DSEI 12-10A PDF

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How are the listings for mental disorders arranged, and what do they require? The listings for mental disorders are arranged in 11 categories: neurocognitive disorders Listings Listing Paragraph A of each listing except Paragraph B of each listing except These criteria represent the areas of mental functioning a person uses in a work setting.

They are: understand, remember, or apply information; interact with others; concentrate, persist, or maintain pace; and adapt or manage oneself. We will determine the degree to which your medically determinable mental impairment affects the four areas of mental functioning and your ability to function independently, appropriately, effectively, and on a sustained basis see Paragraph C of listings Each paragraph requires that you have significantly subaverage general intellectual functioning; significant deficits in current adaptive functioning; and evidence that demonstrates or supports is consistent with the conclusion that your disorder began prior to age Which mental disorders do we evaluate under each listing category?

Neurocognitive disorders These disorders are characterized by a clinically significant decline in cognitive functioning. Symptoms and signs may include, but are not limited to, disturbances in memory, executive functioning that is, higher-level cognitive processes; for example, regulating attention, planning, inhibiting responses, decision-making , visual-spatial functioning, language and speech, perception, insight, judgment, and insensitivity to social standards.

Examples of disorders that we evaluate in this category include major neurocognitive disorder; dementia of the Alzheimer type; vascular dementia; dementia due to a medical condition such as a metabolic disease for example, late-onset Tay-Sachs disease , human immunodeficiency virus infection, vascular malformation, progressive brain tumor, neurological disease for example, multiple sclerosis, Parkinsonian syndrome, Huntington disease , or traumatic brain injury; or substance-induced cognitive disorder associated with drugs of abuse, medications, or toxins.

We evaluate neurological disorders under that body system see We evaluate cognitive impairments that result from neurological disorders under This category does not include the mental disorders that we evaluate under intellectual disorder Schizophrenia spectrum and other psychotic disorders These disorders are characterized by delusions, hallucinations, disorganized speech, or grossly disorganized or catatonic behavior, causing a clinically significant decline in functioning.

Symptoms and signs may include, but are not limited to, inability to initiate and persist in goal-directed activities, social withdrawal, flat or inappropriate affect, poverty of thought and speech, loss of interest or pleasure, disturbances of mood, odd beliefs and mannerisms, and paranoia.

Examples of disorders that we evaluate in this category include schizophrenia, schizoaffective disorder, delusional disorder, and psychotic disorder due to another medical condition. Depressive, bipolar and related disorders These disorders are characterized by an irritable, depressed, elevated, or expansive mood, or by a loss of interest or pleasure in all or almost all activities, causing a clinically significant decline in functioning.

Symptoms and signs may include, but are not limited to, feelings of hopelessness or guilt, suicidal ideation, a clinically significant change in body weight or appetite, sleep disturbances, an increase or decrease in energy, psychomotor abnormalities, disturbed concentration, pressured speech, grandiosity, reduced impulse control, sadness, euphoria, and social withdrawal.

Examples of disorders that we evaluate in this category include bipolar disorders I or II , cyclothymic disorder, major depressive disorder, persistent depressive disorder dysthymia , and bipolar or depressive disorder due to another medical condition. Intellectual disorder This disorder is characterized by significantly subaverage general intellectual functioning, significant deficits in current adaptive functioning, and manifestation of the disorder before age Signs may include, but are not limited to, poor conceptual, social, or practical skills evident in your adaptive functioning.

Anxiety and obsessive-compulsive disorders These disorders are characterized by excessive anxiety, worry, apprehension, and fear, or by avoidance of feelings, thoughts, activities, objects, places, or people.

Symptoms and signs may include, but are not limited to, restlessness, difficulty concentrating, hyper-vigilance, muscle tension, sleep disturbance, fatigue, panic attacks, obsessions and compulsions, constant thoughts and fears about safety, and frequent physical complaints.

Examples of disorders that we evaluate in this category include social anxiety disorder, panic disorder, generalized anxiety disorder, agoraphobia, and obsessive-compulsive disorder.

This category does not include the mental disorders that we evaluate under trauma- and stressor-related disorders Somatic symptom and related disorders These disorders are characterized by physical symptoms or deficits that are not intentionally produced or feigned, and that, following clinical investigation, cannot be fully explained by a general medical condition, another mental disorder, the direct effects of a substance, or a culturally sanctioned behavior or experience.

These disorders may also be characterized by a preoccupation with having or acquiring a serious medical condition that has not been identified or diagnosed. Symptoms and signs may include, but are not limited to, pain and other abnormalities of sensation, gastrointestinal symptoms, fatigue, a high level of anxiety about personal health status, abnormal motor movement, pseudoseizures, and pseudoneurological symptoms, such as blindness or deafness.

Examples of disorders that we evaluate in this category include somatic symptom disorder, illness anxiety disorder, and conversion disorder. Personality and impulse-control disorders These disorders are characterized by enduring, inflexible, maladaptive, and pervasive patterns of behavior. Onset typically occurs in adolescence or young adulthood. Symptoms and signs may include, but are not limited to, patterns of distrust, suspiciousness, and odd beliefs; social detachment, discomfort, or avoidance; hypersensitivity to negative evaluation; an excessive need to be taken care of; difficulty making independent decisions; a preoccupation with orderliness, perfectionism, and control; and inappropriate, intense, impulsive anger and behavioral expression grossly out of proportion to any external provocation or psychosocial stressors.

Examples of disorders that we evaluate in this category include paranoid, schizoid, schizotypal, borderline, avoidant, dependent, obsessive-compulsive personality disorders, and intermittent explosive disorder.

