DSM-5 SELF-EXAM QUESTIONS

Disruptive, Impulse Control, and Conduct Disorders

he chapter on disruptive, impulse book, available in February 2014, contains 500 that coexists with ODD is (ADHD, with control, and conduct disorders is questions for all the categories of psychiatric comorbidity rates reportedly reaching up to Tnew to DSM-5. It combines disorders disorders and includes Section III. The ques- 39%. Other disorders that frequently occur that were previously included among dis- tions were developed under the leadership of with ODD include anxiety and depressive orders usually first diagnosed in infancy, Philip Muskin, M.D., a professor of clinical disorders. childhood, or adolescence (that is, opposi- psychiatry at Columbia University College of tional defiant disorder; conduct disorder; Physicians and Surgeons. APA members may 3. A 21-year-old male with history of other specified and unspecified disrup- purchase the book at a discount. oppositional defiant disorder presents with tive, impulse-control, and conduct dis- frequent impulsive behavioral outbursts that orders) or impulse-control disorders not 1. Which of the following is new in are grossly out of proportion to the stressor. otherwise specified (that is., intermittent DSM-5 for the diagnosis of ODD? He reports that he is unable to control himself explosive disorder). These disorders are and worried that he might lose his job if this all characterized by problems in emo- a) Categorization of ODD symptoms behavior continues. What is his most likely tional and behavioral self-control. Of note, b) Failure to resist an impulse, drive, or diagnosis? attention-deficit/hyperactivity disordertemptation to perform an act that is harmful (ADHD) is frequently comorbid with the to the person or to others a) Bipolar disorder disorders in this chapter but is listed with c) The individual feels an increasing b) ADHD neurodevelopmental disorders. The crite- sense of tension or arousal before the act, c) Intermittent explosive disorder ria for oppositional defiant disorder (ODD) pleasure, gratification, or relief during the act d) Conduct disorder are largely unchanged from DSM-IV-TR. d) The individual experiences a sense of e) Adjustment disorder The criteria for conduct disorder are also relief from the urge after the act largely unchanged from DSM-IV-TR. A e) Premeditation of the act Correct Answer: C. Intermittent explo- descriptive-features specifier is added for sive disorder individuals who meet full criteria for the Correct Answer: A. Categorization of Rationale: The diagnosis of intermittent disorder and who also present with limited ODD symptoms. explosive disorder can be made in older ado- prosocial emotions. The primary change in Rationale: DSM-5 has instituted a new lescents and young adults aged 18 or older in DSM-5 for intermittent explosive disorder categorization of ODD symptoms that groups addition to the diagnosis of ADHD, opposi- is what type of aggressive outbursts should together symptoms based on whether they tional defiant disorder, conduct disorder, or be considered: DSM-IV-TR required physi- have an emotional component (for example, autistic spectrum disorder when recurrent cal aggression, whereas in DSM-5 verbal angry, irritable, resentful), a behavioral ele- impulsive aggressive outbursts warrant inde- aggression and nondestructive/noninju- ment (for example, argumentative, defiant), pendent clinical attention. PN rious physical aggression also meet cri- or a spiteful/ vindictive aspect to them. This teria. An important departure from past classification structure is important because diagnostic manuals is that the substance- recent research suggests that the emotional related and addictive-disorders chapter is symptoms are linked to the development of expanded to include gambling disorder. future mood and anxiety disorders and spite- This reflects the increasing and consistent ful and vindictive behaviors are predictive of evidence that some behaviors, such as gam- conduct disorder and delinquent behaviors. bling, also activate the same reward system with effects similar to those of drugs of 2. Which disorder is most commonly abuse. comorbid with ODD? The questions below are from DSM-5 Self-Exam Questions: Test Questions for the a) ADHD Diagnostic Criteria, which may be preor- b) Mood disorder dered from American Psychiatric Publish- c) Conduct disorder ing here. [http://www.appi.org/SearchCen- d) Bipolar disorder ter/Pages/SearchDetail.aspx?ItemId=62467] e) Learning disorders The answers and rationales are posted here. [http://www.psychnews.org/pdfs/DSM-5_ Correct Answer: A. ADHD Self_Examination_QandA_18.pdf] The Rationale: The most common disorder