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DSM-5® Self-Exam Questions DSM-5® Self-Exam Questions Test Questions for the Diagnostic Criteria This page intentionally left blank Note: The authors have worked to ensure that all information in this book is accurate at the time of publication and consistent with general psychiatric and medical stan- dards, and that information concerning drug dosages, schedules, and routes of ad- ministration is accurate at the time of publication and consistent with standards set by the U.S. Food and Drug Administration and the general medical community. As medical research and practice continue to advance, however, therapeutic standards may change. Moreover, specific situations may require a specific therapeutic response not included in this book. For these reasons and because human and mechanical er- rors sometimes occur, we recommend that readers follow the advice of physicians di- rectly involved in their care or the care of a member of their family. Books published by American Psychiatric Publishing (APP) represent the findings, conclusions, and views of the individual authors and do not necessarily represent the policies and opinions of APP or the American Psychiatric Association. If you would like to buy between 25 and 99 copies of this or any other American Psy- chiatric Publishing title, you are eligible for a 20% discount; please contact Customer Service at [email protected] or 800-368-5777. If you wish to buy 100 or more copies of the same title, please e-mail us at [email protected] for a price quote. Copyright © 2014 American Psychiatric Association ALL RIGHTS RESERVED Manufactured in the United States of America on acid-free paper 18 17 16 15 14 5 4 3 2 1 ISBN 978-1-58562-467-6 First Edition Typeset in Adobe’s Palatino and Helvetica. American Psychiatric Publishing, a Division of American Psychiatric Association 1000 Wilson Boulevard Arlington, VA 22209-3901 www.appi.org Contents Contributors . ix Preface. xi Part I: Questions DSM-5 Introduction . .2 CHAPTER 1 Neurodevelopmental Disorders . .3 CHAPTER 2 Schizophrenia Spectrum and Other Psychotic Disorders . .25 CHAPTER 3 Bipolar and Related Disorders. .34 CHAPTER 4 Depressive Disorders. .39 CHAPTER 5 Anxiety Disorders. .49 CHAPTER 6 Obsessive-Compulsive and Related Disorders . .55 CHAPTER 7 Trauma- and Stressor-Related Disorders . .61 CHAPTER 8 Dissociative Disorders . .70 CHAPTER 9 Somatic Symptom and Related Disorders. .73 CHAPTER 10 Feeding and Eating Disorders . .80 CHAPTER 11 Elimination Disorders. 84 CHAPTER 12 Sleep-Wake Disorders. 87 CHAPTER 13 Sexual Dysfunctions . 95 CHAPTER 14 Gender Dysphoria . 99 CHAPTER 15 Disruptive, Impulse-Control, and Conduct Disorders . 101 CHAPTER 16 Substance-Related and Addictive Disorders. 109 CHAPTER 17 Neurocognitive Disorders . 120 CHAPTER 18 Personality Disorders . 128 CHAPTER 19 Paraphilic Disorders . 136 CHAPTER 20 Assessment Measures (DSM-5 Section III). 139 CHAPTER 21 Cultural Formulation (DSM-5 Section III) and Glossary of Cultural Concepts of Distress (DSM-5 Appendix) . 142 CHAPTER 22 Alternative DSM-5 Model for Personality Disorders (DSM-5 Section III) . 147 CHAPTER 23 Glossary of Technical Terms (DSM-5 Appendix) . 151 Part II: Answer Guide DSM-5 Introduction . .156 CHAPTER 1 Neurodevelopmental Disorders . .159 CHAPTER 2 Schizophrenia Spectrum and Other Psychotic Disorders . .206 CHAPTER 3 Bipolar and Related Disorders. .226 CHAPTER 4 Depressive Disorders. .237 CHAPTER 5 Anxiety Disorders. .258 CHAPTER 6 Obsessive-Compulsive and Related Disorders . .273 CHAPTER 7 Trauma- and Stressor-Related Disorders . .285 CHAPTER 8 Dissociative Disorders . .303 CHAPTER 9 Somatic Symptom and Related Disorders. .310 CHAPTER 10 Feeding and Eating Disorders . .325 CHAPTER 11 Elimination Disorders. .333 CHAPTER 12 Sleep-Wake Disorders. .339 CHAPTER 13 Sexual Dysfunctions . .355 CHAPTER 14 Gender Dysphoria . 363 CHAPTER 15 Disruptive, Impulse-Control, and Conduct Disorders . 367 CHAPTER 16 Substance-Related and Addictive Disorders. 383 CHAPTER 17 Neurocognitive Disorders . 406 CHAPTER 18 Personality Disorders . 423 CHAPTER 19 Paraphilic Disorders . 438 CHAPTER 20 Assessment Measures (DSM-5 Section III). 443 CHAPTER 21 Cultural Formulation (DSM-5 Section III) and Glossary of Cultural Concepts of Distress (DSM-5 Appendix) . 449 CHAPTER 22 Alternative DSM-5 Model for Personality Disorders (DSM-5 Section III) . 458 CHAPTER 23 Glossary of Technical Terms (DSM-5 Appendix) . 