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PTSD - The Latest Research

Literature on DSM-5 and ICD-11

1. Major changes in the DSM-5 are all of the following, except for:

A. The establishment of a new diagnostic category, “Trauma and Stressor-Related Disorders” for PTSD.

B. The inclusion of Complex PTSD as a separate diagnosis.

C. The reconceptualizing of PTSD broadly to include posttraumatic anhedonic / dysphoric, externalizing and dissociative clinical presentations along with the original fear-based anxiety disorder.

D. The establishment of preschool and dissociative subtypes.

2. After the addition of two symptoms in the Negative Mood and Cognitions category, corrections with depression were enhanced.

A. True

B. False

3. Pre/post-deployment data from National Guard service members deployed to Iraq observed that increased _____ was most closely associated with PTSD.

A. Anger

B. Negative expectations

C. Aggressive behaviors

D. All of the above

4. PTSD’s negative alterations in cognitions and mood factor is more sternly related to depression’s nonsomatic factor than its somatic factor.

A. True

B. False

5. In addition to the fear-based symptoms emphasized in DSM-IV, traumatic exposure is also followed by:

A. Aggressive / externalizing symptoms.

B. Guilt / shame symptoms.

C. Negative appraisals about oneself and the world.

D. All of the above.

6. Major reasons individuals meet DSM-IV criteria, but not DSM-5 criteria are:

A. The exclusion of nonaccidental, nonviolent deaths from Criterion A.

B. The new requirement of at least 1 avoidance symptom.

C. Both (A) and (B).

D. None of the above.

Group Treatment for PTSD

7. There is debate about whether conducting trauma exposure within the group setting, rather than individually, is problematic, owing to vicarious traumatization of other members.

A. True

B. False

8. Which of the following is based on strong empirical evidence favoring exposure therapy delivered individually, which combines with group treatment to address social functions, thereby providing a more comprehensive approach?

A. Trauma Management Therapy

B. Cognitive Behavioral Therapy

C. Mindfulness Therapy

D. None of the above

9. Given the data reported so far, it may be most cost effective to use a group treatment that involves more time.

A. True

B. False

10. Self-management group therapy is designed to target depression and includes which of the following?

A. Self-monitoring of positive activities and daily mood

B. Goal setting

C. Self-reinforcement for gains

D. All of the above

11. Seeking Safety is a well-known group treatment that targets which common comorbid condition in PTSD?

A. Depression

B. Anxiety

C. Substance use disorder

D. Withdrawal disorder

12. In light of considerable comorbidity, efforts to address PTSD in a group treatment setting are wise to incorporate therapeutic components that also focus on:

A. Co-occurring psychiatric problems

B. Physical health problems

C. Both (A) and (B)

D. None of the above

13. Multi-component CBT shows promise for improving social functioning beyond that provided by exposure therapy alone, particularly by increasing social engagement / interpersonal functioning in a cohort of veterans with severe and chronic PTSD.

A. True

B. False

14. When using treatment studies for comorbid substance use disorder and posttraumatic stress disorder, most models show more effect on SUD than PTSD, suggesting PTSD is harder to treat.

A. True

B. False

Implementation of Evidence-Based Treatment for PTSD

15. Research indicates that when evidence-based treatments are implemented into routine care settings, patients with PTSD and related disorders experience substantial symptom reduction.

A. True

B. False

16. Which of the following emerged as a reason that patients were perceived to be less suitable or “ready” for the treatment?

A. The presence of psychiatric comorbidities

B. Cognitive limitation

C. Low levels of patient motivation

D. All of the above

17. Clinicians trained by newly-trained peers can produce clinical outcomes that are comparable to treatment delivered by expert-trained clinicians.

A. True

B. False

18. Cognitive processing therapy is an evidence-based treatment that has been shown to be effective at treating which type of trauma?

A. Combat

B. Assault

C. Interpersonal violence

D. All of the above

19. Prolonged exposure is effective in reducing ______, even though it is not a direct target of the treatment.

A. Substance use disorder

B. Depression symptoms

C. Anxiety

D. Withdrawal disorders

20. All of the following statements are true, except for:

A. Most prefer medication only over psychotherapy plus medication or psychotherapy only.

B. Participants endorse a significantly stronger preference for CPT versus other psychotherapies.

C. PE is significantly preferred over nightmare resolution therapy and present-centered therapy.

D. Both PE and cognitive-behavioral conjoint therapy is preferred over virtual reality exposure therapy.

New Research in Treating Child and Adolescent Trauma

21. Therapeutic alliance predicts positive child outcomes in:

A. Trauma Systems Therapy

B. Trauma-Focused Cognitive Behavioral Therapy

C. Care as Usual

D. All of the above

22. Empirical evidence from the few well controlled, scientifically rigorous studies conducted to date has failed to support the efficacy of any pharmacologic agent in improving PTSD symptoms in children.

