hello everybody my name is Iman welcome back to my YouTube channel today we're going to tackle a practice problem set that relates to our chapter on psychological disorders let's go ahead and start with problem number one problem number one says which of the following is an example of a negative symptom seen in schizophrenia now when we T talked about types of psychological disorders we talked about schizophrenia and we discussed that schizophrenia is the prototyp typical disorder with psychosis as a feature and it contains positive and negative symptoms we defined positive symptoms as symptoms that add something to behavior cognition or affect and includes things like delusions hallucinations disorganized speech and disorganized behavior in addition we said that negative symptoms are the loss of something from Behavior avior cognition or affect and they include disturbance of affect and avolition so considering all of this information let's try to tackle this problem we're trying to find out of these four options what is an example of negative symptom seen in schizophrenia knowing that it's the absence of normal or desired behavior and that it includes disturbance of affect or avolition were're able to confidently say that the correct answer is C the other answer choices auditory hallucinations disorganized behavior and delusions these are all examples of positive symptoms and so again the correct answer to one is C now when we move into problem two problem two says during an interview with a schizophrenic patient a psychiatrist noticed that the patient keeps repeating what the psychiatrist says this phenomena is known as blank now this is going to require us to Define some terminology the first answer is echolalia this is the involuntary repetition of others words and utterances and it can actually be seen in schizophrenia this is exactly what the problem is asking and it is the correct answer but I still want to go through the other answer choices as well exoa this is the imitation of others actions then see loosening of associations this is a type of disordered thought where patients move between remotely related ideas and the last answer Choice D this is newly invented Words which is not what this patient is doing the patient is just repeating what the psychiatrist says and the correct answer for two is a moving on to problem three problem three says A 42-year-old woman has always been extremely neat and tidy she works as a secretary and stays long after normal working hours to check the punctuation and spelling of letters she prepared during the day her boss referred her for counseling after she repeatedly got into fights with her co-workers they don't take the job to heart she says they just joke around all day the most likely preliminary diagnosis for this patient is blank a says obsessive compulsive personality disorder B says antisocial personality disorder C says narcissistic personality disorder and D says borderline personality disorder now right off the bat what I want to say is that focusing on details loving routine and having a sense that there is only one right way to do things and also having a lack of humor suggests an obsessive compulsive personality disorder now we did talk about other disorders as well other personality disorders but what I have here is a bit about obsessive compulsive disorder which we did talk about earlier in the lecture as well and we did make a note not to confuse this with obsessive compulsive Personality Disorder so I put this here to remind myself to make note that as a reminder obsessive compulsive disorder is characterized by obsessions these are persistent intrusive thoughts and impulses and compulsions which are repetitive tasks that relieve tension but cause significant impairment in a person's life then we also talked about obsessive compulsive personality disorder this involves perfectionism inflexibility and preoccupation with rules and it is not necessarily similar in the sense that there are obsessions and compulsions related here now the other an answer choices we have antisocial personality disorder this involves a disregard for the rights of others narcissistic personality disorder this involves like a grand sense of self-importance and need for admiration and the last answer Choice here is borderline personality disorder borderline personality disorder involves instability in relationships mood and self-image and so can covering all the answer choices here and also reminding you the difference between obsessive compulsive disorder and obsessive compulsive personality disorder the correct answer here is going to be a this is a sign of obsessive compulsive personality disorder at Le at least this is the most likely preliminary diagnosis for the patient considering the information we were given let's go ahead and move into problem four four reads which of the following is true with regard to a major depressive episode let's go through this a says it may last less than 2 weeks B says it must involve thoughts of suicide or a suicide attempt C says it may involve a decrease in sleep and D says it must involve feelings of sadness now depression is marked by a period of at least two weeks in which the patient has five of the nine Cardinal symptoms one of which must be depressed mood or lack of interest and just as a reminder you can remember what um the nine Cardinal symptoms are using sadness plus Sig eaps we talked about this sadness plus Sig eaps sleep loss loss of sleep or or changes in sleep loss of Interest feelings of guilt loss or decreased energy having a hard time concentrating changes in appetite psychomotor symptoms and Suicidal Thoughts so a person that has five of these nine Cardinal symptoms for at least two weeks may be diagnosed with major depressive disorder now we can go ahead and eliminate a because it says it may last less than 2 weeks whereas we just said that depression is marked by a period of at least 2 weeks B says it must involve thoughts of suicide or suicide attempt not all depressed individuals are suicidal so we can eliminate that answer Choice as well C says it may involve a decrease in sleep now this is true this can appear in depression sleep disturbances is one of the nine Cardinal symptoms so this could be potentially be a good answer the last Choice it says it must involve feelings of sadness now this is something that a lot of people might gravitate towards this answer Choice here but remember I want to repeat this okay depression is marked by a period of at least two weeks in which the patient has five of the nine Cardinal symptoms and one of those five has to be either depressed mood or lack of Interest with that being said depression can sometimes manifest as loss of Interest with other symptoms sadness not being one of them and so this answer Choice says it must involve feelings of sadness again this must this is not true it doesn't have to involve feelings of sadness as long a as the individual has five of the nine Cardinal symptoms for at least two weeks and so we can go ahead and eliminate D and that leaves us with just answer Choice C the correct answer for four is going going to be C wonderful let's go ahead and move into problem five problem five says a 36-year-old who works from home is referred for evaluation he is reluctant to venture out to meet with other people and rarely has people in to visit when selected for a companywide award he refused to have his picture taken for the company newsletter during an assessment he says his face he averts his face and asks the examiner to stop looking at me although he is average in appearance he is convinced that his face is ugly and misshapen the most likely diagnosis for this man would be blank we have schizophrenia we have obsessive compulsive disorder we have body dysmorphic disorder or SK yoid personality disorder these are our answer choices now focusing here on the problem the central issue is this negative appraisal of his own appearance this indicates body dysmorphic disorder and it is likely that all other symptoms that this patient is experiencing arises from the fact that they are displeased with the way that they look and so the correct answer here for five is going to be C wonderful let's move on to problem six problem six says a young woman of unknown age is brought by the Philadelphia police to the local emergency department for evaluation after they found her wandering in a park she carries no purse or identification she is unable to State her name or any details about her life except that the name Phoenix seems familiar the police in Arizona are contacted and find a missing person's report matching the patient description based on this information the most likely diagnosis for this patient is Blink is it a depersonalization or derealization disorder B dissociative identity disorder C sematic symptom disorder or D dissociative Amnesia with dissociative Fugue and forgive me if I'm mispronouncing that word okay when we talked about dissociative disorders in lecture we said that they include things like dissociative Amnesia dissociative identity disorder and depersonalization or derealization disorder and we defined each one of them so let's remind ourselves we said that dissociative Amnesia is the inability to recall past experiences without an underlying neurological disorders and in severe forms it may involve dissociative fug which is a sudden change in Lo change in location that may involve the Assumption of a new identity then we discussed dissociative identity disorder this is the occurrence of two or more personalities that take control of a person's Behavior then depersonalization or derealization disorder this involves feelings of Detachment from the mind and body or from the environment now one of the answer choices also says sematic symptom disorder sematic symptom disorder involves at least one sematic symptom which may or may not be linked to an underlying medical condition that causes disproportionate concern it usually involves significant bodily symptoms okay now that we've reminded ourselves of the definition of the answer choices let's go back to the problem so this woman doesn't remember anything she has no identifications she can't recall any details about her life just one name that she thinks has some significance now this matches really this aligns with when we talked about dissociative Amnesia with dissociative Fugue this is characterized by remember the dissociative fug is characterized by sudden truth travel or change in normal day-to-day activities and it occurs in some cases of dissociative Amnesia which is what this patient seems to exhibit in addition symptoms include an inability to recall one's past to recall who they are or have some confusion about their identity which this young women seems to exhibit in addition to being in a different location and so the correct answer here is going to be D dissociative Amnesia with dissociative Fugue wonderful let's move on to problem seven problem seven says in addition to being a freestanding diagnosis agoraphobia is most often seen in association with which other psychiatric