1. Over a period of at least 6 months, recurrent, intense sexually arousing fantasies, sexual urges, or behaviors involving sexual activity with a prepubescent child or children (generally age 13 years or younger, most common age is just before a child hits puberty - earlier for females than males)
2. The person has acted on these sexual urges, or the sexual urges/fantasies cause marked distress or interpersonal difficulty
3. The person is at least 16 years and at least 5 years older than the child or children in Criterion 1

Note: Do not include an individual in late adolescence involved in an ongoing sexual relationship with a 12- or 13-year-old

Specify if:

• Sexually attracted to males, females, or both
• Limited to incest

Specify type:

• Exclusive type (attracted only to children)
• Nonexclusive type (attracted to both adults and children)

1. Distinct period of abnormally and persistently elevated, expansive, or irritable mood, lasting at least 1 week
2. During the mood disturbance, 3 or more of the following symptoms have persisted if mood is happy or elevated:
• Inflated self-esteeem or grandiosity - sometimes believe that they can do things that they aren't able to do
• Decreased need for sleep - not tired at all
• More talkative than usual, or pressure to keep talking - can't just talk; must be a change from normal
• Racing thoughts ("flight of ideas") - not necessarily worrying or ruminating, just a lot of ideas very quickly
• Distractibility
• Increase in goal-directed activity - get a lot of things done, cleaning is very frequent, excessive involvement in pleasurable activities that have the potential for negative consequences - impulsive things (buying, unprotected sex, alcohol consumption)
3. The symptoms do not met criteria for a Mixed Episode
4. The symptoms cause significant impairment in functioning or necessitate
   

• Child-like silliness
• Unpredictable or inappropriate behavior
• Unpredictable agitation
• Markedly disheveled appearance
• Dresses in unusual manner
• Clearly inappropriate sexual behavior

• Factors important for the client
• Motivation to change is the most crucial factor for success
• Expectation that you are receiving help (placebo effect)
• Factors important for the therapist
• Personal characteristics (e.g. empathy, trustworthiness, etc.)
• Level of expertise (some research has shown that level of expertise doesn't really matter)
• Experience (even just one previous client with the same problem helps)
• Key elements of the relationship
• Sense of working collaboratively on a problem
• Agreement between patient and therapist about goals and tasks
• Affective bond between patient and therapist

• Behavior therapy
• Cognitive and cognitive-behavior therapy
• Humanistic-experiential therapy
• Psychodynamic therapy
• Marital and family therapy

• Maladaptive (often cause problems not only for the individual, but also for other people)
• Inflexible (difficult to adapt to different situations, always think/behave in the same way)
• Pervasive (think/behaive the same way in all life roles)
• Enduring (persist for years, decades, even for entire lifespan - usually from adolescence)
• Deviant (thoughts/behavior not considered normal in the individual's culture)
• Cause significant distress or impairment

• Flat affect (no emotional response to events/news)
• No emotional expression in speech
• Restricted fluency of thought and speech (don't have much to add, one- or two-word answers; alogia)

1. Five or more of the following:
1. Has difficulty making everyday decisions without an excessive amount of advice and reassurance from others
2. Needs others to assume responsibility for most major areas of his or her life
3. Has difficulty expressing disagreement with others because of fear of loss of support or approval
4. Has difficulty initiating projects or doing things on his or her own (because of a lack of self-confidence rather than a lack of motivation or energy)
5. Goes to excessive lengths to obtain nurturance and support grom others, to the point of volunteering to do things that are unpleasant
6. Feels uncomfortable or helpless when alone because of exaggerated fears of being unable to care for himself or herself
7. Urgently seeks another relationship as a source of care and support when a close relationship ends
8. Is unrealistically preoccupied with fears of being left to take care of himself or herself

• False sense perception
• Types
• Auditory - hear something that is not there; most common hallucination
• Tactile - feel something that is not there (i.e. feel insects crawling on you)
• Visual - see something that is not there; more commonly results from substance abuse or brain damage
• Olfactory/Gustatory - smell or taste something that is not there (usually a bad smell/taste; be sure that they don't just have a really, really good sense of smell)
• Somatic - feels like something is going on inside the body (i.e. electricity is flowing through you)

Note: It is very uncommon to have a visual hallucination that speaks, too (hallucinations don't overlap; malingering can be common)

1. Non-bizarre delusions lasting for at least 1 month
2. Criterin 1 for schizophrenia have never been met (however, tactile and olfactory may be present if they are related to the delusional theme)
3. Behavioral functioning is not markedly impaired and behavior is not obviously odd or bizarre
4. If mood episodes have occurred concurrently with delusions, their total duration has been brief relative to the duration of the delusional periods
5. Not due to the direct effects of a GMC or substance

1. Fixed, false beliefs (person cannot see reality no matter how much evidence is provided against the belief; misinterpretation of stimuli that are actually there)
2. Types
1. Bizarre - something seen as implausible or impossible
2. Thought insertion - thoughts are being inserted into person's head
3. Thought withdrawal - thoughts are being taken out of a person's head
4. Thought broadcast - thoughts are being broadcast
5. Reference - neutral stimuli have special meaning to the person
6. Control - person is being controlled by something or someone else
7. Somatic - things happening to body
8. Nihilistic - person believes s/he is dead or does not exist
9. Grandiose - exaggeration of self (i.e. I have super powers, I am very important)
10. Religious - related to religious beliefs or themes
11. Persecutory - person is being chased, watched, or persecuted

Note: Delusions can fall under more than one category

1. Disturbance of consciousness
• i.e. reduced clarity of awareness of the environment (orientation)
• reduced ability to focus, sustain, or shift attention
2. Change in cognition (change in ability to think)
• i.e. memory deficit, disorientation, language disturbance
3. Disturbance develops over a short period of time (hours* to days) and tends to fluctuate over the course of the day
4. Evidence that the disturbance is caused by the direct physiological consequences of a GMC, substance, or both

1. Memory
• Retrograde - affects memory before the injury (e.g. childhood memories, previous month, etc.)
• Anterograde - affects memory after the injury (e.g. learning new skills, remembering new experiences, etc.)
2. Orientation (where you are, who you are, what time it is, why you are where you are; general confusion)
3. Learning, comprehension, & judgment
4. Emotional control (over-reacting, inappropriate emotions)
5. Apathy/emotional blunting (constricted emotional experience)
6. Initiating behavior (motivation, etc.)
7. Ethical conduct (lowered standards of appearance, sexual behavior, hygiene, language, etc.)
8. Communication (coming up with words, talking, understanding)
9. Visuaspatial ability (maps)

Shared Psychotic Disorder

(Folie a Deux)

1. A delusion develops in an individual in the context of a close relationship with another person(s), who has an already-established delusion (e.g. a child acquires a parent's delusion and claims it as one's own)
2. The delusion is similar in content to that of the person who already has established the delusion
3. The disturbance is not better accounted for by another psychotic disorder or is due to a GMC or substance