EMDR Complex PTSD & Dissociative Disorders 2 — Questions and Answers
Question 1: Which diagnostic category was introduced in ICD-11 but is NOT included as a distinct diagnosis in DSM-5?
- Acute Stress Disorder
- Complex PTSD (CPTSD) (Correct answer)
- Adjustment Disorder
- Persistent Depressive Disorder
Correct answer: Complex PTSD (CPTSD)
Complex PTSD (CPTSD) is a distinct diagnosis in ICD-11 but DSM-5 does not include it as a separate category, instead subsuming features under PTSD specifiers.
Question 2: The 'disturbances in self-organization' (DSO) cluster in ICD-11 Complex PTSD includes all of the following EXCEPT:
- Affect dysregulation
- Negative self-concept
- Dissociative amnesia (Correct answer)
- Disturbances in relationships
Correct answer: Dissociative amnesia
The DSO cluster comprises affect dysregulation, negative self-concept, and relational disturbances; dissociative amnesia is a PTSD symptom cluster, not part of DSO.
Question 3: In the Structural Dissociation of the Personality (SDP) model, the 'Apparently Normal Part' (ANP) is best described as:
- A fully integrated personality state with no trauma memories
- The part focused on daily functioning that avoids trauma-related stimuli (Correct answer)
- The part that holds all traumatic memories in explicit detail
- A fragmented ego state that only emerges under extreme stress
Correct answer: The part focused on daily functioning that avoids trauma-related stimuli
The ANP manages daily functioning and is oriented toward avoiding trauma-related cues, while the Emotional Part (EP) holds traumatic memories and responds to threat.
Question 4: When an EMDR therapist notices a client with suspected DID switches to a different self-state mid-processing, the recommended immediate action is to:
- Continue the bilateral stimulation to process the new state's material
- Stop BLS, orient to the present, and assess safety and stability (Correct answer)
- Ask the new state to return to the original traumatic memory
- Increase the intensity of bilateral stimulation to prevent further switching
Correct answer: Stop BLS, orient to the present, and assess safety and stability
Switching mid-session warrants stopping BLS, grounding the client in the present, and stabilizing before deciding whether to continue, ensuring no part is overwhelmed.
Question 5: Which EMDR protocol adaptation is specifically designed to address phobia of trauma memories in clients with complex dissociative presentations?
- EMD (Eye Movement Desensitization only)
- EMDR-PRECI protocol
- Phobia of Traumatic Memory protocol by Kluft
- The Phobia of Traumatic Memory protocol within EMDR-ISSTD guidelines (Correct answer)
Correct answer: The Phobia of Traumatic Memory protocol within EMDR-ISSTD guidelines
The ISSTD guidelines for EMDR with dissociative disorders include a specific protocol for addressing the phobia of traumatic memories before direct trauma processing.
Question 6: A client with CPTSD reports feeling like they are 'watching themselves from outside their body' during a therapy session. This experience is best classified as:
- Derealization
- Depersonalization (Correct answer)
- Dissociative fugue
- Emotional numbing
Correct answer: Depersonalization
Depersonalization refers to feeling detached from or observing oneself from outside, whereas derealization involves the external world feeling unreal.
Question 7: The Window of Tolerance concept, critical in CPTSD treatment, describes the optimal arousal zone for trauma processing. Who originally developed this concept?
- Bessel van der Kolk
- Dan Siegel (Correct answer)
- Peter Levine
- Judith Herman
Correct answer: Dan Siegel
Dan Siegel developed the Window of Tolerance framework to describe the zone of arousal within which a person can effectively process information without becoming hyperaroused or hypoaroused.
EMDR Complex PTSD & Dissociative Disorders 2
Which diagnostic category was introduced in ICD-11 but is NOT included as a distinct diagnosis in DSM-5?