CTRI Study guide 2025/2026 Exam
Questions and Detailed Answers | Get it
100% Correct Answers
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
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,-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
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,-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]
-very basic sense of self as bad, disgusting and worthless
Hyperarousal vs. Hypoarousal - 🧠 ANSWER ✔✔Very aware of surroundings
(PTSD -like)
vs.
Feeling numb
COPYRIGHT©NINJANERD 2025/2026. YEAR PUBLISHED 2025. COMPANY REGISTRATION NUMBER: 619652435.
TERMS OF USE. PRIVACY STATEMENT. ALL RIGHTS RESERVED 3
, 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.
-Disrespect - reminds us of previous times when we were disrespected
-Emotions associated with previous incidents may greatly magnified the current
incident
90/10 Reaction - 🧠 ANSWER ✔✔Emotions associated with previous incidents
may greatly magnified the current incident
COPYRIGHT©NINJANERD 2025/2026. YEAR PUBLISHED 2025. COMPANY REGISTRATION NUMBER: 619652435.
TERMS OF USE. PRIVACY STATEMENT. ALL RIGHTS RESERVED 4
Questions and Detailed Answers | Get it
100% Correct Answers
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
COPYRIGHT©NINJANERD 2025/2026. YEAR PUBLISHED 2025. COMPANY REGISTRATION NUMBER: 619652435.
TERMS OF USE. PRIVACY STATEMENT. ALL RIGHTS RESERVED 1
,-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
COPYRIGHT©NINJANERD 2025/2026. YEAR PUBLISHED 2025. COMPANY REGISTRATION NUMBER: 619652435.
TERMS OF USE. PRIVACY STATEMENT. ALL RIGHTS RESERVED 2
,-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]
-very basic sense of self as bad, disgusting and worthless
Hyperarousal vs. Hypoarousal - 🧠 ANSWER ✔✔Very aware of surroundings
(PTSD -like)
vs.
Feeling numb
COPYRIGHT©NINJANERD 2025/2026. YEAR PUBLISHED 2025. COMPANY REGISTRATION NUMBER: 619652435.
TERMS OF USE. PRIVACY STATEMENT. ALL RIGHTS RESERVED 3
, 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.
-Disrespect - reminds us of previous times when we were disrespected
-Emotions associated with previous incidents may greatly magnified the current
incident
90/10 Reaction - 🧠 ANSWER ✔✔Emotions associated with previous incidents
may greatly magnified the current incident
COPYRIGHT©NINJANERD 2025/2026. YEAR PUBLISHED 2025. COMPANY REGISTRATION NUMBER: 619652435.
TERMS OF USE. PRIVACY STATEMENT. ALL RIGHTS RESERVED 4
