As 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 full DSM 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As for the other answers: Reactive attachment disorder involves the opposite--"inhibited, emotionally withdrawn behavior."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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