For 5 of the questions, tell me where you got the answer (source, article and page; class discussion, etc.)
1. What best characterizes the meaning of the “Biopsychosocial” approach to Mental
Disorders?
A. The clinician needs to keep an open mind as to whether a clinical intervention
entails a medication evaluation, a psychological intervention such as cognitive
behavioral therapy, or addressing social needs.
B. The clinician needs to focus more on the client’s strengths as opposed to
pathology.
C. The clients’ opinions as to what interventions are useful for him/her need to be
seriously considered.
D. If there is a genetic predisposition to a particular mental disorder, psychotropic
meds should be considered first over psychological and social interventions
2. Which of the following demonstrate how the DSM 5 differs from the DSM IV?
A. There will no longer be any Axis I-V to make a multi-axial assessment.
B. A developmental/lifespan approach occurs in each of the disorders
C. There is an increased incorporation of multi-cultural diagnoses
D. Just A & B
E. All the above
3. Carl, who is 35 years old, states in an initial session that he has suffered for many years with depression. He states that it hasn’t gotten too severe so he can experience some pleasure especially
with his hobbies and spending time with his partner. He is affected though with low mood, fatigue,
overeating and problems concentrating. Which Disorder best characterizes what he is experiencing:
A. Adjustment Disorder with Depression
B. Major Depressive Disorder
C. Bipolar 2 disorder
D. Persistent Depressive Disorder (Dysthymia)
4. Miriam had been taken to the Psych ER after neighbors called the police because of her banging on the ceiling repeatedly throughout the middle of the night. The police found that she was struggling with auditory hallucinations, delusional thinking, and was exhibiting disorganized behavior. She was hospitalized subsequently and was no longer psychotic after two weeks. She responded well to medications and was discharged to a local outpatient clinic. It has been two months, no psychotic symptoms persist, and her medication had been tapered. After 6 months, she has been off her medications and is just receiving psychotherapy. Which diagnosis best addresses the above
A. Psychotic D/O NOS
B. Schizophrenia, undifferentiated type (provisional)
C. Schizoaffective Disorder
D. Brief Psychotic Disorder
5. In the book, DSM Made Easy, Morrison states that psychosis:
A. affects the client’s being out of touch with reality
B. has two notable symptoms: delusions and hallucinations
C. Can be precipitated by substance use and medication-induced
D. A and B only
E. All the above
6. According to Preston & Johnson, which of the following is FALSE when comparing Grief
with Major Depression
A. Grief is a normal response to a major interpersonal loss. This experience can be tremendously painful and is much more prolonged than reactive sadness.
B. Both Major Depression and Grief entail a significant loss of self-esteem.
C. At least 25% of people experiencing a major loss will initially exhibit grief reactions, but during the year following the loss will go on to develop major depression/Persistent Complex Bereavement Disorder.
D. 10% of bereaved individuals will develop traumatic stress symptoms following interpersonal losses (e.g. intense anxiety, nightmares).
7. Based on your reading of Preston and Johnson on Depression, which of the answers is FALSE:
A. Side effects along with tremendous feelings of hopelessness and pessimism are factors for Depressed clients discontinuing treatment prematurely.
B. MAO Inhibitors are one of the primary groups for Antidepressant medications.
C. Hypothyroidism is the most common medical disorder causing depressive symptoms.
D. Vegetative/Physiological Symptoms are less significant than Anhedonia and Moods of sadness, despair and emptiness in Major Depressive Disorder.
8. According to Preston and Johnson, which answer is FALSE pertaining to Negative Symptoms in Psychotic Disorders:
A. Negative Symptoms in schizophrenia are considered a neuro-developmental disorder.
B. Negative Symptoms include delusions
C. Negative Symptoms include flat or blunted affected
D. Negative symptoms include marked social aloofness/withdrawal.
9. According to Preston and Johnson, which one does NOT pertain to rapid cycling:
A. When there are two or more episodes of both depression and mania within a year.
B. When the depression turns to mania within hours and back to depression a few hours later
C. People who experience rapid cycling can return to more typical episodes of mania and depression
D. People with rapid cycling tend to experience increased hypersomnia during their manic episode
10. The following are common disorders or drugs that cause mania according to Preston and Johnson.
Which answer tends to be less of a cause:
A. Cocaine
B. Antidepressants
C. Alcohol
D. Brain tumors
11. Of the psychological theories related to depression, which emphasizes “helplessness” as a key factor:
A. Freud’s theory
B. Self-Psychology
C. Object Relations Theory
D. Ego Psychology
12. Which of the following pertains to one of Freud’s contributions to understanding Depression?
A. Depression is essentially an anger turned inward and lacking sufficient expression
B. Depression is often the result of severe neglect and abuse in childhood
C. Depression is a result of the sever schism between the ego and ego ideal
D. Depression has much to do with early maternal/paternal separation and loss
13. George talked about his depression in the following way: he states that he often feels down, apathetic, empty and low self-esteem due to his history of separation and loss. His mother struggled with psychoses throughout his early childhood and was hospitalized for 6 months when he was 5 years old; he was placed in foster care for a few months until his mother returned (his father was unable to adequately take care of him) and he frequently moved from 8-13 years old. Which theory best characteristics the nature of his depression.
