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Focused Disorders (Anxiety (Social anxiety disorder (Marked fear or…

- - - - Recurrent excessive distress when anticipating or experiencing separation from home or from major attachment figures
      - Persistent and excessive worry about losing major attachment figures or about possible harm to them such as illness, injury, disasters, or death
      - Persistent and excessive worry about experiencing an untoward event that causes separation from a major attachment figure
      - Persistent reluctance or refusal to go out away from home because of fear of separation
      - Persistent and excessive fear of or reluctance/refusal to sleep away from home or sleep without a major attachment figure nearby
      - Repeated nightmares about separation
      - Repeated complaints of physical symptoms when separating from a major attachment figure
  - - - Palpitations, pounding heart, or accelerated heart rate
      - Sweating
      - Trembling or shaking
      - Sensations of shortness of breath or smothering
      - Feelings of choking
      - Chest pain or discomfort
      - Nausea or abdominal distress
      - Feeling dizzy, unsteady, light headed, or feint
      - Chills or heat sensations
      - Paresthesias (numbness or tingling feeling)
      - Derealisation or depersonalisation
      - Fear of losing control or going crazy
      - Fear of dying
    - - Persistent concern or worry about an additional attack or their consequences
      - A significant maladaptive change in behaviour related to the attacks
  - - - Using public transport
      - Being in open spaces
      - Being in enclosed spaces
      - Standing in line or in a crowd
      - Being outside of the home alone
  - - - Restlessness or feeling keyed up or on edge
      - Being easily fatigued
      - Difficulty concentrating or mind going blank
      - Irritability
      - Muscle tension
      - Sleep disturbance
- - - - A pervasive distrust and suspicion of others. Beginning in early adulthood
        
        Suspects without sufficient basis that others or exploiting them
        
        Preoccupied with doubts of trustworthiness of friends
        
        Reluctance to confide in others for fear the info will be used against them
        
        Reading negative meaning in benign comments/actions
        
        Persistently bears grudges
        
        Perceives attack on character not apparent to others
        
        Recurrent suspicions w/o justification, of spousal infidelity
      - Does not occur exclusively during the course of schizophrenia, bipolar, depressive disorder w/ psychotic features, or another psychotic disorder and is not attributed to physiological effects of a medical condition
    - - A pervasive pattern of detachment from social relationships and a restricted range of emotions in interpersonal settings. beginning in early adulthood.
        
        Neither enjoys or desires close relationships
        
        Almost always chooses solitary activities
        
        Has little, if any, interest in sexual experiences
        
        Takes pleasure in few if any activities
        
        Lacks close friends
        
        Appears indifferent to praise/critique
        
        Shows emotional coldness or flattened affect
      - Does not occur exclusively in the course of schizophrenia, bipolar or depressive disorder with psychotic features, other psychotic disorder, or ASD, or effects from a medical condition
    - - A pervasive pattern of social and interpersonal deficits marked by acute discomfort with, and reduced capacity for, close relationships as well as cognitive or perceptual distortions and eccentricities of behaviour. beginning early adulthood
        
        Ideas of reference
        
        Odd beliefs or magical thinking that influence behaviour (outside of cultural norms)
        
        Unusual perceptual experiences
        
        Odd thinking and speech
        
        Suspicious or paranoid ideation
        
        Inappropriate or constricted affect
        
        Behaviour appears odd, eccentric, or peculiar
        
        Excessive social anxiety that does not diminish with familiarity. tends to be associated with paranoid fears rather than negative self judgements
      - Does not occur exclusively in the course of schizophrenia, bipolar or depressive disorder with psychotic features, other psychotic disorder, or ASD
  - - - A pervasive pattern of disregard for and violation of the rights of others. Occurring since age 15
        
        Failure to conform to social norms with respect to lawful behaviours. Indicated by repeatedly performing acts that are grounds for arrest
        
        Deceitfulness
        
        Impulsivity or failure to plan ahead
        
        Irritability and aggressiveness. Indicated by repeated fights or assaults
        
        Reckless disregard for safety of self and others
        
        Consistent irresponsibility. Indicated by repeated failure to sustain consistent work behaviour or meet financial obligations
        
        Lack of remorse
      - At least 18
      - Evidence of conduct disorder before 15
      - Not exclusively during the course of Schizophrenia or bipolar
    - - A pervasive pattern of instability of interpersonal relationships, self image, and affect. marked by impulsivity. beginning in early adulthood.
        
