A 28-year-old woman is referred to the PMHNP for persistent insomnia and depression after being treated in the emergency department of her local hospital for headaches, stomach pain, and various other physical complaints five times in the past 6 months. Which findings on the mental status exam would lead the PMHNP to suspect intimate partner violence?

Choice A reason: Hyperactivity, flight of ideas, and rapid speech are more indicative of manic or hypomanic states. These symptoms are not typically associated with intimate partner violence. Choice B reason: Withdrawal, fearfulness, and hypersensitivity to touch are classic signs of trauma and abuse. These behaviors may reflect hypervigilance, fear of physical contact, and emotional distress, all of which are consistent with a history of intimate partner violence. Choice C reason: Defensiveness and anger may be present in various psychiatric conditions, including personality disorders or trauma responses. However, they are not as specific or telling as the signs in choice B. Choice D reason: Disorganized thinking and labile mood may suggest psychosis or mood disorders but are not specific indicators of intimate partner violence. They lack the trauma-related behavioral cues seen in choice B.