PTSD — MRCPsych Paper B MCQ

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EasyAnxiety & Stress-Related DisordersPTSDMRCPsych Paper B

A 32-year-old woman presents 2 months after a serious road traffic accident. She has recurrent flashbacks and nightmares, avoids reminders of the accident, is persistently hyperaroused and feels emotionally numb. She is willing to engage in psychological treatment. According to NICE NG116, which treatment should be offered?

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Correct answer: D — Individual trauma-focused CBT

Individual trauma-focused CBT should be offered. She has clinically important PTSD symptoms and presents more than 1 month after the trauma, meeting NICE recommendation 1.6.16. Between 1 and 3 months after a non-combat trauma, EMDR is considered if the person specifically prefers it; no such preference is given here. Supported trauma-focused computerised CBT is considered only after more than 3 months and when additional suitability criteria are met. Sertraline or another SSRI may be considered when an adult prefers drug treatment, but medication should not routinely displace trauma-focused psychological therapy. Paroxetine is therefore also not the best answer.

Reference: National Institute for Health and Care Excellence. Post-traumatic stress disorder (NG116), recommendations 1.6.16, 1.6.18, 1.6.21 and 1.6.25. 2018. https://www.nice.org.uk/guidance/ng116/chapter/recommendations