LMSW Clinical Assessment and Diagnosis 4 — Questions and Answers
Question 1: A client with no prior psychiatric history presents after a traumatic car accident with flashbacks, nightmares, hypervigilance, and avoidance of driving for 2 weeks. The most appropriate diagnosis to consider is:
- PTSD
- Acute Stress Disorder (Correct answer)
- Adjustment Disorder
- Specific Phobia
Correct answer: Acute Stress Disorder
Acute Stress Disorder is diagnosed when PTSD-like symptoms occur within 3 days to 4 weeks following a traumatic event; PTSD requires symptoms lasting more than 1 month.
Question 2: Which of the following is an example of a negative symptom of schizophrenia?
- Auditory hallucinations
- Grandiose delusions
- Alogia (Correct answer)
- Disorganized speech
Correct answer: Alogia
Alogia (poverty of speech) is a negative symptom reflecting diminished thought and communication, contrasted with positive symptoms like hallucinations and delusions.
Question 3: A social worker is assessing an elderly client for cognitive impairment. The Mini-Mental State Examination (MMSE) is administered. Which domain is NOT assessed by the MMSE?
- Orientation to time and place
- Short-term memory recall
- Language and writing
- Abstract reasoning and executive function (Correct answer)
Correct answer: Abstract reasoning and executive function
The MMSE does not comprehensively assess executive function or abstract reasoning; the MoCA is more sensitive for these domains.
Question 4: A client describes episodes of unexpected intense fear lasting about 10 minutes with heart pounding, sweating, and fear of dying, occurring twice in the past month. Between episodes they worry constantly about having another one. This best describes:
- Generalized Anxiety Disorder
- Social Anxiety Disorder
- Panic Disorder (Correct answer)
- Agoraphobia
Correct answer: Panic Disorder
Panic Disorder requires recurrent unexpected panic attacks plus persistent concern or behavioral change related to the attacks for at least 1 month.
Question 5: When using the Columbia Suicide Severity Rating Scale (C-SSRS), which item most specifically indicates HIGH acute risk?
- Passive suicidal ideation without intent or plan
- Active ideation with intent and a specific plan (Correct answer)
- History of a single low-lethality attempt more than 5 years ago
- Verbal reports of hopelessness without ideation
Correct answer: Active ideation with intent and a specific plan
Active suicidal ideation with intent to act and a specific plan is the highest-risk category on the C-SSRS and requires immediate intervention.
Question 6: A social worker is assessing a client who recently immigrated and notes that the client's described experiences of spiritual visitations may reflect cultural beliefs rather than psychotic symptoms. This consideration is an example of:
- Countertransference management
- Cultural formulation and differential diagnosis (Correct answer)
- Diagnostic overshadowing
- Confirmatory bias
Correct answer: Cultural formulation and differential diagnosis
Cultural formulation requires clinicians to consider how cultural context shapes symptom expression and whether experiences reflect pathology or normative cultural/religious beliefs.
Question 7: Which DSM-5 disorder is characterized by recurrent episodes of binge eating without compensatory purging behaviors, occurring at least once a week for 3 months?
- Bulimia Nervosa
- Purging Disorder
- Binge Eating Disorder (Correct answer)
- Other Specified Feeding or Eating Disorder
Correct answer: Binge Eating Disorder
Binge Eating Disorder involves recurrent binge eating with marked distress but without the compensatory behaviors (purging, fasting, excessive exercise) seen in Bulimia Nervosa.
LMSW Clinical Assessment and Diagnosis 4
A client with no prior psychiatric history presents after a traumatic car accident with flashbacks, nightmares, hypervigilance, and avoidance of driving for 2 weeks.
The most appropriate diagnosis to consider is: