Trauma and Stressor-Related Disorders

What qualifies as a traumatic event?

An extraordinarily intense or severe event that goes beyond normal daily stress, such as natural disasters, combat, assault, or childhood abuse.

Why do some people develop trauma-related disorders after a traumatic event?

Because they develop persistent problems instead of returning to their usual coping levels.

What is Posttraumatic Stress Disorder (PTSD)?

A chronic condition characterized by a disturbing pattern of behavior following exposure to a traumatic event.

When do PTSD symptoms typically begin?

3 months or more after the trauma.

How does PTSD differ from Acute Stress Disorder in terms of onset?

PTSD begins after 3 months, while Acute Stress Disorder occurs 3 days to 4 weeks after trauma.

Can PTSD symptoms be delayed?

Yes, full expression can be delayed for months or even years.

Is PTSD acute or chronic?

Chronic, with symptoms fluctuating in intensity.

What can exacerbate PTSD symptoms?

Stressful periods or significant life events.

What disorders commonly co-occur with PTSD?

Depression, anxiety disorders, alcohol use disorder, and substance use disorders.

What percentage of individuals with PTSD may have persistent symptoms for many years?

Roughly one-third.

What is the Life Events Checklist (LEC-5)?

A standard assessment tool used to identify exposure to 17 potentially traumatic events.

What does the LEC-5 assess about traumatic events?

Whether the person experienced, witnessed, or learned about the event.

What is the PTSD Checklist (PCL-5)?

A tool used to measure the severity of PTSD symptoms over the past month.

What scale does the PCL-5 use?

0 (Not at all) to 4 (Extremely).

What types of symptoms does the PCL-5 measure?

Disturbing memories, avoidance, feeling distant, trouble sleeping, and physical reactions to reminders.

What is required for a PTSD diagnosis?

Exposure to actual or threatened death, serious injury, or sexual violence.

Is PTSD caused by personality traits?

No, it is associated with exposure to trauma, though risk factors may increase vulnerability.

What are pre-trauma risk factors for PTSD?

Lack of social support, peri-trauma dissociation, and previous psychiatric history.

How can early counseling affect PTSD risk?

It can decrease the risk of developing PTSD.

What is Adjustment Disorder?

A reaction to a stressful event that causes difficulty coping, with symptoms developing within one month and lasting no more than six months.

What types of stressors commonly cause Adjustment Disorder?

Financial, relationship, or work-related stress.

What is Acute Stress Disorder (ASD)?

A trauma-related disorder with PTSD-like symptoms occurring 3 days to 4 weeks after trauma.

What happens if ASD symptoms persist beyond one month?

It may progress to PTSD.

At what age do Reactive Attachment Disorder (RAD) and Disinhibited Social Engagement Disorder (DSED) occur?

Before age 5.

What causes RAD and DSED?

Child abuse, neglect, or grossly deficient parenting.

What behaviors are seen in RAD and DSED?

Disturbed social relatedness, minimal emotional responses, lack of positive affect, or inappropriate social engagement.

What is dissociation?

A subconscious defense mechanism that protects the emotional self from traumatic memories.

What functions are disrupted in dissociative disorders?

Consciousness, memory, identity, and perception of the environment.

What is Dissociative Amnesia?

Inability to remember important personal information related to stressful events.

What is a fugue state?

A dissociative amnesia subtype where a person moves to a new location, assumes a new identity, and has no memory of past events.

What is Dissociative Identity Disorder (DID)?

A disorder involving two or more distinct identities that recurrently control behavior, with memory gaps.

What was DID formerly called?

Multiple Personality Disorder.

What is Depersonalization?

Feeling detached from one’s mental processes or body.

What is Derealization?

Feeling like the environment is dream-like, foggy, or unreal.

Are clients with depersonalization/derealization psychotic?

No, they remain in touch with reality.

What are common immediate responses to trauma?

Anxiety, insomnia, difficulty coping, and grief.

Who is at high risk for PTSD?

Military personnel, first responders, healthcare workers, and victims of disasters or violence.

What are military-specific risk factors for PTSD?

Lower education, combat specialization, firing a weapon, and witnessing death.

Which age group is more likely to develop PTSD?

Adolescents.

What risks increase in adolescents with PTSD?

Suicide, substance abuse, and academic problems.

How are trauma responses influenced?

They are dynamic and culturally influenced.

How does cultural identity affect PTSD outcomes?

Strong cultural identity is linked to better long-term outcomes and fewer diagnoses.

How does political oppression affect trauma outcomes?

It can lead to alienation and poorer outcomes.

What percentage of at-risk individuals may develop PTSD?

Up to 60%.

What factors influence the likelihood of developing PTSD?

Severity, duration, and proximity to the trauma.

What are the most frequent traumatic events leading to PTSD in women?

Physical assault and rape.

What percentage of physical assault victims develop PTSD?

One-fourth.

What are the four core PTSD symptom categories?

Reexperiencing, Avoidance, Negative cognition/mood, and Hyperarousal.

What are examples of reexperiencing symptoms?

Nightmares, intrusive thoughts, and flashbacks.

What are avoidance symptoms?

Avoiding trauma-related thoughts, feelings, or stimuli.

What are negative cognition/mood symptoms?

Persistent negative emotions, distorted beliefs, detachment.

What are hyperarousal symptoms?

Being on guard, easily startled, irritable.

What is the focus of therapy for DID?

Reassociation (integrating identities).

What therapy risk exists for DID?

Highly persuasive psychotherapy may create false memories of childhood trauma.

What is the focus of education after trauma?

Mental health promotion and prevention of pathologic responses.

Why is early emotional expression important after trauma?

Suppressing or denying emotions increases PTSD risk.

What coping strategies should clients be taught?

Stress management, relaxation, assertiveness, self-defense skills.

What daily habits should be encouraged after trauma?

Maintaining routine, adequate sleep, healthy diet, avoiding alcohol/drugs, setting small goals.

Why is social support important after trauma?

It reduces isolation and decreases PTSD risk.

What should be assessed in trauma-related diagnoses?

Hyper-alertness, memory gaps, self-destructive thoughts, appetite changes, sleep disturbances.

Should clients detail trauma during general assessments?

No, it is not necessary and may be triggering.

What is the priority outcome in trauma care?

Physical safety, including suicide and self-harm assessment.

What are additional goals in trauma care?

Non-destructive emotional expression and building social support.

How should nurses address self-harm thoughts?

Discuss them directly and validate fears while increasing contact with reality.

Why should clients be called “survivors” instead of “victims”?

It promotes empowerment and resilience.

What are grounding techniques used for?

Managing flashbacks or dissociative episodes.

How should nurses speak during grounding?

Calm, reassuring tone; remind the client they are safe and in the present.

What is essential for nurses working with trauma survivors?

Professional boundaries and emotional regulation.

Why is nurse self-care important?

To prevent projection and maintain therapeutic effectiveness.

What should nurses seek if overwhelmed?

Peer support or personal counseling.

What communication style should nurses use?

Nonjudgmental, empathetic, validating.

What should nurses avoid saying to trauma survivors?

Platitudes like “Be glad you’re alive” or “It was meant to be.”