A client goes to the mental health center for difficulty concentrating, insomnia, and nightmares.

Childhood sexual abuse is associated with adult-onset depression and with an increased risk for lifetime and current post-traumatic stress disorder (PTSD). About one-third of all victims of sexual abuse meet the diagnostic criteria for PTSD. A person with PTSD has three main types of symptoms: (1) Re-experiencing the traumatic event with flashbacks, nightmares, and exaggerated reactions to triggers that remind the person of the event. (2) Emotional numbing is evidenced by avoidance of activities, places, thoughts, feelings, or conversations related to the trauma; feelings of detachment from others; and restricted or blunted emotions. (3) Increased activity is seen in bursts of anger, difficulty sleeping, hypervigilence, difficulty concentrating, and an exaggerated startle response. Other problems associated with PTSD are panic attacks, suicidal thoughts and feelings, substance abuse, eating disorders, feelings of alienation and isolation, and feelings of mistrust and betrayal.Psychosocial Integrity