PTSD Trauma Evaluation and Diagnosis 3 — Questions and Answers
Question 1: A survivor of sexual assault denies remembering important aspects of the trauma. Under DSM-5, this falls under which PTSD criterion?
- Criterion B – Intrusion
- Criterion C – Avoidance
- Criterion D – Negative cognitions and mood (Correct answer)
- Criterion E – Arousal and reactivity
Correct answer: Criterion D – Negative cognitions and mood
Inability to remember key aspects of the traumatic event (dissociative amnesia) is listed under Criterion D in DSM-5.
Question 2: The Life Events Checklist for DSM-5 (LEC-5) is used primarily to:
- Rate PTSD symptom severity
- Identify the Index Trauma for further evaluation (Correct answer)
- Screen for comorbid depression
- Assess functional impairment
Correct answer: Identify the Index Trauma for further evaluation
The LEC-5 screens for a range of potentially traumatic events and is used to identify the Index Trauma to anchor subsequent PTSD assessment.
Question 3: Which specifier should be noted when a client first meets full PTSD criteria six months after a traumatic event?
- Chronic PTSD
- Delayed Expression (Correct answer)
- Complex PTSD
- Subthreshold PTSD
Correct answer: Delayed Expression
DSM-5 includes a 'With Delayed Expression' specifier when full criteria are not met until at least 6 months after the traumatic event.
Question 4: When conducting a trauma evaluation, asking about all categories of potential trauma exposure is important because:
- Clients always volunteer every trauma spontaneously
- A single traumatic event never produces PTSD
- Clinicians must identify the worst event to anchor diagnosis
- Multiple traumas may compound symptom severity and alter treatment planning (Correct answer)
Correct answer: Multiple traumas may compound symptom severity and alter treatment planning
Polyvictimization and cumulative trauma exposure significantly impact symptom severity, comorbidity, and treatment complexity.
Question 5: In assessing functional impairment for PTSD diagnosis, the DSM-5 requires that symptoms cause:
- Hospitalization or medication use
- Clinically significant distress or impairment in social, occupational, or other important areas of functioning (Correct answer)
- At least 50% reduction in work productivity
- Relationship breakdown or divorce
Correct answer: Clinically significant distress or impairment in social, occupational, or other important areas of functioning
DSM-5 requires clinically significant distress or functional impairment as a necessary criterion for a PTSD diagnosis.
Question 6: The Primary Care PTSD Screen for DSM-5 (PC-PTSD-5) is best suited for which setting?
- Inpatient psychiatric units
- Forensic evaluations
- Brief screening in primary care or emergency medicine (Correct answer)
- Research diagnostic interviews
Correct answer: Brief screening in primary care or emergency medicine
The PC-PTSD-5 is a 5-item screen designed for rapid use in busy primary care and emergency settings to identify patients warranting further evaluation.
Question 7: A client with PTSD reports feeling emotionally numb, detached from loved ones, and unable to experience positive emotions. Which Criterion D symptom does this represent?
- Persistent negative beliefs about the world
- Dissociative amnesia
- Persistent negative emotional states
- Persistent inability to experience positive emotions (emotional anhedonia/constriction) (Correct answer)
Correct answer: Persistent inability to experience positive emotions (emotional anhedonia/constriction)
Persistent inability to experience positive emotions (emotional numbing) is a distinct Criterion D symptom sometimes called emotional constriction or anhedonia.
PTSD Trauma Evaluation and Diagnosis 3
A survivor of sexual assault denies remembering important aspects of the trauma.
Under DSM-5, this falls under which PTSD criterion?