An 8-year-old boy begins to exhibit chronic, severe, persistent irritability associated with frequent temper outbursts. Which of the following disorders is he most likely to develop in adulthood?
Borderline personality disorder
Schizophrenia
Bipolar I disorder
Unipolar depressive disorder
The Correct Answer is D
Choice A reason: Borderline personality disorder is characterized by instability in interpersonal relationships, self-image, and affect, typically emerging in adolescence or early adulthood. While emotional dysregulation is present, chronic irritability in childhood is not a strong predictor of developing borderline personality disorder.
Choice B reason: Schizophrenia involves psychosis, delusions, and hallucinations, typically emerging in late adolescence or early adulthood. Chronic irritability and temper outbursts in childhood are not predictive of schizophrenia.
Choice C reason: Bipolar I disorder is characterized by episodes of mania and depression. While irritability can appear in pediatric bipolar disorder, research shows that chronic, severe irritability with frequent temper outbursts without distinct manic episodes predicts unipolar depressive disorders rather than bipolar disorder.
Choice D reason: This is the correct answer. Chronic, severe irritability in childhood, especially when associated with temper outbursts, is strongly associated with the later development of unipolar depressive disorder in adulthood. It reflects persistent negative mood and emotional dysregulation rather than episodic mania.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Homosexuality was removed as a psychiatric disorder in the DSM-3 and is not a relevant change between DSM-4 and DSM-5.
Choice B reason: The DSM-5 continues to consider psychosocial and environmental factors through the use of diagnostic codes and specifiers; it does not eliminate these considerations.
Choice C reason: DSM-5 eliminated the multiaxial system of DSM-4; it does not use two axes, but instead provides a single-axis approach with descriptive specifiers and dimensional assessments.
Choice D reason: The DSM-4 included a five-axis system (clinical disorders, personality disorders, medical conditions, psychosocial and environmental problems, and global assessment of functioning), which was a defining feature of its multiaxial assessment. This represents the key change when transitioning to DSM-5.
Correct Answer is A
Explanation
Choice A reason: Neuroimaging studies in children with ADHD often show reduced total brain volume, particularly in the prefrontal cortex, basal ganglia, and cerebellum, supporting neurodevelopmental involvement in the disorder.
Choice B reason: Slow-wave activity on EEG may be altered in some neurodevelopmental disorders, but decreased slow-wave activity is not a specific marker for ADHD.
Choice C reason: Thalamic volume reduction is not consistently associated with ADHD; abnormalities are more commonly observed in cortical and subcortical structures.
Choice D reason: ADHD is associated with delayed cortical maturation, particularly in the prefrontal cortex, rather than early posterior-to-anterior cortical maturation.
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