Autism spectrum disorder These disorders are characterized by qualitative deficits in the development of reciprocal social interaction, verbal and nonverbal communication skills, and symbolic or imaginative activity; restricted repetitive and stereotyped patterns of behavior, interests, and activities; and stagnation of development or loss of acquired skills early in life.

Symptoms and signs may include, but are not limited to, abnormalities and unevenness in the development of cognitive skills; unusual responses to sensory stimuli; and behavioral difficulties, including hyperactivity, short attention span, impulsivity, aggressiveness, or self-injurious actions.

Examples of disorders that we evaluate in this category include autism spectrum disorder with or without accompanying intellectual impairment, and autism spectrum disorder with or without accompanying language impairment. This category does not include the mental disorders that we evaluate under neurocognitive disorders Neurodevelopmental disorders These disorders are characterized by onset during the developmental period, that is, during childhood or adolescence, although sometimes they are not diagnosed until adulthood.

Symptoms and signs may include, but are not limited to, underlying abnormalities in cognitive processing for example, deficits in learning and applying verbal or nonverbal information, visual perception, memory, or a combination of these ; deficits in attention or impulse control; low frustration tolerance; excessive or poorly planned motor activity; difficulty with organizing time, space, materials, or tasks ; repeated accidental injury; and deficits in social skills.

Symptoms and signs specific to tic disorders include sudden, rapid, recurrent, non-rhythmic, motor movement or vocalization. Examples of disorders that we evaluate in this category include specific learning disorder, borderline intellectual functioning, and tic disorders such as Tourette syndrome. Eating disorders These disorders are characterized by disturbances in eating behavior and preoccupation with, and excessive self-evaluation of, body weight and shape.

Symptoms and signs may include, but are not limited to, restriction of energy consumption when compared with individual requirements; recurrent episodes of binge eating or behavior intended to prevent weight gain, such as self-induced vomiting, excessive exercise, or misuse of laxatives; mood disturbances, social withdrawal, or irritability; amenorrhea; dental problems; abnormal laboratory findings; and cardiac abnormalities.

Trauma- and stressor-related disorders These disorders are characterized by experiencing or witnessing a traumatic or stressful event, or learning of a traumatic event occurring to a close family member or close friend, and the psychological aftermath of clinically significant effects on functioning. Symptoms and signs may include, but are not limited to, distressing memories, dreams, and flashbacks related to the trauma or stressor; avoidant behavior; diminished interest or participation in significant activities; persistent negative emotional states for example, fear, anger or persistent inability to experience positive emotions for example, satisfaction, affection ; anxiety; irritability; aggression; exaggerated startle response; difficulty concentrating; and sleep disturbance.

Examples of disorders that we evaluate in this category include posttraumatic stress disorder and other specified trauma- and stressor-related disorders such as adjustment-like disorders with prolonged duration without prolonged duration of stressor. This category does not include the mental disorders that we evaluate under anxiety and obsessive-compulsive disorders What evidence do we need to evaluate your mental disorder?

We need objective medical evidence from an acceptable medical source to establish that you have a medically determinable mental disorder. We also need evidence to assess the severity of your mental disorder and its effects on your ability to function in a work setting.

We will determine the extent and kinds of evidence we need from medical and nonmedical sources based on the individual facts about your disorder. For additional evidence requirements for intellectual disorder For our basic rules on evidence, see For our rules on evaluating medical opinions, see For our rules on evidence about your symptoms, see Evidence from medical sources.

We will consider all relevant medical evidence about your disorder from your physician, psychologist, and other medical sources, which include health care providers such as physician assistants, psychiatric nurse practitioners, licensed clinical social workers, and clinical mental health counselors. Evidence from your medical sources may include: Your reported symptoms. Your medical, psychiatric, and psychological history. The results of physical or mental status examinations, structured clinical interviews, psychiatric or psychological rating scales, measures of adaptive functioning, or other clinical findings.

Psychological testing, imaging results, or other laboratory findings. Your diagnosis. The type, dosage, and beneficial effects of medications you take.

The type, frequency, duration, and beneficial effects of therapy you receive. Side effects of medication or other treatment that limit your ability to function. Your clinical course, including changes in your medication, therapy, or other treatment, and the time required for therapeutic effectiveness. Observations and descriptions of how you function during examinations or therapy. Information about sensory, motor, or speech abnormalities, or about your cultural background for example, language or customs that may affect an evaluation of your mental disorder.

The expected duration of your symptoms and signs and their effects on your functioning, both currently and in the future. Evidence from you and people who know you. We will consider all relevant evidence about your mental disorder and your daily functioning that we receive from you and from people who know you. We will ask about your symptoms, your daily functioning, and your medical treatment. We will ask for information from third parties who can tell us about your mental disorder, but you must give us permission to do so.

This evidence may include information from your family, caregivers, friends, neighbors, clergy, case managers, social workers, shelter staff, or other community support and outreach workers. We will consider whether your statements and the statements from third parties are consistent with the medical and other evidence we have.

Evidence from school, vocational training, work, and work-related programs. You may have recently attended or may still be attending school, and you may have received or may still be receiving special education services. If so, we will try to obtain information from your school sources when we need it to assess how your mental disorder affects your ability to function. Examples of this information include your Individualized Education Programs IEPs , your Section plans, comprehensive evaluation reports, school-related therapy progress notes, information from your teachers about how you function in a classroom setting, and information about any special services or accommodations you receive at school.

Vocational training, work, and work-related programs. You may have recently participated in or may still be participating in vocational training, work-related programs, or work activity. If so, we will try to obtain information from your training program or your employer when we need it to assess how your mental disorder affects your ability to function. Examples of this information include training or work evaluations, modifications to your work duties or work schedule, and any special supports or accommodations you have required or now require in order to work.

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