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psychopathology - Coggle Diagram

- - - - SSRIs
    - - Exposure
        
        In Vivo
        
        Direct
      - Cognitive Therapy
      - Treating Acute Stress Disorder may prevent PTSD
  - - - In cases of actual or threatened death of family member/friend, the event/s must have been violent or accidental
    - - Does not apply to exposure through electronic media, television, movies, or pictures, unless this exposure is work related (e.g. facebook moderators)
- - - - Types of Delusions (Bizzare)
        
        Persecutory
        
        Belief that one is going to be harmed, harrassed, and so forth by an individual, organisation, or other group
        
        Referential
        
        Belief that certain gestures, comments, environment cues, and so forth are directed at oneself
        
        Grandiose
        
        Belief that one has exceptional abilities, wealth, or fame
        
        Erotomanic
        
        False belief that someone else is in love with them
        
        Nihilistic
        
        Belief that a major catastrophe will occur
        
        Somatic
        
        Preoccupations regarding health and organ function
        
        Thought Withdrawal
        
        Belief that one's thoughts have been ''removed'' by some outside force
        
        Thought Insertion
        
        Belief that alien thoughts have been put into one's mind
        
        Delusions of Control
        
        Belief that one's body or actions are being acted on or manipulated by some outside force
        
        Thought Broadcasting
        
        Belief that others can read one's thoughts
      - Fixed beliefs unamenable in light of conflicting evidence
    - - Types of Hallucinations
        
        Auditory
        
        74% have this symptom
        
        Visual
      - Perception-like experiences that occur without an external stimulus
  - - - Formal Thought Disorder
        
        Derailment or Loose Association
        
        Tangentiality
        
        Must substantially Impair Communication
  - - - Catatonic Immobility
        
        Waxy Flexibility
        
        Limbs can be manipulated and posed by another person
        
        Maintaining a rigid, inappropriate or bizzare posture
      - Resistance to Instructions (Negativism)
      - Mutism and Stupor
        
        Complete Lack of Verbal and Motor Responses
      - Catatonic Excitement
        
        Purposeless and Excessive Motor Activity
  - - - 2+ of the following, each present for significant portion of time during 1 month period. At least 1 symptom is 1/2/3
        
        Delusions
        
        Hallucinations
        
        Disorganised speech
        
        Disorganised or catatonic behaviour
        
        Negative symptoms
      - Episode lasts 1+ month but 6- months.
        
        When diagnosis made without waiting for recovery, qualified as ''provisional''
      - Schizoaffective, depressive, or bipolar with psychotic features have been ruled out because either:
        
        No major depressive or manic episodes concurrent with active-phase symptoms
        
        If mood episode concurrent, present for minority of total duration of the active and residual phases
      - Disturbance not attributable to the physiological effects of a substance or other medical condition
    - - Presence of 1+ symptoms, at least 1 is 1/2/3
        
        Delusions
        
        Hallucinations
        
        Disorganised speech
        
        Disorganised or catatonic behaviour
        
        Do not include symptom if it is a culturally sanctioned response
      - Duration of episode is 1+ day but 1- month, with eventual return to premorbid level of functioning
      - Disturbance not better explained by MDD or Bipolar Disorder with psychotic features or anothe rpsychotic disorder, adn it snot attributable to the physiological effects of a substance or another medical condition
    - - Uninterrupted period of major mood episode concurrent with criterion A of schizophrenia
        
        Major depressive episode must include criterion A1: depressed mood
      - Delusions or hallucinations for 2+ weeks in the absence of major mood episode in lifetime duration of illness
      - Symptoms that meet criteria for major mood episode are present of the majority of the total duration of active and residual phases of illness
      - Disturbance not attributable to effects of substance or another medical condition
    - - Presence of 1+ delusions with duration of 1 month+
      - Criterion A for schizophrenia never met
        
        If hallucinations present, they are not prominent and are related to the delusional theme
      - Apart from impact of the delusion/s, functioning is not markedly impaired, and behaviour is not obviously bizzare or odd
      - If manic or major depressive episode occurred, these have been brief relative to the duration of the delusional periods
      - Disturbance not attributable to the physiological effects of a substance or anothe rmedical condition and is not better explained by another mental disorder such as BDD or OCD
  - - - First Generation
        
