657 Midterm Study Guide PDF

657 Midterm Study Guide Meg McGuire Know​ the definition of epidemiology: -Epidemiology is the area of study concerned with disease and health issues -prevalence, rates, patterns, etc. are considered here Know​ the definition of etiology: -Etiology is the factors or ca...

657 Midterm Study Guide Meg McGuire Know​ the definition of epidemiology: -Epidemiology is the area of study concerned with disease and health issues -prevalence, rates, patterns, etc. are considered here Know​ the definition of etiology: -Etiology is the factors or causes that are responsible for or related to development disorders Know​ the definition of mental disorders: -Mental Disorders lead to clinically significant disturbances in behavior, emotion regulation and/or cognitive functioning -Mental Disorders lead to distress in key areas of functioning (social, occupational, etc.) Be able to ​identify ​what’s considered when determining if a behavior is abnormal: 1. Subjective Distress: their experience of symptoms and if they think it’s out of the norm 2. Maladaptive Behaviors: if the behaviors are interfering with their wellbeing and overall functioning (ie: anorexia and not eating) 3. Statistical Deviance: if the behaviors are statistically rare? 4. Violation of Standards of Society: if the behaviors are abnormal in a person’s culture or not? 5. Social Discomfort: if the behaviors are abnormal, do they cause them or others discomfort? 6. Irrational and Unpredictable 7. Dangerous: Will their behaviors harm themselves or others? 8. Always look at social implications to determine if something is abnormal or not Be able to ​state​ the advantages and disadvantages of a taxonomic diagnostic tool such as DSM 5: Advantages: -Gives clinicians a common language and shorthand for terms aka a quick understanding (ie: the individual is depressed) -Helps us structure information in a more helpful manner (ie: all Anxiety Disorders have certain things in common) -Social and political implications (defines range of issues a mental health professional can address; billing/insurance) Disadvantages: -By its very nature, there’s a loss of information -Stigmas are associated with various diagnoses (this can often deter people from seeking treatment or acknowledging their difficulties; they don’t want to be labeled) Understand​ the research approaches utilized to study abnormal psychology as well as their purpose and general designs. (Question: Is it just case study, self report data and observational approaches or do we need to know single case experiment, standard treatment comparison study and correlation research too?) -​Case Study -In dept study of a single case (studying 1 person) -Good way to illustrate clinical material -Rich amount of information -Provide insight to an unusual or rare condition  -May serve as a stimulus for new research -May be biased (lacks generalizability; generalizability means how much can we take and generalize findings) -​Self Report Data -People reporting on their own subjective experience (individual interviews, questionnaire, etc.) -Could lead to a large survey of individuals and in-depth information, but may be misleading (presenting well) -​Observational Approaches -Any method in which information is obtained without asking people directly -Can be time-consuming and limited in generalizability (generalizability means how much can we take and generalize findings) -​Research Design -Hypothesis: an effort to predict, explain or explore a phenomenon you propose to study -Sample and Generalization: develop a criteria we want to study (ie: people diagnosed with a particular disorder); when sampling you want to pick people who represent a larger group of people through random selection -Validity: how confident we can be about the results of the study; the extent to which we can generalize our findings -Criterion Group: people with the disorder being studied -Comparison or Control Group: people who do not have the disorder being studied -Independent Variable: the variable that is changed or controlled in a scientific experiment to test the effects on the dependent variable -Dependent Variable: variable being tested and measured (if the DV changes then the IV can be considered the cause) Know​ what is typically included in a psychological assessment: -Diagnosis -An objective description of the patient’s behavior in measurable and specific terms -are excess behaviors present? (ie: substance use or overeating) -notable deficits (Are they missing things? Social skills/language) -appropriateness of behaviors to