465 Contributors Lawrence Amsel, M.D., M.P.H. Assistant Professor of Clinical Psychiatry, Columbia University College of Physicians and Surgeons, New York, New York Elizabeth L. Auchincloss, M.D. Vice-Chair, Graduate Medical Education, Department of Psychiatry, Weill Cornell Medical College; Senior Associate Director, Columbia University Center for Psycho- analytic Training and Research, New York, New York Robert J. Boland, M.D. Professor of Psychiatry and Human Behavior; Associate Director, Residency Training, Alpert School of Medicine, Brown University, Providence, Rhode Island Joyce T. Chen, M.D. Public Psychiatry Postdoctoral Clinical Fellow, Department of Psychiatry, New York State Psychiatric Institute/Columbia University Medical Center, New York, New York Christina Kitt Garza, M.D. Instructor in Psychiatry, NY-Presbyterian Hospital/Columbia University Medical Center, New York, New York Philip R. Muskin, M.D. Professor of Psychiatry, Columbia University Medical Center; Chief of Service, Con- sultation-Liaison Psychiatry at NY-Presbyterian Hospital/Columbia University Medical Center, New York, New York Michelle B. Riba, M.D., M.S. Professor and Associate Chair for Integrated Medical and Psychiatric Services, De- partment of Psychiatry; Associate Director, University of Michigan Comprehensive Depression Center; Director, PsychOncology Program, University of Michigan Com- prehensive Cancer Center; Associate Director, Michigan Institute for Clinical and Health Research, Ann Arbor, Michigan Julie K. Schulman, M.D. Assistant Professor of Clinical Psychiatry, Columbia University College of Physicians and Surgeons; Consultation-Liaison Psychiatry at NY–Presbyterian Hospital/Co- lumbia University Medical Center, New York, New York ix Peter A. Shapiro, M.D. Professor of Psychiatry, Columbia University Medical Center; Associate Director, Consultation-Liaison Psychiatry Service, and Director, Fellowship Training Program in Psychosomatic Medicine, NY–Presbyterian Hospital/Columbia University Medi- cal Center, New York, New York Jonathan A. Slater, M.D. Clinical Professor of Psychiatry (in Pediatrics), Columbia University College of Phy- sicians and Surgeons; Director, Consultation and Emergency Service, Morgan Stanley Children’s Hospital of New York, NY–Presbyterian Hospital/Columbia University Medical Center, New York, New York Disclosure of Interests The contributors have declared all forms of support received within the 12 months prior to manuscript submittal that may represent a competing interest in relation to their work published in this volume, as follows: Philip R. Muskin, M.D. Speakers Bureau: Otsuka. The following contributors stated that they had no competing interests during the year preceding man- uscript submission: Lawrence Amsel, M.D., M.P.H.; Elizabeth L. Auchincloss, M.D.; Robert J. Boland, M.D.; Joyce T. Chen, M.D.; Christina Kitt Garza, M.D.; Michelle B. Riba, M.D., M.S.; Julie K. Schulman, M.D.; Peter A. Shapiro, M.D.; Jonathan A. Slater, M.D. x | Contributors Preface This self-examination guide is a companion to, not a replacement for, a thorough reading of DSM-5. The most recent edition of the diagnostic manual brings a new set of diagnoses while retaining many familiar diagnoses. There are new approaches to diagnosis in DSM-5. Our framework in preparing this self-examination guide was to challenge the reader, hopefully engagingly, to learn about the new diag- noses, to understand the changes from DSM-IV, and to self-educate about new ap- proaches to the diagnostic endeavor. Some questions will seem obvious or easy and some questions will be quite difficult. As you work through the book, let it guide you to diagnostic sections where you would like to learn more as well as reassure you about those areas in which you are already well versed. The contributors took on a daunting task—i.e., to write a book about a book that was itself being written. The contributors to this book are a group of clinicians and educators who undertook the task of learning about DSM-5 in order to help others self-educate. There is no com- mentary or politics about diagnosis in this study guide. The contributors have gra- ciously donated the proceeds from this book to a charitable foundation. Philip R. Muskin, M.D. New York, New York xi This page intentionally left blank PART I Questions DSM-5 Introduction I.1 DSM-IV employed a multiaxial diagnostic system. Which of the following statements best describes the multiaxial system in DSM-5? A. There is a different multiaxial system in DSM-5. B. The multiaxial system in DSM-IV has been retained in DSM-5. C. DSM-5 has moved to a nonaxial documentation of diagnosis. D. Axis I (Clinical Disorders) and Axis II (Personality Disorders) have been re- tained in DSM-5. E. Axis IV (Psychosocial and Environmental Problems) and Axis V (Global Assessment of Functioning) have been retained in DSM-5. I.2 True or False: The Global Assessment of Functioning (GAF) Scale (DSM-IV Axis V) remains a separate category that should be coded in DSM-5. A. True. B. False. I.3 To enhance diagnostic specificity, DSM-5 replaced the previous “not otherwise specified” (NOS) designation with two options
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