LMSW Clinical Assessment and Diagnosis 5 — Questions and Answers
Question 1: A client is diagnosed with Major Depressive Disorder with Peripartum Onset. According to DSM-5, when must symptoms begin for this specifier to apply?
- Only during pregnancy
- During pregnancy or within 4 weeks of delivery (Correct answer)
- Within 6 months of delivery
- Exclusively after delivery
Correct answer: During pregnancy or within 4 weeks of delivery
DSM-5's peripartum onset specifier applies when a major depressive episode begins during pregnancy or within 4 weeks after delivery.
Question 2: Which of the following best differentiates Social Anxiety Disorder from Avoidant Personality Disorder in assessment?
- Social Anxiety Disorder is more severe and pervasive across all situations
- Avoidant Personality Disorder is limited to performance-based social situations
- Social Anxiety Disorder may be situationally triggered while AvPD is ego-syntonic and pervasive (Correct answer)
- They are identical disorders differentiated only by DSM edition
Correct answer: Social Anxiety Disorder may be situationally triggered while AvPD is ego-syntonic and pervasive
Social Anxiety Disorder is often situational (e.g., public speaking) while Avoidant Personality Disorder involves a pervasive, ego-syntonic pattern of social inhibition and feelings of inadequacy across contexts.
Question 3: A social worker is reviewing a client's history and notes repeated episodes of elevated mood, decreased need for sleep, and grandiosity lasting 4 days, not requiring hospitalization. These episodes alternate with depression. The most likely diagnosis is:
- Bipolar I Disorder
- Cyclothymic Disorder
- Bipolar II Disorder (Correct answer)
- Major Depressive Disorder with mixed features
Correct answer: Bipolar II Disorder
Bipolar II Disorder is characterized by at least one hypomanic episode (4+ days, not requiring hospitalization) and at least one major depressive episode.
Question 4: An adolescent client avoids school due to fear of embarrassment but has no difficulty with other social or performance situations. This pattern most closely aligns with:
- School Refusal secondary to Separation Anxiety Disorder
- Social Anxiety Disorder, performance only specifier (Correct answer)
- Specific Phobia, situational type
- Agoraphobia
Correct answer: Social Anxiety Disorder, performance only specifier
When social anxiety is confined to performance situations like speaking or performing in front of others, DSM-5 allows for a 'performance only' specifier.
Question 5: A client with ADHD reports that symptoms have been present since childhood but were not formally diagnosed. For a DSM-5 ADHD diagnosis in adults, symptoms must have been present before what age?
- Age 5
- Age 7
- Age 12 (Correct answer)
- Age 16
Correct answer: Age 12
DSM-5 raised the age of onset criterion for ADHD from age 7 (DSM-IV) to age 12, requiring that several inattentive or hyperactive symptoms were present before that age.
Question 6: A social worker conducts an initial assessment and uses the PIE (Person-in-Environment) system. What is the PRIMARY advantage of using PIE in social work assessment?
- It provides DSM-5 diagnostic codes for billing purposes
- It captures both social role functioning problems and environmental factors alongside mental health (Correct answer)
- It replaces the biopsychosocial assessment in clinical settings
- It is mandated by NASW for all clinical social work assessments
Correct answer: It captures both social role functioning problems and environmental factors alongside mental health
The PIE system uniquely incorporates social role functioning and environmental problems alongside mental health factors, aligning with social work's ecological perspective.
Question 7: A client with a history of trauma reports that they sometimes feel detached from their own body and experience the world as unreal. This symptom is best described as:
- Derealization/depersonalization (Correct answer)
- Dissociative amnesia
- Thought insertion
- Nihilistic delusion
Correct answer: Derealization/depersonalization
Depersonalization refers to feeling detached from oneself, while derealization involves experiencing the external world as unreal; both can occur together in Depersonalization/Derealization Disorder and in trauma responses.
LMSW Clinical Assessment and Diagnosis 5
A client is diagnosed with Major Depressive Disorder with Peripartum Onset.
According to DSM-5, when must symptoms begin for this specifier to apply?