Secondary traumatic stress can include which of the following symptoms?

• A. Intrusive images or thoughts
• B. Decreased emotional distress
• C. Improved ability to function at work
• D. Decreased sensitivity to others' pain

Answer: (A)

Secondary traumatic stress manifests with re-experiencing symptoms from exposure to others’ trauma, similar to PTSD. Intrusive images or thoughts are a classic example: distressing, involuntary memories or vivid mental pictures of traumatic events that disrupt daily life or work. This happens because repeated exposure to patients’ traumatic stories can trigger involuntary recall and distress, even when you’re not directly dealing with the event at that moment.

The other options don’t fit as well. Decreased emotional distress would go against the typical pattern of STS, which tends to heighten distress and emotional reactivity. An improved ability to function at work is not characteristic, since STS often leads to difficulties with concentration, sleep, and mood that can impair performance. Decreased sensitivity to others’ pain points toward emotional numbing, which can occur but is not the primary or most distinguishing symptom described by STS in this context.