Week 7: NR606/ NR 606 (Latest Update 2024/ 2025) Diagnosis & Management in Psychiatric Mental Health II Practicum Review |Complete Guide with Questions and Verified Answers| 100% Correct- Chamberlain

Week 7: NR606/ NR 606 (Latest Update
2024/ 2025) Diagnosis & Management in
Psychiatric Mental Health II Practicum
Review |Complete Guide with Questions and
Verified Answers| 100% CorrectChamberlain
Q: How common are ACEs in adults?
Answer:
One in six adults have experienced four or more ACEs.
Q: What are the leading causes of death related to ACEs?
Answer:
Five or more of the top 10 leading causes of death.
Q: Who is at greater risk of experiencing four or more ACEs?
Answer:
Females and racial/ethnic minority groups.
Q: What is the ACE Pyramid?
Answer:
Conceptual framework for studying ACEs.

Q: What did the ACE study reveal?
Answer:
ACEs are strongly related to risk factors for poor health and social consequences.
Q: What did the ACE study identify?
Answer:
Risk factors for ACEs and informed prevention programs.
Q: What does the ACE Pyramid represent?
Answer:
Mechanisms by which ACEs influence health and well-being.
Q: What is at the top of the ACE Pyramid?
Answer:
Generational embodiment / Historical trauma.
Q: What is in the middle of the ACE Pyramid?
Answer:
Social conditions / Local context.
Q: What is at the bottom of the ACE Pyramid?
Answer:

Early death.
Q: What is disrupted by ACEs?
Answer:
Neurodevelopment.
Q: What impairments can result from ACEs?
Answer:
Social, emotional, and cognitive impairment.
Q: What behavior may be adopted as a result of ACEs?
Answer:
Health risk behavior.
Q: What problems can arise from ACEs?
Answer:
Disease, disability, and social problems.
Q: What are individual risk factors for ACEs?
Answer:
Factors specific to the individual’s circumstances.

Q: What is a lack of closeness to parents/caregivers?
Answer:
Emotional distance from parents or caregivers.
Q: What is early sexual activity?
Answer:
Engaging in sexual behavior at a young age.
Q: What does it mean to have few or no friends?
Answer:
Having a small or nonexistent social circle.
Q: What are friends who engage in aggressive or delinquent behavior?
Answer:
Peers who participate in violent or criminal activities.
Q: What are caregiving challenges related to children with disabilities, mental health issues, or
chronic physical illnesses?
Answer:
Difficulties faced by caregivers of children with special needs.
Q: What is a limited understanding of children’s needs or development?
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What did the CDC and Kaiser Permanente investigate? Childhood abuse, neglect, and stressful events
What did the study find? Strong relationship between ACEs and health risk behaviors and disease in adulthood
What did later studies find? ACEs increase likelihood of adversity, chronic illness, and early death
What are some examples of later studies? Boppre & Boyer (2021), LaNoue et al. (2020), Lee et al. (2020), Struck et al. (2021)
What are some examples of ACEs? Sexual or domestic violence, abuse, neglect, unsafe home environment.
How do ACEs affect the developing brain? They adversely affect brain structure and functioning.
What factors impact a child’s response to trauma? Frequency, seriousness, type of traumatic event, prior trauma history, and availability of support.
How common are ACEs in adults? One in six adults have experienced four or more ACEs.
What are the leading causes of death related to ACEs? Five or more of the top 10 leading causes of death.
Who is at greater risk of experiencing four or more ACEs? Females and racial/ethnic minority groups.
What is the ACE Pyramid? Conceptual framework for studying ACEs.
What did the ACE study reveal? ACEs are strongly related to risk factors for poor health and social consequences.
What did the ACE study identify? Risk factors for ACEs and informed prevention programs.
What does the ACE Pyramid represent? Mechanisms by which ACEs influence health and well-being.
What is at the top of the ACE Pyramid? Generational embodiment / Historical trauma.
What is in the middle of the ACE Pyramid? Social conditions / Local context.
What is at the bottom of the ACE Pyramid? Early death.
What is disrupted by ACEs? Neurodevelopment.
What impairments can result from ACEs? Social, emotional, and cognitive impairment.
What behavior may be adopted as a result of ACEs? Health risk behavior.
What problems can arise from ACEs? Disease, disability, and social problems.
