Trauma and Stressor-Related Disorders
Q: What qualifies as a traumatic event?
A: An extraordinarily intense or severe event that goes beyond normal daily stress, such as natural disasters, combat, assault, or childhood abuse.
Q: Why do some people develop trauma-related disorders after a traumatic event?
A: Because they develop persistent problems instead of returning to their usual coping levels.
Q: What is Posttraumatic Stress Disorder (PTSD)?
A: A chronic condition characterized by a disturbing pattern of behavior following exposure to a traumatic event.
Q: When do PTSD symptoms typically begin?
A: 3 months or more after the trauma.
Q: How does PTSD differ from Acute Stress Disorder in terms of onset?
A: PTSD begins after 3 months, while Acute Stress Disorder occurs 3 days to 4 weeks after trauma.
Q: Can PTSD symptoms be delayed?
A: Yes, full expression can be delayed for months or even years.
Q: Is PTSD acute or chronic?
A: Chronic, with symptoms fluctuating in intensity.
Q: What can exacerbate PTSD symptoms?
A: Stressful periods or significant life events.
Q: What disorders commonly co-occur with PTSD?
A: Depression, anxiety disorders, alcohol use disorder, and substance use disorders.
Q: What percentage of individuals with PTSD may have persistent symptoms for many years?
A: Roughly one-third.
Q: What is the Life Events Checklist (LEC-5)?
A: A standard assessment tool used to identify exposure to 17 potentially traumatic events.
Q: What does the LEC-5 assess about traumatic events?
A: Whether the person experienced, witnessed, or learned about the event.
Q: What is the PTSD Checklist (PCL-5)?
A: A tool used to measure the severity of PTSD symptoms over the past month.
Q: What scale does the PCL-5 use?
A: 0 (Not at all) to 4 (Extremely).
Q: What types of symptoms does the PCL-5 measure?
A: Disturbing memories, avoidance, feeling distant, trouble sleeping, and physical reactions to reminders.
Q: What is required for a PTSD diagnosis?
A: Exposure to actual or threatened death, serious injury, or sexual violence.
Q: Is PTSD caused by personality traits?
A: No, it is associated with exposure to trauma, though risk factors may increase vulnerability.
Q: What are pre-trauma risk factors for PTSD?
A: Lack of social support, peri-trauma dissociation, and previous psychiatric history.
Q: How can early counseling affect PTSD risk?
A: It can decrease the risk of developing PTSD.
Q: What is Adjustment Disorder?
A: A reaction to a stressful event that causes difficulty coping, with symptoms developing within one month and lasting no more than six months.
Q: What types of stressors commonly cause Adjustment Disorder?
A: Financial, relationship, or work-related stress.
Q: What is Acute Stress Disorder (ASD)?
A: A trauma-related disorder with PTSD-like symptoms occurring 3 days to 4 weeks after trauma.
Q: What happens if ASD symptoms persist beyond one month?
A: It may progress to PTSD.
Q: At what age do Reactive Attachment Disorder (RAD) and Disinhibited Social Engagement Disorder (DSED) occur?
A: Before age 5.
Q: What causes RAD and DSED?
A: Child abuse, neglect, or grossly deficient parenting.
Q: What behaviors are seen in RAD and DSED?
A: Disturbed social relatedness, minimal emotional responses, lack of positive affect, or inappropriate social engagement.
Q: What is dissociation?
A: A subconscious defense mechanism that protects the emotional self from traumatic memories.
Q: What functions are disrupted in dissociative disorders?
A: Consciousness, memory, identity, and perception of the environment.
Q: What is Dissociative Amnesia?
A: Inability to remember important personal information related to stressful events.
Q: What is a fugue state?
A: A dissociative amnesia subtype where a person moves to a new location, assumes a new identity, and has no memory of past events.
Q: What is Dissociative Identity Disorder (DID)?
A: A disorder involving two or more distinct identities that recurrently control behavior, with memory gaps.
Q: What was DID formerly called?
A: Multiple Personality Disorder.
Q: What is Depersonalization?
A: Feeling detached from one’s mental processes or body.