A. Freudian Theory
B. Object Relations Theory
C. Ego Psychology
D. Cognitive Behavioral Theory
14. According to Bridge et. Al,et al. when assessing suicidal risk for an adolescent, which of the following are important factor or factors to consider:
A. History and time period of previous suicidal ideation/attempt
B. History of parent’s suicide attempts
C. Identifying oneself as gay, lesbian or bisexual and negative parental responses and rejection as a result
D. All the above
15. With regards to older adolescent suicide, which of the following according to Bridge et. al are one or more major risk factors for completing the attempt:
A. Level of hopelessness
B. Family history of suicide
C. Access to firearms
D. All the above
16. Which answer best determines the difference between Bipolar 1 and Bipolar 2
A. Bipolar 1 clients can experience psychotic symptoms
B. Bipolar 1 has less elevated mood and expansiveness
C. Bipolar 1 incorporates Major Depression and Hypomania
D. Bipolar 2 clients tend to have more serious impairment in social, occupational functioning than Bipolar 1 clients.
17. A manic episode includes:
A. A distinct period of abnormally and persistently elevated, expansive or irritable mood lasting 3 days
without hospitalization.
B. There is inflated self-esteem or grandiosity, increase goal-directed activity
C. The symptoms meet the criteria for Mixed Episode
D. All the above
18. Which of the following best describes a biopsychosocial understanding of depression?
A. Loss of significant others
B. Biological factors such as genetics, biochemistry, and hormonal
C. Social Class
D. All the above
E. Just A & B
19. According to Preston and Johnson, when treating Depression, which statement is True?
A. Biological treatments are more helpful than psychological treatments
B. Most purely psychological problems are not helped by medication treatment.
C. Marijuana is more of a depressant than Alcohol
D. Antihypertensives were once thought to cause Depression. This is now not the case.
20. At the intake, Mr. Johnson arrived late, was coherent and appeared somewhat down, discussing the numerous stressors he’s facing. The social worker had little diagnostic information to discuss in the team mgt. Which of the following diagnoses seems best to give him?
A. Unspecified Depressive D/O –
B. Other Specified Depressive Disorder
C. Persistent Depressive Disorder
D. Major Depressive Disorder
For the case of Angelo, write 2 pages by
1. Choosing the Diagnoses from the DSM 5 or DSM 5 Made easy that best address his psychiatric symptoms and functioning. Only look in the chapters we have covered so far to determine this (Schizophrenia Spectrum and Other Psychotic Disorders; Depressive Disorders; Bipolar and Related Disorders and Other Conditions that may be a focus of Clinical Attention). Make sure you provide the coding as well.
2. Discuss why you chose your diagnoses and give examples from the case. Even if I disagree with your diagnoses, the more you give examples to back up your reasoning, the more points you will receive.
Include any medical issues and social stressors in the diagnoses you find pertinent as well.
No references needed except for drawing on the DSM 5 or Morrison.
ANGELO
Nineteen-year-old Angelo is brought to the clinic by his mother. Angelo appears agitated and is reluctant to speak with the social worker, but he answers the worker’s questions when they are asked by mother. He is a nice-looking young man, tall and quite thin, and seems clean but somewhat disheveled. His hair sticks out all over and his eyes burn with intensity. Most of the information reported here was obtained from his mother.
Angelo has been a strain on the family. They are a working-class Italian-American family, father an electrician and mother a full-time homemaker and part-time hairdresser. The brother and two sisters are doing well in their lives, have moved out and are either attending college or working. Although he engages with family members, Angelo has no real relationships. He’s totally self-absorbed, totally inward-facing. In his view, “other people are reflections of you.”
Angelo lives in his own apartment attached to the family home in Queens NY, with a broken doorbell and no phone since he prefers not to have too much contact with other people. Angelo had a job for about eight weeks when he was taking his medication, washing dishes in a coffee shop, but he’s been unemployed for several months now. Recently he has complained a lot about toothaches and headaches, but he refuses to go to the dentist. In fact, his teeth haven’t been checked for years.
Angelo has had four previous psychiatric hospitalizations. He always leaves the hospital in pretty good shape, apparently as a result of the medication he receives. But, consistently after a month or two, he goes off the meds. His mother states that “He won’t admit he is sick. He’ll tell you that he’s in another dimension, or that he got the wrong input when he was young.” At present, he resists taking medication because “it makes me not be able to see things. It makes me sleepy and you can’t heal unless you see what’s wrong.”
Mother says he was pretty much a regular little kid, but very sensitive to noise and confusion. The first real sign of trouble came when Angelo was 15. Mother says,” I came home one night and found him passed out on the dining room floor. The neighborhood kids were trying to revive him. One of them had found Angelo lying in the middle of the street vomiting and had got him home. He’d chugged 80-proof whiskey.” They later found out he was smoking a lot of pot too. “When I confronted him, he told me we would all be better off if he were dead.” He has stopped abusing drugs or alcohol for the past 3 years.
.
About a year ago, Angelo became increasingly upset with “what the evil people do to one another” and talked about living alone in the woods. Gradually, he got very religious. At Easter, he thought he was Jesus, and he lay on the floor for hours with his arms out as though he was being crucified. He kept saying, I’m Angelo, I’m Angelo. What does God want me to do? I can’t walk,” his mother remembers. “I was feeding him in his room, and suddenly he spat out the meatballs and milk all over the floor. He cursed and stated Jesus wants me to deny myself!”. He was very scared and vulnerable.
A few months later, Angelo refused to wear any color but white, not even a shirt with a little lettering. Then he dyed everything orange when he was into some guru. He’s been into Satanism, astrology, hypnotism, Shintoism, Taoism. He lights fires, incense, candles. Once he carved a cross into his arm with the point of a compass. Recently, he started thinking that parts of his body were disintegrating. That, if he opened his mouth, his thoughts would fall out. That his teeth were actually someone else’s.
Apparently, beginning to feel a little more comfortable, Angelo begins to talk directly to the social worker without his mother attending. He seems on the edge of making sense without fully doing so. When asked about his earring, he ends up discoursing on numerology and the meaning of his social security number. After a while, the social worker is not able to decipher the meaning of his tangential speech. The social worker is currently working on his resistance to taking meds, and is encouraging his participation
in day treatment while being in individual/ family therapy.
