Psychologists strive to maintain high standards of competence in their work. They recognize the boundaries of their particular competencies and the limitations of their expertise. They provide only those services and use only those techniques for which they are qualified by education, training, or experience. Psychologists are cognizant of the fact that the competencies required in serving, teaching, and/or studying groups of people vary with the characteristics of those groups. In those areas in which recognized professional standards do not yet exist, psychologists exercise careful judgment and take appropriate precautions to protect the welfare of those with whom they work. They maintain knowledge of relevant scientific and professional information related to the services they render, and they recognize the need for ongoing education. Psychologists make appropriate use of scientific, professional, technical, and administrative resources.
(A) development of multiple cognitive deficits manifested by both
(1) memory impairment (impaired ability to learn new information or recall previously learned information);
(2) cognitive disturbances (1+):
(a) aphasia (language disturbance);
(b) apraxia (impaired ability to carry out motor activities despite intact motor function);
(c) agnosia (failure to recognize or identify objects despite intact sensory function);
(d) disturbance in executive functioning (i.e. planning, organization, sequencing, abstracting);
(B) the cognitive deficits in criteria A1 and A2 each cause significant impairment in social or occupational
functioning and represent a significant decline from a previous level of functioning;
(C) the course is characterized by gradual onset and continuing cognitive decline;
(D) the cognitive deficits in criteria A1 and A2 are not due to any of the following:
(1) other central nervous system conditions that cause progressive deficits in memory and cognition
(e.g. cerebrovascular disease, Parkinson’s disease, Huntington’s disease, subdural hematoma,
normal-pressure hydrocephalus, brain tumor);
(2) systemic conditions that are known to cause dementia (e.g. hypothyroidism, vitamin B12 or folic acid
deficiency, niacin deficiency, hypercalcemia, neurosyphilis, HIV infection);
(3) substance-induced conditions;
(E) the deficits do not occur exclusively during the course of a delirium;
(F) the disturbance is not better accounted for by another Axis 1 disorder (e.g. Major Depressive Disorder,
Schizophrenia). p. 477
(A) the development of multiple cognitive deficits manifested by both
(1) memory impairment (impaired ability to learn new information or to recall previously learned information);
(2) cognitive disturbances (1+):
(a) aphasia (language disturbance);
(b) apraxia (impaired ability to carry out motor activities despite intact motor functioning);
(c) agnosia (failure to recognize or identify objects despite intact sensory function);
(d) disturbance in executive functioning (i.e. planning, organizing, sequencing, abstracting);
(B) the cognitive deficits in criteria A1 and A2 each cause significant impairment in social or occupational
functioning and represent a significant decline from a previous level of functioning;
(C) focal neurological signs and symptoms (e.g. exaggeration of deep tendon reflexes, extensor plantar response,
pseudobulbar palsy, gait abnormalities, weakness of an extremity) or laboratory evidence indicative of
cerebrovascular disease (e.g. multiple infarctions involving cortex and underlying white matter) that are
judged to be etiologically related to the disturbance;
(D) the deficits do not occur exclusively during the course of a delirium.
p. 477
Horatio, 85, was taken to your office by his daughter-in-law after a series of problems: (1) a major car accident following a 25 year accident-free history; (2) being charged with using a handicapped parking permit when he was ineligible, then causing a disruption in the courtroom during his hearing; (3) going to his deceased wife's place of employment, although she hasn’t worked there for 40+ years, accusing her of having an affair. You note that he is well-groomed and pleasant.A brief symptom checklist was filled out by both Horatio and his daughter-in-law. They report that he is not eating regularly, has difficulty sleeping, is "paranoid" and "confused," rarely leaves home, and no longer goes to church or visits friends. He denied being depressed, anxious, or having hallucinations. You note that his daughter-in-law responds to the question about "Your chief complaint" by stating that he repeatedly (50+ times/day) says, "I don't know where Philamena [his wife] is. I know she is angry at me..." When asked about major stressors, he says there aren't any; she says that her mother-in-law died a year earlier. They note no major medical problems except a hiatal hernia and a heart attack 40 years earlier. He is taking .5 mg of Ativan at bedtime.
1. Memory loss that affects job skills.
2. Difficulty performing familiar tasks.
3. Problems with language.
4. Disorientation of time and place.
5. Poor or decreased judgment.
6. Problems with abstract thinking.
7. Misplacing things.
8. Changes in mood or behavior.
9. Changes in personality.
10. Loss of initiative.
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URL= http://psy1.clarion.edu/jms/Abn1abnormal.html
Last modified November 10, 2001.