NCMHCE Intake, Assessment, and Diagnosis 2 — Questions and Answers
Question 1: A client reports persistent sadness, loss of interest, weight gain, hypersomnia, and fatigue for 8 weeks. Which DSM-5 diagnosis is MOST appropriate?
- Persistent Depressive Disorder
- Major Depressive Disorder (Correct answer)
- Bipolar II Disorder, Depressive Episode
- Adjustment Disorder with Depressed Mood
Correct answer: Major Depressive Disorder
Major Depressive Disorder requires five or more symptoms during the same 2-week period, and this client meets that threshold with a 8-week duration.
Question 2: During a mental status exam, a client jumps rapidly from topic to topic with no logical connection. This is BEST described as:
- Tangential thinking
- Flight of ideas
- Loosening of associations (Correct answer)
- Circumstantial thinking
Correct answer: Loosening of associations
Loosening of associations refers to illogical, disorganized shifts between unrelated topics with no apparent connection.
Question 3: Which structured diagnostic interview is specifically designed to assess DSM-5 criteria across major mental health disorders in adult outpatient settings?
- Beck Anxiety Inventory (BAI)
- Structured Clinical Interview for DSM-5 (SCID-5) (Correct answer)
- Hamilton Rating Scale for Depression
- Minnesota Multiphasic Personality Inventory (MMPI-2)
Correct answer: Structured Clinical Interview for DSM-5 (SCID-5)
The SCID-5 is a semi-structured diagnostic interview used by clinicians to assess DSM-5 diagnoses systematically.
Question 4: A counselor notices a client's affect is dramatically exaggerated and rapidly shifting during intake. This presentation is BEST described as:
- Blunted affect
- Flat affect
- Labile affect (Correct answer)
- Restricted affect
Correct answer: Labile affect
Labile affect is characterized by rapid, exaggerated shifts in emotional expression that are often disproportionate to the situation.
Question 5: A 17-year-old client is brought in by parents. The client refuses to speak and the parents report the client has been arrested twice for theft. The counselor suspects Conduct Disorder. Which additional criterion is essential for this diagnosis?
- Symptoms must be present for at least 6 months
- Onset must occur before age 15
- Behavior must violate the rights of others or societal norms (Correct answer)
- The client must show remorse for actions
Correct answer: Behavior must violate the rights of others or societal norms
Conduct Disorder requires a repetitive pattern of behavior violating the basic rights of others or major age-appropriate societal norms.
Question 6: Which of the following BEST represents a biopsychosocial model component during intake assessment?
- Administering only standardized psychological tests
- Exploring family history, current stressors, and medical conditions together (Correct answer)
- Focusing exclusively on presenting symptoms
- Reviewing insurance coverage and treatment history
Correct answer: Exploring family history, current stressors, and medical conditions together
The biopsychosocial model integrates biological factors (medical history), psychological factors (mental symptoms), and social factors (stressors, support).
Question 7: A client describes feeling detached from their body, as if watching themselves from outside. This experience is BEST described as:
- Derealization
- Dissociative amnesia
- Depersonalization (Correct answer)
- Dissociative fugue
Correct answer: Depersonalization
Depersonalization involves a sense of detachment from one's own mental processes or body, often described as feeling like an outside observer.
NCMHCE Intake, Assessment, and Diagnosis 2
A client reports persistent sadness, loss of interest, weight gain, hypersomnia, and fatigue for 8 weeks.
Which DSM-5 diagnosis is MOST appropriate?