LMSW Psychopathology and DSM Diagnostic Criteria

Question 1

A client presents with a 2-week period of depressed mood most of the day, loss of interest in previously enjoyed activities, hypersomnia, psychomotor retardation, and feelings of worthlessness. There is no history of manic or hypomanic episodes. Which diagnosis BEST fits this presentation?

Accepted Answer

Major Depressive Disorder

Answer

A discrete episode of at least 5 DSM symptoms (including depressed mood or anhedonia) lasting at least 2 weeks, without a history of mania or hypomania, meets criteria for Major Depressive Disorder. Persistent Depressive Disorder requires symptoms lasting at least 2 years. Bipolar diagnoses require a manic/hypomanic history.

Question 2

A client describes hearing voices that comment on his behavior and experiencing the belief that his thoughts are being broadcast on television. These symptoms have been present for 7 months. His mood is unremarkable. Which diagnosis is MOST consistent with this presentation?

Accepted Answer

Schizophrenia

Answer

Schizophrenia requires at least two positive/negative symptoms (one must be hallucinations, delusions, or disorganized speech) for at least 1 month, with continuous signs of disturbance for 6 months. Thought broadcasting and third-person auditory hallucinations are classic positive symptoms. No mood episode rules out schizoaffective and bipolar with psychosis.

Question 3

A client has a pervasive pattern of instability in interpersonal relationships, self-image, and affect, along with impulsivity and recurrent self-harming behavior. She describes intense fear of abandonment and reports alternately idealizing and then devaluing her close relationships. These features BEST align with which personality disorder?

Accepted Answer

Borderline Personality Disorder

Answer

Borderline Personality Disorder (BPD) is defined by unstable relationships, self-image, and affect, combined with impulsivity, self-harm, and frantic efforts to avoid abandonment. The hallmark features — splitting (idealization/devaluation), self-harm, and abandonment fears — distinguish it from other Cluster B disorders.

Question 4

According to the DSM-5-TR, which of the following is a criterion that distinguishes Posttraumatic Stress Disorder (PTSD) from Acute Stress Disorder (ASD)?

Accepted Answer

ASD symptoms must resolve within 3 days of the trauma; PTSD symptoms persist beyond 1 month

Answer

The primary temporal distinction is duration: ASD is diagnosed when symptoms appear within 3 days to 1 month post-trauma. If symptoms persist beyond 1 month, the diagnosis becomes PTSD. Both disorders require the same trauma exposure criterion. Dissociative symptoms may appear in either disorder.

Question 5

A client meets criteria for both Alcohol Use Disorder and Major Depressive Disorder. To determine whether the depression is a separate diagnosis or substance-induced, the social worker should PRIMARILY consider:

Accepted Answer

Whether depressive symptoms preceded alcohol use or persist after a period of sustained abstinence

Answer

Substance-induced depressive disorder is distinguished from an independent depressive disorder by temporal sequencing: if depressive symptoms substantially predate the substance use OR persist (typically 1 month or more) after cessation of the substance, an independent diagnosis is supported. The DSM-5-TR emphasizes this temporal criterion.

LMSW - Licensed Master Social Worker Practice Test

LMSW - Licensed Master Social Worker Practice Test

LMSW Psychopathology and DSM Diagnostic Criteria