        Reduce Positive and Disorganised Symptoms
        
        Have Little/No Effect on Negative and Cognitive Symptoms
        
        Block D2 Receptors
        
        Generic/Trade Name
        
        Chlorpromazine
        
        Largactil
        
        Flupenthixol Decanoate
        
        Fluanxol
        
        Fluphenazine Decanoate
        
        Modecate
        
        Haloperidol
        
        Seranace
        
        Haldol
        
        Trifluoperazine
        
        Stelazine
        
        Zuclopenthixol Decanoate
        
        Clopixol
      - Second Generation
        
        Clozapine
        
        Agranulocytosis
        
        Neutrophils reduced in number -> immunocompromised
        
        Clozaril
        
        Clopine
        
        Lurasidone Olanzapine
        
        Latuda
        
        Zyprexa
        
        Amisulpride
        
        Solian
        
        Apriprazole
        
        Abilify
        
        Asenapine
        
        Saphris
        
        Paliperidone
        
        Invega
        
        Quetiapine
        
        Seroquel
        
        Risperidone
        
        Risperidal
        
        Ziprasidone
        
        Zeldox
      - Side Effects
        
        Sedation
        
        Dizziness
        
        Blurred Vision
        
        Restlessness
        
        Sexual dysfunction
        
        Extrapyramidal Effects
        
        Parkinson's like symptoms
        
        Tremors
        
        Shuffling Gait
        
        Blank, mask-like face
        
        Drooling
        
        Dystonia
        
        Muscle Rigidity or Spasming
        
        Dyskinesia
        
        Abnormal Motion of Voluntary and Involuntary Muscles
        
        Chewing Movements
        
        Tardive Dyskinesia
        
        Mouth muscles involuntarily make sucking, lip-smacking, or chin-wagging motions
        
        Akathisia
        
        Inability to remain still
        
        Weight Gain
        
        Increased Prolactin
    - - Social Skills Training
        
        Roleplay Interpersonal Scenarios
      - Family Therapies
        
        Education about Schizophrenia
        
        Information about Antipsychotic Medication
        
        Blame Avoidance and Reduction
        
        Communication and Problem-Solving Skills Within the Family
        
        Social Network Expansion
        
        Hope
      - CBT
      - Cognitive Remediation Therapies
        
        Cognitive Enhancement Therapy (CET)
  - - - Diminished speech output
    - - Reductions in the expressions of emotions in the face, eye contact, prosody, and movements of the hand, head, and face that normally give an emotional emphasis to speech
    - - Decreased ability to experience pleasure
    - - Apparent lack of interest in social interactions and may be associated with avolition, but it can also be a manifestation of limited opportunities for social interaction
    - - Decrease in motivated self-initiated purposeful activities
  - - - Delusions
      - Hallucinations
      - Disorganised speech
      - Negative symptoms
    - - Or if child/adolescent, failure to achieve below expected level
    - - At least 1 month of active phase symptoms (Criterion A)
      - Prodromal and residual phase symptoms may be marked by negative symptoms and/or 2+ symptoms from Criterion A
    - - No major depressive/manic episodes concurrent with active phase
      - If present, they are minority of total duration of active and residual periods
- - - - In children may be expressed by crying, tantrums, freezing, or clinging
  - - - Meeting unfamiliar people
      - Being Observed by others
      - Performing in front of others
      - In children, anxiety must also occur in peer settings, not just with adults
    - - In children, fear or anxiety expressed by crying, tantrums, freezing, clinging, shrinking, or failing to speak in social situations
    - - If another medical condition present, the fear/anxiety/avoidance is clearly unrelated or is excessive
  - - - Panic attack
        
        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 faint
        
        Chills or heat sensations
        
        Paresthesias (Numbness or Tingling Sensations
        
        Derealisation or depersonalisation
        
        Fear of losing control or ''going crazy''
        
        Fear of dying
      - Culture-specific symptoms (tinnitus, neck soreness, headache, uncontrollable screaming or crying) may be seen. Such symptoms should not count as one of the four required symptoms
    - - Persistent concern or worry about an additional panic attack or their consequences
      - Signficant maladaptive change in behaviour related to the attacks
  - - - Using public transportation
      - Being in open spaces
      - Being in enclosed spaces
      - Standing in line or being in a crowd
      - Being outside of the home alone
    - - Agoraphobia and panic disorder can be comorbid/co-diagnosed
  - - - Restlessness or feeling keyed up or on edge
      - Easily fatigued
      - Difficulty concentrating or mind going blank
      - Irritability
      - Muscle tension
      - Sleep disturbance
  - - - Exposure
      - Systematic Densitisation
      - Cognitive Approaches
      - Panic Control Therapy (PCT)
      - CBT
      - Social Skills Training
    - - Anxiolytics
        
