PTSD Practice Questions PDF

**Reactive Attachment Disorder (RAD) & Disinhibited Social Engagement Disorder (DSED)** 1. **Which feature most clearly differentiates Reactive Attachment Disorder (RAD) from Disinhibited Social Engagement Disorder (DSED)?** - A\) Age of onset - B\) History of early neglect...

**Reactive Attachment Disorder (RAD) & Disinhibited Social Engagement Disorder (DSED)** 1. **Which feature most clearly differentiates Reactive Attachment Disorder (RAD) from Disinhibited Social Engagement Disorder (DSED)?** - A\) Age of onset - B\) History of early neglect - C\) Social disinhibition with unfamiliar adults - D\) Emotional withdrawal from caregivers **Answer: C) Social disinhibition with unfamiliar adults** *(DSED is characterized by indiscriminate social behavior, while RAD involves social withdrawal.)* 2. **A child in foster care has minimal social responsiveness, avoids seeking comfort from caregivers, and rarely smiles. Which additional symptom would be required for a diagnosis of Reactive Attachment Disorder?** - A\) A history of excessive crying in infancy - B\) Exposure to multiple caregivers or severe neglect - C\) Aggression toward peers - D\) Hyperactivity and impulsivity **Answer: B) Exposure to multiple caregivers or severe neglect** *(A history of neglect or unstable caregiving is required for RAD diagnosis.)* 3. **Which intervention is contraindicated in the treatment of RAD?** - A\) Play therapy - B\) Parent-child psychotherapy - C\) Holding therapy - D\) Consistent caregiving environment **Answer: C) Holding therapy** *(This outdated and controversial approach is contraindicated due to ethical concerns.)* **PTSD Diagnosis & Clinical Features** 4. **A 28-year-old combat veteran reports recurrent distressing dreams and flashbacks of a traumatic event. Which symptom would be required to meet PTSD criteria?** - A\) An exaggerated startle response - B\) Active avoidance of trauma-related cues - C\) Persistent guilt or shame - D\) A history of multiple traumatic exposures **Answer: B) Active avoidance of trauma-related cues** *(Avoidance of trauma-related stimuli is a core feature of PTSD.)* 5. **Which factor differentiates PTSD from Acute Stress Disorder?** - A\) Severity of symptoms - B\) Duration of symptoms - C\) Type of trauma experienced - D\) Presence of dissociative symptoms **Answer: B) Duration of symptoms** *(Acute Stress Disorder lasts **3 days to 1 month**, PTSD lasts **\>1 month**.)* 6. **Which symptom is least characteristic of PTSD?** - A\) Dissociative flashbacks - B\) Excessive sleep - C\) Negative self-blame related to the trauma - D\) Hypervigilance **Answer: B) Excessive sleep** *(PTSD is associated with **insomnia, nightmares, and hyperarousal**, not hypersomnia.)* 7. **Which of the following individuals would not meet criteria for PTSD?** - A\) A firefighter who repeatedly views burned bodies at accident scenes - B\) A woman who develops nightmares after reading news articles about violent crimes - C\) A man who witnessed his best friend being shot in a robbery - D\) A nurse who experiences dissociative flashbacks after treating trauma patients **Answer: B) A woman who develops nightmares after reading news articles about violent crimes** *(PTSD requires **direct exposure, witnessing, or repeated professional exposure**; media exposure alone does not qualify.)* **Risk Factors & Neurobiology of PTSD** 8. **Which factor is most strongly associated with increased PTSD risk?** - A\) Family history of depression - B\) Low intelligence - C\) Prior childhood trauma - D\) Low cortisol levels **Answer: C) Prior childhood trauma** *(Early trauma **increases vulnerability** to PTSD following later trauma.)* 9. **Which brain region is hyperactive in PTSD and responsible for emotional fear processing?** - A\) Prefrontal cortex - B\) Hippocampus - C\) Amygdala - D\) Basal ganglia **Answer: C) Amygdala** *(Overactivation of the amygdala contributes to fear responses and hyperarousal.)* 10. **Which finding is most commonly observed in the brains of individuals with PTSD?** - A\) Increased hippocampal volume - B\) Decreased prefrontal cortex activity - C\) Hyperactive Broca's area - D\) Increased serotonin receptor density **Answer: B) Decreased prefrontal cortex activity** *(Leads to impaired regulation of fear and emotional responses.)* **PTSD Treatments & Their Mechanisms** 11. **Which of the following medications is FDA-approved for PTSD treatment?** - A\) Sertraline - B\) Fluoxetine - C\) Venlafaxine - D\) Mirtazapine **Answer: A) Sertraline** *(Sertraline and paroxetine are the **only** FDA-approved SSRIs for PTSD.)