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PTSD and Sleep

1. All of the following evidence has changed the original view of insomnia and recurrent nightmares being thought of as symptoms of PTSD, except for:

A. Individuals with insomnia prior to trauma exposure are less likely to develop PTSD following the exposure, indicating that disturbed sleep does not increase vulnerability to PTSD.

B. Insomnia occurring in the acute aftermath of a traumatic event is a significant risk factor for the later development of PTSD, suggesting that early sleep disturbance precedes the development of the full disorder.

C. Insomnia and recurrent nightmares are independently associated with a number of negative sequelae, including suicidal ideation and behavior, over and above the effects of PTSD and depression.

D. Insomnia often persists following trauma-focused treatment such as Prolonged Exposure or Cognitive Processing Therapy.


2. The preferred treatment approach for insomnia, when available, is:

A. Pharmacotherapy

B. Prolonged Exposure therapy

C. Cognitive behavioral therapy

D. Group Treatment


3. Prazosin acts in which of the following ways?

A. It is sedating.

B. It promotes REM sleep continuity.

C. It shortens sleep onset latency.

D. Prazosin is sedating and shortens sleep onset latency as well as promotes REM sleep continuity.


4. Sleep disturbance may be targeted in those who experience PTSD to help prevent suicidal ideation.

A. True

B. False


5. Preliminary data suggest that _____ may be effective in reducing the three primary clusters of symptoms of PTSD.

A. Quetiapine monotherapy

B. Prazosin

C. Eszopiclone

D. Trazodone


6. Imagery rehearsal therapy is a brief, well-tolerated treatment that appears to:

A. Decrease chronic nightmares

B. Improve sleep quality

C. Decrease PTSD symptom severity

D. Imagery rehearsal therapy decreases chronic nightmares, improves sleep quality, and decreases PTSD symptom severity


7. A greater proportion of PTSD patients with comorbid panic disorder complain of sleep-related problems than other comorbid groups and this effect appears unique to panic, rather than other general anxiety disorder or depression.

A. True

B. False


8. Variations in nightmare prevalence, frequency, severity, and psychopathological comorbidity reflect the influence of:

A. Affect load, a consequence of daily variations in emotional pressure.

B. Affect distress, a disposition to experience events with distressing, highly reactive emotions.

C. Both affect load and affect distress influence variations in nightmare prevalence, frequency, severity, and psychopathological comorbidity.

D. Neither affect load nor affect distress influence variations in nightmare prevalence, frequency, severity, and psychopathological comorbidity.


9. The development of PTSD symptoms after traumatic injury is associated with a more fragmented pattern of REM sleep.

A. True

B. False


10. In a sample of veterans who served in Vietnam, combat exposure was strongly correlated with:

A. Frequency of nightmares

B. Sleep onset insomnia

C. Disrupted sleep maintenance

D. Combat exposure was strongly correlated with frequency of nightmares, sleep onset insomnia, and disrupted sleep maintenance


11. After the control for nonsleep PTSD symptoms, alcohol abuse, chronic medical illnesses, panic disorder, major depression, mania, and PTSD all predict the frequency of nightmares.

A. True

B. False


12. A role of alpha-1 adrenoceptor activation in the pathophysiology of PTSD suggest that higher standing _____ is a biomarker for identifying Veterans with combat-related PTSD who are likely to benefit from prazosin.

A. Norepinephrine levels

B. Blood pressure

C. C-reactive protein

D. Cortisol levels


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