Rotations 2.0 Episode 77 Insomnia

Episode 77 Insomnia

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Intro Music: KI Instrumental (Rock Celtic) by Lyrium-2025

Outro Music: Code of Reality by Alex Grohl

Courtesy of Pixabay under Creative Commons non-commercial use.

Produced by: Todd Fredricks DO MSS 

Edited by: Todd Fredricks DO MSS

Answers for Episode 76 PTSD

Question 1

A 32-year-old patient presents to a primary care clinic 4 months after witnessing a fatal motor vehicle collision. The patient reports recurrent intrusive memories, avoidance of the road where the crash occurred, persistent negative mood, exaggerated startle response, and impaired occupational functioning. The patient asks about the most evidence-supported first-line treatment. Which of the following is the most appropriate recommendation?

C. Refer for trauma-focused cognitive behavioral therapy or EMDR.

Question 2 

A 41-year-old patient with a history of prolonged interpersonal trauma reports nightmares, avoidance of reminders, hyperarousal, persistent shame, difficulty regulating emotions, and chronic difficulty maintaining relationships. The clinician suspects complex post-traumatic stress disorder. Which of the following best describes complex PTSD as discussed in the article?

C. PTSD symptoms plus affect dysregulation, negative self-concept, and interpersonal disturbances.

Question 3 

A physician is counseling a patient who is hesitant to begin trauma-focused psychotherapy for PTSD because the patient is worried that discussing the trauma may worsen symptoms. The physician wants to provide realistic anticipatory guidance while encouraging treatment engagement. Which of the following counseling statements is most consistent with the evidence summarized in the article?

D. “Some patients experience distress or temporary worsening of symptoms, but trauma-focused therapy remains effective, and support plus a strong therapeutic alliance can help patients continue.”

Paper for next week: 

Smith, John A., and Jane B. Lee. “The Diagnosis and Treatment of Attention-Deficit Hyperactivity Disorder in Older Adults.” Journal of Clinical Psychiatry 78, no. 4 (2017): 456–465. 

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