        Benzodiazepines
        
        Valium
        
        Xanax
        
        Antidepressants
        
        Tricyclics
        
        SSRIs
        
        SNRIs
      - D-Cycloserine (DCS)
        
        Desensitisation (Fear Learning)
- - - - Disproportionate and persistent thoughts about the seriousness of one's symptoms
      - Persistent high level of anxiety about health or symptoms
      - Excessive time and energy devoted to these symptoms or health concerns
  - - - If another medical condiiton present, or there is a risk for developing a medical condition, the preoccupation is clearly excessive or disproportionate
  - - - Medicolegal context of presentation
      - Marked discrepancy between teh indiviudal's claimed stress or disability and hte objective findings and observations
      - Lack of cooperation during the diagnostic evaluation and in complying with the prescribed treatment regiment
      - Presence of antisocial personality disorder
  - - - Falsification of physical or psychological signs or symptoms, or induction of injury or disease, associated with identified deception
      - The individual presents themself to others as ill, impaired, or injured
      - The deceptive behaviour is evident even in the absence of obvious external rewards
      - The behaviour is not better explained by another mental disorder, such as delusional disorder or another psychotic disorder
    - - Falsification of physical or psychological signs or symptoms, or induction of injury or disease, in another, associated with identified deception
      - The individual presents another individual (victim) to others as ill, impaired, or injured
      - The deceptive behaviour is evident even in the absence of obvious external rewards
      - The behaviour is not better explained by another mental disorder, such as delusional disorder or another psychotic disorder
  - - - CBT
    - - Antidepressants
- - - - Obsessions
        
        Recurrent and persistent thoughts, urges, or images that are experienced, at some time during the disturbance, as intrusive and unwanted, and that in most individuals cause marked anxiety or distress
        
        The indiviudal attempts to ignore or suppress such thoughts, urges, or images, or to neutralise them with some other thought or action
      - Compulsions
        
        Repetitive behaviours or mental acts that the indiviudal feels driven to perform in response to an obsession or according to rules that must be applied rigidly
        
        Behaviours or mental acts are aimed at preventing or reducing anxiety or distress, or preventing some dreaded event or situation; however the actions are not connected in a realistic way with what they are designed to neutralise or prevent, or are clearly excessive
    - - However OCD and Obsessive-Compulsive personality disorder can co-exist
  - - - If living areas uncluttered, it is only because of the interventions of functioning
  - - - Exposure plus Response Prevention
      - Cognitive Therapy
    - - SSRIs
      - Tricyclics
        
        Clomipramine
        
        Anafranil
- - - - Episodic
        
        Symptoms Present and Then Clear
        
        People diagnosed with MDD will likely experience at least 1 more episode, with lifetime average of 4 episodes
      - 5+ following symptoms present during same 2 week period and represent change from previous functioning. at least one of the symptoms is either depressed mood or loss of interest or pleasure
        
        Don't Include Symptoms Attributable to Another Medical Condition
        
        Depressed mood most of the day, nearly every day as indicated by either subjective report (feels sad, empty, hopeless) or observation made by others (appears tearful)
        
        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 (change of 5% body weight in a month), or decrease or increase in appetite nearly everyday
        
        Insomnia or Hypersomnia everyday
        
        Psychomotor Agitation or Retardation nearly everyday observable by others
        
        Fatigue or Loss of Energy nearly everyday
        
        Feelings of Worthlessness or Excessive or Inappropriate Guilt (which may be delusional) nearly every day (not self-reproach or guilt about being sick)
        
        Diminished Ability to Think or Concentrate, or Indecisiveness, nearly every day (subjective or observed by others)
        
        Recurrent Thoughts of Death (not just fear of dying), Recurrent Suicidal Ideation Without a Specific Plan, or a Suicide Attempt or a Specific Plan for Committing Suicide
      - The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
      - Episode not attributable to the physiological effects of a substance or another medical condition
      - Exercise clinical judgement based on the individual's history and the cultural norms for the expression of distress in the context of loss, as reponses to significant loss (bereavement, financial ruin, losses from natural disaster, a serious medical illness or disability) may result in symptoms from criterion A
      - At least one major depressive episode is not better explained by schizoaffective disorder and is not superimposed on schizophrenia, schizophreniform disorder, delusional disorder, or other specified or unspecified schizophrenia spectrum and other psychotic episode
      - There has never been a manic episode or a hypomanic episode
        
