LMSW LMSW Clinical Assessment and Diagnosis Questions and Answers 5 — Questions and Answers
Question 1: A client who lost their job 6 weeks ago presents with tearfulness, difficulty concentrating, and mild insomnia. Symptoms do not meet criteria for MDD. Which diagnosis is most appropriate?
- Persistent Depressive Disorder
- Adjustment Disorder with Depressed Mood (Correct answer)
- Brief Depressive Episode
- Unspecified Depressive Disorder
Correct answer: Adjustment Disorder with Depressed Mood
Adjustment Disorder with Depressed Mood applies when emotional or behavioral symptoms develop in response to an identifiable stressor within 3 months and do not meet criteria for another disorder.
Question 2: Which of the following is an example of circumstantial thinking observed during a clinical interview?
- The client never reaches the point of the question and shifts to unrelated topics
- The client eventually answers the question but takes excessive, tangential detours (Correct answer)
- The client repeats the same phrase regardless of the question asked
- The client responds with single-word answers and minimal elaboration
Correct answer: The client eventually answers the question but takes excessive, tangential detours
Circumstantial thought involves excessive, unnecessary detail and digressions, but unlike tangential thought, the client eventually returns to the original point.
Question 3: In the DSM-5, which disorder requires the clinician to specify whether the onset was in childhood or adolescence?
- Social Anxiety Disorder
- Specific Phobia
- Persistent Depressive Disorder (Dysthymia) (Correct answer)
- Panic Disorder
Correct answer: Persistent Depressive Disorder (Dysthymia)
Persistent Depressive Disorder (Dysthymia) requires specifying early onset (before age 21) or late onset (age 21 or older) due to differences in course and prognosis.
Question 4: A social worker is assessing suicide risk and uses the Columbia Suicide Severity Rating Scale (C-SSRS). What does this tool primarily measure?
- Presence and severity of depressive symptoms
- Ideation intensity and suicidal behavior across a severity spectrum (Correct answer)
- Lethality of past suicide attempts only
- Protective factors and reasons for living
Correct answer: Ideation intensity and suicidal behavior across a severity spectrum
The C-SSRS measures both the intensity of suicidal ideation and the range of suicidal behaviors on a standardized severity continuum to guide risk stratification.
Question 5: Which of the following best illustrates the difference between an obsession and a compulsion in OCD?
- Obsessions are voluntary; compulsions are involuntary
- Obsessions are intrusive unwanted thoughts; compulsions are repetitive behaviors performed to reduce anxiety (Correct answer)
- Obsessions involve physical urges; compulsions involve cognitive rituals
- There is no meaningful clinical distinction between them
Correct answer: Obsessions are intrusive unwanted thoughts; compulsions are repetitive behaviors performed to reduce anxiety
In OCD, obsessions are recurrent, unwanted intrusive thoughts or images that cause distress, while compulsions are repetitive behaviors or mental acts aimed at neutralizing that distress.
Question 6: A social worker conducting a risk assessment learns a client has a specific plan, access to means, and a history of prior attempts. According to risk stratification, this client should be classified as:
- Low risk — monitor in outpatient setting
- Moderate risk — increase session frequency
- High risk — hospitalization or intensive intervention warranted (Correct answer)
- Indeterminate — defer to a psychiatrist
Correct answer: High risk — hospitalization or intensive intervention warranted
Specific plan, access to lethal means, and prior attempt history are high-risk factors that together indicate need for immediate intensive intervention, including possible hospitalization.
Question 7: Which DSM-5 diagnosis would BEST apply to a client who experiences significant distress about their assigned gender, a strong desire to be treated as another gender, and conviction that their feelings are typical of another gender?
- Body Dysmorphic Disorder
- Gender Dysphoria (Correct answer)
- Depersonalization/Derealization Disorder
- Somatic Symptom Disorder
Correct answer: Gender Dysphoria
Gender Dysphoria in DSM-5 describes a marked incongruence between one's experienced/expressed gender and assigned gender, accompanied by significant distress or functional impairment.
LMSW LMSW Clinical Assessment and Diagnosis Questions and Answers 5
A client who lost their job 6 weeks ago presents with tearfulness, difficulty concentrating, and mild insomnia.
Symptoms do not meet criteria for MDD.
Which diagnosis is most appropriate?