypervigilance, and guilt for 2 months. Which disorder category applies?

Schizophrenia Spectrum and Other Psychotic Disorders, characterized by delusions, hallucinations, and disorganized thinking, not trauma-triggered reexperiencing.

Trauma- and Stressor-Related Disorders, defined by exposure to trauma and subsequent intrusion, avoidance, negative mood/cognition, and arousal symptoms.

Anxiety Disorders, centered on fear and worry without requiring trauma exposure or a specific intrusion-avoidance symptom cluster.

Dissociative Disorders, involving depersonalization, derealization, or amnesia as primary symptoms rather than trauma-linked intrusion and avoidance.

Explanation

This scenario describes Post-Traumatic Stress Disorder (PTSD), which falls under Trauma- and Stressor-Related Disorders. The patient experienced a traumatic event (car crash) followed by the characteristic symptom clusters of PTSD: intrusion symptoms (nightmares), avoidance behaviors, negative alterations in mood and cognition (guilt), and alterations in arousal and reactivity (hypervigilance). These symptoms have persisted for more than one month, meeting the duration criterion for PTSD. Anxiety Disorders do not require trauma exposure as a precipitating event. Dissociative Disorders primarily involve disruptions in consciousness, memory, or identity rather than the trauma-linked symptom constellation seen here. Schizophrenia Spectrum Disorders involve psychotic symptoms like hallucinations and delusions, not trauma-triggered reexperiencing and avoidance.

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