        Frantic efforts to avoid real or imagined abandonment
        
        A pattern of unstable and intense interpersonal relationships characterised by alternating extremes of idealisation and devaluation
        
        Identity disturbance. Marked by persistent unstable self image or sense of self
        
        Impulsivity in at least two areas that are potentially self damaging. eg, spending, sex, substance abuse, reckless driving, binge eating.
        
        Recurrent suicidal behaviour, gestures, threats, or slef mutilating behaviours
        
        Affective instability due to marked reactivity of mood
        
        Chronic feelings of emptiness
        
        Inappropriate intense anger or poor anger control
        
        Transient, stress related paranoid ideation or sever dissociative symptoms
    - - A pervasiven pattern of excessive emotionality and attention seeking. Beginning by early adulthood
        
        Is uncomfortable in situations where they are not the center of attention
        
        Interaction with others is often chracterised by inappropriate sexually seductive or provocative behaviour
        
        Displays rapidly shifting shallow expression of emotions
        
        Consistently uses physical appearance to draw attention to self
        
        Has a style of speech that is excessively impressionistic and lacking in detail
        
        Shows self dramatisation, theatricality, and exaggerated emotion
        
        Is suggestible
        
        Considers relationships to be more intimate than they are
    - - A pervasive pattern f grandiosity (in fantasy or behaviour), need for attention, and lack of empathy. Beginning early adulthood.
        
        Has grandiose sense of self importance
        
        Is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love
        
        Believes they are special and unique and can only be understood by or should be associated with, other special or high status people
        
        Requires excessive admiration
        
        Has a sense of entitlement
        
        Is interpersonally exploitative
        
        Lacks empathy
        
        Is often envious of others or believes other are envious of them
        
        Shows arrogant, haughty behavious or attitudes
  - - - A pervasive pattern of social inhibition, feelings of inadequacy, and hyper sensitivity to negative evaluation. Beginning in early adulthood
        
        Avoids occupational activities that involve significant interpersonal contact because of fears of criticism, disapproval, or rejection
        
        Is unwilling to get involved with people unless certain of being liked
        
        Shows restraint within intimate relationships because of fear of being shamed or ridiculed
        
        Is preoccupied with being criticised or rejected in social situations
        
        Is inhibited in new interpersonal situations because of feelings of inadequacy
        
        Views self as socially inept, personally unappealing, or inferior to others
        
        Is usually reluctant to take personal risks or to engage in any new activities because they may prove embarrassing
    - - A pervasive pattern of excessive need to be taken care of that leads to submissive and clinging behaviour and fears of seperation. Beginning in early adulthood
        
        Has difficulty making everyday decisions without excessive advice and reassurance
        
        Needs others to assume responsibility for most areas of life
        
        Has difficulty expressing disagreement with others for fear of loss of support or approval
        
        Has difficulty initiating projects or doing things on their own
        
        Goes to excessive lengths to obtain nurturence and support from others, to the point of volunteering for things that are unpleasant
        
        Feels uncomfortable or helpless when alone because of exaggerated fears of being unable to care for self
        
        Urgently seeks out another relationship as a source of care and support when a close relationship ends
        
        Is unrealistically preoccupied with fears of being left to take care of self
    - - A pervasive pattern of preoccupation with orderliness, perfectionism, and mental and interpersonal control, at the expense of flexibility, openness, and efficiency. Beginning by early adulthood
        
