Certified Clinical Trauma Specialist: Trauma and Addiction (2021)

Welcome to your Certified Clinical Trauma Specialist: Trauma and Addiction (2021)

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What was found in the brain scan of cocaine abusers?

Increase in white matter integrity

Reduction of dopamine D2 receptors

Increase in grey matter density

Reduction of brain’s basal ganglia

What is the neocortex involved with?

Abstract representation, social behavior, decision making

Converting short-term memory to long-term memory

Relaying all senses except for smell

Autonomic arousal, sensory information, body processing

How can an individual motivate trauma clients?

Utilize long term goals

Decrease distress tolerance

Focus on the year rather than the week

Address avoidance with curiosity

What is implicit memory?

Information one consciously works to remember

An example would be recalling animals that live in the sea

The memory of everyday events

Body and tactile memory

What is a intrusion symptom of PTSD?

Withdrawal and isolation

Maladaptive behaviors such as drug/alcohol use

Flashbacks or dissociative experiences

Avoidance of people, places, and things that are reminders of trauma

What fraction of individuals with 7+ ACEs have heart disease?

1 in 14

1 in 30

1 in 7

1 in 6

What assessment can be used for trauma history and treatment planning?

Trauma Recovery Scale

Graphic Timeline

PCL-5

Session Rating Scale (SRS)

What does oxytocin enable?

Attachment, trust, connection

Self-worth, positive self-image

Euphoria, decreased anxiety

Motivation, learning, goal setting

What is an example of a process addiction?

Caffeine

Hallucinogens

Stimulants

Exercise

How can a clinician support the recovery of people with histories of adversity?

Share vivid, descriptive examples of failure

Focus on behavior and emotion rather than environment

Start trying to intervene with “the Hulk”

Discuss real stumbling blocks and how people deal with them

Which of the following questions asks about the degree of recovery?

If you were to break recovery into 7 or 8 steps, what do you think they would be?

How much improvement would you need to make to feel some real difference?

What would be required on your/family part to shorten the time required for recovery?

How long did it take to get this problem to this stage?

Which of the following questions about symptoms asks about duration?

When has it stopped immediately?

When does the problem occur?

What have you discovered that increases how much it happens?

Is there anywhere the problem does not occur?

When the balance system (ANS) is dysregulated, it responds with ___________

Intentionality

Growth and learning

Survival strategies

Vagal brakes

Which of the following is NOT a principle of a trauma sensitive organization?

Trustworthiness and transparency

Dependence on binaries

Collaboration and mutuality

Peer support and mutual self-help

Which of the following is NOT included in the format to give information?

Disregard sharing how each activity connects within the overviewed material

Summarize by embedding them in a success story

Overview/orient

Ask for their feedback (e.g., As you move through this situation, what do you expect you will experience?)

Which of the following is NOT included in Stage 2: Psychoeducation and Self-regulation?

Normalize perceptions of self, significant relationships, and the world view

Increase understanding around causes, symptoms, and treatment of traumatic stress to provide comprehensive psychoeducation to clients

Create a common language to enhance relational connection

Move discussion away from physiology and towards emotions and psychological states

Which of the following is NOT an attribute of pathogenesis?

Paternalistic

Capacity building

Curative

Disease-centric

Which of the following is NOT included in Stage 1: Preparation and Relationship Building?

Avoid sharing personal weaknesses and biases

Review pacing differences

Discuss how transitions are approached in treatment

Create as many success visuals as possible

Which of the following is NOT a criterion for intermittent explosive disorder?

Age is under 6 years old

Magnitude of aggressiveness is grossly out of proportion to stressor

Aggressive outbursts are impulsive, or anger based

Verbal of physical aggression occurring 2x weekly for 3 months

What do pathogenic approaches address?

Whole person

Lifestyle

Deficits

Prevention

What can sensory integration rooms be used for?

Provide symptom tracking, instant access to support, connection with communities, daily meditations, mindfulness tools, etc.

Create dynamic, 3-D stimulus environments and allows for the recording of behavioral and physiological responses providing clinical assessment options

Help clients identify emotions, understand why they are feeling this way, and learn how to calm themselves without the use of substances

Reduce or eliminate the geographic distance causing spatial barriers for patients to receive care and treatment

What happens when there is increased potentiated reactivity?

Pausing before reacting

Shorter space between stimulus and response

Weighing consequences before acting

Consistent self-control

Which of the following is NOT a question that one should ask themselves to promote personal growth?

How are you making sure you are growing past your upsets, failures, and/or disappointments?

What is your plan to grow tomorrow, and then the next day and the next day?

What have you done today “on purpose with a plan” to improve your character, talents, skills, and relationships?

What did you do wrong today and how will you make sure it does not happen again in the future?

Which of the following is NOT a way that an individual could be invited to engage in the social dominance game?

If the individual perceives status, power, or role is respected

If the individual perceives attention is being forced

If the individual perceives a restriction of movement and action

If the individual perceives that someone is trying to exert control

Which of the following is NOT expected in sympathetic dominance?

Reduced ability to express resilience and self-regulation strategies

Increased volatile, reactive behaviors

Reduction in recognizing social cues

Increase in expressing verbally and modulating emotion

What is the limbic system responsible for?

Learning, memory, and coping with stress

Involuntary physiologic processes (e.g., heart rate, blood pressure, etc.)

Delivering oxygen and nutrients to cells

Movement and muscle contraction

How can an individual avoid activating someone’s “sore spots”?

By never relying on assumptions

By always laying on additional demands

By directly asking what happened

By judging behavior, thinking, and emotions

What are the two categories of ACEs?

