A nurse in an outpatient mental health clinic is discussing the development of anxiety-related disorders in children to a group of parents.
The nurse should include that which of the following is an adverse childhood experience (ACE) that can contribute to the development of an anxiety disorder?

Choice A rationale
Anticipatory grief occurs before death. It is grief that occurs leading up to a death. It may be felt by the person dying or person’s family. When a patient experiences distress, pain, and medical complications, it can add to anticipatory grief.
Choice B rationale
Complicated grief lasts longer than normal grief. It is characterized by the length of time and intensity of grief symptoms. This type of grief can occur when a person has a difficult time

accepting the death, experiences intense and persistent longing for the deceased, or has difficulty moving on with life.
Choice C rationale
Disenfranchised grief refers to a loss that is not or cannot be openly acknowledged, socially sanctioned, or publicly mourned. It is not typically associated with the death of a terminally ill patient.
Choice D rationale
Traumatic grief generally refers to grief resulting from a sudden, unexpected, or violent death. The death of a terminally ill patient, while deeply sad, is typically not categorized as traumatic.

Choice A rationale
Experiencing or witnessing a traumatic event can indeed lead to the development of a trauma- related disorder. When a person’s natural coping mechanisms are overwhelmed by what they’re experiencing — physically, mentally, or both — their body does what it can to protect them. This includes short-term effects like emotional numbing or keeping them in a state of alertness. However, sometimes the effects of trauma linger, persisting throughout life, causing anxiety, trouble sleeping, and intrusive thoughts that can interfere with daily activities.
Choice B rationale
While genetics can play a role in the development of trauma-related disorders, it is not the sole cause. Trauma-related disorders typically develop after exposure to a traumatic or stressful event.
Choice C rationale
A chemical imbalance in the brain can be a result of trauma, but it is not the cause of trauma- related disorders. These disorders typically develop after exposure to a traumatic or stressful event.
Choice D rationale
Physical harm can indeed be traumatic and lead to the development of trauma-related disorders, but it is not a requirement. Trauma can also result from psychological, emotional, or environmental stressors.