Clusters A B C: Odd, Dramatic, Anxious — Always Be Careful
Personality Disorder Clusters
Three clusters of personality disorders — each with a theme
Cluster A (Odd): Paranoid, Schizoid, Schizotypal. Cluster B (Dramatic): Borderline, Narcissistic, Histrionic, Antisocial. Cluster C (Anxious): Avoidant, Dependent, OCPD.
A
Odd/Eccentric
B
Dramatic/Emotional
C
Anxious/Fearful
Anxiety Disorder Types
Anxiety types: Panic, Agoraphobia, Social, GAD, Specific phobia
Anxiety Disorder Types
Five major anxiety disorders and how to tell them apart
Panic disorder: recurrent unexpected panic attacks. Agoraphobia: fear of open/escape-difficult situations. Social anxiety: fear of social scrutiny. GAD: excessive worry about multiple things. Specific phobia: fear of a particular object or situation.
PTSD Symptoms
PTSD: re-experiencing, avoidance, hyperarousal, negative cognition — after trauma
PTSD Symptoms
Four symptom clusters of post-traumatic stress disorder
Mood disorder characterized by swings between mania and depression
Bipolar I: full manic episodes (at least 7 days, may require hospitalization). Bipolar II: hypomania (less severe) + major depression. Manic episode: elevated or irritable mood, decreased need for sleep, grandiosity, racing thoughts, increased goal-directed activity, poor judgment. Treated with mood stabilizers (lithium).
Obsessions: persistent, unwanted, intrusive thoughts that cause anxiety (contamination, harm, symmetry). Compulsions: repetitive behaviors or mental acts to neutralize the anxiety (handwashing, checking, counting). Ego-dystonic: the person knows the thoughts/behaviors are excessive but can't stop. Treated with CBT (ERP) + SSRIs.
Dissociative Disorders
Dissociative disorders: disruption of consciousness, memory, identity. DID = formerly multiple personality disorder.
Dissociative Disorders
The mind's extreme defense against overwhelming trauma
Dissociative amnesia: inability to recall important personal information, usually trauma-related. Depersonalization/derealization: feeling detached from one's mind/body or surroundings. Dissociative Identity Disorder (DID): two or more distinct personality states, associated with severe early trauma.
Eating Disorders
Eating disorders: Anorexia (restricts + distorted body image). Bulimia (binge-purge). Binge eating (binge, no purge).
Eating Disorders
Three major eating disorder diagnoses and how to distinguish them
Anorexia nervosa: severely restricts food intake, intense fear of weight gain, distorted body image. Often normal or low BMI. Bulimia nervosa: recurrent binge eating followed by purging (vomiting, laxatives, excessive exercise). Maintains normal weight. Binge eating disorder: recurrent binges without compensatory behaviors.
Anorexia
Restriction + distorted body image
Bulimia
Binge-purge cycle, normal weight
Binge eating
Binges without purging
Somatic Disorders
Somatic symptom disorder: real physical symptoms with excessive thoughts/feelings/behaviors about health
Somatic Disorders
When psychological distress manifests as physical symptoms
Somatic symptom disorder: one or more physical symptoms plus excessive concern about health. NOT faking — distress is genuine. Illness anxiety disorder (formerly hypochondria): high health anxiety with mild/no symptoms. Conversion disorder: neurological symptoms (paralysis, blindness) without neurological cause.
Autism Spectrum Disorder
Autism Spectrum Disorder: social communication deficits + restricted, repetitive behaviors. Wide spectrum.
Autism Spectrum Disorder
A neurodevelopmental condition affecting social communication and behavior
ASD: persistent deficits in social communication and interaction, plus restricted/repetitive behaviors, interests, or activities. Presents in early development. Wide spectrum: some nonverbal with significant support needs; others high-functioning. Sensory sensitivities common. No single cause — complex genetic and environmental factors.
ADHD
ADHD: inattention and/or hyperactivity-impulsivity. Three types: inattentive, hyperactive-impulsive, combined.
ADHD
Attention-deficit/hyperactivity disorder — three presentations
Inattentive type: fails to attend to details, easily distracted, forgetful, loses things, doesn't follow through. Hyperactive-impulsive: fidgets, can't stay seated, talks excessively, interrupts, difficulty waiting. Combined: meets criteria for both. Symptoms present before age 12 in multiple settings.
Anxiety Disorders
GSPOT — GAD, Social anxiety, Panic, OCD, PTSD (related)
Five major anxiety-spectrum disorders and their defining features
Anxiety disorders share excessive fear but differ in what triggers it and how it manifests
GAD (Generalized Anxiety): chronic uncontrollable worry about multiple areas — key symptom is difficulty controlling worry. Social Anxiety: fear of social scrutiny and embarrassment. Panic Disorder: recurrent unexpected panic attacks + fear of future attacks + agoraphobia. Specific Phobia: marked fear of specific object/situation. OCD (now separate): obsessions + compulsions. PTSD: trauma exposure + intrusion + avoidance + hyperarousal + negative cognitions. Best treatments: CBT + exposure therapy. Medications: SSRIs/SNRIs.
