Test: Psychological Disorders - 1 - MCAT MCQ

This statement describes a possible limitation to the dopamine hypothesis of schizophrenia. If anti-psychotic drugs, which primarily target dopamine receptors, take two to three weeks to show effectiveness in treating symptoms, it suggests that the relationship between dopamine abnormalities and schizophrenia may not be the sole cause of the disorder. This delay in symptom improvement indicates that other factors and neurotransmitters may also be involved in the development and progression of schizophrenia. It highlights the need to consider a more comprehensive understanding of the disorder beyond dopamine dysfunction alone.

The described case is consistent with conversion disorder, which is a somatic symptom disorder characterized by the presence of physical symptoms or deficits that cannot be explained by any known medical condition. In conversion disorder, the symptoms are not intentionally produced or feigned, but they are believed to be a result of psychological factors. The individual in the scenario experiences tremors, weakness, and a loss of function in his ankle, which cannot be attributed to any identifiable medical cause.

The lack of internal consistency in the symptoms, as demonstrated by the difference between weakness in a seated position and the ability to stand on his toes, is a common feature of conversion disorder. It suggests that the symptoms are not due to a physical impairment but rather influenced by psychological factors.

Somatic symptom disorder (option A) involves excessive and distressing physical symptoms that are not fully explained by a medical condition, but the symptoms are typically not inconsistent or incongruent. Illness anxiety disorder (option C) involves excessive worry about having a serious medical condition, but it does not typically manifest as physical symptoms. Hypochondriasis (option D) is an outdated term and has been replaced by illness anxiety disorder. Therefore, the most appropriate diagnosis in this case is conversion disorder (option B).

Research consistently shows that women have a higher prevalence of major depressive episodes compared to men. While both genders can experience depression, studies have consistently found that women are more likely to be diagnosed with depression and report experiencing depressive symptoms. Factors such as hormonal changes, reproductive events (e.g., pregnancy, postpartum period), and social and cultural influences are believed to contribute to the higher rates of depression in women.

Men (option B) also experience depression, but the prevalence rates tend to be lower compared to women. However, it is important to note that depression in men may be underreported due to factors such as societal expectations, stigma, and differences in symptom presentation.

People over the age of 50 (option C) may experience depression, but the rates tend to be lower compared to other age groups. It is worth mentioning that older adults may be at an increased risk for other mental health concerns such as anxiety or cognitive disorders.

People between 26 and 49 years of age (option D) may also experience depression, but the prevalence rates can vary. This age range is often associated with multiple life stressors, such as career demands, family responsibilities, and financial pressures, which can contribute to the risk of developing depression.

Overall, considering the available research, women (option A) are more likely to have experienced at least one major depressive episode over the last 12 months compared to the other cohorts listed.

The distinction made in the DSM-5 regarding paraphilias and paraphilic disorders reflects a shift in how these conditions are conceptualized. The DSM-IV-TR did not clearly differentiate between paraphilias (unusual or nonnormative sexual interests) and paraphilic disorders (when these interests cause distress or impairment). However, the DSM-5 highlights that a paraphilia, in and of itself, is not sufficient to diagnose a paraphilic disorder.

This approach implies that the focus is not solely on labeling all nonnormative sexual behaviors as psychopathological. Instead, the emphasis is on determining whether the individual's nonnormative sexual interests or behaviors are causing significant distress or impairment in their lives. Only when the nonnormative behavior leads to distress or impairment can it be diagnosed as a paraphilic disorder.

By including the requirement of distress or impairment, the DSM-5 acknowledges that individuals may have nonnormative sexual interests or engage in nonnormative sexual behaviors without experiencing significant distress or impairment. This recognizes that not all nonnormative sexual interests or behaviors are inherently pathological and allows for a more nuanced understanding of paraphilias and paraphilic disorders.

This statement does not accurately describe the criteria for PTSD as described by the DSM-5. The duration of the traumatic event itself is not a criterion for diagnosing PTSD. Instead, the DSM-5 specifies that the exposure to the traumatic event must be directly experienced, witnessed, or learned about, and it should involve actual or threatened death, serious injury, or sexual violence.

The accurate criteria for PTSD, as described by the DSM-5, include the following:

B. Negative, distorted, or exaggerated beliefs, cognitions, or moods associated with the traumatic event that lasts for more than one month. These can include negative thoughts about oneself, others, or the world, as well as persistent negative emotional states such as fear, anger, or guilt.

C. The presence of memories, dreams, or dissociated reactions that are involuntary, intrusive, distressing, and recurrent, lasting for more than one month. These intrusive symptoms can cause significant distress and may manifest as flashbacks, nightmares, or intense psychological or physiological reactions when exposed to triggers associated with the traumatic event.

D. Persistent avoidance of memories, thoughts, feelings, or external reminders associated with the traumatic event(s) lasting for more than one month. This can involve efforts to avoid triggers or reminders of the traumatic event, as well as emotional numbing or avoidance of discussing or thinking about the event.

It's important to note that the duration of these symptoms must persist for more than one month to meet the criteria for a diagnosis of PTSD.

The main difference between bipolar I and bipolar II disorders lies in the presence or absence of manic episodes. Bipolar I disorder is characterized by the occurrence of at least one manic episode, which is a distinct period of abnormally elevated mood or energy lasting for at least one week. In bipolar I disorder, individuals may also experience depressive episodes.

On the other hand, bipolar II disorder is diagnosed when an individual has experienced at least one major depressive episode and at least one hypomanic episode. Hypomanic episodes are similar to manic episodes but of lesser intensity and duration. Unlike manic episodes, hypomanic episodes do not cause severe impairment in functioning or require hospitalization.

Therefore, option A accurately describes the main difference between bipolar I and bipolar II. Individuals diagnosed with bipolar II have never had a full-blown manic episode, while individuals with bipolar I have experienced at least one manic episode.

Antisocial personality disorder is a personality disorder characterized by a pervasive pattern of disregard for and violation of the rights of others. Individuals with this disorder often engage in impulsive and manipulative behaviors, show a lack of remorse or empathy, and have a history of conduct problems.

Panic disorder is an anxiety disorder characterized by recurring, unexpected panic attacks, which are sudden periods of intense fear or discomfort. Individuals with panic disorder also often experience persistent worry about having more panic attacks or the consequences of panic attacks.

Schizophrenia is a severe mental disorder characterized by a disconnection from reality, including symptoms such as hallucinations, delusions, disorganized thinking and speech, and a lack of emotional expression. It often involves a split between thoughts, emotions, and behaviors.

Obsessive-compulsive disorder (OCD) is an anxiety disorder characterized by the presence of persistent, unwanted, and intrusive thoughts (obsessions) that lead to the performance of repetitive behaviors or mental acts (compulsions) aimed at reducing anxiety or preventing a feared outcome.