culture, setting, developmental levels, etc. -Current level of functioning (language skills, IQ, coping skills, problem solving) -Personality factors (description of any long term personality characteristics) -Social context, environmental demands, stressors -Strengths, natural supports (what strengths do they bring to the table?) -Assessment results and observations -Other assessments (medical, neurological) (The report should be succinct and integrated; want to communicate (hypothesize) what may be causing the maladaptive behaviors and about future behaviors) Know​ what factors may impact a psychological assessment: -Trust and rapport between clinician and client (huge) -Overall purpose of the assessment (if someone’s there because they want to be vs. court ordered) -The treatment facility you’re working for (what you’re doing it for; how often) -The clinician's treatment orientation (psychodynamic vs client centered vs behavioral etc.) Know​ the basic psychological assessment components: -Clinical Interview (talking to patient, caregiver etc.) -Behavioral Observations (noticing themes of things like they are continually defensive and guarded… the themes have to occur in multiple settings) -Projective and objective tests -Personality assessments -Records and chart review (medical, legal, etc.) -Collateral contacts (doctors, school) -Also consider: -Medical assessments (PCP, gastro, neuro) -Neuropsychological assessments Know t​ he typical sources of information in an assessment: -Clinical Observations -direct observations of the patient and the characteristic behaviors -ideally in their natural environment (rare); typically occurs in a clinical setting -clinician provides an objective description of the patient’s appearance and behavior (ie: hygiene, emotional responses, mental status, language quality) -Self Monitoring -following instruction by the clinician, patients engage in self observation and objective reporting of behavior, thoughts and feelings as they occur in natural settings (ie: BDI) -Rating Scales -formal, structured scales rating the presence/absence of a trait or behavior and/or its prominence of degree -Psychological Tests -scientifically developed procedures or tasks for obtaining samples of behaviors, characteristics, traits, etc. -characteristics measured include IQ, coping patterns, personality characteristics, etc. -Intelligence Tests (IQ abilities) -Projective Personality Tests (ink blot test; say what it looks like; bast; mask, etc.; see picture and create a thematic story; finish the sentence) -Objective Personality Tests (Clear tests like the MMPI, BDI, MCMI) ID t​ he ethical issues in a psychological assessment: -Potential cultural bias of the instrument or clinician -Theoretical orientation of the clinician -Under-emphasis on external situation (sometimes you forget something externally is happening that might be a trigger.. 9/11 for example) -Insufficient validation (need to give the test on 100s of people to validate it; need to know the mean, where people fall on curves etc.) -Inaccurate date or premature evaluation (ie: how you administered it may be problematic... you weren’t trained well enough to give it etc.) Understand​ the components involved in determining a test’s utility: -Reliability: the degree to which an assessment produces the same result each time (if it’s not reliable it’s not useful) -Validity: extent to which the instrument actually measures what it is supposed to measure -Standardization: test administered, scored and interpreted in a consistent or standard manner (if you don’t have standardization, the test won’t be considered valid) What​ are some characteristics of stressors that a clinician should consider? -Severity -Chronic and Duration -Timing (Mild-Moderate … can cope but if you’re going through a divorce and a mild stressor happens it will be harder for your to cope) -Impact on our lives -Predictability -Controllable (natural disasters are unpredictable and out of your control) What​ are some factors that improve a patient’s ability to manage stress? -Coping skills -High levels of optimism -Greater psychological control -Increased self esteem -Social support and available resources -Stress Sensitive (certain genes make you more sensitive to stress) -Experiences of stress early in life may make an individual more sensitive to stress later on (early childhood trauma makes you on high alert) -Cognitive appraisal of stress (if you have high self esteem then you have a more positive appraisal … “Studying for this test will suck but I will get through it.” What​ is the difference between