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Catecholamine suppression is the opposite of sympathetic activation, which markedly increases their release. Adrenal medullary secretion rises within seconds. Suppression occurs only with pharmacologic blockade. The statement is physiologically inverted.

Hippocampal neurogenesis is suppressed by sustained glucocorticoid exposure during chronic stress. Dentate gyrus proliferation declines with cortisol elevation. The process is not sympathetically mediated. Chronic trauma reduces hippocampal volume.

Cortisol release is mediated by the hypothalamic-pituitary-adrenal axis through corticotropin-releasing hormone and adrenocorticotropic hormone. The pathway is endocrine, not neural. Onset requires minutes rather than seconds. Sympathetic mediation is indirect at best.

The outward adjustment phase involves apparent resumption of routine with underlying suppression and denial. It develops weeks after the assault. Function superficially normalizes. The immediate timeframe excludes it.

Delayed expression describes posttraumatic stress disorder criteria met 6 months or later after exposure. It is a diagnostic specifier, not a syndrome phase. Symptoms here are immediate. The terminology is misapplied.

Long-term reorganization unfolds over months to years, involving lifestyle change, relocation, and identity restructuring. Nightmares and phobias may persist. The phase follows acute presentation. Timing entirely excludes it.

Intrusive memories and nightmares are psychological manifestations without physical evidentiary substrate. Documentation supports diagnosis but carries no decay window. Symptoms may be recorded at any later visit. No forensic testing applies.

Sleep disturbance is a subjective symptom reflecting hyperarousal. It persists over weeks rather than degrading. No biological specimen derives from it. Timing has no evidentiary consequence.

Five-day-old abrasions are already healing with granulation and crust formation. Trace evidence at that site has long degraded. Documentation remains useful but not urgent. The window for recovery has closed.

Acute confusion requires disturbed consciousness and fluctuating cognition of recent onset. No head injury or disorientation is documented. The presentation is chronic and cognitively intact. The related factor is fabricated.

Risk for self-directed violence demands evidence of suicidal ideation or self-harm behaviour. None is reported. Grief additionally applies to bereavement, not assault. The diagnosis is speculative and unsupported.

Ineffective coping with absent support lacks stated evidence of maladaptive coping or social isolation. The reported symptoms are trauma-specific rather than general. Posttrauma syndrome is the more precise label. Specificity determines selection.