Trauma and Stress-Related Disorders Practice Questions

Q: What is the most common presenting symptom in conversion disorder (historically termed hysteria)?

Motor or sensory symptoms. ***Motor or sensory symptoms*** - Historically, **hysteria** (now largely replaced by terms like **conversion disorder** or functional neurological symptom disorder) frequently presented with **unexplained motor or sensory deficits** such as paralysis, tremor, blindness, or aphonia. - These symptoms are neurological in nature but are not attributable to a known neurological or medical condition, often appearing in response to psychological stress. *Excessive health concerns* - This symptom is more characteristic of **illness anxiety disorder** (formerly hypochondriasis), where individuals are preoccupied with having or acquiring a serious illness. - While there is a psychological component, it does not typically involve the dramatic functional neurological symptoms seen in hysteria. *Disorganized speech* - **Disorganized speech** is a hallmark symptom of **psychotic disorders**, particularly **schizophrenia**, reflecting a disturbance in thought processes. - It is not a common presentation of conversion disorder or what was historically termed hysteria. *Dissociative fugue* - **Dissociative fugue** involves sudden, unexpected travel away from home or one's customary workplace, with **amnesia for identity** or other important autobiographical information. - While a dissociative symptom, it is distinct from the motor and sensory symptoms that were classically associated with hysteria and conversion disorder.

Q: Which of the following is not a clinical feature of post-traumatic stress disorder?

Grandiosity. ***Grandiosity*** - **Grandiosity** refers to an inflated sense of self-importance, superiority, or special abilities, which is characteristic of manic or hypomanic episodes in bipolar disorder, not PTSD. - PTSD typically involves negative alterations in cognition and mood, including persistent negative beliefs about oneself (e.g., "I am bad," "I can't trust anyone"), which is opposite to grandiose thinking. - The core symptoms of PTSD do not include elevated mood, inflated self-esteem, or grandiose delusions. *Flashbacks* - **Flashbacks** are a hallmark feature of PTSD, involving vivid, intrusive re-experiences of the traumatic event where the individual feels as if the trauma is happening again. - They are a key symptom in the **intrusion cluster (Criterion B)** of DSM-5 PTSD diagnostic criteria. - Flashbacks can involve sensory, emotional, or physical re-experiencing with dissociative qualities. *Nightmares* - **Nightmares** related to the traumatic event are a common and distressing feature of PTSD, falling under the **intrusion symptom cluster (Criterion B)**. - They often involve re-enacting the trauma or experiencing themes related to its content, leading to sleep disturbance and significant emotional distress. - Trauma-related nightmares occur in the majority of PTSD patients and contribute to sleep avoidance. *Emotional distress* - **Emotional distress** is a pervasive symptom in PTSD, including intense anxiety, fear, sadness, anger, or irritability. - This distress appears across multiple symptom clusters: **intrusion (Criterion B)**, **negative alterations in cognition and mood (Criterion D)**, and **alterations in arousal and reactivity (Criterion E)**. - Emotional distress can be triggered by trauma reminders (internal or external cues) and is a core feature of the disorder.

Q: Which of the following dissociative disorders involves the presence of two or more distinct identities?

Dissociative Identity Disorder. ***Dissociative Identity Disorder*** - This disorder is characterized by the presence of **two or more distinct personality states** or an experience of **possession**. - These distinct identities recurrently take control of the individual's behavior, accompanied by an inability to recall important personal information that is too extensive to be explained by ordinary forgetfulness. - This is the **defining feature** that distinguishes DID from other dissociative disorders. *Depersonalization/Derealization Disorder* - This involves **persistent or recurrent experiences of depersonalization** (feeling detached from one's mental processes or body) or **derealization** (feeling that the world is unreal or dreamlike). - While consciousness is maintained, there is no presence of multiple distinct identities. - The person retains awareness that these are subjective experiences. *Dissociative Amnesia* - This is characterized by an inability to recall important **autobiographical information**, usually of a traumatic or stressful nature, that is inconsistent with ordinary forgetting. - May include dissociative fugue as a specifier (sudden travel with amnesia for identity). - It does not involve the presence of multiple distinct identities. *Major Depressive Disorder* - This is a mood disorder characterized by a persistently **depressed mood or loss of interest** in activities, causing significant impairment in daily life. - It is not a dissociative disorder and does not involve the presence of multiple identities.

Question 1

What is the most common presenting symptom in conversion disorder (historically termed hysteria)?

Accepted Answer

Motor or sensory symptoms

Answer

Excessive health concerns

Answer

Disorganized speech

Answer

Dissociative fugue

Question 2

Which of the following is not a clinical feature of post-traumatic stress disorder?

Accepted Answer

Grandiosity

Answer

Emotional distress

Answer

Flashbacks

Answer

Nightmares

Question 3

Which of the following dissociative disorders involves the presence of two or more distinct identities?

Accepted Answer

Dissociative Identity Disorder

Answer

Dissociative Amnesia

Answer

Depersonalization/Derealization Disorder

Answer

Major Depressive Disorder

Trauma and Stress-Related Disorders — MCQs

Trauma and Stress-Related Disorders — MCQs

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