Sample BCPP Question 3
A 29-year-old inpatient with schizophrenia demonstrates severe impairment in daily functioning. The patient requires frequent prompting for hygiene, avoids social interaction, and exhibits poor understanding of treatment goals. Based on the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0), which score range most accurately reflects this level of disability?
-
0–4% (no disability)
- 5–24% (mild disability)
- 25–49% (moderate disability)
- 50–95% (severe to extreme disability)
Answer: D: 50–95% (severe to extreme disability)
Rationale:
- Correct: "50–95% (severe to extreme disability)" — This range on the WHODAS 2.0 corresponds to marked impairment across multiple domains such as self-care, understanding and communicating, and participation in society. Patients needing frequent support or demonstrating inability to function independently typically fall in this range.
- "0–4% (no disability)" — Reflects individuals with normal functioning and no meaningful difficulty in any WHODAS domain.
- "5–24% (mild disability)" — Represents minimal functional difficulty that does not significantly interfere with daily life.
- "25–49% (moderate disability)" — Indicates some impairment across domains but with preserved basic independence; less consistent with the inpatient’s presentation.
High-Yield Core Concept
The WHODAS 2.0 assesses functioning across six domains: understanding and communication, getting around, self-care, getting along with people, life activities, and participation in society. Scores reflect overall disability rather than symptom severity.
High-Yield Fast Fact
The GAF score was discontinued in DSM-5 due to poor interrater reliability and replaced by the WHODAS 2.0, a validated, cross-cultural measure of disability aligned with the International Classification of Functioning, Disability and Health (ICF).
References
- American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 5th ed., Text Revision (DSM-5-TR). American Psychiatric Publishing; 2022.
- World Health Organization. WHO Disability Assessment Schedule 2.0 (WHODAS 2.0). WHO Press; 2010. Available at: https://www.who.int/classifications/icf/whodasii/en/