GAD
Worry about everything for 6+ months — hard to control
Panic
Sudden intense fear with physical symptoms — peaks in 10 min
Diagnostic criteria for Major Depressive Episode — 5 of 9 for 2+ weeks
SIGECAPS is the classic medical mnemonic for diagnosing major depression
Major Depression: 5+ SIGECAPS symptoms for 2+ weeks, must include depressed mood OR loss of interest. Bipolar I: at least one manic episode (elevated/irritable mood, grandiosity, decreased need for sleep, racing thoughts, risky behavior — 7+ days). Bipolar II: hypomanic + major depressive episodes. Dysthymia (Persistent Depressive Disorder): chronic low-grade depression 2+ years. Bipolar treatments: mood stabilizers (lithium), atypical antipsychotics.
Q: What are the DSM-5 criteria for Major Depressive Disorder?
A: Five or more symptoms during the same two-week period, representing a change from baseline. Must include either: (1) depressed mood most of the day nearly every day, or (2) loss of interest or pleasure (anhedonia). Additional SIGECAPS symptoms: Sleep disturbance, Interest loss, Guilt or worthlessness, Energy loss, Concentration difficulty, Appetite/weight change, Psychomotor agitation or retardation, Suicidal ideation. Symptoms cause significant distress or functional impairment. Not due to substance or medical condition. Distinguish from: normal grief (time-limited, focused on loss), Bipolar (requires manic/hypomanic episodes), Dysthymia (chronic, less severe, 2+ years).
Q: Distinguish Bipolar I, Bipolar II, and Cyclothymia.
A: Bipolar I: at least one manic episode lasting 7+ days (or any duration if hospitalized). Mania = elevated or irritable mood plus three of: grandiosity, decreased sleep, pressured speech, racing thoughts, distractibility, increased goal-directed activity, risky behavior. May or may not have major depressive episodes. Bipolar II: one or more hypomanic episodes (4+ days, less severe than mania, no hospitalization or psychosis) plus at least one major depressive episode — no full manic episodes. Cyclothymia: chronic mood fluctuations (2+ years) between hypomanic symptoms and depressive symptoms that don't meet full criteria for either. All treated with mood stabilizers (lithium, valproate) and atypical antipsychotics.
Q: What are the positive and negative symptoms of schizophrenia and what causes each?
A: Positive symptoms (excesses added to normal experience): delusions (fixed false beliefs, most often paranoid), hallucinations (most often auditory — hearing voices commenting or commanding), disorganized speech (loose associations, word salad), disorganized behavior, and catatonia. Negative symptoms (deficits from normal function): flat affect (reduced emotional expression), alogia (poverty of speech), avolition (inability to initiate goal-directed activity), anhedonia (inability to feel pleasure), asociality. Biological basis: dopamine hypothesis — excess dopamine in mesolimbic pathway produces positive symptoms; decreased dopamine in prefrontal cortex produces negative symptoms. Antipsychotics block D2 receptors and primarily reduce positive symptoms; negative symptoms harder to treat.
Q: What are the three clusters of personality disorders and what defines each?
A: Cluster A (Odd/Eccentric): Paranoid PD (pervasive distrust and suspicion), Schizoid PD (social detachment, limited emotional expression), Schizotypal PD (odd beliefs, magical thinking, perceptual distortions, social discomfort). Often seen as attenuated versions of psychotic disorders. Cluster B (Dramatic/Emotional/Erratic): Antisocial PD (disregard for others, criminality, no remorse), Borderline PD (unstable relationships, identity, mood + impulsivity + self-harm), Histrionic PD (excessive emotionality, attention-seeking), Narcissistic PD (grandiosity, lack of empathy, need for admiration). Cluster C (Anxious/Fearful): Avoidant PD (social inhibition from fear of rejection), Dependent PD (excessive need for care, submissive), Obsessive-Compulsive PD (perfectionism and control — different from OCD).
Q: Compare CBT, psychodynamic therapy, and humanistic therapy in approach and effectiveness.
A: Cognitive-Behavioral Therapy (CBT): identifies and challenges distorted thinking patterns and maladaptive behaviors. Structured, present-focused, time-limited. Strong empirical support — gold standard for depression, anxiety, PTSD, OCD. Techniques: thought records, behavioral activation, exposure, behavioral experiments. Psychodynamic therapy: insight into unconscious conflicts, early attachment experiences, and relationship patterns. Less structured, longer-term. Empirical support is growing — effective for personality disorders and chronic depression. Humanistic (Person-centered, Gestalt): focuses on present experience, unconditional positive regard, congruence. Most evidence-based elements: therapeutic alliance (relationship quality) predicts outcome across ALL therapy types — accounts for roughly 30% of improvement.