LMSW Clinical Assessment and Diagnosis 2 — Questions and Answers
Question 1: A client presents with persistent depressed mood, loss of interest, fatigue, and hypersomnia lasting 3 weeks. Which DSM-5 diagnosis is most appropriate to consider?
- Persistent Depressive Disorder
- Major Depressive Disorder (Correct answer)
- Bipolar II Disorder
- Adjustment Disorder with Depressed Mood
Correct answer: Major Depressive Disorder
Major Depressive Disorder requires at least 5 symptoms during a 2-week period, including depressed mood or anhedonia, which this client meets.
Question 2: During a biopsychosocial assessment, a social worker learns a client drinks 6 beers daily and experiences withdrawal symptoms when attempting to stop. This pattern best indicates:
- Alcohol Abuse
- Alcohol Use Disorder, Severe (Correct answer)
- Alcohol Dependence (DSM-IV)
- Alcohol Use Disorder, Mild
Correct answer: Alcohol Use Disorder, Severe
Daily heavy use plus physiological withdrawal indicates at least 6 DSM-5 criteria, qualifying as Alcohol Use Disorder, Severe.
Question 3: A social worker notices a client's affect is restricted and inconsistent with the content of their speech about a happy event. This observation belongs in which section of the mental status exam?
- Thought content
- Insight and judgment
- Mood and affect (Correct answer)
- Orientation
Correct answer: Mood and affect
Affect (the observable expression of emotion) and its congruence with speech content are assessed under the mood and affect section of the MSE.
Question 4: Which of the following best describes the diagnostic concept of 'specifiers' in DSM-5?
- Alternative diagnoses to consider when primary diagnosis is uncertain
- Subtypes that replace the primary diagnosis
- Additional descriptors that communicate clinical information beyond the core diagnosis (Correct answer)
- Severity ratings used only for psychotic disorders
Correct answer: Additional descriptors that communicate clinical information beyond the core diagnosis
Specifiers are extensions of diagnoses that provide more detail about course, severity, or features without changing the primary diagnosis.
Question 5: A 14-year-old client has shown a persistent pattern of lying, shoplifting, and fighting for over 12 months. The most appropriate diagnosis to evaluate is:
- Antisocial Personality Disorder
- Oppositional Defiant Disorder
- Conduct Disorder (Correct answer)
- Intermittent Explosive Disorder
Correct answer: Conduct Disorder
Conduct Disorder involves a repetitive pattern of violating societal norms or others' rights and is diagnosed in individuals under 18.
Question 6: When assessing a client for PTSD, which symptom cluster involves persistent negative alterations in cognition and mood?
- Cluster B — Intrusion symptoms
- Cluster C — Avoidance symptoms
- Cluster D — Negative alterations in cognition and mood (Correct answer)
- Cluster E — Alterations in arousal and reactivity
Correct answer: Cluster D — Negative alterations in cognition and mood
DSM-5 Cluster D of PTSD includes persistent negative beliefs, distorted blame, emotional numbing, and diminished interest in activities.
Question 7: A social worker is conducting a risk assessment and asks about the client's specific plan, means, and timeline for suicide. This line of inquiry is designed to assess:
- Passive suicidal ideation
- Suicidal intent and lethality (Correct answer)
- Hopelessness and cognitive distortions
- Protective factors and reasons for living
Correct answer: Suicidal intent and lethality
Assessing plan, means, and timeline evaluates the lethality and intent of suicidal ideation, which guides clinical decision-making about safety.
LMSW Clinical Assessment and Diagnosis 2
A client presents with persistent depressed mood, loss of interest, fatigue, and hypersomnia lasting 3 weeks.
Which DSM-5 diagnosis is most appropriate to consider?