diagnosis agoraphobia is the fear of places or situations in which it would be difficult to escape it is commonly seen in panic disorder concerns about having panic attack in public may make these individuals actually very fearful of even leaving their own home with that being said agoraphobia falls under panic disorder generalized anxiety disorder this is disproportionate and persistent worry about many different things um which isn't the correct answer for this specific description obsessive compulsive disorder this is characterized by obsessions and compulsions this is also not what is being described here and avoidant personality disorder this involves extreme shyness and fear of rejection again not what is being described here all right we're being we're given a gphobia and we're trying to categorize it right we're trying to see what this is most often associated with in terms of other psychiatric diagnosis and the correct answer here is going to be panic disorder now panic disorder falls under the larger realm of anxiety disorders so therefore the correct answer for seven is D let's go ahead and move into problem eight problem 8 reads a 20-year-old male comes to a clinic concerned that he has pancreatic cancer review of his medical records shows that this is this is his fourth time in the past year that the patient has appeared for medical attention no identifiable medical problem is found when confronted with his history he confesses that he feels relieved after being told that all of the tests are negative netive but soon becomes worried again that he has cancer based on this information the most likely diagnosis for this patient would be blank a major depressive disorder B illness anxiety disorder C conversion disorder and D narcissistic personality disorder now when we covered sematic symptom and Related Disorders in in lecture we said they involve significant bodily symptoms we covered illness anxiety disorder and we said that this is a preoccupation with thoughts about having or coming down with a serious medical condition and this is exactly what this 20-year-old male patient is displaying they are constantly afraid that they are going to come down with cancer even though previous exams and current exams show no sign signs of the illness that they are worried about the correct answer here for eight is going to be B now just as a friendly reminder for the other answer choices conversion disorder this involves unexplained symptoms affecting motor or sensory function and it's associated with prior trauma which is not what this is what the symptoms of this male being described is narcissistic personality disorder in involves having a great sense of self-importance and need for admiration also not what this patient is displaying and major depressive disorder we've talked about this many times now it contains at least one major depressive episode that lasts for at least five uh two weeks and the patient has five out of nine Cardinal symptoms which is not what is being described here either so again the answer the correct answer choice for eight is B illness anxiety disorder now these next set of problems says question 9 and 10 refer to the scenario described below a physician is attempting to diagnose a patient mental disorder based on a set of symptoms the confirmed symptoms currently include appetite disturbance substantial weight change decreased energy feeling of worthlessness and excessive guilt what two disorders could these symptoms indicate a says major depressive and bipolar disorder B says dissociative Amnesia and D personalization D realization disorder C says Alzheimer's disease and Parkinson's disease and D says specific phobia and panic disorder the symptoms that are listed indicate and indicate either major depressive episode and or bipolar disorder okay so the correct answer here is going to be a these symptoms you know very much indicate a major depressive episode however depressive episodes by the way can also be a part of bipolar disorders which also contain manic episodes and so if manic episodes have not yet been asked about one not one cannot actually confidently choose between depression or bipolar disorder as the correct diagnosis yet hence why the two disorders that these symptoms could be indicating could either be major depressive or bipolar disorder none of these symptoms align with the other answer choices B says what should the physician ask about to to distinguish between the two possible disorders affecting that patient should they ask whether the patient has Amnesia or should they ask the patient whether they've also had a manic episode or should they ask the patient uh whether the patient is irrationally afraid of anything or whether the patient has experienced difficulty performing familiar tasks now we determined in the previous problem it's either major depressive or bipolar disorder to Det determine if this patient has major depressive disorder or a bipolar disorder we have to confirm whether there is the presence of a manic episode bipolar disorders contain manic episodes while major depressive disorder does not and that means the correct answer here is going to be B 10 is B wonderful let's go ahead and move into problem 11 problem 11 says a mother notices that her teenage son seems to have a phobia for snakes in the past week on several occasions the teenager has had more severe fear symptoms than usual without seeing or even thinking about a snake which mental disorder could cause this reaction a schizophrenia B antisocial personality disorder C obsessive