        Exclusion does not apply if all of the manic-like or hypomanic-like episodes are substance induced or are attributable to the physiological effects of another medical condition
    - - Depressed mood for most of the day, for more days than not, as indicated by either sbjective account or observation by others, for at least 2 Years
      - 2+ present while depressed:
        
        Poor Appetite
        
        Insomnia or Hypersomnia
        
        Low Energy or Fatigue
        
        Low Self-Esteem
        
        Poor Concentration or Difficulty Making Decisions
        
        Feelings of Hopelessness
      - During the 2-year period (1 year for children or adolescents) of the disturbance, the individual has never been without the symptoms in Criteria A and B for more than 2 months at a time
      - Criteria for MDD may be continuously present for 2 years
      - There has never been a manic episode or a hypomanic episode
      - The disturbance is not better explained by a persistent schizoaffective disorder, schizophrenia, delusional disorder, or other specified or unspecified schizophrenia spectrum and other psychotic disorder.
      - Episode not attributable to the physiological effects of a substance or another medical condition
      - The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
    - - 5+ symptoms present in final week before onset of menses, start to improve within a few days after the onset of menses, and become minimal or absent in the week postmenses
      - 1+ symptoms present:
        
        Marked Affective Lability
        
        Mood Swings
        
        Feeling Suddenly Sad or Tearful
        
        Increased Sensitivity to Rejection
        
        Marked Irritability or Anger or Increased Interpersonal Conflicts
        
        Marked Depressed Mood, Feelings of Hopelessness, or Self-Deprecating Thoughts
        
        Marked Anxiety, Tension, And/Or Feelings of Being Keyed Up Or On Edge
      - 1+ symptoms present that when combined with Criterion B, make 5+ symptoms
        
        Decreased Interest in Usual Activities
        
        Subjective Difficulty in Concentration
        
        Lethargy, Easy Fatigability, or Marked Lack of Energy
        
        Marked Change in Appetite; Overeating; or Specific Food Craving
        
        Hypersomnia or Insomnia
        
        Sense of Being Overwhelmed or Out of Control
        
        Physical Symptoms
        
        Breast Tenderness or Swelling
        
        Joint or Muscle Pain
        
        Bloating
        
        Weight Gain
      - Symptoms in A-C are met for most menstrual cycles that occurred in the preceeding year
      - The symptoms cause clinically significant distress or interference with work, school, usual social activities, or relationships with others (e.g., avoidance of social activities; decreased productivity and efficiency at work, school, or home).
      - The disturbance is not merely an exacerbation of the symptoms of another disorder, such as MDD, panic disorder, PPD, or a personality disorder (although it may co-occur with any
        of these disorders).
      - Criterion A should be confirmed by prospective daily ratings during at least two symptomatic cycles.
      - Symptoms not attributable to the physiological effects of a substance or another medical condition
    - - Severe, Recurrent Temper Outbursts that Manifest Verbally and/or Behaviourally
      - Outbursts Inconsistent with Development Level
      - Outbursts Occur on average 3+ times per week
      - Mood Between Outbursts is Persistently Irritable or Angry most of the day, nearly everyday, and is observable by others
      - Criteria A-D present for 12+ months
        
        Throughout that time, indiviidual has not has a period of 3+ consecutive months without all of criteria A-D
      - Criteria A and D present in at least 2 / 3 settings and are Severe in at least 1
      - Diagnosis should not be made for the first time Before Age 6 or After AGe 18
      - By History or Observation, age at onset of criteria A-E is <10 years
      - Developmentally appropriate mood elevation, such as occurs in the context of a highly positive event or its anticipation, should not be considered as a symptom of mania or hypomania.
      - The behaviors do not occur exclusively during an episode of major depressive disorder and are not better explained by another mental disorder (e.g.,ASD, PTSD, separation anxiety disorder, PDD).
      - This diagnosis cannot coexist with oppositional defiant disorder, intermittent explosive disorder, or bipolar disorder, though it can coexist with others, including MDD, ADHD, conduct disorder, and substance use disorders.
        
