Examination for Professional Practice of Psychology (EPPP) Practice Test

What diagnosis is suggested for a client who has sleep problems characterized by frightening screams after going to sleep?

1. Nightmare disorder

2. Non-rapid eye movement sleep arousal disorder

3. Sleep terror disorder

4. Insomnia disorder

The correct answer is: Non-rapid eye movement sleep arousal disorder

The most appropriate diagnosis for a client experiencing sleep problems characterized by frightening screams after going to sleep is sleep terror disorder, also known as night terrors. This condition typically occurs during non-rapid eye movement (NREM) sleep, often in the first third of the night, and is characterized by episodes of intense fear, screaming, and autonomic arousal, which may include increased heart rate, sweating, and rapid breathing. Individuals experiencing sleep terrors typically do not have detailed recall of the episode upon waking and may appear confused if they are awakened during the event. This differs significantly from other sleep disorders like nightmare disorder, which involves frightening dreams that occur during REM sleep and are often recalled in vivid detail upon waking. Non-rapid eye movement sleep arousal disorder could also seem relevant, as it encompasses sleep terrors and sleepwalking, but in this context, the key symptoms align more directly with sleep terror disorder due to the description of screaming and the nature of the arousal. While insomnia disorder is related to difficulties in sleep initiation or maintenance and is characterized by dissatisfaction with sleep quantity or quality, it does not typically involve the dramatic episodes described in the question. Thus, sleep terror disorder is the most suitable diagnosis for the symptoms presented.