What are individual risk factors for ACEs? Factors specific to the individual’s circumstances.
What is a lack of closeness to parents/caregivers? Emotional distance from parents or caregivers.
What is early sexual activity? Engaging in sexual behavior at a young age.
What does it mean to have few or no friends? Having a small or nonexistent social circle.
What are friends who engage in aggressive or delinquent behavior? Peers who participate in violent or criminal activities.
What are caregiving challenges related to children with disabilities, mental health issues, or chronic physical illnesses? Difficulties faced by caregivers of children with special needs.
What is a limited understanding of children’s needs or development? Lack of knowledge about child development and their requirements.
What are caregivers who were abused or neglected as children? Parents or caregivers who experienced abuse or neglect during their own childhood.
Who are young caregivers or single parents? Individuals who take care of children at a young age or without a partner.
What are the effects of low income or low levels of education? Negative impact of poverty and limited education on parenting.
What are high levels of parenting stress or economic stress? Significant stress experienced by parents due to financial or parenting challenges.
What is isolation in the context of risk factors? Being socially isolated or lacking a support network.
What are high conflict and negative communication styles? Frequent arguments and unhealthy communication patterns within the family.
What are attitudes accepting of or justifying violence or aggression? Beliefs that condone or rationalize violent or aggressive behavior.
What are high rates of violence and crime in the community? A community with a significant amount of violent and criminal activities.
What are high rates of poverty and limited educational and economic opportunities? A community with a large number of people living in poverty and lacking educational and economic prospects.
What are high unemployment rates? A community with a high percentage of people without jobs.
What is easy access to drugs and alcohol? Readily available substances that can be abused.
What are few community activities for young people? Limited opportunities for youth engagement and involvement in the community.
What is unstable housing and frequent resident movement? Lack of stable housing and frequent relocation of residents.
What is food insecurity? Lack of consistent access to nutritious and sufficient food.
What is intimate partner violence? Abuse or violence within a romantic or domestic relationship.
What is physical abuse? Parent or caregiver causing physical injury to a child.
What percentage of child maltreatment cases involve physical abuse? Approximately 10%.
What are some effects of physical abuse on children? Struggle with self-esteem, social relationships, trust, stress reactions.
What is sexual abuse? Any interaction where a child is used for sexual gratification.
What percentage of child maltreatment cases involve sexual abuse? Approximately 7%.
What are some long-term consequences of sexual abuse? Increased risk for substance abuse, risky sexual behaviors, self-harm, PTSD, depression, and anxiety.
What is child neglect? Failure to provide for a child’s needs.
What percentage of child maltreatment cases involve neglect? Approximately 60%.
What are some age-appropriate needs that can be neglected? Food, shelter, clothing, education, medical care, supervision, and emotional needs.
What can neglect result in? Long-lasting physical or psychological harm.
What is neglect often tied to? Poverty.
What are some signs of neglect in children? Poor hygiene, inadequate weight gain, inappropriate clothing.
What is household instability? Contributing factor to adverse childhood experiences (ACEs).
What can cause family instability? Parental mental illness, stress, substance abuse, or suicide.
How does parental mental health problems affect children? Positively associated with mental health problems in children and adolescents.
What is a risk factor for family instability? Violence toward the mother in the family.
What can children exposed to family instability struggle with? Social, cognitive, or behavioral difficulties.
What can cause instability in children? Loss of a parent or caregiver due to death, divorce, abandonment, or incarceration.
How many children worldwide lost a parent or caregiver due to the COVID-19 pandemic? Over 5.2 million by 2022.
Why was the loss of a parent or caregiver included in the National Survey of Children’s Health? Due to its profound impact on a child’s psychological well-being.
What are cultural challenges? Challenges related to a person’s cultural background.
How does community violence affect children? Can have negative effects on their well-being and development.
What are some examples of community violence? Gang violence, shootings, or domestic violence.
How can cultural challenges impact children? Can affect their sense of identity, belonging, and well-being.
What are some examples of cultural challenges? Language barriers, discrimination, or conflicting cultural values.
What is community violence? Exposure to interpersonal violence in public settings
Give examples of community violence. Shootings, fights, bullying, war, terrorist attacks
What is bullying? Aggression or harassment causing harm to someone perceived as less powerful
What are the types of bullying? Physical, verbal, social, cyberbullying
What is cyberbullying? Bullying that occurs through electronic means
What are the effects of bullying? Stress, trauma, anger, isolation, poor self-esteem, school issues, health problems, self-injury, eating disorders, suicidal or homicidal thoughts
What are the effects of community violence? Heightened fear and stress
What is peer victimization? Another term for bullying
What is the definition of racism? Discrimination based on race
What is structural racism? Systemic discrimination embedded in institutions and policies
What are traumatic stress reactions? Psychological responses to traumatic events
What is school avoidance? Avoiding school due to bullying or other reasons
What is racism? System of assigning value based on physical properties.
Give an example of overt racism. Hate crimes and slurs.
Give an example of subtle racism. Discrimination, marginalization, prejudice in everyday interactions.
What are the potential health consequences of racism? Health disparities, trauma.
How is racism considered a major life stressor for Black youth? Bernard et al. propose it as a culturally informed ACE.
What are the lasting health consequences of childhood adversity perpetuated by racism? Health disparities.
Give examples of ACEs that place a child in immediate physical danger. Traumatic brain injury, fractures, burns.
What are some mental health consequences of ACEs? Depression, anxiety, PTSD.
How can ACEs impact maternal health? Unintended pregnancy, pregnancy complications, fetal death.
What infectious diseases can be impacted by ACEs? HIV, STDs.
What are some physical health consequences of ACEs? Cancer, diabetes.
What risky health behaviors can be influenced by ACEs? Alcohol and drug abuse, unsafe sex.
What are some autoimmune disorders that can be increased by ACEs? Arthritis.
What is the relationship between ACEs and type 2 diabetes? Increased risk.
What are some mental illnesses that can be influenced by ACEs? Depression, anxiety, PTSD.
What are some risky behaviors associated with ACEs? Substance use disorder, suicide, unemployment.
What are the potential impacts of ACEs on education, occupation, and income? Opportunity disparities.
How does the wounded child adapt? Develops protective behaviors that hinder healthy relationships.
What is the wounded child? A young, vulnerable child wounded by abuse or neglect.
What are some characteristics of the wounded child? Overwhelmed, longing for connection, focus of trauma work.
Who usually brings dysfunction into adult relationships? Not usually the wounded child.
What is the adaptive child? A child’s version of an adult that protects the wounded child.
What are some characteristics of the adaptive child? Perfectionist, sees world in black and white, cares only about self-preservation.
How does the adaptive child view intimacy? As a threat.
Who does the adaptive child react to and identify with? Both the aggressor and themselves.
What is the functional adult? The part of the psyche that makes thoughtful decisions.
What are some characteristics of the functional adult? Mature, thoughtful, forgiving, understands trauma’s impact on relationships.
How is the functional adult different from the child parts? Adaptable and capable of learning and using new skills.
According to Terry Real, who creates problems in a client’s relationships? The adaptive child.
What do interventions need to focus on? The adaptive child to engage the functional adult.
What is the ACE questionnaire? Assessment of childhood adversity exposure.
What does a high ACE score indicate? High exposure to adversity in childhood.
Does a high ACE score guarantee negative outcomes? No, it does not guarantee negative outcomes.
What can providers do to support children with high ACE scores? Teach stress-reduction techniques and positive coping skills.
How can parent training help caregivers? Learn healthy ways to manage child behaviors.
What can early childhood programs provide? Protective factors for positive development in young children.
What is resilience? Ability to adapt and recover from adversity.
What are some factors that promote resilience? Close relationships, positive parenting, sense of purpose, individual competencies, social connections, support services, community support.
What does trauma-informed care mean? Approach that recognizes and responds to the impact of trauma.
What are the six guiding principles of trauma-informed care? Understanding trauma’s impact, determining treatment plan, avoiding retraumatization.
Why is trauma-informed care important? To effectively care for clients who have experienced adversity.
What can trauma-informed care help providers with? Better understanding the impact of trauma and developing appropriate treatment plans.
What does trauma-informed care aim to avoid? Retraumatization of clients.
What can providers do to enhance resilience? Enhance biological and developmental characteristics, provide external protective factors.
What can resilience help offset? Neurobiological changes associated with trauma.
What does resilience protect? Developing brain, immune system, and body from negative effects of trauma.
What is the role of caregivers in promoting resilience? Close relationships and positive parenting skills.
