American Board of Psychiatry and Neurology ABPN Child and Adolescent Psychiatry 2 — Questions and Answers
Question 1: A 14-year-old boy has a persistent eye-blinking tic and throat-clearing for more than 1 year, with onset before age 18. What diagnosis does this MOST likely represent?
- Tourette disorder
- Persistent (chronic) motor or vocal tic disorder (Correct answer)
- Provisional tic disorder
- Stereotypic movement disorder
Correct answer: Persistent (chronic) motor or vocal tic disorder
Persistent tic disorder requires at least one motor OR vocal (not both) tic for more than 1 year; Tourette requires both motor and vocal tics.
Question 2: Which psychotherapy is MOST effective for adolescent depression according to evidence-based guidelines?
- Interpersonal therapy for adolescents (IPT-A) or CBT (Correct answer)
- Psychoanalysis
- Art therapy alone
- Supportive counseling only
Correct answer: Interpersonal therapy for adolescents (IPT-A) or CBT
Both IPT-A and CBT have strong evidence for adolescent depression and are recommended as first-line psychotherapies by clinical guidelines.
Question 3: A 10-year-old is brought in for evaluation after 8 months of irritability, severe outbursts, and persistently dysphoric mood that is not episodic. What DSM-5 diagnosis BEST fits?
- Bipolar I disorder
- Oppositional defiant disorder
- Disruptive mood dysregulation disorder (DMDD) (Correct answer)
- Major depressive disorder
Correct answer: Disruptive mood dysregulation disorder (DMDD)
DMDD is characterized by severe, recurrent temper outbursts and persistently irritable/angry mood that is non-episodic, distinguishing it from bipolar disorder.
Question 4: In the United States, what is the FDA's black box warning for antidepressants in children and adolescents?
- Increased risk of agranulocytosis
- Increased risk of suicidal ideation and behavior in those under 25 (Correct answer)
- Increased risk of mania induction
- Increased risk of Stevens-Johnson syndrome
Correct answer: Increased risk of suicidal ideation and behavior in those under 25
The FDA mandates a black box warning on all antidepressants about increased risk of suicidal thinking and behavior in children, adolescents, and young adults up to age 25.
Question 5: Which condition is characterized by a child's failure to speak in specific social situations (e.g., school) despite speaking normally in other settings (e.g., home)?
- Social anxiety disorder
- Selective mutism (Correct answer)
- Autism spectrum disorder
- Expressive language disorder
Correct answer: Selective mutism
Selective mutism involves consistent failure to speak in specific social situations where speech is expected, despite speaking in other settings.
Question 6: What is the MINIMUM age at which conduct disorder can be diagnosed, and what key feature distinguishes it from oppositional defiant disorder?
- Age 5; conduct disorder includes violations of others' basic rights (Correct answer)
- Age 10; conduct disorder requires truancy
- Age 5; conduct disorder requires peer rejection
- Age 12; conduct disorder includes substance use
Correct answer: Age 5; conduct disorder includes violations of others' basic rights
Conduct disorder can be diagnosed at any age but requires a persistent pattern that violates the basic rights of others or major age-appropriate societal norms, beyond the defiant behavior of ODD.
American Board of Psychiatry and Neurology ABPN Child and Adolescent Psychiatry 2
A 14-year-old boy has a persistent eye-blinking tic and throat-clearing for more than 1 year, with onset before age 18.
What diagnosis does this MOST likely represent?