MFT Assessment and Diagnosis 5 — Questions and Answers
Question 1: A client endorses recurrent, intrusive thoughts about contamination that are ego-dystonic and tries to suppress them through repetitive hand-washing. The DSM-5 diagnosis is:
- Generalized Anxiety Disorder
- Obsessive-Compulsive Disorder (Correct answer)
- Obsessive-Compulsive Personality Disorder
- Specific Phobia
Correct answer: Obsessive-Compulsive Disorder
OCD is characterized by ego-dystonic obsessions (unwanted intrusive thoughts) and compulsions (repetitive behaviors to neutralize distress), distinguishing it from OCPD.
Question 2: Which of the following BEST characterizes the difference between a delusion and an overvalued idea?
- Delusions are always bizarre; overvalued ideas are never bizarre
- Overvalued ideas are held with some doubt; delusions are held with absolute certainty (Correct answer)
- Delusions are only found in schizophrenia; overvalued ideas occur in depression
- Overvalued ideas are culturally sanctioned; delusions are always culturally deviant
Correct answer: Overvalued ideas are held with some doubt; delusions are held with absolute certainty
A key distinction is that overvalued ideas are strongly held beliefs that admit some doubt, while delusions are fixed, false beliefs held with unshakeable certainty.
Question 3: During intake, a client's spouse reports that the client's mood has been 'all over the place' — cycling from very high energy to depressed within a single week, occurring regularly. This pattern is consistent with which DSM-5 specifier?
- With mixed features
- With rapid cycling (Correct answer)
- With seasonal pattern
- With peripartum onset
Correct answer: With rapid cycling
Rapid cycling specifier applies when there are 4 or more mood episodes (manic, hypomanic, or depressive) within a 12-month period.
Question 4: A family genogram that marks a family member with a square containing an 'X' indicates:
- A member who is estranged from the family
- A deceased male family member (Correct answer)
- A male with a diagnosed mental illness
- An unknown or unidentified male
Correct answer: A deceased male family member
In standard genogram notation, an 'X' through a symbol indicates the person is deceased; a square denotes male gender.
Question 5: Which of the following criteria distinguishes Acute Stress Disorder from PTSD in the DSM-5?
- Acute Stress Disorder requires exposure to death or serious injury
- Acute Stress Disorder symptoms occur within 1 month and last 3 days to 1 month post-trauma (Correct answer)
- PTSD cannot include dissociative symptoms
- Acute Stress Disorder only applies to combat veterans
Correct answer: Acute Stress Disorder symptoms occur within 1 month and last 3 days to 1 month post-trauma
Acute Stress Disorder is diagnosed when trauma-related symptoms emerge within 1 month of the trauma and last between 3 days and 1 month; beyond that, PTSD is considered.
Question 6: When assessing for ADHD in adults, a clinician must establish that symptoms were present:
- For at least 2 years in the current relationship
- Before age 12, with impairment in two or more settings (Correct answer)
- Only in occupational settings to distinguish from anxiety
- During periods without substance use
Correct answer: Before age 12, with impairment in two or more settings
DSM-5 requires that several ADHD symptoms were present before age 12 and that impairment is evident in at least two settings (e.g., home, work, school).
Question 7: An ecomap, used in family assessment, is designed to illustrate:
- Intergenerational patterns of mental illness
- A family's connections and relationships with external systems and community resources (Correct answer)
- The internal communication style within a nuclear family
- Triangulation patterns among three family members
Correct answer: A family's connections and relationships with external systems and community resources
An ecomap visually maps the family's relationships with external systems such as work, school, healthcare, religion, and social supports, showing resource strength and stress.
MFT Assessment and Diagnosis 5
A client endorses recurrent, intrusive thoughts about contamination that are ego-dystonic and tries to suppress them through repetitive hand-washing.
The DSM-5 diagnosis is: