LMHC Intake, Assessment, and Diagnosis 3 — Questions and Answers
Question 1: When conducting a risk assessment, which factor is considered MOST predictive of future suicide attempt?
- Family history of depression
- Current suicidal ideation with a specific plan and intent (Correct answer)
- History of substance use
- Diagnosis of Borderline Personality Disorder
Correct answer: Current suicidal ideation with a specific plan and intent
The combination of suicidal ideation with a specific plan and stated intent is the strongest proximal predictor of imminent suicide risk.
Question 2: A client describes hearing voices telling him to harm others only when severely intoxicated, with no psychotic symptoms when sober. The MOST appropriate initial diagnosis is:
- Schizophrenia
- Substance-Induced Psychotic Disorder (Correct answer)
- Brief Psychotic Disorder
- Schizoaffective Disorder
Correct answer: Substance-Induced Psychotic Disorder
Substance-Induced Psychotic Disorder is diagnosed when psychotic symptoms occur exclusively during or shortly after intoxication or withdrawal.
Question 3: Which diagnostic principle requires the clinician to rule out medical conditions as the cause of psychiatric symptoms before assigning a primary mental health diagnosis?
- Differential diagnosis (Correct answer)
- Occam's Razor
- Medical-first rule
- Hierarchical diagnosis
Correct answer: Differential diagnosis
Differential diagnosis involves systematically ruling out alternative explanations, including medical causes, before settling on a psychiatric diagnosis.
Question 4: A client reports experiencing recurring, unexpected panic attacks followed by a month of persistent worry about having more attacks. Which diagnosis BEST fits?
- Generalized Anxiety Disorder
- Panic Disorder (Correct answer)
- Specific Phobia
- Illness Anxiety Disorder
Correct answer: Panic Disorder
Panic Disorder requires recurrent unexpected panic attacks plus at least one month of anticipatory anxiety or behavioral change related to the attacks.
Question 5: The CAGE questionnaire is MOST commonly used to screen for which condition?
- Gambling disorder
- Alcohol use problems (Correct answer)
- Cannabis dependence
- Prescription drug misuse
Correct answer: Alcohol use problems
The CAGE (Cut down, Annoyed, Guilty, Eye-opener) is a brief validated screening tool specifically designed to identify problematic alcohol use.
Question 6: Which of the following is an example of a projective assessment technique used to gather information about personality and unconscious processes?
- Minnesota Multiphasic Personality Inventory-2 (MMPI-2)
- Rorschach Inkblot Test (Correct answer)
- Millon Clinical Multiaxial Inventory (MCMI-III)
- NEO Personality Inventory-Revised (NEO PI-R)
Correct answer: Rorschach Inkblot Test
The Rorschach Inkblot Test is a projective technique where ambiguous stimuli are used to elicit responses believed to reflect unconscious dynamics.
Question 7: A counselor notes that a client has poor insight into their disorder during the MSE. This MOST likely means the client:
- Is being deliberately deceptive about their symptoms
- Does not recognize that their experiences or behaviors are problematic or illness-related (Correct answer)
- Has intellectual disability affecting their comprehension
- Is in denial due to a substance use disorder
Correct answer: Does not recognize that their experiences or behaviors are problematic or illness-related
Poor insight refers to limited awareness or understanding that one's symptoms constitute a mental disorder, which is clinically significant for treatment planning.
LMHC Intake, Assessment, and Diagnosis 3
When conducting a risk assessment, which factor is considered MOST predictive of future suicide attempt?