COUNSELING AND EDUCATIONAL PSYCHOLOGY

COU 855: DIAGNOSIS AND TREATMENT IN COUNSELING, 3 Cr. Hrs.

Summer 2010, Fully Online Course, No on campus meetings

COURSE DESCRIPTION: The course will focus on the history, use, limitations, benefits, multi axial assessment, and major adult diagnostic categories of the DSM as well as the psychiatric mental status examination and the role of psychopharmacology in diagnosis and treatment. COU 855 focuses onadult pathology and COU 848 focuses on child pathology. COU 846 is a pre-requisite not co-requisite for the course

REQUIRED TEXT:

AUTHOR: American Psychiatric Association (APA)

TITLE: Diagnostic and Statistical Manual of Mental Disorders-TR (Training Revision)

PUBLISHER: American Psychiatric Association (APA)(large silver book)

Knowledge of Blackboard and access to high speed internet are required. Daily checking of email is recommended and checking email several times per week is required.

Recommended Texts: The Psychiatric Interview, by Carlat; Clinician’s Thesaurus by Zuckerman; The Psychiatric Mental Status Examination by Trzepacz

Online Requirements

Since this is an online course, you may begin the work as soon as you register for the class and have access to BB. If you have problems with BB and have reviewed the BB Help Manual and Tutorial, contact the technology office at 622.3000. Common BB problems include: name change not recognized by EKU and change in password. BB will send emails to your official EKU email account. The instructor will officially communicate with you about the class ONLY through your BB email account. Since this is an online class and the only communication is through email, you must check your email daily or every other day to stay in communication with the instructor. Make sure that your email in BB is correct.

STUDENT LEARNING OUTCOMES:

1.Understand the mental health and mental illness continuum with attitudes, beliefs, understandings and acculturative experiences of diverse groups

2.Understand the DSM history, limitations, and benefits

3.Understand and apply the criteria for the major adult DSM disorders

4.Understand and apply the multi axial assessment process

5.Understand the current paradigms and best practice issues in counseling relative to diagnosis and treatment in counseling

6.Understand the role of psychopharmacology in treatment planning

7.Understand the legal and ethical issues in diagnosis and treatment

8.Ability to develop “best practices, evidence-based practices” treatment plans (included both psychological and psychopharmacological treatments).

COURSE REQUIREMENTS AND COURSE OUTLINE:

Read and discuss the information in the DSM-IV TR regarding adult disorders. Each major category is covered by a paper written on the psychological and psychopharmacological treatments for that disorder. These papers are on treatment issues/techniques not specific treatment plans. Papers will include both psychological and psychopharmacological treatments that are considered “best practices, evidence-based practices” for these disorders. The papers are 3pages minimum of content on treatment issues excluding the references and introductory paragraph (double spaced, 12 point type, one inch margins,no 2.5 or 2.75 or 2.9 papers please:).Papers that do not meet the minimum page requirement for content will need to be re-done/re-posted and will count as a late paper.Your papers may be as long as you like, the 3 pages is a minimum requirement.

Your papers will require research beyond the DSM because the Manual only deals with the background information and diagnostic criteria for the disorder. Good sources for information on “best practices and evidence based research” for treatment for the disorders are the professional associations websites and journals (such as the American Counseling Association, American Psychological Association, American Psychiatric Association, National Association of Social Work.Only use an introductory paragraph of less than a half page to introduce the disorder, the focus of the papers is on the treatment of the disorder (psychological and psychopharmacological).

NOTE: Papers are due weekly whether EKU is in session or not

1. Substance Use and Abuse Related Disorders(Due 5/31)

Pick any one or combination of subtypes of substance use/abuse disorders.

Clinicians can assume that a client has substance abuse issues until proven otherwise. Because

substance abuse is related to many psychiatric symptoms, the substance abuse diagnosis

is usually ruled in or out before other diagnoses are made. Therefore, it is important for all

counselors to be aware of the diagnosis and treatment of substance use and abuse, especially

12-step programs or other significant recovery programs.

2. Psychotic Disorders

Pick one

Brief Psychotic Disorder

Psychotic Disorder due to…..