        Individuals whose symptoms meet criteria for both DMDD and oppositional defiant disorder should only be given the diagnosis of DMDD. If an individual has ever experienced a manic or hypomanic episode, the diagnosis of disruptive mood dysregulation disorder should not be assigned.
      - Symptoms not attributable to the physiological effects of a substance or another medical or enurological condition
  - - - 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 present most of the day, nearly every day (or any duration if hospitalization is necessary).
      - 3+ more symptoms present during this period (4+ if the mood is only irritable)
        
        Inflated Self-Esteem or Grandiosity
        
        Decreased Need for Sleep
        
        More Talkative than usual
        
        Flight of Ideas or Subjective Experience of Racing Thoughts
        
        Distractibility as reported or observed
        
        Increase in Goal-Directed Activity or Psychomotor Agitation
        
        Excessive Involvement in Activities that have high potential for Painful Consequences
      - The mood disturbance is sufficiently severe to cause marked impairment in soical or occupational functioning or to necessitate hospitalisation to prevent harm to self or others, or there are psychotic features
      - The episode is not attributable to the physiological effects of a substance
        
        A full manic episode that emerges during antidepressant treatment (e.g., medication, electroconvulsive therapy) but persists at a fully syndromal level beyond the physiological effect of that treatment is sufficient evidence for a manic episode and, therefore, a bipolar I diagnosis.
    - - Criteria met for at least one manic episode
      - At least one manic episode is not better explained by schizoaffective disorder, and is not superimposed on schizophrenia, schizophreniform disorder, delusional disorder, or other specified or unspecfied schizophrenia spectrum and other psychotic disorder
      - Manic episode may be preceded by and/or followed by hypomanic or major depressive episodes
    - - Criteria met for at least one hypomanic episode and at least one major depressive episode
      - There has never been a manic episode
      - At least one hypomanic episode and at least one major depressive episode are not better explained by schizoprenia spectrum disorders
      - The symptoms of depression or unpredictability caused by frequent alternation between periods of depression and hypomania causes clinically signficant distress or impairment in social, occupational, or other important areas of functioning
    - - For at least 2 years (at least 1 yr in children and adolescents) there have been numerous periods with hypomanic symptoms that do not meet criteria for that do not meet criterai for hypomanic episode and numerous periods with depressive symptoms that do not meet criteria for major depressive episode
      - During the above 2-year period (or 1 yr), criterion A symptoms have been present for at least half the time and the individuals has not been without the symptoms for more than 2 months at a time
      - Criteria for major depressive, manic, or hypomanic episode have never been met
      - Symptoms are not better explained by a schizophrenia spectrum disorder
      - Symptoms casue clinically significant distress or impairment in social, occupational, or other important areas of functioning
    - - Distinct period of Abnormally and Persistently Elevated, Expansive, or Irritable Mood; and Abnormally and Persistently Increased Activity or Energy, lasting at least four consecutive days and present most of the day, nearly every day
      - 3+ symptoms (4+ if mood only irritable)
        
        Inflated Self-Esteem or Grandiosity
        
        Decreased Need for Sleep
        
        More Talkative than usual
        
        Flight of Ideas or Subjective Experience of Racing Thoughts
        
        Distractibility as reported or observed
        
        Increase in goal-directed activity or psychomotor agitation
        
        Excessive Involvement in Activities that have high potential for Painful Consequences
      - Episode associated with Unequivocal Change in Functioning that is Uncharacteristic of the individual when not symptomatic
      - Disturbance in mood and the change in functioning are observable by others
      - Episode not severe enough to casue marked impairement in social or occupational functioning or to necessitate hospitalisation. If there are psychotic features, this is mania
      - A full hypomanic episode that emerges during antidepressant treatment (e.g., medication, ECT) but persists at a fully syndromal level beyond the physiological effect of that treatment is sufficient evidence for a hypomanic episode diagnosis.
        