Discrimination and household dysfunction

Abuse or neglect and socioeconomic status

Distress and deviance

Abuse or neglect and household dysfunction

Which of the following is NOT an attribute of an optimal living environment?

Goals that inspire the individual or whole family

Self-awareness used to monitor behavior

Connecting with the spiritual, or universal

Series of tasks rather than a purpose

Which of the following is NOT an indication of an integrated brain?

Attunement to others

Ability to isolate

Sequential memory

Logic and reason

A trauma informed lens ___________

Looks at the person and the behavior as a problem

Encourages authoritarian control through power and force

Validates the humanity of the individual

Marginalizes and criticizes the individual

How long does it take for a single dose of the fiery cocktail to metabolize?

Seconds

Minutes

Hours

It metabolizes immediately

What can one do to build their inner resources daily?

Rewiring the brain by focusing on pathology

Connecting to nature

Asking questions like, “what’s wrong with you?”

Practicing compassion and kindness except for in annoying circumstances

What is the bottom-up method from Bessel Van der Kolk?

Allowing the body to have experiences that deeply and viscerally contradict the helplessness, rage, and collapse that result from the trauma

Talking, connecting with others, learning, cognitive processing

Medications to shut down inappropriate alarm reactions, other therapies, changes the way the brain organizes information

Changes in thinking that will positively affect emotions and then the body

Which of the following is NOT relational-developmental trauma?

Emotional neglect

Unstable environment

Natural disaster

Attachment trauma

What percentage of U.S. adults indicate they have a family member/close friend who is addicted to drugs or has been in the past?

37%

46%

53%

62%

Which of the following is NOT provided by the integrated brain?

Impulse control

Reward evaluation

Evaluation and planning

Erratic thinking/behavior

Which of the following statements about the vagus nerve is false?

It is the 9th cranial nerve extending from the medulla oblongata to the pharynx

It provides the nervous system with critical information

It connects several major organs such as lungs, heart, stomach, and intestines

It regulates heart rate variability

Changes in the hormones and biochemistry of the body lead to _____ changes in behavior, emotions, and thinking

Abnormal

Problematic

Predictable

Volitional

How can a clinician show cultural humility and competence?

Expect people of color to educate them

Avoid making client’s culture and worldview a priority

Maintain a commitment to continually grow and change over time

Change the subject away from perspectives, beliefs, and values

Which of the following does NOT indicate that a client is ready to begin exposure work?

Ability to distinguish being safe from feeling safe

Clinician is needed to help client regulate from abreaction

Informed consent for resolution of trauma memories

Ability to self-regulate while confronting perceived threats and imaginal exposure

What happens when the body moves into sympathetic dominance?

Diaphragm muscles relax

Inhibited insulin production

Maintaining baseline blood pressure

Minimal or no muscle tension

In 2008, what was the prevalence of PTSD in SUD clients in comparison to the general population?

13x higher

13x lower

17x higher

17x lower

Which of the following is NOT a way to stimulate the vagus nerve?

Loud singing, chanting, or humming

Yoga poses (such as twists)

Inhaling longer than exhaling

Cold water immersion

Which of the following is NOT a core feature in resilience?

Intentional applications of personal strengths

Appreciation of life except when faced with stressors

Exploring new possibilities

Relating to others, reconnecting or creating new connections

Which of the following statements is false about the reptilian brain?

It is indistinctive, automatic

It aids in the functioning of the heart, lungs, intestines, throat/larynx via the pharyngeal nerve

It is the oldest, primitive part of the brain

It is everything individuals have in common with a lizard

What is an example of tolerable stress?

Presence of buffering, caring adult

Temporary, mild elevation in stress hormones

Disrupted development of brain and immune system

Lifelong consequences for poor health outcomes

What is indicative of a substance use disorder rather than addiction?

Cannot stop behavior by act of will

Current use of alcohol/drugs causes clinically significant impairment

Dissociative experiences

Self-administered analgesia

Which of the following statements is false regarding epigenetics and addiction?

Chemical signatures can be temporary or permanent

Genes are turned on and off due to environmental factors

There are no genes for mental health conditions

Genes can cause addiction

What is a common medication to treat alcohol use disorder?

Buprenorphine

Naloxone

Disulfiram

Methadone

Which of the following is NOT how the human body reacts to threat, toxic stress, or adversity?

Muscles tighten throughout the body

Hypothalamus activates the adrenal glands

Liver produces extra insulin resulting in low levels of glucose in the blood

Stress hormones affect the respiratory and cardiovascular systems

Which statement about memory is true?

Attention is always focused on everything in the environment

Memory is built on the foundation of relevance

Energy competition in the brain is high in parasympathetic dominant states

Memory is always reliable

Which of the following is NOT one of the four R’s from SAMHSA?

Resist re-traumatization

Realize

Recognize

Reactivate

Which of the following is NOT a step to interoception?

Learn to calm, relax, and reduce arousal in the limbic system

Detect what in the environment is activating the limbic shift

Practice detecting and reducing limbic shifts at higher thresholds

Recognize when a limbic shift is occurring

What can happen when there is reduced serotonin in the body?

An interruption in sequential memory

Loneliness, stress, alienation

A reduction in ability to reality check

Low self-esteem, hopelessness, panic attacks

Which of the following is NOT a hippocampal function

Connects separate brain regions as part of active integration

Serializes and/or sequences time within a context

Enhances executive functioning and cognitive flexibility

Modifies and governs hypothalamus function

What is a behavioral salutogenic attribute?

Alcohol and drugs

Intimacy/empathy

Meaning/purpose

Cultural identity

Which of the following is NOT associated with SUD and PTSD?

Increased physical health problems

Poorer social functioning

Lower rates of suicide attempts