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A 7-year-old foster child is brought to the clinic. The child was abused by her parents before going into foster care. As part of a psychosocial assessment to rule out any chronic dissociative pattern of coping, the nurse would ask about which of the following?

Explanation

•The patient may not always be able to report emotional trauma because the event is dissociated. The nurse should watch for signs of abuse such as startled reactions, erratic sleep, and fear of objects or other people. Because some patients are not aware they dissociate, the nurse should also observe for a pattern of amnesia or unexplained behaviors.

•Dissocation is a subconscious defense mechanism that helps a person protect his or her emotional self from recognizing the full effects of some horrific or traumatic event by allowing the mind to forget or remove itself from the painful situation or memory.

•Most patients experience lack of appetite or overeating, estrangement from family members, intrusive thoughts, flashbacks, or dissociative episodes. Dissociative episodes and avoidant behavior may interfere with the patients ability to socialize and play.

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