A 40-year-old refugee from Syria presents to a community mental health center through an interpreter. He fled his country 3 years ago after witnessing violence and losing family members. He reports persistent headaches, chest pain, and 'pressure in the head' but denies feeling sad or anxious when asked directly. Medical workup is negative. The PMHNP suspects a trauma-related disorder but recognizes that the patient's symptom presentation may be influenced by cultural factors.