Trauma-Informed Care - Questions with Correct Answers
(Verified Update)
1. How does SAMHSA define individual trauma?
Answer: Trauma results from an event, series of events, or set of circumstances experienced by an
individual as physically or emotionally harmful or life-threatening, with lasting adverse effects on the
person's functioning and mental, physical, social, emotional, or spiritual well-being.
2. What are SAMHSA's 'Three E's' of trauma?
Answer: Event(s), Experience of the event(s), and Effect(s).
3. What primarily determines whether an event is traumatic?
Answer: Not the event itself but the individual's experience of it and the meaning they make of it - the
same event can be traumatic for one person and not another.
4. Can a person be traumatized by witnessing an event rather than experiencing it directly?
Answer: Yes. Witnessing violence (e.g., a child seeing domestic violence) or learning of harm to a
loved one can be traumatic.
5. What are Adverse Childhood Experiences (ACEs)?
Answer: Potentially traumatic events occurring before age 18, such as abuse (physical, emotional,
sexual), neglect, and household dysfunction (domestic violence, parental substance use, mental
illness, incarceration, separation/divorce).
6. What did the original CDC-Kaiser ACE Study (1998) show?
Answer: A dose-response relationship: the more ACEs a person has, the higher their risk of chronic
disease, mental illness, substance use, and early death in adulthood.
7. True or False: Trauma can occur at any point in the life span.
Answer: True.
8. What is acute (Type I / single-incident) trauma?
Answer: Trauma resulting from a single, time-limited event, such as an accident, assault, or natural
disaster.
9. What is complex (Type II) trauma?
Answer: Repeated, prolonged, often interpersonal trauma, frequently beginning in childhood (e.g.,
ongoing abuse or neglect), from which escape is difficult.
10. What is developmental trauma?
Answer: Trauma occurring during childhood that disrupts normal physical, emotional, cognitive, and
relational development (e.g., abuse, neglect, witnessing violence at home).
11. What is historical trauma?
Answer: Cumulative emotional and psychological wounding across generations, resulting from
massive group trauma such as colonization, genocide, slavery, or forced removal (e.g., Indigenous
residential schools, the Holocaust).
12. What is intergenerational (transgenerational) trauma?
Answer: Trauma transmitted from survivors to their children and later generations through parenting
patterns, family dynamics, and possibly biological mechanisms.
13. What is vicarious (secondary) trauma?
Answer: Trauma-like reactions experienced by helpers and professionals through repeated
exposure to the traumatic stories and experiences of the people they serve.
, 14. Distinguish interpersonal from external (non-interpersonal) trauma, with examples.
Answer: Interpersonal: harm caused by people - child abuse, sexual assault, domestic or elder
abuse. External: war, natural disasters, poverty, sudden loss of job or family.
15. Name the five domains in which effects of trauma may appear.
Answer: Physical, emotional, behavioural, cognitive, and spiritual.
16. Give examples of physical effects of trauma.
Answer: Sleep disturbance, chronic pain, headaches, gastrointestinal problems, fatigue,
hyperarousal, and elevated risk of chronic disease.
17. Give examples of emotional effects of trauma.
Answer: Fear, anxiety, depression, anger, shame, guilt, numbness, and difficulty regulating
emotions.
18. Give examples of cognitive effects of trauma.
Answer: Poor concentration, memory gaps, intrusive thoughts, flashbacks, negative beliefs about
self and others, and difficulty making decisions.
19. Give examples of behavioural effects of trauma.
Answer: Avoidance, withdrawal, substance use, self-harm, aggression, risk-taking, and difficulty
trusting others.
20. What is a trigger?
Answer: A reminder (sight, sound, smell, touch, situation) that sets off a memory or flashback,
making the person feel or act as if the original trauma is happening again.
21. What is hypervigilance?
Answer: A persistent state of heightened alertness and scanning for threat.
22. What is dissociation?
Answer: A disconnection between thoughts, memories, feelings, surroundings, or sense of identity -
a protective response that can cause 'zoning out' or memory gaps.
23. Name the common survival responses to threat.
Answer: Fight, flight, freeze, and fawn (appeasing).
24. What is the 'window of tolerance'?
Answer: The optimal zone of arousal in which a person can function and regulate emotions; trauma
can narrow it, pushing people into hyperarousal or hypoarousal.
25. Which brain structures are most associated with the trauma response?
Answer: The amygdala (threat detection - overactive), the hippocampus (memory - may
shrink/impair), and the prefrontal cortex (reasoning and regulation - underactive under stress).
26. What is Trauma-Informed Care (TIC)?
Answer: A strengths-based, organization-wide framework grounded in understanding of and
responsiveness to the impact of trauma, emphasizing physical, psychological, and emotional safety
for both service users and providers, and creating opportunities to rebuild control and empowerment.
27. TIC shifts the key question from ____ to ____.
Answer: From 'What is wrong with you?' to 'What happened to you?'
28. Does trauma-informed care treat or heal trauma directly?
Answer: No. TIC is a universal approach to how all services are delivered; it does not directly treat
trauma. Trauma-specific services (e.g., TF-CBT, EMDR, prolonged exposure) treat trauma
symptoms.
