The main concept here is how demographic factors relate to the risk of developing a stress disorder after trauma. The strongest and most consistent finding is that women are more likely than men to develop PTSD following exposure to a traumatic event. This holds even when accounting for differences in how often each gender experiences trauma, and it helps explain why the gender difference shows up across many studies. Part of this disparity is that women are more likely to experience certain high-impact traumas (such as sexual assault and domestic violence), which carry a higher risk for PTSD, but there are also potential biological and psychosocial factors that contribute to the higher vulnerability. Stress disorders can develop at any age, not just in late adulthood, so that option isn’t accurate. Differences by race/ethnicity or income exist in various ways but don’t show the clear, consistent pattern described in the other statements, and they don’t outweigh the robust gender difference. So, the statement that women are more likely than men to develop a stress disorder best reflects the well-supported demographic pattern.

Graded exposure aims to reduce avoidance and anxiety by gradually confronting feared stimuli in a controlled way. The idea is that avoidance helps keep anxiety going because it prevents you from learning that the feared situation is not actually dangerous or harmful. By slowly facing the fear, you experience situations that are still uncomfortable but tolerable, and over time your fear response diminishes through habituation and extinction learning. A typical approach uses a fear hierarchy, starting with mildly distressing situations and moving up as tolerance improves, which can be done in real life or through imagination. As exposure continues, avoidance decreases, anxiety drops, and functioning improves. Increasing avoidance would reinforce the fear instead of reducing it, so it’s not effective. Improving dream recall isn’t related to how exposure reduces anxiety, and ignoring feared situations only maintains or worsens the fear.

The difference hinges on why the person fabricates symptoms. In factitious disorder, the individual deliberately creates or exaggerates illness to assume the sick role and receive attention, care, and sympathy, with no obvious external rewards. This reflects an internal psychological need rather than a concrete, tangible benefit. Malingering, by contrast, involves intentional feigning of symptoms to gain something outside the illness itself—external rewards such as avoiding work, obtaining financial compensation, or accessing drugs. So the distinction is internal motivation and the social-psychological payoff versus External incentives: factitious is about the need to be cared for, malingering is about getting a specific external benefit.

Substance use disorder is diagnosed when there is a problematic pattern of substance use that leads to clinically significant impairment or distress, demonstrated by at least two of eleven diagnostic criteria within a 12-month period. This captures why the description is correct: it requires both a pattern of use and meaningful impact on functioning, not just a one-off event. DSM-5-TR treats this as a spectrum, with severity increasing as more criteria are met (2–3 mild, 4–5 moderate, 6+ severe). The criteria cover cravings, taking in larger amounts or over longer periods than intended, unsuccessful efforts to cut down, a lot of time spent obtaining or using the substance, giving up activities, continued use despite problems caused by use, hazardous use, tolerance, and withdrawal, among others. The other options don’t fit because they describe use without impairment, a single occasion, or any use at all, none of which meet the diagnostic threshold.

The key idea here is what cocaine withdrawal looks like after prolonged use: a “crash” with a drop in mood and energy, often accompanied by headaches. When the drug wears off, dopamine levels dip, leading to depressed feelings, fatigue, and sleep-related changes, and headaches are a common accompanying symptom. This pattern—depressed mood, fatigue, and a crash after stopping—best captures the typical cocaine withdrawal experience. The other clusters don’t fit as well because they point to different withdrawal or intoxication profiles. Very rapid heart rate, tremors, and convulsions suggest withdrawal from substances with strong autonomic or seizure risks (like alcohol or certain sedatives), not the usual cocaine crash. Mania or severe, unbalanced mood changes aren’t characteristic of cocaine withdrawal, and excitability with insomnia and hallucinations aligns more with acute intoxication or withdrawal from other stimulants or substances rather than the classic cocaine crash.