ASWB Clinical Assessment 2 — Questions and Answers
Question 1: A client presents with persistent sadness, anhedonia, hypersomnia, and psychomotor retardation lasting 6 weeks. Which diagnostic category BEST fits this presentation?
- Persistent Depressive Disorder
- Major Depressive Disorder (Correct answer)
- Bipolar II Disorder, depressive episode
- Adjustment Disorder with depressed mood
Correct answer: Major Depressive Disorder
The cluster of neurovegetative symptoms lasting at least two weeks with functional impairment meets DSM-5 criteria for Major Depressive Disorder.
Question 2: During a biopsychosocial assessment, a social worker learns that a client's 'panic attacks' occur only in specific social situations. What assessment distinction is MOST important to clarify?
- Whether the attacks meet full panic disorder criteria
- Whether the fear is of negative evaluation versus physical danger (Correct answer)
- Whether the client has a prior psychiatric hospitalization
- Whether the attacks began before age 18
Correct answer: Whether the fear is of negative evaluation versus physical danger
Distinguishing fear of negative evaluation (Social Anxiety Disorder) from unexpected attacks with fear of physical symptoms (Panic Disorder) drives accurate diagnosis.
Question 3: A social worker uses the Columbia Suicide Severity Rating Scale (C-SSRS). What does this instrument primarily measure?
- Depression severity and hopelessness
- Suicidal ideation intensity and suicidal behavior (Correct answer)
- Impulse control and aggression risk
- Trauma history and PTSD symptoms
Correct answer: Suicidal ideation intensity and suicidal behavior
The C-SSRS categorizes suicidal ideation across a spectrum of severity and separately tracks actual suicidal behaviors.
Question 4: A client who survived combat reports nightmares, hypervigilance, emotional numbing, and avoidance of crowds. These symptoms began 3 months after returning home. Which assessment finding is MOST consistent with PTSD?
- Onset within 30 days of the event
- Symptom duration of at least one month with functional impairment (Correct answer)
- Presence of dissociative identity symptoms
- Symptoms limited to sleep disturbance only
Correct answer: Symptom duration of at least one month with functional impairment
PTSD requires symptoms from all four clusters lasting more than one month with clinically significant distress or functional impairment.
Question 5: When assessing a child for ADHD, a social worker MUST gather information from multiple informants because:
- Children's self-report is legally inadmissible in clinical settings
- Symptoms must be present in two or more settings per DSM-5 criteria (Correct answer)
- Parents are required by law to consent to all diagnostic tools
- School records alone are sufficient for diagnosis
Correct answer: Symptoms must be present in two or more settings per DSM-5 criteria
DSM-5 requires ADHD symptoms to be present in two or more settings, making multi-informant data from home and school essential.
Question 6: A social worker completes a mental status examination and notes that a client's speech is rapid, goal-directed, and difficult to interrupt. This finding is BEST documented as:
- Tangential speech
- Pressured speech (Correct answer)
- Circumstantial speech
- Neologistic speech
Correct answer: Pressured speech
Pressured speech is characterized by an increased rate and volume that is difficult to interrupt, commonly associated with manic or hypomanic states.
Question 7: A client denies current suicidal ideation but has a history of two prior attempts and recent access to firearms. How should the social worker weight static versus dynamic risk factors?
- Static factors like prior attempts are irrelevant once ideation resolves
- Both static (history) and dynamic (current access) factors must inform the overall risk level (Correct answer)
- Only dynamic factors matter for immediate safety planning
- Access to means is a protective factor if the client denies intent
Correct answer: Both static (history) and dynamic (current access) factors must inform the overall risk level
Comprehensive suicide risk assessment integrates static historical factors and modifiable dynamic factors to yield an accurate overall risk formulation.
ASWB Clinical Assessment 2
A client presents with persistent sadness, anhedonia, hypersomnia, and psychomotor retardation lasting 6 weeks.
Which diagnostic category BEST fits this presentation?