What are some individual competencies that promote resilience? Problem-solving skills, self-regulation, autonomy.
What are some community resources that support resilience? Access to support services for parents and families, community support resources.
What is safety in trauma-informed care? Creating physical and psychological safety to avoid retraumatization.
Why is trust and transparency important in trauma-informed care? Establishing a therapeutic alliance and empowering intake procedures.
How does peer support contribute to trauma-informed care? Fosters safety, hope, and healing through shared experiences.
What is the role of collaboration in trauma-informed care? Empowering clients to be active in treatment decisions.
How does empowerment and choice impact trauma-informed care? Gives clients a sense of control and promotes self-efficacy.
Why is cultural, historical, and gender awareness important in trauma-informed care? Acknowledges trauma related to culture, history, or gender identity.
What are some psychological distress symptoms after a traumatic event? Anxiety, fear, anhedonia, anger, aggression, dissociative symptoms
What are some long-term reactions to traumatic events? Depression, anxiety, behavioral changes, academic difficulties
When do symptoms often present in children? When reminded of the traumatic event
What manual provides diagnostic criteria for disorders associated with traumatic events? DSM-5-TR
What percentage of adolescents experience PTSD each year? Approximately 5%
What are some factors that increase the risk of developing PTSD? Prior trauma, adverse childhood experiences, personal or family history of psychiatric disorders, female gender, severe trauma exposure
What are some consequences of PTSD? Social, occupational, and physical impairment, physical health problems, reduced quality of life, increased risk of suicide
What are some common comorbidities with PTSD? Major depressive disorder, anxiety disorder, substance use disorder
What is PTSD? Occurs after exposure to death, injury, or violence.
What are intrusion symptoms? Recurrent memories, nightmares, flashbacks, distress when exposed to trauma cues.
What are avoidance symptoms? Avoidance of distressing memories, reminders of the trauma.
What are negative cognitive or mood symptoms? Memory deficits, negative beliefs, distorted cognitions, persistent negative emotions.
What are arousal or reactivity symptoms? Irritability, aggression, risk-taking, hypervigilance, concentration difficulty, startle response, sleep disturbances.
When do symptoms of PTSD typically begin? Within the first 3 months after the traumatic event.
How long must symptoms persist for a PTSD diagnosis? At least 1 month.
What are some examples of traumatic events that can cause PTSD? Actual or threatened death, serious injury, sexual violence.
Can PTSD be caused by exposure to traumatic events through media? No, the source of exposure must not be through media.
Can witnessing a traumatic event cause PTSD? Yes, witnessing a traumatic event can cause PTSD.
Can learning about the violent or accidental death of a loved one cause PTSD? Yes, learning about the death of a loved one can cause PTSD.
What are some examples of intrusion symptoms in children? Repetitive play expressing themes of the trauma.
What are some examples of avoidance symptoms? Avoidance of distressing memories, thoughts, feelings, and reminders of the trauma.
What are some examples of negative cognitive or mood symptoms? Memory deficits, negative beliefs, distorted cognitions, persistent negative emotions, detachment from others, inability to experience positive emotions.
What are some examples of arousal or reactivity symptoms? Irritability, aggression, risk-taking, hypervigilance, concentration difficulty, exaggerated startle response, sleep disturbances.
What are some examples of sleep disturbances in PTSD? Difficulty falling asleep, staying asleep, or having nightmares.
What are screening instruments used for in children? To assist with the diagnosis of trauma.
How are screening tools selected for children? Based on the age of the child.
Who completes the screening tool for children under the age of 6? Parent or caregiver.
Who may complete the screening for children ages 7-17? Both the child and parent.
What are some evidence-based treatments for children and adolescents with PTSD? Trauma-focused cognitive behavior therapy (TF-CBT), eye movement desensitization and reprocessing (EMDR), narrative exposure therapy, and classroom-based interventions.
What types of therapy can be used for the treatment of PTSD in children and adolescents? Individual or group-based therapy.
Why is parental involvement important in the treatment of children and adolescents with PTSD? To help establish family resilience.
What is acute stress disorder? A diagnosis given when a child or youth experiences symptoms after a traumatic event.
What are some symptoms of acute stress disorder? Intrusive thoughts, negative mood, dissociative symptoms, avoidance, or arousal symptoms.
How long do the symptoms of acute stress disorder typically last? From three days to 1 month immediately following exposure to the traumatic event.
