When a news story focuses on mental illness, it's often Schizophrenia, Major Depressive Disorder or Bipolar Disorder that takes center stage. Recently, however, a news story put a different kind of mental illness in the spotlight, and I have to admit, for me, it's been fascinating to follow. Before I give too much away, here's a sample question that was partially inspired by the recent story involving the high school students in New York.
A 17 year-old girl is admitted to a psychiatric unit after sudden onset of symptoms. According to her assessment, 2 weeks before her admission, she began experiencing frequent motor tics, shaking, and paralysis on her right side; she was evaluated by a team of doctors, but they were unable to account for her symptoms. Her history indicates a lack of mental health symptoms earlier in her life, no substance use or abuse, and her academic records indicate that she has been an honors' student since she entered high school. When the social worker interviews the girl, she states, "I've just been really stressed out...the SAT's are a week away and my whole future is riding on that." What is the most likely diagnosis in this case?
A. Tourette's Disorder
C. Somatization Disorder
D. Conversion Disorder
For our purposes, health-related disorders include both eating disorder and Somatoform Disorders. All Somatoform Disorders include the presence of physical symptoms that suggest a medical condition and are not fully explained by a general medical condition, by the direct effects of a substance, or by another mental disorder. In particular, Conversion Disorder is defined by the following criteria: one or more symptoms or deficits affecting voluntary motor or sensory functioning that suggest a neurological or general medical condition; psychological factors are judged to be associated with the symptoms because the initiation of symptoms is preceded by stress or other conflict; the symptoms are not intentionally produced; the symptoms, after appropriate investigation, cannot be fully explained by a general medical condition, substance use, or a culturally sanctioned behavior/experience; the symptoms are not limited to pain or sexual dysfunction.
D is the best answer to the question above because the client is experiencing physical symptoms that would suggest a neurological condition but cannot be explained by a general medical or neurological condition and have been preceded by an increase in stress (SAT's). A is not the best choice due to the paralysis and shaking; B is not the best choice because the client has no history of preoccupation with fears of having a medical condition; C is not the best answer because Somatization Disorder involves a variety of physical complaints that occur over a period of years. For more information on our test prep materials and workshops, check out the "LCSW Exam Prep" and "MFT Exam Prep" tabs on our website. Also, find us on Facebook!
Coming up next week: Sexual Disorders
Think our straightforward, sensible approach could help you PASS your social work or MFT exam? If you're preparing for a social work exam, check out our Social Work Study Materials. If you're preparing for an MFT exam, check out our MFT Study Materials. Learn more about our offerings at The Therapist Development Center.
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