* 12. **Which therapy directly targets fear extinction by exposing patients to trauma-related stimuli?** - A\) Eye Movement Desensitization and Reprocessing (EMDR) - B\) Cognitive Behavioral Therapy (CBT) - C\) Prolonged Exposure Therapy - D\) Acceptance and Commitment Therapy **Answer: C) Prolonged Exposure Therapy** *(PE therapy helps patients habituate to trauma-related stimuli.)* 13. **Which medication is used off-label to reduce nightmares in PTSD patients?** - A\) Prazosin - B\) Trazodone - C\) Clonidine - D\) Quetiapine **Answer: A) Prazosin** *(Blocks norepinephrine receptors to reduce nightmares.)* 14. **Which PTSD treatment has been shown to potentially prevent PTSD if administered immediately after trauma exposure?** - A\) Propranolol - B\) Sertraline - C\) Ketamine - D\) Benzodiazepines **Answer: A) Propranolol** *(May reduce consolidation of traumatic memories if given **immediately post-trauma**.)* **Trauma-Related Disorders in Children** 15. **Which symptom is more likely to be seen in a child with PTSD rather than an adult?** - A\) Emotional numbing - B\) Play reenactment of trauma - C\) Hypervigilance - D\) Insomnia **Answer: B) Play reenactment of trauma** *(Children may **act out trauma** rather than verbalizing distress.)* 16. **Which therapy is most effective for PTSD in children?** - A\) EMDR - B\) Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) - C\) Exposure Therapy - D\) Psychodynamic Therapy **Answer: B) Trauma-Focused Cognitive Behavioral Therapy (TF-CBT)** *(First-line therapy for pediatric PTSD.)* **Controversial & Ineffective PTSD Treatments** 17. **Which PTSD treatment can worsen symptoms if administered immediately after a trauma?** - A\) Benzodiazepines - B\) Group debriefing therapy - C\) Beta-blockers - D\) EMDR **Answer: A) Benzodiazepines** *(Can interfere with fear extinction and increase PTSD risk.)* 18. **Which form of PTSD therapy is considered potentially harmful if forced upon patients shortly after a traumatic event?** - A\) Group therapy - B\) Prolonged Exposure Therapy - C\) Cognitive Processing Therapy - D\) Critical Incident Stress Debriefing **Answer: D) Critical Incident Stress Debriefing** *(May **increase PTSD risk** by forcing premature trauma processing.)* **Complex PTSD, Dissociation, & Trauma Responses** 1. **Which feature differentiates Complex PTSD (C-PTSD) from standard PTSD?** - A\) Presence of flashbacks and nightmares - B\) Hyperarousal and exaggerated startle response - C\) Difficulty with emotional regulation and identity disturbances - D\) Avoidance of trauma-related stimuli **Answer: C) Difficulty with emotional regulation and identity disturbances** *(C-PTSD includes **chronic self-identity disruptions** beyond standard PTSD symptoms.)* 2. **A 35-year-old woman who survived prolonged childhood abuse presents with chronic emotional numbing, dissociative episodes, and a distorted sense of self-worth. She meets criteria for PTSD but also displays extreme mistrust in relationships. Which additional diagnosis should be considered?** - A\) Borderline Personality Disorder - B\) Complex PTSD - C\) Dissociative Identity Disorder - D\) Adjustment Disorder **Answer: B) Complex PTSD** *(Associated with **long-term abuse and interpersonal distrust**.)* 3. **A patient with PTSD experiences frequent dissociative episodes where they feel like they are watching their own body from a distance. What is the term for this symptom?** - A\) Derealization - B\) Dissociative amnesia - C\) Depersonalization - D\) Autoscopic hallucination **Answer: C) Depersonalization** *(Feeling detached from oneself is **depersonalization**, whereas **derealization** is detachment from surroundings.)* 4. **Which symptom would suggest a diagnosis of Dissociative Amnesia rather than PTSD?** - A\) Vivid nightmares - B\) Loss of autobiographical memory without organic cause - C\) Avoidance of trauma reminders - D\) Hypervigilance in daily life **Answer: B) Loss of autobiographical memory without organic cause** *(Dissociative Amnesia involves **localized memory loss** without other PTSD symptoms.)* **PTSD Symptom Progression & Diagnosis Traps** 5. **A 29-year-old male presents with intrusive thoughts about a traumatic event he witnessed 2.5 weeks ago. He experiences hypervigilance but does not actively avoid trauma reminders. What is the most appropriate diagnosis?** - A\) PTSD - B\) Acute Stress Disorder - C\) Adjustment Disorder - D\) Generalized Anxiety Disorder **Answer: B) Acute Stress Disorder** *(Symptoms lasting **3 days -- 1 month** after trauma = **Acute Stress Disorder**.)