Case Vignettes
A client has 2 weeks of hallucinations after a traumatic event and then returns to baseline functioning. This is most likely what diagnosis.
What is Brief Psychotic Disorder?
These are the key distinctions between mania and hypomania.
What is level of impairment and duration?
Family history of bipolar disorder is an example of this type of factor.
What is a predisposing factor?
This medication is considered the gold standard for bipolar disorder.
What is lithium?
This concept explains why a behavior might appear problematic in one age group but typical in another.
What is developmental context (or developmental norms)?
A client reports 5 days of elevated mood, decreased need for sleep, and increased productivity, but no impairment. This is what type of mood episode.
What is a hypomanic episode?
This feature distinguishes mood shifts in Bipolar Disorder from those in Borderline Personality Disorder.
What is episodic vs. rapid/reactive mood changes?
A recent breakup triggering a depressive episode is an example of this type of factor.
What is a precipitating factor?
This therapy is most strongly associated with treatment of borderline personality disorder.
What is Dialectical Behavior Therapy (DBT)?
This pattern of functioning involves difficulty with planning, organization, and sustained attention, often discussed in relation to ADHD.
What is executive functioning deficit?
A client has persistent delusions of being followed but otherwise maintains daily functioning. This is most likely what diagnosis.
What is Delusional Disorder?
This is the primary factor used to differentiate schizophrenia from schizophreniform disorder.
What is duration of symptoms?
Schizophreniform = less than 6 months
Schizophrenia = 6 months or more
Ongoing sleep disruption maintaining manic symptoms represents this type of factor.
What is a perpetuating factor?
This class of medications is commonly used to reduce positive symptoms such as hallucinations and delusions in schizophrenia spectrum disorders.
What are antipsychotics?
A clinician uses one tool to broadly screen symptoms and then follows up with a more specific measure—this reflects this two-step assessment approach.
What is using Level 1 followed by Level 2 measures?
A client has a history of mania and depression, but also experiences hallucinations for several weeks when mood symptoms are absent. This is most likely what diagnosis.
What is Schizoaffective Disorder?
This distinction separates Intermittent Explosive Disorder from Conduct Disorder.
What is impulsive vs. premeditated aggression?
Strong social support and consistent medication adherence represent this type of factor.
What are protective factors?
This type of intervention for disruptive behavior disorders focuses on modifying caregiver responses to reinforce appropriate behavior and reduce oppositional patterns.
What is parent management training (or parent training)?
This limitation of the DSM is reflected when clients narrowly miss criteria but still experience significant distress.
What is the categorical approach?
Versus a spectrum approach that views symptoms along a continuum
A client shows aggressive outbursts that are impulsive and brief, while another shows repeated theft and lack of remorse—this distinction separates these two diagnoses.
What is Intermittent Explosive Disorder vs. Conduct Disorder?
A client has psychotic symptoms only during mood episodes—this is why this diagnosis is ruled out in favor of another.
What is Schizoaffective Disorder is ruled out in favor of Bipolar Disorder or Major Depressive Disorder with psychotic features?
A client with genetic vulnerability develops symptoms after substance use and continues to worsen due to poor sleep—this question is asking you to identify all three types of factors involved.
What are predisposing, precipitating, and perpetuating factors?
predisposing = genetics
precipitating = substance use
perpetuating = poor sleep
A clinician avoids prescribing antidepressant monotherapy for a client with a history of elevated mood because of the risk of triggering this outcome.
What is inducing a manic episode?
A diagnosis alone does not explain why a client developed symptoms—this framework is used to organize contributing factors across multiple domains.
What is case formulation (or the 5 P’s framework)?