(Verified Update)
1. How does SAMHSA define individual trauma?
Answer: Trauma results from an event, series of events, or set of circumstances experienced by an
individual as physically or emotionally harmful or life-threatening, with lasting adverse effects on the
person's functioning and mental, physical, social, emotional, or spiritual well-being.
2. What are SAMHSA's 'Three E's' of trauma?
Answer: Event(s), Experience of the event(s), and Effect(s).
3. What primarily determines whether an event is traumatic?
Answer: Not the event itself but the individual's experience of it and the meaning they make of it - the
same event can be traumatic for one person and not another.
4. Can a person be traumatized by witnessing an event rather than experiencing it directly?
Answer: Yes. Witnessing violence (e.g., a child seeing domestic violence) or learning of harm to a
loved one can be traumatic.
5. What are Adverse Childhood Experiences (ACEs)?
Answer: Potentially traumatic events occurring before age 18, such as abuse (physical, emotional,
sexual), neglect, and household dysfunction (domestic violence, parental substance use, mental
illness, incarceration, separation/divorce).
6. What did the original CDC-Kaiser ACE Study (1998) show?
Answer: A dose-response relationship: the more ACEs a person has, the higher their risk of chronic
disease, mental illness, substance use, and early death in adulthood.
7. True or False: Trauma can occur at any point in the life span.
Answer: True.
8. What is acute (Type I / single-incident) trauma?
Answer: Trauma resulting from a single, time-limited event, such as an accident, assault, or natural
disaster.
9. What is complex (Type II) trauma?
Answer: Repeated, prolonged, often interpersonal trauma, frequently beginning in childhood (e.g.,
ongoing abuse or neglect), from which escape is difficult.
10. What is developmental trauma?
Answer: Trauma occurring during childhood that disrupts normal physical, emotional, cognitive, and
relational development (e.g., abuse, neglect, witnessing violence at home).
11. What is historical trauma?
Answer: Cumulative emotional and psychological wounding across generations, resulting from
massive group trauma such as colonization, genocide, slavery, or forced removal (e.g., Indigenous
residential schools, the Holocaust).
12. What is intergenerational (transgenerational) trauma?
Answer: Trauma transmitted from survivors to their children and later generations through parenting
patterns, family dynamics, and possibly biological mechanisms.
13. What is vicarious (secondary) trauma?
Answer: Trauma-like reactions experienced by helpers and professionals through repeated
exposure to the traumatic stories and experiences of the people they serve.
, 14. Distinguish interpersonal from external (non-interpersonal) trauma, with examples.
Answer: Interpersonal: harm caused by people - child abuse, sexual assault, domestic or elder
abuse. External: war, natural disasters, poverty, sudden loss of job or family.
15. Name the five domains in which effects of trauma may appear.
Answer: Physical, emotional, behavioural, cognitive, and spiritual.
16. Give examples of physical effects of trauma.
Answer: Sleep disturbance, chronic pain, headaches, gastrointestinal problems, fatigue,
hyperarousal, and elevated risk of chronic disease.
17. Give examples of emotional effects of trauma.
Answer: Fear, anxiety, depression, anger, shame, guilt, numbness, and difficulty regulating
emotions.
18. Give examples of cognitive effects of trauma.
Answer: Poor concentration, memory gaps, intrusive thoughts, flashbacks, negative beliefs about
self and others, and difficulty making decisions.
19. Give examples of behavioural effects of trauma.
Answer: Avoidance, withdrawal, substance use, self-harm, aggression, risk-taking, and difficulty
trusting others.
20. What is a trigger?
Answer: A reminder (sight, sound, smell, touch, situation) that sets off a memory or flashback,
making the person feel or act as if the original trauma is happening again.
21. What is hypervigilance?
Answer: A persistent state of heightened alertness and scanning for threat.
22. What is dissociation?
Answer: A disconnection between thoughts, memories, feelings, surroundings, or sense of identity -
a protective response that can cause 'zoning out' or memory gaps.
23. Name the common survival responses to threat.
Answer: Fight, flight, freeze, and fawn (appeasing).
24. What is the 'window of tolerance'?
Answer: The optimal zone of arousal in which a person can function and regulate emotions; trauma
can narrow it, pushing people into hyperarousal or hypoarousal.
25. Which brain structures are most associated with the trauma response?
Answer: The amygdala (threat detection - overactive), the hippocampus (memory - may
shrink/impair), and the prefrontal cortex (reasoning and regulation - underactive under stress).
26. What is Trauma-Informed Care (TIC)?
Answer: A strengths-based, organization-wide framework grounded in understanding of and
responsiveness to the impact of trauma, emphasizing physical, psychological, and emotional safety
for both service users and providers, and creating opportunities to rebuild control and empowerment.
27. TIC shifts the key question from ____ to ____.
Answer: From 'What is wrong with you?' to 'What happened to you?'
28. Does trauma-informed care treat or heal trauma directly?
Answer: No. TIC is a universal approach to how all services are delivered; it does not directly treat
trauma. Trauma-specific services (e.g., TF-CBT, EMDR, prolonged exposure) treat trauma
symptoms.
