PMHS flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

M-CHAT-R/F timing

Autism screening tool administered at 18 and 24 months; a positive result triggers follow-up interview and, if still positive, diagnostic evaluation-not diagnosis.

PHQ-A severe threshold

PHQ-A total of 20–27 indicates severe depression; any positive response to item 9 (suicidal ideation) requires immediate safety assessment regardless of total score.

ADHD DSM-5-TR symptom threshold

For children under 17, at least six inattentive and/or six hyperactive-impulsive symptoms are required; for ages 17 and older, the threshold is five symptoms.

ADHD cross-setting requirement

Symptoms must be present in two or more settings (home, school, community) and cause clear impairment; use parent and teacher rating scales to document this.

SCARED anxiety cutoff

Screen for Child Anxiety Related Emotional Disorders; a total score of 25 or higher suggests clinically significant anxiety and warrants further evaluation.

Separation anxiety disorder duration

DSM-5-TR requires developmentally inappropriate, persistent distress lasting at least four weeks that impairs functioning, distinguishing it from normative toddler separation distress.

MDD duration in children

Major depressive disorder requires at least two weeks of depressed mood or irritability plus associated symptoms; irritability may substitute for depressed mood in children.

Medical mimics of psychiatric symptoms

Thyroid disease, anemia, sleep apnea, medication effects, and substance use can mimic anxiety, depression, or ADHD; evaluate before assigning a psychiatric diagnosis.

Preschool ADHD first-line

For children ages 4–5, behavioral parent training is first-line before medication; stimulants are considered only if behavioral interventions are insufficient.

Stimulant monitoring parameters

Obtain baseline height, weight, blood pressure, and heart rate; recheck at dose changes and every visit; monitor appetite, sleep, tics, and cardiovascular symptoms.

Fluoxetine pediatric approval

Fluoxetine is FDA-approved for major depressive disorder in adolescents and has evidence for pediatric OCD; start low (10 mg) and titrate slowly.

Antidepressant black box warning

Antidepressants increase suicidality risk in patients under 25; provide education, close early follow-up, and safety planning, but do not withhold indicated treatment.

SSRI discontinuation syndrome

Abrupt SSRI cessation causes dizziness, nausea, irritability, and flu-like symptoms; taper gradually, though fluoxetine's long half-life reduces this risk.

Suicide risk assessment

Ask directly about ideation, plan, intent, and access to means; use C-SSRS or ASQ; remove lethal means and document a safety plan with follow-up.

PCIT indication

Parent-Child Interaction Therapy is an evidence-based treatment for disruptive behavior in young children (roughly ages 2–7), emphasizing live coaching of parent-child interactions.

CBT for pediatric anxiety

Cognitive-behavioral therapy with exposure is first-line psychotherapy for pediatric anxiety disorders and OCD; combine with SSRIs for moderate-to-severe cases.

504 plan versus IEP

A 504 plan provides accommodations for a disability; an IEP provides special education services when a child meets eligibility criteria under IDEA.

988 Suicide and Crisis Lifeline

The 988 dialing code connects callers to the Suicide and Crisis Lifeline; use for acute risk, and involve emergency services when risk is imminent.

ADHD comorbidity patterns

ADHD commonly co-occurs with oppositional defiant disorder, anxiety, learning disorders, and tic disorders; screen broadly rather than anchoring on a single diagnosis.

Autism comorbidity screening

Screen for intellectual disability, epilepsy, anxiety, ADHD, sleep disorders, and GI problems; avoid diagnosing ADHD without impairment beyond autism symptoms.

TF-CBT indication

Trauma-focused cognitive-behavioral therapy is first-line psychotherapy for children with PTSD or significant trauma symptoms; it includes caregiver involvement.

Pediatric PTSD presentation

Children with PTSD may show regression, aggression, hypervigilance, avoidance, or somatic complaints rather than classic adult re-experiencing symptoms.

CRAFFT screening

A brief adolescent substance use screen; a score of 2 or higher indicates need for further assessment and brief intervention or referral.

Eating disorder medical instability

Bradycardia, hypotension, hypothermia, orthostasis, or electrolyte abnormalities in an eating disorder warrant urgent medical evaluation or hospitalization.

ARFID definition

Avoidant/restrictive food intake disorder involves restrictive eating without body image disturbance, causing nutritional deficiency, weight loss, or psychosocial impairment.

Sleep apnea before ADHD

Rule out obstructive sleep apnea (snoring, daytime sleepiness) before attributing inattention or sleep problems to ADHD or anxiety.

Developmental regression red flag

Loss of previously acquired skills at any age warrants urgent evaluation for autism, seizure disorder, or neurodegenerative conditions rather than behavioral attribution.

Transition planning age

Adolescents with mental health conditions need a transition plan to adult care by age 18, coordinating school, family, and adult providers.

ACE screening

Adverse childhood experiences screening identifies trauma exposure; positive screens prompt trauma-informed care and consideration of TF-CBT or other evidence-based therapy.

ASQ-3 domains

Ages & Stages Questionnaires assess communication, gross motor, fine motor, problem-solving, and personal-social development; results guide referral for further evaluation.

Vanderbilt rating scale use

Parent and teacher Vanderbilt forms document ADHD symptom counts and impairment across settings, supporting DSM-5-TR cross-setting criteria and treatment monitoring.

Selective mutism first-line

Behavioral intervention with exposure-based strategies is first-line for selective mutism; SSRIs may be considered when impairment is significant or therapy is insufficient.