a crisis and a stressful situation? -Stress: when we experience or perceive challenges to our physical or emotional well-being that exceed our coping resources and abilities -Stressor: external demands that create the stress -Coping Strategies: efforts to deal with the stress -Crisis: times in which a stressful situation threatens to exceed or exceeds the adaptive capacities of a person or group -the stressors are so potent that the coping techniques we usually use do not work -a traumatic situation overwhelms a person’s ability to cope (whereas stressors do not necessarily overwhelm the person) What​ are common characteristics of Neurodevelopmental Disorders (ie: age of onset, clinical presentation)? -Has to occur by early onset (in childhood 5-18; has to occur before 18) -Has to have a persistent course (one may get better or worse but the symptoms are still there) -Characterized by developmental defects that produce impairments in personal, social, academic and/or occupational functioning -Neurodevelopmental Disorders frequently co-occur -Clinical presentation may include symptoms of excess (repetitive behaviors in Autism) or deficits and delays (deficits in social communication in Autism) -bad social communication but repetitive behaviors What​ is the diagnostic criteria for an Intellectual Disability (previously retardation)? How is the severity level determined? 1. Deficits in both intellectual and adaptive functioning (HAVE TO HAVE BOTH) 2. Onset of intellectual and adaptive deficits in developmental period  a. Adaptive functioning means social and practical skills (ie: communication, social participation, personal independence, academic functioning, etc.) i. Determine the severity of adaptive functioning (mild, moderate, severe or profound) ii. Severity is based on the deficits in adaptive functioning and NOT IQ iii. To determine the severity level consider the below: 1. Conceptual: behaviors needed to communicate to others, accomplish tasks etc. (ie: tell time, use the ATM) 2. Social: behaviors needed to engage in interpersonal interactions (ie: how to play with others; do they share?) 3. Practical: behaviors needed to address personal and health needs (ie: brush teeth, cook/clean) What​ is the diagnostic criteria for an Autism Spectrum Disorder (ASD)? 1. Persistent deficits in social communication and social interaction across multiple contexts. Manifested by ​all​ of the following: a. Deficits in social-emotional reciprocity (ie: not able to engage in a back and forth conversation) b. Deficits in nonverbal communication behaviors for social interactions (ie: gestures… don’t point, no eye contact, etc.) c. Deficits in developing, maintaining and understanding relationships (ie: hard time making friends) 2. Restrictive, repetitive patterns of behavior (RRBs), interest or activities manifested by at least two of the following: a. Stereotyped or repetitive motor movements, use of objects or speech (ie: move/flick doll eyes) b. Insistence on sameness, inflexible adherence to routines or ritualized patterns of verbal or nonverbal behavior (ie: getting Wendy’s and not Burger King will set them off because they like the sameness of Burger King) c. Highly restricted, fixated interests that are abnormal in intensity or focus d. Hyper or Hypo-sensitive to sensory input or unusual interest in sensory aspects of the environment (ie: repeat phrases over and over from movies, etc.) Based on the development and course of ASD, ​what​ information does the clinician need to gather to determine if criteria were met for the diagnosis if a patient comes to you for an assessment after the developmental period? ​(I am not 100% sure the below is right, but I think it is correct.) -Symptoms typically recognized between 12 and 24 months -Adults with autism can go through life longer without a diagnosis if their RRBs were corrected early on in childhood (ie: can only talk about cats four times then have to move on). They typically come in for depression or anxiety, so it’s important to see if they had learned to repress their RBIs earlier in life. What​ is the diagnostic criteria for Attention Deficit/Hyperactivity Disorder (ADHD), combined presentation? -Persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development as characterized by A. and/or B. A. Inattention (6+ of the below symptoms have to be present for at least 6 months and are inappropriate for the developmental level): -Often fails to give close attention to details or makes careless mistakes  -Often has trouble holding attention on tasks or play activities -Often does not seem