        Is preoccupied with details, rules, lists, order, organisation, or schedules to the extent that the major point of the activity is lost
        
        Shows perfectionism that interferes with task completion
        
        Is excessively devoted to work and productivity to the exclusion of leisure activities and friendship
        
        Is overconscientious, scrupulous, and inflexible about matters of morality, ethics, or values
        
        Is unable to discard worn-out or worthless objects even when they have no sentimental value
        
        Is reluctant to delegate tasks or work to others unless they submit to exactly they way of doing things
        
        Adopts a miserly spending style towards both self and others. Money is viewed as something to be hoarded against future catastrophy
        
        Shows rigidity and stubbornness
- - - - Criteria has been met for at least one manic episode
        
        Manic Episode
        
        A distinct period of abnormally and persistently elevated, expansive, or irritable mood and abnormally and persistently increased activity or energy. Lasting at least 1 week and last most of the day, nearly every day (or any duration if hospitalisation is required)
        
        During the period of mood disturbance and increased energy and activity 3+ of the following symptoms are present to a significant degree and are a noticable change from usual behaviour
        
        Inflated self esteem or grandiosity
        
        Decreased need for sleep
        
        More talkative
        
        Flight of ideas or subjective experience that thoughts are racing
        
        Distractibility
        
        Increase in goal directed activity or psychomotor agitation
        
        Excessive involvement in in activities that have a high risk for painful consequences
        
        The mood disturbance is sufficiently severe to cause marked impairment in social or occupational functioning, or to necessitate hospitalisation to prevent harm, or there are psychotic features
        
        The episode is not attributed to effects of a substance
      - The occurrence of the manic and major depressive episode(s) are not better explained by another disorder
    - - Criteria has been met for a hypomanic episode
        
        Hypomanic Episode
        
        A distinct period of abnormally and persistently elevated, expansive, or irritable mood and abnormally and persistently increased activity or energy. Lasting at least 4 consecutive days and lasting most of the day, nearly every day
        
        During the period of mood disturbance and increased energy and activity 3+ of the following symptoms have persisted and are a noticable change from usual behaviour
        
        The episode is associated with an unequivocal change in functioning that is uncharacteristic of the individual
        
        The disturbance in mood and change in functioning is observable by others
        
        The episode is not severe enough to cause marked impairment to social or occupational functioning or to necessitate hospitalisation. There are no psychotic features (this would cause it to be classified as a manic episode)
        
        The episode is not attributable to the effects of a substance
      - Criteria has been met for a major depressive episode
        
        Major Depressive Episode
        
        5+ of the following have been present during the same 2 week period and represent a change from previous functioning. At least one symptom is either depressed moon or loss of interest or pleasure.
        
        Depressed mood most of the day, nearly every day
        
        Markedly diminished interest or pleasure in all or almost all activities most of the day, nearly every day
        
        Significant weight loss when not dieting or weight gain (>5% in one month) or decrease/increase in appetite nearly every day
        
        Insomnia or hyposomnia nearly every day
        
        Psychomotor agitation or retardation nearly every day. Observable by others
        
        Fatigue or loss of energy nearly every day
        
        Feelings of worthlessness or excessive inappropriate guilt nearly every day
        
        Diminished ability to think or concentrate, or indecisiveness, nearly every day
        
        Recurrent thoughts of death, recurrent suicidal ideation without a specific plan, a suicide attempt, or a specific plan for suicide
        
        The symptoms cause clinically significant distress or impairment in social, occupational, or other areas of functioning
        