Shared Psychotic Disorder

Schizophrenia (Undifferentiated) and Disorganized)

Schizophrenia (Paranoid)

Schizophreniform

Schizoaffective Disorder

3. Delusional Disorders

Pick one

Persecutory

Jealous

Somatic

Grandiose

4. Cognitive Disorders

Dementia Due to…( HIV or Head Trauma or Disease, or Alzheimer's Type) Pick one

Delirium Disorders

5. Somataform Disorders

Pick one

Hypochondrias

Body Dysmorphic Disorder

Pain Disorder with (Psychological Factors and/or General Medical Condition)

6. Factitious Disorder

Pick one

Psychological and/or Physical Factitious Disorder

Factitious Disorder By Proxy Under Research (coded under NOS currently, Munchausen Syndrome)

7. Dissociative Disorders Dissociative Identity Disorder (DID formerly MPD)

8. Personality Disorders

Pick one cluster A, B, or C(Sometimes referred to as meanies (B), weenies (C), and crazies (A))

Cluster A: Schizoid, Schizotypal, Paranoid

Cluster B: Antisocial, Histrionic, Narcissistic, Borderline

Cluster C: Avoidant, Dependent, Obsessive-Compulsive

9. Mood DisordersPick one

Major Depression

Dysthymia

Bipolar I, II

Cyclothymia

10. Anxiety Disorders

Pick one

Panic Disorder with or without Agoraphobia

Obsessive Compulsive Disorder (OCD)

Post-Traumatic Stress Disorder (PTSD)

Specific Phobias

Social Anxiety

11. Sleep Disorders

Pick one

Dyssomnias

Parasomnias

12. Eating Disorders

Pick one

Anorexia

Bulumia

13. Impulse Control Disorders

Pick one

Intermittent Explosive Disorder,

Kleptomania

Pyromania

Pathological Gambling

Trichotillomania

14. Sexual Dysfunctions

Pick one

Desire

Arousal

Orgasmic

15. Paraphilias

Pick one

Exhibitionism

Frotteurism

Voyeurism

Pedophilia

16. Gender Identity Disorder (GID)

GID or GID NOS (Reminder that gender identity is different from sexual orientation. Sexual orientation is often defined as asexual, bisexual, homosexual, or heterosexual) This paper focuses on gender identity. The DSM V is currently being researched and there is controversary over whether this category should remain in the DSM, discuss your personal opinions on this controversarial topic. NOTE use evidence based, professional association approved research. You will have to do some research on this topic before you can draw any conclusions on whether or not it should be listed in the DSM and whether or not it is a mental illness/disorder.

A Contract Grade:

Includes all of the work for the B Contract Grade plus a complete Final Exam Due(copy questions below into a word document, add short answer responses in RED, and send to instructor by email attachment and post on BB).Every question must be answered to fulfill this contract.

FINAL EXAM: DSM-IV (TR) TEXT QUESTIONS WITH BRIEF ANSWERS

(This is an individual project not a group project—using the work of others is plagiarism and subject to student discipline by the university). Copy the questions into a word document and then provide the answers in the same document with the questions.

THIS IS A VERY LENGTHY PROJECT, NOT TO BE UNDERTAKEN AT THE LAST MINUTE. LOOK IT OVER EARLY IN THE SEMESTER AND DETERMINE IF YOU HAVE THE TIME AND INTEREST TO DEVOTE TO IT, OTHERWISE CONTRACT FOR THE B GRADE.

Introduction

  1. What was the initial reason for developing a classification of mental disorders in the US?
  2. What was the one category listed in the classification of mental disorders in 1840?
  3. List the 7 classifications of mental disorders in the 1880 census.
  4. When was the DSM I published?
  5. What prompted the revisions of the DSM I, II, III?
  6. What were the 3 main changes in the DSM III in 1974?
  7. What does Text Revision mean in the DSM IV?
  8. What is the difference in classifying people v. classifying the disorder that people have?

Use of the Manual

  1. What does the specifer partial and full remission mean?
  2. What is the difference in the terms principal diagnosis and reason for visit?
  3. What is a provisional diagnosis?
  4. What does NOS mean and when is it used?
  5. What code is used to defer a diagnosis?
  6. How many major categories are listed in the DSM-IV?
  7. Can an adult be diagnosed with an infancy, child, or adolescent disorder?

Multi-Axial Assessment

  1. What goes on Axis I?
  2. What goes on Axis II?
  3. What goes on Axis III?
  4. What goes on Axis IV?
  5. What goes on Axis V?
  6. What would a GAF score of 50 or less mean?