to listen when spoken to directly -Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (ie: loses focus, side-tracked) -Often has trouble organizing tasks and activities -Often avoids dislikes or is reluctant to do tasks that require mental effort over a long period of time -Often loses things necessary for tasks and activities (ie: school materials, keys, paperwork, glasses) -Is often easily distracted by external stimuli -Is often forgetful in daily activities B. Hyperactivity/Impulsivity (6+ of the below symptoms have persisted for at least 6 months and are inappropriate for the developmental level): -Often fidgets with or taps hands or feet or moves in seat -Often leaves seat in situations when remaining seated is expected -Often runs about or climbs in situations where not appropriate (adolescents or adults may be limited to feeling restless) -Often unable to play or take part in leisure activities quietly -Is often “on the go” acting as if “driven by a motor” -Often talks excessively -Often blurts out an answer before a question has been completed -Often has trouble waiting for his/her turn -Often interrupts or intrudes on others (ie: butts into conversations) -Several inattentive or hyperactive impulsive symptoms ​must​ be present ​prior to age 12 -Several inattentive or hyperactive impulsive symptoms are present in ​2 or more settings​ (ie: at home, school, work, with friends, etc.) -Clear evidence that symptoms interfere with or reduce the quality of functioning -note symptoms may be masked when individual is receiving frequent rewards, constant supervision, is in a novel setting, or engaged in an interesting activity -Symptoms do not occur exclusively during the course of another mental disorder (ie: Depression, substance intoxication, schizophrenia, etc.) What​ is the criterion for Other Specified VS Unspecified Disorders? Be able to ​ID​ how they are the same and how they differ: (Eg: Other Specified ADHD) -Presentation in which inattention and hyperactivity causes clinically significant distress or impairment but do not meet full criteria -The clinician chooses to communicate the reason that the presentation does not meet criteria -Ie: Other specified attention deficit/hyperactivity disorder with insufficient inattention symptoms (Eg: Unspecified Attention Deficit Hyperactivity Disorder) -Presentation in which inattention and hyperactivity causes clinically significant distress or impairment but do not meet full criteria -Used when clinician chooses ​not​ to specify the reason criteria are not met ​or​ when there is insufficient information to make a more specific diagnosis -(Only use this when you’re truly not sure; don’t meet criteria but don’t want to say why they don’t meet it) Similarities: -Both have presentations of X which causes significant distress and both do not meet full criteria Differences: -Other Specified: the clinician chooses to communicate the reason that the presentation does not meet criteria -Unspecified: used when the clinician chooses not to specify the reason criteria are not met OR when there is insufficient information to make a more specific diagnosis Be able to ​ID​ the specifiers of a Learning Disorder. Be able to ​ID​ the coding requirements for a Learning Disorder when multiple domains are impaired: -Difficulties learning and using academic skills that have persisted for ​at least 6 months ​despite the provision of an intervention that targets the difficulties (ie: word reading, reading comprehension, spelling, written expression, numerical understanding, mathematical reasoning) -Difficulties are substantially and quantifiably (ie: have to give all tests to confirm this) below expectations for chronological age -Learning difficulties are not better accounted for by Intellectual Disabilities, visual or auditory acuity, lack of language proficiency of academic institution, inadequate educational instruction -Specify it: -Learning Disorder with impairment in reading -Learning Disorder with impairment in written expression -Learning Disorder with impairment in mathematics **Specify all academic domains that are impaired and code individually with severity specifier -Specify current severity: (not clear cut, no set number, use clinical judgement) -Mild: some difficulties in learning skills in one or two academic areas but mild enough that individual may be able to function when provided with appropriate accommodations or support services -Moderate: marked difficulties learning skills in one or more academic domains so that the individual is unlikely to become proficient without intervals