* 6. **A veteran presents with severe nightmares, emotional detachment, and alcohol dependence. He describes intense guilt about actions taken in combat, feeling he doesn't deserve to be alive. What PTSD symptom cluster does this most closely align with?** - A\) Re-experiencing symptoms - B\) Negative alterations in cognition and mood - C\) Hyperarousal symptoms - D\) Avoidance symptoms **Answer: B) Negative alterations in cognition and mood** *(Includes **guilt, self-blame, and emotional detachment**.)* 7. **Which trauma-related disorder can occur without the individual directly experiencing or witnessing a traumatic event?** - A\) PTSD - B\) Acute Stress Disorder - C\) Adjustment Disorder - D\) Dissociative Amnesia **Answer: C) Adjustment Disorder** *(Triggered by **any major life stressor, not just trauma**.)* **Neurobiology & Trauma Processing** 8. **Which physiological response pattern is most strongly associated with PTSD?** - A\) Chronically low cortisol levels - B\) Increased dopamine signaling in the prefrontal cortex - C\) Increased volume of the hippocampus - D\) Decreased activity in the amygdala **Answer: A) Chronically low cortisol levels** *(PTSD **paradoxically lowers cortisol**, impairing stress recovery.)* 9. **Which of the following brain abnormalities is most commonly associated with PTSD?** - A\) Enlarged amygdala - B\) Increased prefrontal cortex activation - C\) Decreased hippocampal volume - D\) Increased serotonin receptor density **Answer: C) Decreased hippocampal volume** *(Linked to **impaired memory and trauma regulation** in PTSD.)* 10. **Which neurotransmitter is most strongly linked to hypervigilance in PTSD?** - A\) Dopamine - B\) Norepinephrine - C\) GABA - D\) Acetylcholine **Answer: B) Norepinephrine** *(Increased norepinephrine **drives hyperarousal** and startle responses.)* **PTSD Treatment & Pharmacology** 11. **Which therapy is considered the most effective first-line treatment for PTSD?** - A\) Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) - B\) Exposure and Response Prevention (ERP) - C\) Dialectical Behavior Therapy (DBT) - D\) Eye Movement Desensitization and Reprocessing (EMDR) **Answer: A) Trauma-Focused Cognitive Behavioral Therapy (TF-CBT)** *(TF-CBT has the **strongest evidence** for PTSD treatment.)* 12. **A patient with PTSD is prescribed prazosin for nightmares but reports persistent daytime anxiety. Which of the following would be the best alternative treatment?** - A\) Sertraline - B\) Clonidine - C\) Mirtazapine - D\) Alprazolam **Answer: A) Sertraline** *(SSRIs are **first-line pharmacologic treatment** for PTSD.)* 13. **Which PTSD medication should be avoided due to risk of worsening symptoms?** - A\) Beta-blockers - B\) Benzodiazepines - C\) Antipsychotics - D\) SNRIs **Answer: B) Benzodiazepines** *(Can **worsen dissociation** and interfere with **fear extinction**.)* 14. **Which treatment has been shown to prevent PTSD if given immediately after trauma exposure?** - A\) Fluoxetine - B\) Propranolol - C\) Trazodone - D\) Lamotrigine **Answer: B) Propranolol** *(May reduce trauma memory consolidation.)* **Suicide Risk & PTSD** 15. **Which PTSD symptom is most predictive of suicide risk?** - A\) Dissociation - B\) Avoidance - C\) Insomnia - D\) Hyperarousal **Answer: C) Insomnia** *(Persistent insomnia in PTSD is **highly correlated with suicide risk**.)* 16. **Which patient is at highest risk of developing PTSD following trauma?** - A\) A 30-year-old firefighter who repeatedly encounters trauma - B\) A 42-year-old woman who was sexually assaulted by a stranger - C\) A 25-year-old man who experienced a car accident but sustained no injuries - D\) A 60-year-old veteran who served in combat 30 years ago **Answer: B) A 42-year-old woman who was sexually assaulted by a stranger** *(Interpersonal violence is **most strongly associated with PTSD development**.)* **Applied Case-Based Questions** 17. **A police officer involved in a fatal shooting experiences distressing nightmares but continues to work. He avoids talking about the event but maintains daily functioning. His symptoms have lasted for three weeks. What is the most appropriate diagnosis?** - A\) PTSD - B\) Acute Stress Disorder - C\) Adjustment Disorder - D\) Dissociative Amnesia **Answer: B) Acute Stress Disorder** *(Symptoms **3 days -- 1 month** post-trauma suggest ASD.)* 18. **A veteran with PTSD frequently self-medicates with alcohol to avoid intrusive memories. What additional psychiatric diagnosis is most likely?** - A\) Major Depressive Disorder - B\) Generalized Anxiety Disorder - C\) Substance Use Disorder - D\) Borderline Personality Disorder **Answer: C) Substance Use Disorder** *(High comorbidity between PTSD and substance abuse.)*