Which of the following statements made by a client diagnosed with posttraumatic stress disorder (PTSD) leads the nurse to believe the client is experiencing dissociative symptoms?
A) "It's like I'm having flashbacks every time I fall asleep."
B) "I describe my feelings like I'm having an out-of-body experience."
C) "Loud noises always make me a little jittery now."
D) "I feel guilty that I survived the attack and my friend didn't."
Ans: B
Dissociation is a disruption in the normally occurring linkages among subjective awareness, feelings, thoughts, behavior, and memories. A person who dissociates is making him- or herself "disappear." That is, the person has the feeling of leaving his or her body and observing what happens to him or her from a distance. During trauma, dissociation enables a person to observe the event while experiencing no or only limited pain and to protect him- or herself from awareness of the full impact of the traumatic event. Flashbacks are common with PTSD; loud noises associated with the trauma cause flashbacks. Guilt is common for survivors.
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