of intensive and specialized teaching. Some accommodations/support may be needed at least part of the day to complete activities -Severe: severe difficulties in learning skills, affecting several academic domains so that the individual is unlikely to learn those skills without ongoing intensive, individualized and specified teaching. Even with an array of appropriate accommodations and support, the individual may not be able to complete all activities effectively Know​ the 5 key features of Schizophrenia Spectrum and Other Psychotic Disorders: 1. Delusions a. Erroneous fixed beliefs that are not amendable to change in the light of conflicting evidence (ie: the FBI is after me; newscaster talking directly to you) i. Persecutory (most common; belief that one is going to be harmed; FBI after me) ii. Referential: Belief that certain gestures, comments, etc. are directed at oneself (newscaster talking directly to you) iii. Grandiose: Belief of exceptional abilities iv. Erotomanic: Falsely believes another person is in love with them v. Nihilistic: Belief a major catastrophe will occur vi. Somatic: preoccupation with health 2. Hallucinations a. Perception-like experiences that occur without external stimulus (see, hear, feel something) i. Are very vivid and clear  ii. Impact normal perceptions iii. Not under voluntary control iv. Must occur when you’re awake and lucid v. Ie: Hear voices, see someone, bugs crawling on you, etc. 3. Disorganized thinking/speech a. Failing to make sense despite using language in a conventional way (not attributed to IQ, poor education or cultural deprivation) i. Switching topics ii. Tangentially iii. Rarely speech may be incomprehensible (“word salad”) iv. Made up words (Neologism) b. Must be severe enough to substantially impair effective communication 4. Grossly disorganized or abnormal motor behavior a. Ranges from childlike silliness, unusual dress to unpredictable agitation 5. Negative Symptoms a. Reflect an absence or deficit of behaviors that are normally present b. Includes: i. Diminished emotional expression (flat affect; emotions not expressed on their faces) ii. Avolition: decrease in motivated self initiated purposeful activities iii. Alogia: diminished speech output iv. Anhedonia: decreased ability to experience pleasure from positive stimuli v. Asociatility: lack of interest in social interactions Be able to ​state​ the diagnosis criteria for Schizophrenia with a focus on Criterion A or the “active phase symptoms”: (FYI: Schizophrenia spectrum diagnosis requires exclusion of another condition that may give rise to psychosis; this is important) A. Criterion A (or the Active Phase Symptoms: Two (or more) of the following, each present for a significant portion of time during a one-month period (or less if successfully treated). At least one of these must be 1, 2 or 3: 1. Delusions 2. Hallucinations 3. Disorganized speech 4. Grossly disorganized or abnormal motor behavior (catatonic behavior) 5. Negative symptoms (ie: diminished emotional expression) B. Criterion B: For a significant portion of time, level of functioning in one or more major areas is markedly below the level achieved prior to the onset (ie: work, personal relationships) C. Signs of the disturbance persist for at least 6 months a. Must include at least 1 month of active phase symptoms (or less if treated) that meet criterion A D. Schizoaffective Disorder and Depressive or Bipolar Disorder with Psychotic Features have been ruled out E. Disturbance is not because of a substance or medical condition F. If there is a history of Autism Spectrum Disorder or a Communication Disorder of childhood onset, the additional diagnosis of Schizophrenia is made only if prominent delusions or hallucinations, in addition to the other required symptoms of schizophrenia, are also present for at least 1 month (less if treated) ​On my slides I wrote that we don’t have to memorize this one For the psychotic disorders, be able to ​ID​ the timeline requirements for meeting symptom criteria when making a differential diagnosis (ie: 1 day to less than 1 month vs. 6 or more months): A. Brief Psychotic Disorder (brief; 1+ of criterion A present and 1 of them must be from 1, 2 or 3) a. 1 day to < 1 month B. Schizophreniform (short form schizophrenia; 2+ of criterion A present and 1 of them must be from 1, 2 or 3) a. 1 month to < 6 months C. Schizophrenia a. 6+ months (with at least 1+ month of active phase) Be able to​ ID t​ he diagnostic difference between Schizoaffective Disorder and Mood Disorders with Psychotic Features: Schizoaffective Disorder: -Psychotic