compulsive disorder or D panic disorder let's go over these answer choic ches now schizophrenia is a prototypical disorder with psychosis as a feature and it contains positive and negative symptoms positive symptoms include hallucinations delusions disorganized speech and disorganized behavior while negative symptoms include disturbance of aect and then B is antisocial personality disorder antisocial personality disorder involves a disregard for the rights of others C says obsessive compulsive disorder obsessive compulsive disorder is characterized by obsessions and compulsions and then D is panic disorder panic disorder is marked by reoccurring panic attacks these are intense overwhelming fear um feeling of overwhelming fear and um sympathetic nervous system activity with no clear stimulus all right considering those definitions what we are seeing is that this Mother's teenage son has a fear for snakes but then there is this increased fear even without seeing or thinking about a fear exhibiting signs of panic and irrational fear without any instigating object present this indicates panic disorder so this teenager the these symptoms can maybe fall under the category of panic disorder now the teenager may have diagnosis of both specific phobia for the snakes and also panic disorder as well but specific phobias is not part of the answer choices here for us to um choose from the correct answer for 11 is going to be D panic disorder none of the other answer choices make sense with the symptoms that are being displaced this severe fear symp symptom without anything actually stimulating it all right so 11 is D 12 says splitting is a defense mechanism commonly seen with which personality disorder antisocial borderline his histrionic or narcissistic all right so let's go over these antisocial involves a disregard for the rights of others borderline this involves instability in Rel relationships mood and self-image histrionic involves constant attention-seeking behavior and narcissistic involves a great sense of self-importance and need for admiration now splitting this is the consideration that this is when um this is a consideration of others as either all good or all bad and this is a characteristic of borderline personality disorder and so the correct answer here is going to be a 13 says a woman comes to the doctor with a two week history of complete paralysis of her left arm she has had no injury to the extremity and full neurological workup fails to demonstrate any underlying cause she seems surprisingly uncon concerned about the paralysis and seems more worried about an argument she had 1 month ago in which she hit her daughter based on this information the woman's most likely diagnosis is blank a conversion disorder B generalized anxiety disorder C illness anxiety disorder or D histrionic personality disorder conversion disorder if you recall is marked by a motor or s symptom in the absence of any underlying physical or neurological cause it is associated with some sort of inciting event that in this case may have been that argument with her daughter her lack of concern over the deficit is also a symptom that falls under conversion disorder and So based on this information the woman's most likely diagnosis is going to be a conversion disorder let's go ahead and move into problem 14 14 says a woman notices that her father has started to move his fingers in such a way that it looks like he is rolling something despite nothing actually be there being there she also notes slowed movement and a shuffling gut which neurotransmitter is likely to be present in decreased levels in her father's brain now these symptoms that are noted here are symptoms that indicate that the women's father likely has Parkinson's disease One giveaway to this is that he started to move his fingers in a way that looks like he's rolling something despite nothing being there pill rolling Tremor is um a symptom of Parkinson's disease now if the woman's father has Parkinson's disease this disease is caused by decreased dopamine production and so the correct answer here is going to be C dopamine 15 says which of the following is our true regarding bipolar disorder statement one says they have little if any genetic heritability two says they're associated with increased levels of serotonin in the brain and three says they all require at least one depressive episode for diagnosis bipolar disorder has been shown to be highly heritable and um are associated with increased levels of both norepinephrine and serotonin in the brain right off the bat one is a false statement and two they are associated with increased levels of Serotonin that is a true statement so one is false two is true now what about three they all require at least one depressive episode for diagnosis bipolar one disorder this can be diagnosed with a single manic episode it does not require major major depressive episode bipolar two disorder requires at least one hypomanic episode and at least one major depressive episode episode now the statement says they all require at least one depressive episode for diagnosis that's not true bipolar one disorder does not need or does not require a major depressive episode so three is also false the only true statement here is statement two which means the correct answer for 15 is going to be B and with that we've completed our practice problem set for chapter 7 I really hope this was helpful let me know if you have any questions comments concerns down below other than that good luck happy studying and have a beautiful beautiful day future doctors