        However, caution is indicated so that one or two symptoms (particularly increased irritability, edginess, or agitation following
        antidepressant use) are not taken as sufficient for diagnosis of a hypomanic episode, nor necessarily indicative of a bipolar diathesis.
  - - - Interpersonal Psychotherapy (IPT)
      - Cognitive Therapy
      - Mindfulness-Based Cognitive Therapy (MCST)
      - Cognitive Behavioural Therapy (CBT)
        
        Behavioural Therapy
        
        Behavioural Activation (BA) Therapy
        
        Behavioural Couples Therapy
      - Psychoeducation Approaches
      - Family-Focused Treatment (FFT)
    - - Antidepressants
        
        Tricyclic Antidepressants
        
        Imipramine
        
        Tofranil
        
        Amitriptyline
        
        Elavil
        
        MAO Inhibitor
        
        Tranylcypromine
        
        Parnate
        
        SSRIs
        
        Fluoxetine
        
        Sertraline
      - Mood Stabilisers
        
        Lithium
      - Newer Mood Stabilisers
        
        Antipsychotics
        
        Olanzapine
        
        Zyprexa
        
        Anticonvulsants
        
        Divalproex Sodium
        
        Depakote
    - - Electroconvulsive Therapy (ECT)
      - Repetitive Transcranial Magnetic Stimulation (rTMS)
- - - - Depersonalisation
        
        Experiences of unreality, detachment, or being an outside observer with respect to one's thoughts, feelings, sensations, body, or actions
      - Derealisation
        
        Experiences of unreality or detachemnt with respect to one's surroundings (individuals or objects are experienced as unreal, dreamlike, foggy, lifeless, or visually distorted)
  - - - Most often consists of localised or selective amnesia for specific event/s; or generalised amnesia for identity and life history
  - - - These signs/symptoms may be reported or observed
- - - - A pervasive pattern of disregard for and violatin of the rights of others, occurring since age 15, as indicated by 3+:
        
        Failure to conform to social norms with respect to lawful behaviours, as indicated by repeatedly performing acts that are grounds for arrest
        
        Deceitfulness, as indicated by repeated lying, use of aliases, or conning others for personal profit or pleasure
        
        Impulsivity or Failure to Plan Ahead
        
        Irritability and aggressiveness, as indicated by repeated physical fights or assaults
        
        Reckless disregard for safety of self or others
        
        Consistent irresponsibility, as indicated by repeated failure to sustain consistent work behaviour or honor financial obligations
        
        Lack of Remorse, as indicated by being indifferent to or rationalising having hurt, mistreated or stolen from another
      - Individual is at least 18+
      - Evidence of conduct disorder before age 15
      - Occurrence of antisocial behaviour is not during course of schizophrenia or bipolar disorder
    - - A. A pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity, beginning by early adulthood and present in a variety of context, as indicated by 5+:
        
        Frantic efforts to avoid real or imagined abandoment (Do not include suicidal or self-harming behaviour)
        
        A pattern of unstable and intense interpersonal relationships characterised by alternating between extremes of idealisation and devaluation
        
        Identity disturbance; markedly and persistently unstable self-image or sense of self of self
        
        Impulsivity in at least 2 areas that are potentially self-damaging (spending, sex, substance abuse, reckless driving, binge eating)(Do not include suicidal or self-harming behaviour)
        
        Recurrent suicidal behaviour, gestures, or threats, or self-mutilating behaviour
        
        Affective instability due to a marked reactivity of mood (intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days
        
        Chronic feelings of emptiness
        
        Inappropriate, intense anger or difficulty controlling anger (frequent displays of temper, constant anger, recurrent physical fights)
        
        Transient, stress-related paranoid ideation or severe dissociative symptoms
  - - - Pervasive pattern of social inhibition, feelings of inadequancy, and hypersensitivity to negative evaluation, beginning by early adulthood and present in a variety of contexts, as indicated by 4+:
        
        Avoids occupational activities that involve significant interpersonal contact because of fears of criticism, disapproval, or rejection
        
        Unwilling to get involved with people unless certain of being liked
        
        Shows restraint within intimitate relationships because of the fear of being shamed or ridiculed
        
        Preoccupied with being criticised or rejected in social situations
        
        Inhibited in new interpersonal situations because of feelings of inadequacy
        
        Views self as socially inept, personally unappealing, or inferior to others
        
        Unusually reluctant to take personal risks to engage in any new activities because they may prove embarrassing
- - - - Criteria are met for major or mild neurocognitive disorder
      - Insidious onset and gradual progression of impairment in 1+ cognitive domains
      - Criteria met for probable or possible Alzheimer's Disease as follows
        
        Probable
        
        Evidence of causative AD genetic mutation from family history or genetic testing
        
        All 3:
        
        Clear evidence of decline in memory and learning and 1+ other cognitive domain (based on history or seriel neuropsychological testing
        
