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PTSD — USMLE Step 2 CK MCQ

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HardPsychiatryPTSDUSMLE Step 2 CK

A 32-year-old paramedic has nightmares, avoidance, hypervigilance, and intrusive memories 5 months after treating victims of a mass-casualty event. He drinks one beer nightly, has no psychosis or mania, and wants the intervention with the strongest evidence for durable improvement in the full symptom syndrome. Which treatment should be offered?

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Correct answer: A — Prolonged exposure or cognitive processing therapy delivered individually

The best answer is “Prolonged exposure or cognitive processing therapy delivered individually”. Trauma-focused psychotherapy directly addresses the traumatic memory and avoidance and is recommended over medication as first-line treatment when it is available and acceptable. Prazosin can target nightmares in selected patients but is not comprehensive monotherapy; benzodiazepines are discouraged, and propranolol or nondirective counseling does not provide equivalent evidence for the full disorder.

Reference: American Psychiatric Association: Posttraumatic Stress Disorder: https://www.psychiatry.org/patients-families/ptsd