What are some additional symptoms that clients with acute stress disorder may experience? Catastrophic thoughts, panic attacks, guilt, separation anxiety (in young children), and post-concussive symptoms.
What are post-concussive symptoms? Symptoms such as headaches, sensitivity to light, difficulty concentrating, irritability, and dizziness that can occur even without a head injury.
Which type of trauma is associated with a higher incidence of acute stress disorder? Interpersonal trauma, such as assault or rape.
What types of trauma can lead to acute stress disorder? Interpersonal trauma (assault, rape) or traumatic motor vehicle/industrial accidents.
What is the difference between acute stress disorder and PTSD? Acute stress disorder occurs immediately following a traumatic event and lasts up to 1 month, while PTSD is diagnosed when symptoms persist for longer than 1 month.
What is the timeframe for diagnosing acute stress disorder? Symptoms must last from three days to 1 month immediately following exposure to the traumatic event.
What is the incidence of acute stress disorder compared to traumatic motor vehicle or industrial accidents? Higher in clients who experienced interpersonal trauma (assault, rape).
What are dissociative symptoms? Depersonalization and derealization.
What is the Structural Dissociation Model? A model that explains the internal conflict between defense and attachment systems.
What is the defense system in the Structural Dissociation Model? The system that shields a child from harm.
What is the attachment system in the Structural Dissociation Model? The system that seeks love and care from a parent.
What can happen when the defense and attachment systems conflict? Conflicting parts can separate, leading to a split sense of self and dysregulated nervous system.
How many symptoms must be present for a diagnosis of acute stress disorder? Nine symptoms of intrusion, negative mood, dissociation, avoidance, or arousal.
When do symptoms of adjustment disorders typically develop? Within 3 months of the onset of a new stressor.
How long do symptoms of adjustment disorders persist? They do not persist past 6 months after the initial stressor has resolved.
When can persistent adjustment disorder occur? When stressors have no clear resolution, such as physical disability or living in a community with high crime rates.
Who is at high risk for adjustment disorders? Children with multiple adverse childhood experiences (ACEs).
What are the specifiers used to classify adjustment disorders? Depressed mood, anxiety, mixed anxiety and depressed mood, disturbance of conduct, mixed disturbance of emotions and conduct.
What is the initial treatment for adjustment disorders? Family therapy and/or individual therapy
What is the purpose of parent training in adjustment disorders? To ensure consistent addressing of behavior problems
When is medication used in adjustment disorders? If symptoms persist beyond 6 months
What is reactive attachment disorder (RAD)? A trauma- and stressor-related condition where a child fails to form an emotional bond with caregivers
What are common causes of RAD? Abandonment, severe neglect, or maltreatment
What are the characteristics of children with RAD? Difficulty forming emotional attachments, decreased ability to experience positive emotions, inability to seek or accept physical or emotional closeness, violent reactions to attempts of holding or cuddling
How do children with RAD behave? Unpredictable behavior and moods, living in a constant state of fight, flight, or freeze mode, difficult to discipline or console
Do children with RAD struggle even with treatment? Yes
What can be helpful for children with RAD? Early identification and intervention
What is critical in the care of children with RAD? Parent education and support
What kind of team is involved in the care of children with RAD? An interprofessional team of providers
What is prolonged grief disorder? Persistent, maladaptive grief causing significant impairment in functioning.
How long do symptoms of prolonged grief disorder persist in adults? At least one year following the death of a loved one.
How long do symptoms of prolonged grief disorder persist in children and adolescents? 6 months following the death of a loved one.
What are some symptoms of prolonged grief disorder? Disbelief, avoidance, emotional pain, difficulty engaging, loneliness, meaninglessness.
How do children express distress in prolonged grief disorder? Through play, behavior changes, regression, separation anxiety.
What are some specific behaviors children may exhibit in prolonged grief disorder? Excessive worry about health, asking questions about death.
How might children with prolonged grief disorder feel different from their peers? Difficulty with loss reminders at school or with peers.
What feelings might adolescents with prolonged grief disorder endorse? Feelings of ‘giving up’ on hopes and aspirations.
What are some consequences of prolonged grief disorder? Increased substance use, risk for cardiovascular disease, risk of dropping out of school.
What are some potential interventions for clients with prolonged grief disorder? Referral to grief specialist, bereavement support groups.