        The episode is not attributed to the psychological effects of substance or another medical condition
      - There has never been a manic episode
      - The occurrence of the episodes (hypomania/depressive) is not better explained by by another disorder
      - The symptoms of the depressive episode or the unpredictablitiy of the alternating periods of depression/hypomania cause clinically significant distress or social/occupational impairment
    - - For at least 2 years (one of which in childhood or adolescence) there have been numerous periods with hypomanic symptoms that do not meet criteria for a hypomanic episode, and numerous periods with depressive symptoms that do not meet the criteria for a major depressive episode
      - During the two year period the hypomanic/depressive periods have been present for at least half the time and the symptoms have not been absent for more than two months at a time
      - Criteria for mania, hypomania, and major depression episodes have never been met
      - Symptoms are not better explained by another disorder
      - Symptoms are not better explained by physiological effects of substances or other medical conditions
      - The symptoms cause clinically significant distress or impairment in social/occupational/other areas of functioning
  - - - A severe recurrent temper outbursts manifested verbally and/or behaviourally, that are grossly disproportionate to the the situation
      - Outbursts are inconsistent with developmental level
      - Outburst occur, on average, 3+ times a week
      - Mood between outbursts is persistently angry or irritable, nearly every day
      - Symptoms have been present 12+ months (without three consecutive months without all symptoms)
      - Symptoms present in 3+ settings (home, school, peers) and is severe in at least 1
      - Diagnosed between 6-18
      - No period where symptoms would be met for mania or hypomania
      - Symptoms do not occur exclusively in a major depressive episode and are not better explained by another disorder
      - Symptoms are not an effect of substances or neurological condition
      - Onset before 10
    - - Symptoms for a major depressive episode are met
      - The occurance of the makor depressive episode is not better explained by another disorder
      - There has never been a manic or hypomanic episode (exclude manic/hypomanic like symptoms if they were substance induced or the effect of another medical condition
    - - Depressed mood most of the day for more days than not, as indicated by subjective account or observation by others, for at least two years
      - Presence, while depressed, of 2+
        
        Poor appetite/over eating
        
        Insomnnia/hypersomnia
        
        Low energy/fatigue
        
        Low self esteem
        
        Poor concentration or difficulty making decisions
        
        Feelings of hopelessness
      - During the two year period (1 year for child/adolescence) the individual has never been without symptoms for more than two months at a time
      - Criteria for a major depressive disorder may be present for 2 years
      - There has never been a manic or hypomanic episode, and criteria for cyclothymia has never been met
      - The disturbance is not better explained by another disorder
      - The symptoms are not the result of substances
      - Symptoms cause clinically significant distress or impairment
    - - In the majority of menstrual cycles 5+ symptoms must be present in the final week before onset of menses, start to improve within a few days after the onset, and become minimal or absent in the week post menses
        
        1+ Symptoms
        
        Marked affect lability
        
        Marked irritability or anger or increased interpersonal conflict
        
        Marked depressed mood, feelings of hopelessness, or self depreciating thoughts
        
        Marked anxiety, tension, or feelings of being on edge
        
        1+ symptoms for a total of 5+ in combination with other symptoms
        
        Decreased interest in usual activities
        
        Subjective difficulty to concentrate
        
        Lethargy
        
        Marked change in appetite +/-
        
        Hypersomnia/ insomnia
        
        A sense of being overwhelmed/ out of control
        
        Physical symptoms such as breast tenderness or swelling, joint or muscle pain, a sense of bloating, or weight gain
      - The symptoms are associated with clinically significant distress or interference with work, activities, social etc.
      - The disturbance is not merely exacerbation of symptoms from another disorder
      - The symptoms should be confirmed by at least two symptomatic cycles
      - The symptoms are not attributed to the use of substance
- - - - Concern of the individual, a knowledgeable informant, or the clinician of significant decline
      - A substantial impairment in cognitive performance, preferably documented by psychological assessment
    - - Alzheimers
      - Frontotemporal lobar degeneration
      - Lewy body disease
      - Vascular disease
      - Traumatic brain injury
      - HIV
      - Substance use
      - Prion disease
      - Parkinson's
      - Huntington's
      - Other
    - - Mild
        
        Difficulties with instrumental activities of daily living
      - Moderate
        
        Difficulties with basic activities in daily living
      - Severe
        
        Fully dependant