Author Question: A young adult says, I was sexually abused by my older brother. During those assaults, I went ... (Read 89 times)

geodog55 · **on:** Jul 19, 2018

A young adult says, I was sexually abused by my older brother. During those assaults, I went somewhere else in my mind. I don't remember the details. Now, I often feel numb or unreal in romantic relationships, so I just avoid them.

Which disorders should the nurse suspect based on this history? Select all that apply.

a. Acute stress disorder
b. Depersonalization disorder
c. Generalized anxiety disorder
d. Posttraumatic stress disorder
e. Reactive attachment disorder
f. Disinhibited social engagement disorder

Question 2

Which experiences are most likely to precipitate posttraumatic stress disorder (PTSD)? Select all that apply.

a. A young adult bungee jumped from a bridge with a best friend.
b. An 8-year-old child watched an R-rated movie with both parents.
c. An adolescent was kidnapped and held for 2 years in the home of a sexual predator.
d. A passenger was in a bus that overturned on a sharp curve and tumbled down an embankment.
e. An adult was trapped for 3 hours at an angle in an elevator after a portion of the supporting cable breaks.

welcom1000 · **Reply #1 on:** Jul 19, 2018

Answer to Question 1

ANS: A, B, D
Acute stress disorder, depersonalization disorder, and posttraumatic stress disorder can involve dissociative elements, such as numbing, feeling unreal, and being amnesic for traumatic events. All three disorders are also responses to acute stress or trauma, which has occurred here. The distracters are disorders not evident in this patient's presentation. Generalized anxiety disorder involves extensive worrying that is disproportionate to the stressors or foci of the worrying. Reactive attachment disorder and disinhibited social engagement disorder are problems of childhood.

Answer to Question 2

ANS: C, D, E
PTSD usually occurs after a traumatic event that is outside the range of usual experience. Examples are childhood physical abuse, torture/kidnap, military combat, sexual assault, and natural disasters, such as floods, tornados, earthquakes, tsunamis; human disasters, such as a bus or elevator accident; or crime-related events, such being taken hostage. The common element in these experiences is the individual's extraordinary helplessness or powerlessness in the face of such stressors. Bungee jumps by adolescents are part of the developmental task and might be frightening, but in an exhilarating way rather than a harmful way. A child may be disturbed by an R-rated movie, but the presence of the parents would modify the experience in a positive way.