nightmareLet's hop to the Trauma- and Stressor-Related Disorders chapter of the DSM. It's stressful out there, so questions from this chapter may seem especially pertinent. Today's free social work licensing exam prep is about posttraumatic stress disorder (PTSD):

A client  reports intrusive distressing memories and recurring nightmares for the last month, ever since hearing about the sexual assault of a close friend. The client says she has had trouble talking to the friend since the reported events--"It's just too disturbing." When diagnosing the client, the social worker should keep in mind:

A. PTSD can only be diagnosed with three or more intrusion symptoms present (e.g., memories, dreams, flashbacks).

B. The diagnosis cannot be PTSD because the trauma was only reported, not experienced or witnessed.

C. PTSD can only be diagnosed when avoidance of trauma-associated stimuli is present (e.g., not talking to the friend).

D. PTSD can only be diagnosed after symptoms have been present for three months.

What do you say?

Items like this take a fair amount of focus and close reading (in addition to familiarity with PTSD criteria). But that's exactly what you're practicing for, right?

Let's eliminate the answers one by one.

A...isn't right. PTSD requires the presence of one or more intrusion symptoms, not three or more.

B...isn't right. PTSD can be diagnosed whether the trauma (exposure to actual or threatened death, serious injury, or sexual violence) was experienced, witnessed, or involved close family or a close friend. Repeated or extreme exposure to trauma (as experienced by EMTs, workers) also counts.

D...isn't right. PTSD symptoms need to be present for one month, not three.

That leaves one answer, the correct answer, answer C! PTSD can only be diagnosed when the avoidance of trauma-associated stimuli is present, and, in this vignette it's present. The client reports difficulty talking to the friend.

You may have had other diagnoses in mind, but since they weren't offered, they can't be the right answer, no matter how correct they are.

All make sense? If not, let us know!

With each practice question, you're more and more prepped for the real thing--the ASWB exam. Good luck!

For more details about PTSD criteria and symptoms, take a look at these sites:

For more questions about PTSD and lots, lots more, try SWTP's full-length, real-time practice tests!

October 15, 2016
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