Putting It All Together: Differential Diagnosis

Clinicians often have to employ multiple skills simultaneously while engaging with clients. Not least among them are reflective listening, information gathering and sensitive questioning, recording key responses, observing for signs of syndromes, and identifying the chief complaints. This week you address the complex process for identifying and distinguishing among similar diagnostic syndromes.

This process begins in the diagnostic interview. Research of skilled clinicians shows that forming diagnostic impressions too quickly increases the risk of errors in diagnosis. Every clinician should be evaluating differential diagnoses at the diagnostic interview and beyond. While social workers want to resolve their own uncertainty, using the formal steps of a decision tree ensures accuracy. A decision tree is especially important when all available data is not pointing in the same direction.

This week, you walk through the steps of a differential diagnostic decision tree using a case within the neurodevelopmental disorders and/or within Disruptive, Impulse-Control, and Conduct Disorders. At the same time, you begin to meet with your colleague in case consultation about your individual case assignment.  

Learning Objectives

Students will:

• Develop a DSM diagnosis utilizing a differential diagnostic process
• Analyze a case study focused on neurodevelopmental disorders and/or within Disruptive, Impulse-Control, and Conduct Disorders utilizing steps of differential diagnosis
• Assess progress with a colleague on a collaborative assignment
• Outline a plan to create a diagnosis

Learning Resources

Required Readings

American Psychiatric Association. (2022). Disruptive, impulse-control, and conduct disorders. In Diagnostic and statistical manual of mental disorders (5th ed., text rev.). 

American Psychiatric Association. (2022). Neurodevelopmental disorders. In Diagnostic and statistical manual of mental disorders (5th ed., text rev.). 

American Psychiatric Association. (2022). Other mental disorders and additional codes. In Diagnostic and statistical manual of mental disorders (5th ed., text rev.).

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)

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

Document: How to Write a Diagnosis According to the DSM-5-TR (PDF)

Required Media

Walden University, LLC. (Producer). (2018f). Steps in differential diagnosis [Video files]. Baltimore, MD: Author Retrieved from https://cdn-media.waldenu.edu/2dett4d/Walden/SOCW/6090/04/DD/index.html.

Optional Resources

Optional Resources

American Psychiatric Association. (2022). Assessment measures. Diagnostic and statistical manual of mental disorders (5th ed., text rev.). https://go.openathens.net/redirector/waldenu.edu?url= https://dsm.psychiatryonline.org/doi/full/10.1176/appi.books.9780890425787.Assessment_Measures

Coker, T. R., Elliott, M. N., Toomey, S. L., Schwebel, D. C., Cuccaro, P., Emery, S. T., … Schuster, M. A. (2017). Racial and ethnic disparities in ADHD diagnosis and treatment. Pediatrics, 138(3), 1–11. Retrieved from http://pediatrics.aappublications.org/content/138/3/e20160407

Optional Media

University at Buffalo School of Social Work (Producer). (2017). Episode 221—Dr. Jennifer Cullen and Dr. Jolynn Haney: Understanding and treating autism in women: Using lived experiences to shape practice [Audio podcast]. Retrieved from http://www.insocialwork.org/episode.asp?ep=221