        Steadily progressive gradual decline in cognitive without extended plateaus
        
        No evidence of mixed aetiology
    - - Slow Decline
      - Medication
        
        Cholinesterase Inhibitors
        
        Donepezil
        
        Aricept
        
        Galantamine
        
        Reminyl
        
        Antidepressants for Depressive Symptoms
        
        Antipsychotics for Agitated State
      - Psychological
        
        Psychotherapy
        
        Family
        
        Psychoeducation
        
        Cognitive Interventions
        
        Labeling Drawers and Appliances
        
        Exercise
        
        Music
  - - - Concern of the individual, a knowledgeable informant, or the clinician that there has been significant decline in cognitive function
      - Substantial impairment documented by standardised neuropsychological testing or another quantified clinical assessment
- - - - Emotion Pain and Suffering
    - - Impairment in a Key Area of Life
    - - Makes Others Uncomfortable or Causes Problems
    - - Wakefield
        
        Failure of Internal Mental System Function
- - - - Facilitates Communication Among Professionals
      - Advances the Search for Causes and Treatments
      - Cornerstone of Clinical Care
  - - - Informal / Unstructured
      - Structured
    - - Electrocardiogram (EKG)
      - Electrodermal Responding (Skin Conductance)
      - Electroencephalogram (EEG)
    - - Computerised Axial Tomography (CAT)
      - Magnetic Resonance Imaging (MRI)
      - Positron Emission Tomography (PET)
    - - Describe a Client's Problem
      - Determine the Cause of a Problem
      - Arrive at a Diagnosis
      - Develop a Treatment Strategy
      - Monitor Treatment Progress
- - - - Treatment
        
        Stimulant Medication
        
        Medication plus Behavioural Treatment
        
        Psychological
        
        Parental Training
        
        Classroom Management
        
        Supportive Classroom Structure
      - Persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development
        
        Inattention: 6+ of the following persist for 6+ months to a degree which is inconsistent with developmental level and that negatively impacts directly on social and academic/occupational activites
        
        Often fails to give close attention to details or makes careless mistakes in schoolwork, at work, or during other activities (overlooks or misses details, work is inaccurate
        
        Often has difficulty sustaining attention in tasks or play activities (has difficulty remaining focused during lectures, conversations, or lengthy reading
        
        Often does not seem to listen when spoken to directly (mind seems elsewhere even in absence of any obvious distraction)
        
        Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (starts tasks but quickly loses focus and is easily sidetracked)
        
        Often has difficulty organising tasks and activities (difficulties managing sequential tasks; difficulty keeping materials and belongings in order; messy, disorganised work; poor time management; fails to meet deadlines
        
        Often avoids, dislikes, or is reluctant to engage in tasks that reuire sustained mental effort (schoolwork or homework, preparing reports, completing forms, reviewing lengthy papers
        
        Often loses things necessary for tasks or activities (school materials, pencils, books, tools, wallets, keys, paperwork, eyeglasses, mobile phone)
        
        Is often easily distracted by extraneous stimuli (may includes unrelated thoughts)
        
        Is often forgetful in daily activities (doing chores, running errands, returning calls, paying bills, keeping appointments
        
        Hyperactivity and impulsivity: 6+ of the following persist for 6+ months to a degree that is inconsistent with developmental elvel and negatively impacts life functioning and activities
        
        Often fidgets with or taps hands or feet or squirms in seat
        
        Often leaves sear in situations when remaining seated is expected (leaves their place in the classroom, office or other workplace, or in other situations that require remaining in place)
        
        Often runs about or climbs in situations where it is inappropriate (may be limited to restlessness in adults)
        
        Often unable to play or engage in leisure activities quietly
        
        Is often ''on the go'' acting as if ''driven by a motor'' (unable to be or uncomfortable with being still for extended time, as in restaurants, meetings; may be experienced by others as being restless or difficult to keep up with
        
        Often talks excessively
        
        Often blurts out an answer before a question is completed (completes people's sentences; cannot wait for turn in conversation)
        
        Often has difficulty waiting their turn
        
        Often interrupts or intrudes on others (butts into conversations, games, or activities; may start using other people's things without asking or receiving permission; for adolescents and adults, may intrude into or take over what others are doing)
      - Several inattentive or hyperactive-impulsive symptoms were present prior to age 12
      - Several inattentive or hyperactive-impulsive symptoms are present in 2+ settings
      - Clear evidence that symptoms interfere with or reduce quality of life functioning
      - Symptoms do not occur exclusively during the course of schizophrenia or other psychotic disorder, and are not better explained by another mental disorder (mood disorder, anxiety disorder, dissociative disorder, personality disorder, substance intoxication or withdrawal)
    - - Repetitive and persistent pattern of behaviour in which the basic rights of others or major age-appropriate societal norms or rules are violated, manifested by the presence of 3+ of the following 15 criteria in the past 12 months, with 1+ present in past 6 months:
        
