DSM-5® Self-Exam Questions Test Questions for the Diagnostic Criteria

Contributors Lawrence Amsel, M.D., M.P.H. Assistant Professor of Clinical Psychiatry, Columbia University College of Physicians and Surgeons, New York, New York Elizabeth L. Auchincloss, M.D. Vice-Chair, Graduate Medical Education, Department of Psychiatry, Weill Cornell Medical College; Senior Associate Director, Columbia University Center for Psychoanalytic Training and Research, New York, New York Robert J. Boland, M.D. Professor of Psychiatry and Human Behavior; Associate Director, Residency Training, Alpert School of Medicine, Brown University, Providence, Rhode Island Joyce T. Chen, M.D. Public Psychiatry Postdoctoral Clinical Fellow, Department of Psychiatry, New York State Psychiatric Institute/Columbia University Medical Center, New York, New York Christina Kitt Garza, M.D. Instructor in Psychiatry, NY-Presbyterian Hospital/Columbia University Medical Center, New York, New York Philip R. Muskin, M.D. Professor of Psychiatry, Columbia University Medical Center; Chief of Service, Consultation-Liaison Psychiatry at NY-Presbyterian Hospital/Columbia University Medical Center, New York, New York Michelle B. Riba, M.D., M.S. Professor and Associate Chair for Integrated Medical and Psychiatric Services, Department of Psychiatry; Associate Director, University of Michigan Comprehensive Depression Center; Director, PsychOncology Program, University of Michigan Comprehensive Cancer Center; Associate Director, Michigan Institute for Clinical and Health Research, Ann Arbor, Michigan Julie K. Schulman, M.D. Assistant Professor of Clinical Psychiatry, Columbia University College of Physicians and Surgeons; Consultation-Liaison Psychiatry at NY–Presbyterian Hospital/Columbia University Medical Center, New York, New York ix Peter A. Shapiro, M.D. Professor of Psychiatry, Columbia University Medical Center; Associate Director, Consultation-Liaison Psychiatry Service, and Director, Fellowship Training Program in Psychosomatic Medicine, NY–Presbyterian Hospital/Columbia University Medical Center, New York, New York Jonathan A. Slater, M.D. Clinical Professor of Psychiatry (in Pediatrics), Columbia University College of Physicians and Surgeons; Director, Consultation and Emergency Service, Morgan Stanley Children’s Hospital of New York, NY–Presbyterian Hospital/Columbia University Medical Center, New York, New York Disclosure of Interests The contributors have declared all forms of support received within the 12 months prior to manuscript submittal that may represent a competing interest in relation to their work published in this volume, as follows: Philip R. Muskin, M.D. Speakers Bureau: Otsuka. The following contributors stated that they had no competing interests during the year preceding manuscript submission: Lawrence Amsel, M.D., M.P.H.; Elizabeth L. Auchincloss, M.D.; Robert J. Boland, M.D.; Joyce T. Chen, M.D.; Christina Kitt Garza, M.D.; Michelle B. Riba, M.D., M.S.; Julie K. Schulman, M.D.; Peter A. Shapiro, M.D.; Jonathan A. Slater, M.D. x | Contributors Preface This self-examination guide is a companion to, not a replacement for, a thorough reading of DSM-5. The most recent edition of the diagnostic manual brings a new set of diagnoses while retaining many familiar diagnoses. There are new approaches to diagnosis in DSM-5. Our framework in preparing this self-examination guide was to challenge the reader, hopefully engagingly, to learn about the new diagnoses, to understand the changes from DSM-IV, and to self-educate about new approaches to the diagnostic endeavor. Some questions will seem obvious or easy and some questions will be quite difficult. As you work through the book, let it guide you to diagnostic sections where you would like to learn more as well as reassure you about those areas in which you are already well versed. The contributors took on a daunting task—i.e., to write a book about a book that was itself being written. The contributors to this book are a group of clinicians and educators who undertook the task of learning about DSM-5 in order to help others self-educate. There is no commentary or politics about diagnosis in this study guide. The contributors have graciously donated the proceeds from this book to a charitable foundation. Philip R. Muskin, M.D. New York, New York xi This page intentionally left blank PART I Questions DSM-5 Introduction I.1 DSM-IV employed a multiaxial diagnostic system. Which of the following statements best describes the multiaxial system in DSM-5? A. There is a different multiaxial system in DSM-5. B. The multiaxial system in DSM-IV has been retained in DSM-5. C. DSM-5 has moved to a nonaxial documentation of diagnosis. D. Axis I (Clinical Disorders) and Axis II (Personality Disorders) have been retained in DSM-5. E. Axis IV (Psychosocial and Environmental Problems) and Axis V (Global Assessment of Functioning) have been retained in DSM-5. I.2 True or False: The Global Assessment of Functioning (GAF) Scale (DSM-IV Axis V) remains a separate category that should be coded in DSM-5. A. True. B. False. I.3 To enhance diagnostic specificity, DSM-5 replaced the previous “not otherwise specified” (NOS) designation with two options for clinical use: Other Specified [disorder] and Unspecified [disorder]. Which of the following statements about use of the Unspecified designation is true? A. The Unspecified designation is used when the clinician chooses not to specify the reason that criteria for a specific disorder were not met. B. The Unspecified designation is used when there is no recognized Other Specified disorder (e.g., recurrent brief depression, sexual aversion). C. The Unspecified designation is used when the individual has fewer than three symptoms of any of the recognized disorders within the diagnostic class. D. The Unspecified designation is used when the individual presents with symptomatology of disorders in two or more diagnostic classes. E. The Unspecified designation is used when the clinician believes the condition is of a temporary nature. 2 | DSM-5 Introduction—QUESTIONS CHAPTER 1 Neurodevelopmental Disorders 1.1 Which of the following is not required for a DSM-5 diagnosis of intellectual disability (intellectual developmental disorder)? A. Full-scale IQ below 70. B. Deficits in intellectual functions confirmed by clinical assessment. C. Deficits in adaptive functioning that result in failure to meet developmental and sociocultural standards for personal independence and social responsibility. D. Symptom onset during the developmental period. E. Deficits in intellectual functions confirmed by individualized, standardized intelligence testing.