A. True

B. False

23. Parents of children treated with TF-CBT reported a significant reduction of all of the following, except for:

A. Comorbid depressive symptoms

B. Hyperactive symptoms

C. Aggressive symptoms

D. Parents reported a significant reduction in all of the above

24. Mixed model regression analyses demonstrated generally large effects for pre-post change in PTSD symptoms and emotion regulation for both emotion regulation therapy and relational supportive therapy.

A. True

B. False

25. Compared with youth in treatment-as-usual, intent-to-treat analysis using mixed effects models show that youth receiving TF-CBT report significantly lower levels of all of the following, except for:

A. Posttraumatic stress symptoms

B. Anxiety

C. Depression

D. General mental health symptoms

Technology and PTSD Care: An Update

26. Telemental health technologies can facilitate delivery of care and provide critical support:

A. Before therapy

B. In-between therapy sessions

C. Following therapy for maintenance and relapse prevention

D. All of the above

27. Randomized clinical trials have demonstrated that PTSD outcomes with clinical videoconferencing technology delivery of trauma-focused therapies are generally comparable to outcomes associated with traditional service delivery methods.

A. True

B. False

28. Research investigating therapist effects in CVT indicates that which of the following is similar in CVT and in-person modalities when delivering manualized treatment protocols?

A. Therapist adherence

B. Therapist competence

C. Therapist fidelity

D. All of the above

29. Clinicians using any telemedicine tools should familiarize themselves with the content and processes of the tools and actively monitor their use and impact on patient care.

A. True

B. False

30. Results have found all of the following for videoconferencing psychotherapy, except for:

A. VCP is feasible.

B. VCP has been used in a variety of therapeutic formats and with diverse populations.

C. VCP is generally associated with poor user satisfaction.

D. VCP is found to have similar clinical outcomes to traditional face-to-face psychotherapy.

31. Age significantly predicts which of the following of mHealth?

A. Ownership of mHealth devices.

B. Utilization of mHealth apps among device owners.

C. Interest in mHealth apps among device owners.

D. All of the above.

Biomarkers for Treatment and Diagnosis

32. Which of the following has been replicated in both men and women and constitutes the most consistent biological abnormality in PTSD to date?

A. Dysregulation or corticotropin-releasing factor.

B. Excessive PTSD-related noradrenergic system reactivity.

C. Increased and prolonged cortisol responses to stress.

D. All of the above.

33. Neuropeptide Y levels correlate positively with:

A. Bodyweight

B. Noradrenergic responses to yohimbine

C. PTSD symptom responses to yohimbine

D. All of the above

34. There is a link between high cortisol levels and PTSD risk, but only among study participants with a history of childhood trauma.

A. True

B. False

35. Which of the following is associated with better global mental health after treatment?

A. Higher bedtime salivary cortisol levels.

B. Higher NPY levels at baseline.

C. Possession of BCL1 glucocorticoid receptor genotypes.

D. Increased glucocorticoid receptor sensitivity.

36. A lower resting ratio of DHEA to cortisol has been associated with:

A. Childhood trauma

B. Lower PTSD symptom severity after treatment

C. Both (A) and (B)

D. None of the above

37. A higher _____ in CSF has been linked to greater re-experiencing and negative mood symptoms in women with PTSD.

A. DHEA concentration

B. DHEA / allopregnanolone ratio

C. DHEA / cortisol ratio

D. Pregnanolone concentration

38. PTSD is associated with altered immunological function as indicated by increased methylation of immune system genes in association with decreased titers of antibodies to an infectious agent with high community prevalence.

A. True

B. False

39. There is evidence of decreased hippocampal volume in PTSD, a brain region related to memory and fear extinction.

A. True

B. False

40. Hyperresponsivity in the _____ appears to be a familial risk factor for the development of PTSD following psychological trauma.

A. Dorsal anterior cingulate

B. Dorsal posterior cingulate

C. Ventral anterior cingulate

D. Ventral posterior cingulate

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