Mastering Differential Diagnosis with the DSM-5: A Symptom-Based Approach

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Margaret L. Bloom, Ph.D. Related seminars and products

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Margaret (Peggy) L. Bloom, Ph.D., Professor Emerita, Counselor Education and Counseling Psychology, Marquette University, Milwaukee, Wisconsin is a licensed psychologist and NCC certified counselor. Dr. Bloom is nationally recognized for her knowledge and expertise in assessment, DSM diagnosis and counselor education. She is past chair and member of the board of directors of the Center for Credentialing & Education (NBCC), an elected fellow of the American Psychological Association (APA) and past-president of the Association for Counselor Education and Supervision (ACES). Beginning her career as a psychiatric nurse and earning graduate degrees in nursing, counseling, and a Ph.D. in counseling psychology, Peggy brings a unique interdisciplinary perspective to each seminar. She has published numerous journal articles and presented professional education seminars across the world on assessment, diagnosis and counselor education. In addition to her university positions, she maintained a private therapy practice for many years.

Speaker Disclosures:
Financial: Margaret Bloom is a Professor of Counselor Education and Counseling Psychology at Marquette University. She receives a speaking honorarium from PESI, Inc.
Non-financial: Margaret Bloom has no relevant non-financial relationship to disclose.

Additional Info

Program Information

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Target Audience

• Counselors
• Social Workers
• Psychologists
• Case Managers
• Addiction Counselors
• Therapists
• Marriage & Family Therapists
• Nurses
• Nurse Practitioners
• Other Mental Health Professionals

Outline

Quick Review of Using the DSM-5 and ICD-10

• Diagnosis of mental disorders in the U.S.A.
  • Use of two models DSM-5 and ICD-10
  • Use of Specifiers
  • DSM-5 and ICD Coding and Recording 
• Web-based DSM-5 Resources
  • Digital Updates
  • DSM-5 Cross-Cutting Symptom Measures and Screening Tools

Four Step Diagnostic Method

• Case 1: Michelle 
• Goals of the Clinical Interview
• Steps to a DSM-5 Diagnosis
• Step 1: Gathering Client Information and Behavior Sample
  • Interview Phases I, II, and III
  • Using Client Observation Sheet in Step 1
  • Using assessment tools to supplement data
  • Sources of Error to avoid in the clinical interview
• Step 2: Identifying Key DSM-5 Symptom Clusters
• Step 3: Differential Diagnosis List
  • Considering medical and substance causes of symptoms
  • Assessments for Alcohol, Drug and Tobacco use
  • Differential Diagnosis Guides in DSM-5 Manual
• Step 4: Initial DSM-5 Diagnosis
  • Comorbidity considerations

Differential Diagnosis of Specific DSM-5 Mental Disorders
Clients with Symptoms of Depression 

• Key symptoms of Depression and Dysphoria
• Substance-Related and Medical conditions with Depressive Symptoms
• Mental Disorders with Symptoms of Depression
• Diagnosis Challenge: Case 2: Marilyn Wilson
• Differentiating Disorders with Symptoms of Depression 
• Frequent Comorbid Disorders

Clients with Fear and Anxiety 

• Key Symptom Patterns of Anxiety
• Substance-Related and Medical conditions with Anxiety Symptoms
• Mental Disorders with Symptoms of Anxiety
• Differentiating by Patterns of Anxiety symptoms
• Diagnosis Challenge: Case 3: Hunter
• Specific Differential Diagnoses
  • Generalized Anxiety Disorder 
  • Panic Disorder 
  • Frequent Comorbid Disorders

Clients with Abnormal or Impaired Cognition

• Diagnostic Challenge: Case 4: Christa 
• Sorting Patterns of Psychosis
• Substance-Related and Medical conditions with Psychosis symptoms
• DSM-5 mental disorders with psychosis symptoms
• Sorting Patterns of Cognitive Deficit: Case 5: Bob Gray
• Substance-Related and Medical conditions that produce cognitive deficits
• Differential Diagnosis when Cognitive Deficits as a Key Symptom​
  • Neurodevelopmental Disorders 
  • Neurocognitive Disorders

Clients with Repetitive Thoughts and Behaviors

• Diagnostic Challenge: Case 6: Devin
• Mental Disorders with Symptoms of Repetitive Thoughts and Behaviors
• Substance-Related and Medical conditions associated with Repetitive Thoughts and Behaviors
• Frequent Comorbid Disorders

Clients with Disruptive Behaviors

• Disruptive Behavior Symptoms
• Diagnostic Challenge: Case 7: Natalia is a Problem
• Substance-Related and Medical conditions associated with Disruptive Behaviors
• Differential Diagnosis by Patterns of Disruptive Behavior 
  • Defiant, Angry and Vindictive
  • Impulsive and/or Antisocial
• Comorbidity in DSM-5 Disruptive, Impulse Control, and Conduct Disorders

Objectives

1. Apply a four-step diagnostic process to accurately identify and code a client’s diagnosis.
2. Specify key symptoms and diagnostic criteria for frequently diagnosed mental disorders.
3. Determine important differential diagnoses for anxiety, depressive, trauma-related, substance-related, and neurodevelopmental disorders.
4. Analyze differential diagnoses for children who present with disruptive behavior.
5. Differentiate between overlapping symptoms and comorbid conditions in order to provide the correct diagnosis.
6. Utilize the DSM-5® severity tables, assessment tools, and coding notes to improve the accuracy of diagnosis and ICD-10 coding.