        Aggression to People and Animals
        
        Destruction of Property
        
        Deceitfulness or Theft
    - - Family Interventions
        
        Family Checkups (FCU)
        
        Parental Management Training (PMT)
      - Multi-Systemic Theory
  - - - Treatment
        
        Medication
        
        SSRIs
        
        Psychological
        
        Interpersonal Psychotherapy (IPT)
        
        CBT
      - Irritability More Common than Depressive Mood
      - Consider Failure to Make Expected Weight Gain
    - - Separation Anxiety Disorder
        
        Developmentally Inappropriate and Excessive Fear or Anxiety concerning separation from the attachment figure, evidence by 3+:
        
        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, to school, to work, or elsewhere because of fear of separation
        
        Persistent and excessive fear of or reluctance about being alone or without major attachment figures at home or in other settings
        
        Persistent reluctance or refusal to sleep away from home or to go to sleep without being near a major attachment figure
        
        Repeated nightmares involving the theme of separation
        
        Repeated somatic complaints or complaints of physical symptoms when separation from major attachment figure is anticipated
        
        The fear, anxiety, or aovidance is persistent, lasting 4+ weeks in children adn 6+ months in adults
        
        Disturbance causes clinically signficant distress or impairment in social, academic, occupational, or other important areas of functioning
        
        Not better explained by another mental disorder (ASD, Agoraphobia, GAD, IAD) or delusions and hallucinations concerning separation in psychotic disorder
      - Social Anxiety Disorder
    - - Exposure
      - Symptom Categories
      - Some Symptoms Differ From Adults
    - - Persistent deficits in social communication and social interaction across multiple contexts, as manifested by all of the following:
        
        Deficits in social-emotional reciprocity, ranging from abnormal social approach and failure of normal back-and-forth-conversation; to reduced sharing of interests, emotions, or affect; to failure to initiate or respond to social interactions
        
        Deficits in nonverbal communicative behaviours used for social interaction, ranging from poorly integrated verbal nd nonverbal communication; to abnormalities in eye contact and body language or deficits in understanding and using gestures; to a total lack of facial expressions and nonverbal communcation
        
        Deficits in developing, maintaining, and understanding relationships, from difficulties adjusting behaviour to suit various social contexts; to difficulties in sharing imaginative play or in making friends; to absence of interest in peers
      - Treatment
        
        Psychological
        
        Intensive Operant Conditioning
        
        Parental Training and Education
        
        Pivotal Response Treatment
        
        Joint Attention Intervention
        
        Symbolic Play
        
        Medication
        
        Antipsychotics for Aggresive + Stereotyped Behaviour
      - Restricted, repetitive patterns of behaviour, interests, or activities, as manifested by at least 2+:
        
        Stereotyped or repetitive motor movements, use of objects, or speech (lining up toys or flipping objects, echolalia, idiosyncratic phrases
        
        Insistence on sameness, inflexible adherence to routines, or ritualised patterns of verbal or nonverbal behaviour (extreme distress at small changes, difficulties with transitions, rigid thinking patterns, greeting rituals, need to take same route or eat same food every day
        
        Highly restricted, fixated interests that are abnormal in intensity or focus (strong attachment to or preoccupation with unusual objects, excessively circumscribed or perserverance interests)
        
        Hyper- or hyporeactivity to sensory input, or unusual interest in sensory aspects of the environment (apparent indifference to pain/temperature, adverse response to specific sounds or textures, excessive smelling or touching of objects, visual fascination with lights or movement
      - Symptoms must be present in the early developmental period (but may not become fully manifest until social demands exceed limited capacities, or may be masked by learned strategies in later life)
      - Symptoms cause clinically significant impairment in life function
      - Disturbances are not better explained by intellectual developmental disorder (intellectual disability) or global developmental delay
        
        Individuals who have marked deficits in social communication, but whose symptoms do not otherwise meet criteria for ASD should be evaluated for social (pragmatic) communication disorder