Trauma and Stress-Related Disorders MCQs

The 5th edition of DSM-V criteria for PTSD specify that the following symptoms must have lasted >1 month: Intrusion Avoidance Alterations of mood and cognition Hyperarousal Reference: Kaplan and Sadock's Synopsis of Psychiatry, 11th Edition, Page Number-349.

According to DSM-5, acute stress disorder (ASD) and PTSD are differentiated by time duration If symptoms are present up to one month of exposure to traumatic event, it fulfils the criteria for ASD However, if symptoms occur more than a month, the criteria of PTSD is fulfilled In this question, the person developed symptoms of flashbacks, distressing memories, disturbed dreams for 20 days after experiencing the fire accident Hence, the diagnosis of ASD would be more appropriate Reference : Kaplan and Sadock's Synopsis of Psychiatry, 11th edition, Chapter 11, Trauma and stressor related disorders, Page 439-441

Explanation: Emotional blunting is more commonly associated with PTSD, not typically listed as a symptom of Acute Stress Disorder. Acute Stress Disorder (ASD) Diagnostic Criteria (DSM-5) Symptoms occur 3 days to following exposure to trauma. Symptoms arise transiently in response to stress and usually resolve quickly. Required Symptoms: Presence of symptoms from intrusion, negative mood/cognition, dissociation, avoidance, or arousal categories. Nine symptoms needed from these categories. Symptoms Include: Cognitive "daze," narrowed attention, disorientation. Autonomic panic symptoms. May include partial or complete amnesia related to the event. Exclusions: Not due to substance use or other psychiatric disorders.

Explanation: Prazosin is noted for its effectiveness in treating nightmares related to PTSD. Pharmacotherapy: Effective Medications: Sertraline and paroxetine are the most supported. Venlafaxine (SNRI), risperidone (atypical antipsychotic), and topiramate (anticonvulsant). Prazosin (for nightmares), while benzodiazepines lack supportive evidence and are often discouraged. Low-dose trazodone and the orexin antagonist suvorexant are used for insomnia

Acute stress disorder is classified under trauma-and stressor related disorders in DSM-5. While other conditions like Disruptive mood dysregulation disorder, premenstrual dysphoric disorder, and dysthymia are classified under depressive disorder spectrum. Reference: Diagnostic and Statistical manual, 5 th edition.

Flashback and nightmare, avoidance are the features of PTSD Reference: Kaplan and Saddocks Synopsis of Psychiaitry, 11th Edition, Chapter 11, Page No.: 440

A variant of trauma-focused CBT for PTSD is called eye movement desensitization and reprocessing (EMDR) , in which an exposure and cognitive reprocessing interventions are paired with directed eye movements In this, the patient focuses on the lateral movement of the clinician's finger while maintaining a mental image of the trauma experience The general belief is that symptoms can be relieved as patients work through the traumatic event while in a state of deep relaxation Reference : Kaplan and Sadock's Synopsis of Psychiatry, 11th edition, Chapter 11, Trauma and stressor related disorders, Page 445

PTSD occurs following exposure to a violent, accidental, traumatic event The stressor should be severe enough so as to endanger one’s or close one’s life or should be sufficiently overwhelming to affect almost everyone , e.g., sexual assault, directly experiencing or witnessing an accidental death, etc. Stressors such as job loss or a regular surgical procedure are not severe enough to cause PTSD Reference : Kaplan and Sadock's Synopsis of Psychiatry, 11th edition, Chapter 11, Trauma and stressor related disorders, Page 437