CASAC Screening, Assessment, and Diagnosis 4 — Questions and Answers
Question 1: Which screening tool uses a single question — 'How many times in the past year have you used an illegal drug or used a prescription medication for nonmedical reasons?' — as a positive screen if the answer is one or more?
- AUDIT-C
- Single-item drug use screener (Correct answer)
- DAST-10
- CAGE-AID
Correct answer: Single-item drug use screener
The single-item drug use screener (NIDA single question) is validated for detecting drug use disorders in primary care settings.
Question 2: During a biopsychosocial assessment, a counselor notes the client has a family history of alcohol use disorder. This factor is best categorized under which domain?
- Psychological
- Social
- Biological (Correct answer)
- Environmental
Correct answer: Biological
Family history of substance use disorder reflects genetic and biological predisposition, placing it in the biological domain of a biopsychosocial assessment.
Question 3: A client scores 20 on the AUDIT. What level of intervention does this score typically indicate?
- Simple advice
- Brief counseling and monitoring
- Referral to specialist (Correct answer)
- No intervention needed
Correct answer: Referral to specialist
An AUDIT score of 20 or above indicates likely alcohol dependence, warranting referral to a specialist for further assessment and treatment.
Question 4: Which DSM-5 criterion distinguishes a mild substance use disorder from moderate?
- Presence of tolerance
- Two to three criteria met vs. four to five criteria met (Correct answer)
- Duration of use exceeding 12 months
- Presence of withdrawal symptoms
Correct answer: Two to three criteria met vs. four to five criteria met
DSM-5 categorizes mild SUD as 2–3 criteria, moderate as 4–5 criteria, and severe as 6 or more criteria within a 12-month period.
Question 5: A counselor uses the Global Appraisal of Individual Needs (GAIN) instrument. What is the PRIMARY advantage of this tool?
- It is a brief 4-question screener suitable for any setting
- It provides a comprehensive multidimensional assessment covering substance use, mental health, and functioning (Correct answer)
- It is specifically designed to diagnose co-occurring disorders
- It measures only physiological dependence symptoms
Correct answer: It provides a comprehensive multidimensional assessment covering substance use, mental health, and functioning
The GAIN is a comprehensive, multidimensional assessment that evaluates substance use, mental health, physical health, risk behaviors, and environmental factors.
Question 6: When assessing a client's readiness to change, a counselor notes the client says, 'I know my drinking is a problem, and I've been thinking about quitting, but I haven't done anything yet.' This client is in which stage of the Transtheoretical Model?
- Precontemplation
- Contemplation (Correct answer)
- Preparation
- Action
Correct answer: Contemplation
Contemplation is characterized by ambivalence — the person acknowledges the problem and is thinking about change but has not yet committed to action.
Question 7: Which of the following best describes the purpose of a mental status examination (MSE) within a substance abuse assessment?
- To establish a DSM-5 diagnosis of a substance use disorder
- To evaluate the client's cognitive functioning, mood, affect, and thought processes at the time of interview (Correct answer)
- To measure the severity of withdrawal symptoms
- To determine the client's legal history related to substance use
Correct answer: To evaluate the client's cognitive functioning, mood, affect, and thought processes at the time of interview
The MSE systematically evaluates appearance, behavior, cognition, mood, affect, and thought content to establish a clinical baseline at the time of assessment.