Diagnoses Usually First Diagnosed During Infancy, Childhood, or Adolescence

(MR, PDD, LD)

  1. What is the general IQ cut off that determines MR?
  2. Onset of MR symptoms must begin before what age?
  3. Generally what is the SEM in assessing IQ?
  4. What is adaptive behavior?
  5. Which MR category has the largest population?
  6. List 8 causes of MR?
  7. Can someone with MR also be diagnosed with LD?
  8. What is the IQ range for Borderline Intellectual Functioning?
  9. List the 3 areas of LD diagnosis?
  10. Typically what is the statistical discrepancy between achievement and IQ for LD?
  11. What is the school dropout rate for LD?
  12. What is dyslexia?
  13. What is the hallmark deficit in PDD?
  14. How does Rhett’s differ from Autism? Childhood Disintegrative Disorder? Asperger’s

ADHD/CD/ODD

  1. Which subtype of ADHD do most children have?
  2. ADHD must have onset prior to what age?
  3. Which subtype of CD has the worst prognosis?
  4. What is the difference between mild and severe CD specifiers?
  5. What age does CD usually emerge?
  6. Can a diagnosis of CD be used if the client is older than 18?
  7. What is pica?
  8. What is Rumination Disorder?
  9. What is the difference between a Tic disorder and Tourette’s?
  10. What is the difference between encopresis and enuresis?

Separation Anxiety,/Mutism/ RAD/ Stereotypy

  1. Do adults have separation anxiety disorder?
  2. What is selective mutism?
  3. What is the difference between inhibited and disinhibited types of RAD?
  4. RAD begins before what age?
  5. What causes RAD?
  6. What is the difference between stereotypic movement and a complex motor tic?

Delirium/Dementia/Anmesia

  1. What is delirium?
  2. What is dementia?
  3. What is amnesia?
  4. What is the difference between an illusion and a hallucination?
  5. Between delirium and dementia which has a rapid and which a gradual onset?
  6. What is executive functioning?
  7. Describe echolalia?
  8. Describe aprexia?
  9. Describe Agnosia?
  10. Dementia is uncommon in children but can occur due to what?
  11. Highest rates of dementia occur after what age?
  12. The average duration of alzheimer’s from onset to death is how many years?
  13. Can you get dementia from a head injury, HIV, or mad cow disease?
  14. Can you get dementia from over exposure to chemicals used on your yard and painting your car?
  15. What is confabulation?
  16. What is Karsakoff’s syndrome?
  17. Can a general medical condition change your personality?
  18. The frontal lobes control what functions?

Substance Related Disorders

  1. What is drug tolerance?
  2. What is drug withdrawal?
  3. What is the difference between abuse and dependence on drugs?
  4. Which route of drug use leads to escalating patterns of dependence?
  5. Which age group has the highest rate of alcohol and drug use?
  6. What is a relapse?
  7. What is remission?
  8. What is fetal alcohol syndrome (FAS)?
  9. What is the percentage of individuals with substance abuse who commit suicide?
  10. What percent of all fatalities involve intoxication?
  11. What are the 2 prominent alcohol withdrawal symptoms?
  12. Alcohol withdrawal symptoms may persist for how long?
  13. What cultural factors are related to alcohol abuse and dependence?
  14. What is the average person’s risk for alcohol dependence?
  15. What is the predominate symptom of withdrawal from amphetamines?
  16. What extremely negative symptom can be related to an excessive amount of amphetamine use?
  17. What percentage of the population consumes caffeine?
  18. What does intact reality testing with perceptual disturbance mean?
  19. What is the world’s most commonly used illicit drug?
  20. Are you more likely to get lung cancer from tobacco or cannabis?
  21. If you smoke pot how long might it show up in a drug test?
  22. What are hallucinogens?
  23. What is a flashback?
  24. What is synesthesias?
  25. What age group is likely to use inhalants?
  26. What is the gateway drug?
  27. If you continue to smoke cigarettes, by what age do you become a regular smoker?
  28. Smoking and alcohol heredibility risk for dependence is equal, (true or false)?
  29. What are typical symptoms of opoid withdrawal?
  30. What are typical symptoms of anxiolytic withdrawal?
  31. Polysubstance dependence must include at least how many groups?

Psychotic Disorder

  1. What are negative symptoms of schizophrenia?
  2. What are positive symptoms of schizophrenia?
  3. What is a psychosis?
  4. What is a hallucination?
  5. What is a delusion?
  6. What is another name for shared psychotic disorder?
  7. What is the difference between a bizarre and non-bizarre delusion?
  8. What are loose associations?
  9. What is tangential speech?
  10. What is word salad?
  11. What is the most dangerous subtype of schizophrenia to others?
  12. What is anhedonia?
  13. What is water intoxication?
  14. What is the modal age of onset of schizophrenia?
  15. What is the schizophrenia spectrum?
  16. What is catatonia?
  17. How does schizophreniform differ from schizophrenia?
  18. How does schizoaffective differ from schizophrenia?
  19. Describe an erotomania delusion?
  20. Describe a grandiose delusion?
  21. Describe a jealous delusion?
  22. Describe a persecutory delusion?
  23. Describe a somatic delusion?
  24. What is the most common subtype of delusion?

