Assessment and Diagnosis
What this domain tests
Assessment and Diagnosis covers the diagnostic process, use of the DSM-5-TR, standardized and systemic assessment tools, and the integration of individual diagnosis with relational context. Candidates must know criteria-level distinctions among major disorders and understand when a relational problem (e.g., V-code/relational problem) versus an individual disorder is the appropriate focus.
Concepts to master
- DSM-5-TR structure: criteria, duration, functional impairment, specifiers.
- Differential diagnosis: distinguishing depression vs. bipolar, anxiety vs. adjustment, grief vs. major depressive disorder.
- Relational problems and Z-codes (e.g., partner relational problem, parent-child relational problem).
- Systemic assessment tools: genograms, circular questioning, dyadic adjustment measures.
- Suicide/violence risk assessment and documentation.
- Cultural formulation and avoiding over-pathologizing.
Traps to watch
Stems often hinge on duration and impairment thresholds (e.g., 2 weeks for MDD, 1 month for PTSD, 6 months for persistent depressive disorder). Another trap is choosing an individual diagnosis when the stem describes a relational pattern without individual symptom criteria-the correct answer may be a relational problem or V-code. Watch for questions that confuse normal grief with MDD (grief is not a separate DSM-5 diagnosis but requires clinical judgment).
Worked example
A couple reports conflict since a job loss three months ago; neither meets criteria for a mood or anxiety disorder, but functioning is impaired. The best diagnosis is a relational problem (e.g., partner relational problem) rather than an individual disorder. Rule of thumb: if symptoms are confined to the relationship context and no individual criteria are met, diagnose relationally.
Rule of thumb
Before selecting a diagnosis, verify criteria + duration + impairment + not better explained by another condition. If the stem lacks individual symptom criteria, consider a relational/Z-code.