TPC-Journal-V4-Issue3

The Professional Counselor \Volume 4, Issue 3 220 Behavioral Measures. The somatic symptom measures, which were modified from the Patient Health Questionnaire Physical Symptoms (PHQ-15; Spitzer, Williams, & Kroenke, n.d.-a, n.d.-b, n.d.-c), examine different somatic symptoms and the frequency of each symptom in a given week. The modified somatic symptom measures inform the individual and his or her clinician of the severity of symptoms such as headaches, shortness of breath and stomach pain. The main difference between the symptoms measured by the scales and those discussed in the “Somatic Symptom and Related Disorders” chapter of the DSM-5 is that the scales do not include any analysis of the excessive thoughts and feelings associated with the somatic symptoms (APA, 2013g, p. 309). The modified somatic symptom measures tell the client or clinician if and how much a symptom is present, but unlike the DSM-5 criteria, they do not focus on the individual’s actual concern over the symptom. The DSM-5 is not focused on the child population for most somatic disorders, but it does describe the most common symptoms of somatic symptom disorder as abdominal pain, headaches, fatigue and persistent nausea. Children can exhibit somatic symptoms, but they rarely worry about these symptoms before adolescence (APA, 2013g). The adult, child and parent/guardian versions of the somatic symptom measure are similar, but with two exclusions on the child and parent/guardian version (“menstrual cramps or other problems with your periods WOMEN ONLY” and “pain or problems during sexual intercourse”; Spitzer et al., n.d.-a, n.d.-b, n.d.-c). The PROMIS—Sleep Disturbance—Short Forms (PHO and PROMIS Cooperative Group, 2012j, 2012k, 2012l) are utilized to determine sleep issues in the past week. The measures contain such questions as “my sleep was refreshing” and “I had trouble sleeping” (PHO and PROMIS Cooperative Group, 2012j, 2012k). The sleep-wake disorders in the DSM-5 include individual discontent with sleep, which can result in distress and impairment (APA, 2013g). Therefore, the PROMIS measures lack in that they do not have statements regarding whether the sleep disturbance is affecting the individual’s life negatively. The DSM-5 (APA, 2013g) does include different manifestations of certain symptoms for children (e.g., a child may struggle to fall asleep without a caregiver). Symptoms in children can occur because of particular situations such as inconsistent sleep schedule and conditioning issues. The onset of some sleep disorders happens in late adolescence or adulthood, with the exception of narcolepsy, which has an average onset in childhood and adolescence/young adulthood. Also, nightmare disorder happens most often in children and adolescence (APA, 2013g). The repetitive thoughts and behaviors measures, which were adapted from the Florida Obsessive- Compulsive Inventory (FOCI) Severity Scale (Part B) and the Children’s Florida Obsessive-Compulsive Inventory (C-FOCI) Severity Scale, each include five items directing the individual to rate each question. The questions are focused on time, distress, control, avoidance and interference of the thoughts or behaviors (Goodman & Storch, 1994a, 1994b). The “Obsessive-Compulsive and Related Disorders” chapter in the DSM-5 examines main symptoms such as obsessions and compulsions (APA, 2013g, p. 235). Although the DSM-5 specifically identifies the symptoms as obsessions and compulsions, the adaptations of the FOCI and C-FOCI identify the symptoms as simply thoughts and behaviors. The FOCI and C-FOCI include fairly similar symptoms of obsessive-compulsive disorder with simpler terms and language. The FOCI does not include the anxiety portion, but does ask about distress. Also, the FOCI and C-FOCI do not include a specific repetitive behaviors component (Goodman & Storch, 1994a, 1994b). For the most part these two measures are very similar. Each of the five questions is focused on the same topic; the minor difference is language. For example, the adult scale asks how much distress the thoughts/behaviors cause, while the child version asks how much they bother the child. The adult measure utilizes the word work while the child measure uses the word job (Goodman & Storch, 1994a, 1994b). The measures have components similar to DSM-5 criteria, but there are inconsistencies between the two. The Level 2—Substance Use—Adult measure, adapted from the National Institute on Drug Abuse (NIDA)- Modified ASSIST (NIDA, n.d.-a), includes 10 items that measure how often an individual used a substance in