Social work clinicians keep a wide focus on several potential syndromes, analyzing patterns of symptoms, risks, and environmental factors. Narrowing down from that wider focus happens naturally as they match the individual symptoms, behaviors, and risk factors against criteria A–E and other baseline information in the DSM-5.
Over time, as you continue your social work education, this process will become more automatic and integrated. In this Discussion, you practice differential diagnosis by examining a case that falls on the neurodevelopmental spectrum and/or within Disruptive, Impulse-Control, and Conduct Disorders.
- Read the case provided by your instructor for this week’s Discussion and identify relevant symptoms and factors. You may want to make a simple list of the symptoms and facts of the case to help you focus on patterns.
- Read the Morrison (2014) selection. Focus on Figure 1.1, “The Roadmap for Diagnosis,” to guide your decision making.
- Identify four clinical diagnoses relevant to the client that you will consider as part of narrowing down your choices. Be prepared to explain in a concise statement why you ruled three of them out.
- Confirm whether any codes have changed by checking this website: American Psychiatric Association. (2017, October 1). Changes to ICD-10-CM codes for DSM-5 diagnoses. Washington, DC: Author. Retrieved from https://www.psychiatry.org/psychiatrists/practice/dsm/updates-to-dsm-5/coding-updates
Post a 300- to 500-word response in which you address the following:
- Provide a full DSM-5 diagnosis of the client. Remember, a full diagnosis should include the name of the disorder, ICD-10-CM code, specifiers, severity, and the Z codes (other conditions that may be a focus of clinical attention). Keep in mind a diagnosis covers the most recent 12 months.
- Explain the diagnosis by matching the symptoms identified in the case to the specific criteria for the diagnosis.
- Identify which four diagnoses you initially considered in the case of the client, using the DSM-5 diagnostic criteria to explain why you selected these four items. In one or two sentences each, explain why three of these diagnoses were excluded.
- Explain any obvious eliminations that could be made from within the neurodevelopmental spectrum.
- Describe in detail how the client’s symptoms match up with the specific diagnostic criteria for the primary disorder that you finally selected for him. Note two other relevant DSM-5 criteria for that illness from the sections on “diagnostic features” and “development and course” that fit this case.
First, M. B. (2014). Handbook of differential diagnosis. Washington, DC: American Psychiatric Association
Note: You will access this e-book from the Walden Library databases.
- Chapter 1, “Differential Diagnosis Step by Step” (pp. 14–24)
Morrison, J. (2014). Diagnosis made easier (2nd ed.). New York, NY: Guilford Press.
- Part 1, “The Basics of Diagnosis” (pp. 3–56)
American Psychiatric Association. (2013). Disruptive, impulse-control, and conduct disorders. In Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: Author. doi:10.1176/appi.books.9780890425596.dsm15
American Psychiatric Association. (2013). Neurodevelopmental disorders. In Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: Author. doi:10.1176/appi.books.9780890425596.dsm01
American Psychiatric Association. (2013m). Other conditions that may be a focus of clinical attention. In Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: Author. doi:10.1176/appi.books.9780890425596.VandZcodes
Walsh, J. (2016). The utility of the DSM-5 Z-codes for clinical social work diagnosis. Journal of Human Behavior in the Social Environment, 26(2), 149–153. doi:10.1080/10911359.2015.1052913