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DSM Practice: Eating Disorders

DSM practiceContinuing our occasional series of free practice questions based upon the DSM. Here's one that comes from the Feeding and Eating Disorders chapter. There are eight diagnoses included in the chapter (including Unspecified Feeding or Eating Disorder). How many of the other seven can you name? They're listed below, after the question. First, here the practice question:

A woman seeks help from a social worker for an eating disorder. She reports regularly eating large amounts of breakfast cereal right before bedtime, leaving her feeling uncomfortable and miserable. She often takes laxatives in order to flush out the unwanted food. What is the MOST likely diagnosis for this client?

A) Bulimia Nervosa

B) Binge-Eating Disorder

C) Night Eating Syndrome

D) Anorexia Nervosa Binge/Purging Type

What do you say?

In the DSM-5, binge-eating disorder has leapt from "for further study" to a full-fledged diagnosis. What is described here, however, is not binge-eating disorder. The woman's laxative use is what's called a "compensatory behavior" in the DSM-5 (like purging, fasting, or exercising excessively). In binge-eating disorder, there are no compensatory behaviors. Night eating syndrome is diagnosed when criteria for the other Feeding or Eating Disorders aren't met. Anorexia nervosa no longer includes a binge/purging type as it did in DSM-IV-TR. The best answer here is A) bulimia nervosa.

Here are those eight diagnoses from the Feeding and Eating Disorders chapter of DSM-5:

  • Pica (eating nonnutritive food, e.g., dirt)
  • Rumination Disorder (regurgitation of food)
  • Avoidant/Restrictive Food Intake Disorder (what it sounds like--avoiding and restricting food intake)
  • Anorexia Nervosa (restrictive energy intake that leads to low body weight)
  • Bulimia Nervosa (recurrent binge eating with compensatory behaviors, e.g., self-induced vomiting)
  • Binge-Eating Disorder (recurrent binge eating without compensatory behaviors)
  • Other Specified Feeding or Eating Disorder (e.g., purging disorder (purging without binge eating); night eating syndrome)
  • Unspecified Feeding or Eating Disorder (symptoms cause distress but don't meet full criteria of any of the above)

Read more about Feeding and Eating Disorder:

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DSM Practice

DSM practiceAs we've said here before, the majority of the DSM questions that show up on the social work licensing exam are likely to be about the diagnoses that most often show up in regular social work practice. You know the ones: anxiety disorders, depressive disorders, substance use disorders, psychotic disorders, personality disorders... That kind of stuff. But that doesn't mean you should just set aside your DSM once you've got those all under your belt. Here's a question that touches on a lesser-trafficked diagnosis. You may not encounter this question on the ASWB exam, but if you do, you'll sure be glad you took the time to read on!

A teacher refers an eight-year-old girl to a school social worker. On a museum field trip, the girl started talking to a museum-goer she didn't know and wandered off from the school group, holding the man's hand. The teacher says she can't reach the girl's parents to figure out what's going on. Which of the following diagnoses is the MOST likely to fit for the girl?

A) Reactive Attachment Disorder

B) Adjustment Disorder

C) Disinhibited Social Engagement Disorder

D) Conversion Disorder

Have your answer?

The possible answers all come from the Trauma- and Stressor-Related Disorders chapter of the DSM-5, except for conversion disorder, which has little to do with what's described. Since you aren't given much to go on in the vignette, it may be tricky to settle on an answer. But, if you look over DSM criteria, you'll see that disinhibited social engagement disorder is by far the best fit. Seen in that disorder, "a pattern of behavior in which a child actively approaches and interacts with unfamiliar adults."  Also, caretakers are neglectful (thus the attachment problems). Sounds more or less like what's described. Find the full criteria here.

As for the other answers: Reactive attachment disorder involves the opposite--"inhibited, emotionally withdrawn behavior." Adjustment disorder is diagnosed for "the development of emotional or behavioral symptoms in response to an identifiable stressor." The unrelated conversion disorder (aka functional neurological symptom disorder) is diagnosed when a client exhibits "altered voluntary motor or sensory function" (e.g., paralysis, sensory loss, abnormal movement) that cannot be attributed to a medical condition.

Now you have a better sense of not just one, but four diagnoses. That's how practice questions work. Find more DSM-5 questions, a lots more, in SWTP's full-length practice tests. Sign up to get started!

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"I passed on the first try."

i passed on the first try swtpA little flurry of exciting news from recently licensed social workers, Joanne, Nyamah, and Kathy:

 

I passed the LICSW exam, with lots of help from your products. Thank you.

     --Joanne

 

Hello, just wanted to inform you guys that I passed my LGSW exam and I purchased all 5 exams from your site and they were all very helpful!! Thanks!

     --Nyamah

 

Your tests were a helpful resource in preparing for the LCSW exam. I passed on the first try. Needed 99 to pass, got 113 questions correct!

     --Kathy

 

Congratulations to each of you and to all recently licensed social workers! 

Find more success stories on the blog and on the testimonials page. Write to add yours or get started with SWTP practice exams by signing up!

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Study Guide Update

SWTP Study Guide 300xWe've updated our study guide--here's the new cover. If you're serious about getting underway with your licensing exam prep, the SWTP study guide is a great place to start. It includes basic exam info, essential study ideas, anxiety management tips, and a handful of practice questions. How much, you ask? Free! Zero dollars, zero cents.

Just sign up on the site and click  the confirmation email you receive--you'll get a link that'll take you straight to the study guide. More details about contents and such here.

Good luck with the exam!

Delusional Disorder and the Social Work Exam

delusional disorderWe've been reviewing to the NASW Code of Ethics for a while now. Let's look to another book that's just as vital to your preparation for the social work licensing exam: the DSM-5. There's a lot more book there, but that doesn't mean you'll encounter more diagnostic questions than ethics questions on the exam. (About a quarter of the exam, on average, covers "Assessment, Diagnosis, and Treatment Planning"; a full 18% are set aside for law and ethics alone.) That said, it's good to know your way around the basics of the DSM, especially the diagnoses that social workers regularly encounter in the field. So let's get started by jumping right into "Schizophrenia Spectrum and Other Psychotic Disorders": 297.1, Delusional Disorder.

We'll assume you're up to speed on what delusional disorder is. But how up to speed? A question like this can find out:

A client tells a social worker he is certain the social worker is having an affair with the client's wife. The lack of evidence for the affair is seen by the client as evidence that there must be an affair. What type of delusional disorder is the client MOST likely exhibiting?

A) Mixed type

B) Jealous type

C) Persecutory type

D) Unspecified type

Were you able to answer this without glancing at your DSM? The answer is B, Jealous type. From the text:

This subtype applies when the central theme of the individual's delusion is that his or her spouse or lover is unfaithful.

Mixed type has no one theme; persecutory type involved being conspired against; unspecified type doesn't match existing types (which also include erotomanic, grandiose, and somatic types). Got it? Great.

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