Mood Disorder

  1. What is the difference between major depression and dysthymia?
  2. What is the difference between Bipolar I and II?
  3. In children and adolescents how might a depressive mood present instead of sad?
  4. How much more often are females than males diagnosed with depression?
  5. What is the difference between mania and hypomania?
  6. Which occurs more mania or depression?
  7. Can you have psychotic symptoms with depression?
  8. What is a rapid cycler?

Anxiety Disorder

  1. What is a panic attack?
  2. What is agoraphobia?
  3. What is social phobia?
  4. What is an obsession?
  5. What is a compulsion?
  6. List the most common specific phobia subtype for children.
  7. How do you get a specific phobia?
  8. List 3 common OCD behaviors?
  9. What is the difference between OCD and obsessive compulsive personality disorder?
  10. What is the difference between acute stress disorder and PTSD?
  11. Can children have PTSD?
  12. What is the lifetime risk for PTSK?
  13. Name 3 medical conditions that might present as anxiety symptoms.

Somatoform Disorder

  1. What is the historical term for somatization disorders?
  2. What is the difference between malingering and conversion disorder?
  3. Conversion disorder is more reported in what population?
  4. What percent of patients with pain disorder also have substance abuse or dependence?
  5. What is the difference between malingering and factitious disorder?
  6. What is Munchausen syndrome?

Dissociative Disorder

  1. What is the difference between dissociative amnesia and dissociative fugue?
  2. What was DID formerly labeled?
  3. What is Ganser syndrome?
  4. What is depersonalization disorder?

Sexual Disorders and GID

  1. What is the difference between gender, gender role, gender identity, and sexual orientation?
  2. What other disorders are often associated with low sexual desire?
  3. Name 2 common medication groups that may effect male erectile disorder?
  4. What categories make up the majority of apprehended sex offenders?
  5. What is frotteurism?
  6. What percent of individuals with paraphilias are married?
  7. What are the more common fetish objects?
  8. Is pedophilia generally ego syntonic or dystonic?
  9. When does pedophilia usually begin?
  10. What is the difference between exclusive and non-exclusive types of pedophilia?
  11. What is the minimum age for a pedophile diagnosis and minimum number of years difference in age between the pedophile and the victim?
  12. Pedophiles attracted to females generally prefer what age group?
  13. Sexual sadists are sexually aroused by what?
  14. What is hypoxyphilia?
  15. Onset of voyeurism is usually before what age?
  16. What is the sexual orientation of individuals with GID?

Eating Disorders

  1. Is simple obesity a DSM disorder?
  2. What percentage of weight for height defines anorexia?
  3. What does anorexia mean?
  4. What is the mortality rate for anorexia?
  5. Do all bulimics purge?
  6. Do anorexics purge?

Sleep Disorders

  1. What are dysomnias?
  2. What is the circadian rhythm?
  3. What is the average amount of sleep required for an adult in 24 hours?
  4. Can you catch up on sleep?
  5. What is sleep apnea?
  6. What are parasomnias?
  7. What is a typical age for children to have nightmares?
  8. What is a hypnogic hallucination?
  9. Do people really sleepwalk?

Impulse Control Disorders

  1. What is the difference in most shoplifting and kleptomania?
  2. What percent of kleptomaniacs are female?
  3. What is the preferred treatment for pathological gamblers?
  4. What are the most common site for hair removal due to trichotillomania?

Adjustment Disorder

  1. Can you have chronic adjustment disorder?

Personality Disorders

  1. What is Cluster A?
  2. What is Cluster B?
  3. What is Cluster C?
  4. Can a child or adolescent be diagnosed with a personality disorder?
  5. Which personality disorders tends to improve with age?
  6. Which personality disorders tend not to improve with age?
  7. Which personality disorders may be related to psychotic disorder?
  8. What is the difference between charting a personality disorder and personality traits?
  9. Which personality disorder is described as the ultimate loner?
  10. Litigious?
  11. Misfit?
  12. Bully?
  13. Labile?
  14. Snob?
  15. Dramatic?
  16. Shy
  17. Submissive
  18. Perfectionistic
  19. What is the most frequently reported personality disorder in mental health clinics?

V Codes

1. What is a V code?

2. What is malingering?