CTRI Study Guide 2025/2026 Exam
Questions and Verified Answers |
Already Graded A+
What is the most significant public health problem in the US according to
the CDC? - 🧠ANSWER ✔✔Childhood Trauma
How many people affected by Childhood Trauma? - 🧠ANSWER ✔✔1
million children suffer physical and sexual abuse each year
1 in 10 children exposed to intrafamilial violence
Adverse Childhood Experiences - 🧠ANSWER ✔✔ACEs
Mechanisms by Which ACES influence health and wellbeing (pyramid) -
🧠ANSWER ✔✔-disrupted neurodevelopment
-social, emotional, cognitive impairment
,-adaption of health-risk behaviors
-disease disability and social problems
-early death
Impact of Trauma on Emotional/Behavioral Stress - 🧠ANSWER ✔✔-History
of trauma increases likelihood of substance abuse; mental illness - and vice
versa
-Substance abuse and MI decrease a person's ability to mitigate the effects
of trauma and prevent future trauma
-interpersonal trauma increases likelihood of future trauma
Characteristics of ACEs - 🧠ANSWER ✔✔-come in groups
-produce behaviors that if sustained, created illness and disease = as a
coping strategy (smoking)
-Cumulative ACEs increase clinical complexity of individual case (# of
lifetime mental health diagnoses increases)
Clinical Complexity - 🧠ANSWER ✔✔ACEs --> complex, multiple problems
-treatment of presenting problems may not be the best path to significant
change
,-multiple disciplinary approaches may be most effective
Factors that increase difficulty of trauma recovery - 🧠ANSWER ✔✔-
repeated or prolonged trauma
-closer the perp is to the victim emotionally (capacity of victim to trust in the
future)
-intentional action vs. accidents
Why does childhood experience matter so much? - 🧠ANSWER ✔✔-child
cannot escape the problem (especially under 5 y/o)
-don't have good affect-regulation skills yet
-no control over when and how often
-abused children extremely in tune to minute changes in a persons
emotional state
Betrayal Trauma - 🧠ANSWER ✔✔when the abuser is a primary attachment
figure
-particularly difficult for later intimate relationships ---entangles emotional
closeness and care with fear, shame and rage [sexually abusive, nice dad
and very physically abusive mom]
3
COPYRIGHT©JOSHCLAY 2025/2026. YEAR PUBLISHED 2025. COMPANY REGISTRATION NUMBER: 619652435. TERMS OF USE. PRIVACY
STATEMENT. ALL RIGHTS RESERVED
, -very basic sense of self as bad, disgusting and worthless
Hyperarousal vs. Hypoarousal - 🧠ANSWER ✔✔Very aware of surroundings
(PTSD -like)
vs.
Feeling numb
It is common to flip flop
-often attempt to shut off negative feelings, which would require shutting off
positive ones too (feeling numb)
Regulation of Emotions - 🧠ANSWER ✔✔Frequent episodes of intense
dysregulation in childhood lead to harsh difficulties regulating emotions
later.
-If a child is scared and a parent screams at the child - escalates these
feelings. Child learns that when you get emotional - things get worse.
-Example: VERY angry about being "disrespected" for being 15 minutes
late to an appointment
Triggering - 🧠ANSWER ✔✔-Memory and emotion are both associative.
Questions and Verified Answers |
Already Graded A+
What is the most significant public health problem in the US according to
the CDC? - 🧠ANSWER ✔✔Childhood Trauma
How many people affected by Childhood Trauma? - 🧠ANSWER ✔✔1
million children suffer physical and sexual abuse each year
1 in 10 children exposed to intrafamilial violence
Adverse Childhood Experiences - 🧠ANSWER ✔✔ACEs
Mechanisms by Which ACES influence health and wellbeing (pyramid) -
🧠ANSWER ✔✔-disrupted neurodevelopment
-social, emotional, cognitive impairment
,-adaption of health-risk behaviors
-disease disability and social problems
-early death
Impact of Trauma on Emotional/Behavioral Stress - 🧠ANSWER ✔✔-History
of trauma increases likelihood of substance abuse; mental illness - and vice
versa
-Substance abuse and MI decrease a person's ability to mitigate the effects
of trauma and prevent future trauma
-interpersonal trauma increases likelihood of future trauma
Characteristics of ACEs - 🧠ANSWER ✔✔-come in groups
-produce behaviors that if sustained, created illness and disease = as a
coping strategy (smoking)
-Cumulative ACEs increase clinical complexity of individual case (# of
lifetime mental health diagnoses increases)
Clinical Complexity - 🧠ANSWER ✔✔ACEs --> complex, multiple problems
-treatment of presenting problems may not be the best path to significant
change
,-multiple disciplinary approaches may be most effective
Factors that increase difficulty of trauma recovery - 🧠ANSWER ✔✔-
repeated or prolonged trauma
-closer the perp is to the victim emotionally (capacity of victim to trust in the
future)
-intentional action vs. accidents
Why does childhood experience matter so much? - 🧠ANSWER ✔✔-child
cannot escape the problem (especially under 5 y/o)
-don't have good affect-regulation skills yet
-no control over when and how often
-abused children extremely in tune to minute changes in a persons
emotional state
Betrayal Trauma - 🧠ANSWER ✔✔when the abuser is a primary attachment
figure
-particularly difficult for later intimate relationships ---entangles emotional
closeness and care with fear, shame and rage [sexually abusive, nice dad
and very physically abusive mom]
3
COPYRIGHT©JOSHCLAY 2025/2026. YEAR PUBLISHED 2025. COMPANY REGISTRATION NUMBER: 619652435. TERMS OF USE. PRIVACY
STATEMENT. ALL RIGHTS RESERVED
, -very basic sense of self as bad, disgusting and worthless
Hyperarousal vs. Hypoarousal - 🧠ANSWER ✔✔Very aware of surroundings
(PTSD -like)
vs.
Feeling numb
It is common to flip flop
-often attempt to shut off negative feelings, which would require shutting off
positive ones too (feeling numb)
Regulation of Emotions - 🧠ANSWER ✔✔Frequent episodes of intense
dysregulation in childhood lead to harsh difficulties regulating emotions
later.
-If a child is scared and a parent screams at the child - escalates these
feelings. Child learns that when you get emotional - things get worse.
-Example: VERY angry about being "disrespected" for being 15 minutes
late to an appointment
Triggering - 🧠ANSWER ✔✔-Memory and emotion are both associative.