symptoms + mood symptoms -Uninterrupted period where full criteria are met for a major mood episode (manic and depressive) concurrent with Criterion A of Schizophrenia -Delusions or hallucinations for 2+ weeks in the absence of a major mood episode during the lifetime duration of the illness -Symptoms that meet criteria for a major mood episode are present for at least half of the time over the course of the psychotic illness Mood Disorders with Psychotic Features: -Delusions or hallucinations are present at any time during the mood episode (depressive, manic or hypomanic) -If psychotic features are present, clinician specifies if they are mood congruent (ie: manic episode + delusions of grandiosity) or mood incongruent psychotic features Be able to ​ID​ how the various Anxiety Disorders differ from one another based on the type of objects/situations that induce fear or anxiety (ie: having another panic attack is a primary fear in Panic Disorder): (The main thing that differentiates the below disorders is the type of object or situation) A. Separation Anxiety Disorder a. Developmentally inappropriate and excessive fear/anxiety concerning the separation from those whom they are attached B. Specific Phobia a. Marked fear/anxiety about a specific object or situation (ie: flying, heights, blood, receiving an injection) C. Social Anxiety a. Fear/anxiety surrounding situations in which the individual is exposed to possible scrutiny by others D. Agoraphobia a. Fear/avoid situations where escape might be difficult or help may not be available in the event of panic or other incapacitating symptoms E. Generalized Anxiety Disorder (GAD) a. Excessive anxiety/worry about a number of events or activities Be able to ​state​ the symptoms of a panic attack: -An abrupt surge of intense fear or discomfort that reaches a peak within minutes, and during which time 4+ of the following symptoms occur: 1. Heart palpitations 2. Sweating 3. Trembling, shaking 4. Sensations of shortness of breath or smothering 5. Feelings of choking 6. Chest pain or discomfort 7. Nausea or abdominal distress 8. Feeling dizzy, unsteady, light-headed or faint 9. Chills or heat sensations 10. Paresthesias (numbness or tingling sensation) 11. Derealization (feelings of unreality) or depersonalization (being detached from oneself) 12. Fear of losing control or going crazy  13. Fear of dying *Note the abrupt surge can occur from a calm or anxious state Be able to ​state​ the definition of an obsession and of a compulsion in Obsessive-Compulsive and Related Disorders: A. Obsession: recurrent and persistent thoughts, urges or images that are experiences as intrusive and unwanted B. Compulsion: repetitive behaviors or mental acts that the individual feels driven to perform in response to an obsession or according to rules that must be applied rigidly Be able to ​state​ the diagnostic criterion for Somatic Symptom Disorder: -Characterized by prominent somatic symptoms (like pain or fatigue), combined with abnormal thoughts, feelings and behaviors in response to those symptoms, that leads to significant distress and impairment A. 1+ somatic symptoms that are distressing or result in significant disruption in daily life B. Excessive thoughts, feelings or behaviors related to the somatic symptoms or associated health concerns as manifested by at least one of the following: a. Disproportionate and persistent thoughts about the seriousness of one’s symptoms b. Persistently high levels of anxiety about symptoms c. Excessive time and energy devoted to symptoms and concerns C. Symptomatic state is persistent (typically 6 months) Understand​ the diagnostic criteria for Conversion Disorder as it relates to the need for the patient to have a medical and/or neurological workup completed (ie: Criterion B): -Conversion Disorder: mental condition where the person has blindness, paralysis or other nervous system symptoms that cannot be explained by medical evaluation -This is diagnosed in conjunction with a doctor A. 1+ symptoms of altered voluntary motor or sensory function (tunnel vision; feeling paralysis, etc.) B. Evidence of incompatibility between symptoms and recognized neurological medical conditions (Physician rules out whatever they are reporting … it is not medically there) C. Symptom/deficits not better explained by another medical or mental disorder D. Causes clinically significant distress/impairment Understand​ the difference between Factitious Disorder and the other Somatic Symptom and Related Disorders as it relates to falsification of symptoms and deception (Criterion A). Criteria