Q: What is Derealization?
A: Feeling like the environment is dream-like, foggy, or unreal.
Q: Are clients with depersonalization/derealization psychotic?
A: No, they remain in touch with reality.
Q: What are common immediate responses to trauma?
A: Anxiety, insomnia, difficulty coping, and grief.
Q: Who is at high risk for PTSD?
A: Military personnel, first responders, healthcare workers, and victims of disasters or violence.
Q: What are military-specific risk factors for PTSD?
A: Lower education, combat specialization, firing a weapon, and witnessing death.
Q: Which age group is more likely to develop PTSD?
A: Adolescents.
Q: What risks increase in adolescents with PTSD?
A: Suicide, substance abuse, and academic problems.
Q: How are trauma responses influenced?
A: They are dynamic and culturally influenced.
Q: How does cultural identity affect PTSD outcomes?
A: Strong cultural identity is linked to better long-term outcomes and fewer diagnoses.
Q: How does political oppression affect trauma outcomes?
A: It can lead to alienation and poorer outcomes.
Q: What percentage of at-risk individuals may develop PTSD?
A: Up to 60%.
Q: What factors influence the likelihood of developing PTSD?
A: Severity, duration, and proximity to the trauma.
Q: What are the most frequent traumatic events leading to PTSD in women?
A: Physical assault and rape.
Q: What percentage of physical assault victims develop PTSD?
A: One-fourth.
Q: What are the four core PTSD symptom categories?
A: Reexperiencing, Avoidance, Negative cognition/mood, and Hyperarousal.
Q: What are examples of reexperiencing symptoms?
A: Nightmares, intrusive thoughts, and flashbacks.
Q: What are avoidance symptoms?
A: Avoiding trauma-related thoughts, feelings, or stimuli.
Q: What are negative cognition/mood symptoms?
A: Persistent negative emotions, distorted beliefs, detachment.
Q: What are hyperarousal symptoms?
A: Being on guard, easily startled, irritable.
Q: What is the focus of therapy for DID?
A: Reassociation (integrating identities).
Q: What therapy risk exists for DID?
A: Highly persuasive psychotherapy may create false memories of childhood trauma.
Q: What is the focus of education after trauma?
A: Mental health promotion and prevention of pathologic responses.
Q: Why is early emotional expression important after trauma?
A: Suppressing or denying emotions increases PTSD risk.
Q: What coping strategies should clients be taught?
A: Stress management, relaxation, assertiveness, self-defense skills.
Q: What daily habits should be encouraged after trauma?
A: Maintaining routine, adequate sleep, healthy diet, avoiding alcohol/drugs, setting small goals.
Q: Why is social support important after trauma?
A: It reduces isolation and decreases PTSD risk.
Q: What should be assessed in trauma-related diagnoses?
A: Hyper-alertness, memory gaps, self-destructive thoughts, appetite changes, sleep disturbances.
Q: Should clients detail trauma during general assessments?
A: No, it is not necessary and may be triggering.
Q: What is the priority outcome in trauma care?
A: Physical safety, including suicide and self-harm assessment.
Q: What are additional goals in trauma care?
A: Non-destructive emotional expression and building social support.
Q: How should nurses address self-harm thoughts?
A: Discuss them directly and validate fears while increasing contact with reality.
Q: Why should clients be called “survivors” instead of “victims”?
A: It promotes empowerment and resilience.
Q: What are grounding techniques used for?
A: Managing flashbacks or dissociative episodes.
Q: How should nurses speak during grounding?
A: Calm, reassuring tone; remind the client they are safe and in the present.
Q: What is essential for nurses working with trauma survivors?
A: Professional boundaries and emotional regulation.
Q: Why is nurse self-care important?
A: To prevent projection and maintain therapeutic effectiveness.
Q: What should nurses seek if overwhelmed?
A: Peer support or personal counseling.
Q: What communication style should nurses use?
A: Nonjudgmental, empathetic, validating.
Q: What should nurses avoid saying to trauma survivors?
A: Platitudes like “Be glad you’re alive” or “It was meant to be.”