Addictive Disorders: Criteria and Treatments

• Study notes based on the provided exam list
• Focus on criteria, application, and treatments for various disorders

Substance-Related and Addictive Disorders

• Disorders related to the use of substances and addictive behaviors

Substance Use Disorder

• A problematic pattern of substance use leading to clinically significant impairment or distress
• Severity is based on the number of criteria met:
  • Mild: 2-3 criteria
  • Moderate: 4-5 criteria
  • Severe: 6 or more criteria
• Remission specifiers:
  • Early remission: No criteria met for at least 3 months but less than 12 months
  • Sustained remission: No criteria met for 12 months or longer
• Additional specifiers:
  • On maintenance therapy: Individual is taking prescribed medication
  • In a controlled environment: Access to the substance is restricted

Substance Intoxication

• Development of a reversible substance-specific syndrome due to recent ingestion of a substance
• Clinically significant problematic behavioral or psychological changes
• Symptoms are substance-specific

Substance Withdrawal

• Development of a substance-specific syndrome due to the cessation or reduction of substance use that has been heavy and prolonged
• Clinically significant distress or impairment in social, occupational, or other important areas of functioning
• Symptoms are substance-specific

Gambling Disorder

• Persistent and recurrent problematic gambling behavior leading to clinically significant impairment or distress

Anxiety Disorders

• Disorders sharing features of excessive fear and anxiety and related behavioral disturbances

Separation Anxiety Disorder

• Developmentally inappropriate and excessive fear or anxiety concerning separation from those to whom the individual is attached

Selective Mutism

• Consistent failure to speak in specific social situations in which there is an expectation for speaking despite speaking in other situations

Specific Phobia

• Marked fear or anxiety about a specific object or situation
  • Animal Type: Fear of animals
  • Natural Environment Type: Fear of natural events
  • Blood-Injection-Injury Type: Fear of blood, injections, or injuries
  • Situational Type: Fear of specific situations
  • Other Type: Phobias that do not fit into the other categories
• Phobic object or situation almost always provokes immediate fear or anxiety

Social Anxiety Disorder (Social Phobia)

• Marked fear or anxiety about one or more social situations in which the individual is exposed to possible scrutiny by others
  • Performance only: If the fear is restricted to speaking or performing in public

Panic Disorder

• Recurrent unexpected panic attacks
• Panic attack: Abrupt surge of intense fear or intense discomfort that reaches a peak within minutes
• Followed by persistent concern or worry about additional panic attacks or their consequences, or a significant maladaptive change in behavior related to the attacks

Agoraphobia

• Marked fear or anxiety about two or more of the following situations:
  • 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

Generalized Anxiety Disorder

• Excessive anxiety and worry (apprehensive expectation), occurring more days than not for at least 6 months, about a number of events or activities

Obsessive-Compulsive and Related Disorders

• Disorders characterized by obsessions, compulsions, preoccupation with body or appearance, or repetitive behaviors

Obsessive-Compulsive Disorder

• Presence of obsessions, compulsions, or both
  • Obsessions: Recurrent and persistent thoughts, urges, or images that are experienced as intrusive and unwanted
  • Compulsions: Repetitive behaviors or mental acts that an individual feels driven to perform in response to an obsession or according to rules that must be applied rigidly
• Insight specifiers:
  • With good or fair insight: Recognizes that OCD beliefs are definitely or probably not true
  • With poor insight: Thinks OCD beliefs are probably true
  • With absent insight/delusional beliefs: Completely convinced that OCD beliefs are true

Body Dysmorphic Disorder

• Preoccupation with one or more perceived defects or flaws in physical appearance that are not observable or appear slight to others
  • With muscle dysmorphia: Individual is preoccupied with the idea that their body build is too small or insufficiently muscular
• Insight specifiers:
  • With good or fair insight: Recognizes that BDD beliefs are definitely or probably not true
  • With poor insight: Thinks BDD beliefs are probably true
  • With absent insight/delusional beliefs: Completely convinced that BDD beliefs are true

Hoarding Disorder

• Persistent difficulty discarding or parting with possessions, regardless of their actual value
  • With excessive acquisition: If there is excessive acquisition of items that are not needed or for which there is no available space
• Insight specifiers:
  • With good or fair insight: Recognizes that hoarding-related beliefs and behaviors are problematic
  • With poor insight: Thinks hoarding-related beliefs and behaviors are not problematic
  • With absent insight/delusional beliefs: Completely convinced that hoarding-related beliefs and behaviors are not problematic

Trichotillomania

• Recurrent pulling out of one's hair, resulting in hair loss
• Repeated attempts to decrease or stop hair pulling

Excoriation Disorder

• Recurrent skin picking resulting in skin lesions
• Repeated attempts to decrease or stop skin picking

General Information for All Disorders

• Be able to identify diagnoses based on clinical information or short vignettes
• Be able to write a brief case example for the different disorders, linking symptoms described to specific symptomology/criteria
• Recognize specific treatments discussed for the various disorders

Other Important Topics

• Definition of “psychological disorder”
  • A syndrome characterized by clinically significant disturbance in an individual's cognition, emotion regulation, or behavior
• Common indicators of disorders in adults and children/adolescents
  • Varying indicators are related to developmental stage and sociocultural norms
• The therapeutic process
  • Assessment, diagnosis, etiology, course, prognosis, and treatment
• Diathesis-stress model
  • A psychological theory that attempts to explain a disorder, or its trajectory, as the result of an interaction between a predispositional vulnerability, the diathesis, and a stress caused by life experiences.
• The integrated approach to psychopathology
  • A biopsychosocial approach that considers biological, psychological, and social factors
• Medical model & contextual model
  • Medical model: Emphasizes biological causes and treatments
  • Contextual model: Focuses on the context and environment
• Changing the brain
  • Psychopharmacology, psychotherapy, therapeutic lifestyle change
• Tools of psychological assessment
  • Interviews, psychological tests, observations
• Fundamental negative bias
  • The tendency to dwell more on negative than positive events
• Mental illness stigma
  • Negative attitudes and beliefs about people with mental illness
• The purpose of a clinical interview/intake
  • Gather information, establish rapport, assess current functioning
• The components of the clinical interview/intake and what to prioritize
  • Identifying information, presenting problem, history, mental status exam
• The four-front approach
  • Assessing problems, strengths, context, and goals
• Balanced Diagnostic Impressions (DICE-PM) Model
  • D: Diagnosis
  • I: Impairment
  • C: Coping
  • E: Etiology
  • P: Prognosis
  • M: Management
• The different types of psychological tests/assessments & what they’re used for
  • Personality tests, intelligence tests, neuropsychological tests, behavioral assessments

Study notes covering substance-related and addictive disorders. Focus on diagnostic criteria and treatment. Includes remission and severity specifiers.