listed below: -A mental disorder where someone acts as if he has an illness when he has consciously created the symptoms; they are actually lying. A. Falsification of physical or psychological signs or symptoms or induction of injury or disease, associated with deception B. Individual presents to others as ill, impaired or injured C. Deceptive behavior is evident even in the absence of obvious external rewards (ie: they are not faking a back injury to get workers comp) D. Behavior is not better explained by another disorder Be able to ​state​ the symptom acronym and related symptom criteria for Major Depressive Disorder: SIG-E-CAPS; 5+ symptoms during the same two week period (at least one symptom is depressed mood or loss of interest/pleasure) S: sleep changes I: interest loss G: guilt, worthlessness E: energy decrease C: concentration reduced A: appetite change (up or down) P: psychomotor agitation or retardation (lethargic or fidgety) S: suicide, preoccupation with death (And obviously depressed mood may be a symptom) Be able to ​state​ how long symptoms must be present in adults versus children for Persistent Depressive Disorder -Persistent Depressive Disorder is longer but less severe than Major Depressive Disorder -Depressed mood for most of the day, for more days than not (think Eyeore), for​ at least 2 years​ in adults and ​at least 1 year​ for children Be able to ​state​ the symptom acronym and related symptom criteria for Manic/Hypomanic Episodes and how long the symptoms must be present: DIG FAST D: Distractibility (cannot stay on track) I: Impulsivity/indiscretion (excessive involvement in activities with high potential for painful consequences; gambling all money away) G: Grandiosity (thinks really highly of themselves; I made the best coffee so I am going to open a competitive chain to Starbucks) F: Flight of ideas A: Activity increase or psychomotor agitation (increase in goal directed activity; start a bunch of different business but do not see any of them through) S: Sleep Decrease T: Talkativeness Mania: present at least 1 week Hypomania: lasting four consecutive days (Question: Have to have all of these symptoms or a certain #+?) Be able to ​differentiate​ a diagnosis of Major Depressive Disorder, Bipolar I Disorder, Bipolar II Disorder and Other Specified Bipolar and Related Disorder based on the presence/absence of symptoms that meet criteria for manic, hypomanic and/or depressive episodes: Major Depressive Disorder: SIG-E-CAPS; 5+ symptoms during the same two week period (at least one symptom is depressed mood or loss of interest/pleasure) S: sleep changes I: interest loss G: guilt, worthlessness E: energy decrease C: concentration reduced A: appetite change (up or down) P: psychomotor agitation or retardation (lethargic or fidgety) S: suicie, preoccupation with death (And obviously depressed mood may be a symptom) Bipolar I Disorder: -Met criteria for a manic episode (you can just have mania and get a BP1 diagnosis) -manic episode is a distinct period of abnormally and persistently elevated, expansive or irritable mood -present most of the day, nearly every day, for at least 1 week (or any duration if hospitalized) -There may have also been hypomanic or major depressive episodes -they are very common in BP1 but not required for diagnosis -At least one lifetime manic episode is required for a diagnosis of BP1 -Mania kicks diagnosis up to BP1 (only have to have mania for one week) Bipolar II Disorder: -Current/past hypomanic episode ​and​ current/past major depressive episode (have to have both of these) -Hypomanic episode criteria: -Criterion A: -distinct period of abnormally and persistently elevated, expansive or irritable mood ​and persistently increased activity/energy -lasting at least 4 consecutive days, present most of the day, nearly every day -Criterion B (3+ of the following… 4 if mood is only irritable): -inflated self esteem/grandiosity -decreased need for sleep -talkativeness/pressured speech -flight of ideas/racing thoughts -distractibility -increased goal-directed activity or psychomotor agitation -excessive involvement in activities with potential for painful consequences Other Specified Bipolar and Related Disorder: -Hypomanic episode without prior major depressive episode -Short duration hypomanic episodes (2-3 days) and major depressive episodes -Hypomanic episodes with insufficient symptoms and major depressive episodes -Short duration cyclothymia (less than 24 months) BP1 *Mania with hypomania or depression *Mania alone *Mania with hypomania and depression BP2 *Hypomania and *Depression