The next day, Aura Petrescu, a troubled young Romanian immigrant suffering from a severe eating disorder, escapes from a local psychiatric hospital and is saved from a suicide attempt on a bridge by David Parsons, a sober drug addict and television newswriter.

Meanwhile, Aura ventures into the city to shop at a farmer's market, where she is spotted by Dr. Judd, her obsessive former psychologist, who chases after her before forcing her to return to his home with him.

Judd forces Aura to consume berries that produce psychedelic effects, causing her to recall memories of the night her parents were killed.

Gabriel, meanwhile, notices the killer return home that night from his bedroom window, and watches as the gloved individual removes Hilda's severed head from a satchel.

In a last-ditch effort, David tracks down Dr. Lloyd, the murdered nurses' superior who has since lost his medical career and descended into a life of destitution and drug addiction.

Some time later, David, who has lapsed back into addiction and lost his job, sees a cloaked figure in the city wearing a distinctive bracelet Aura owned.

He awakens and finds himself locked in the basement, alongside Aura—it is revealed that Adriana is in fact the killer, who faked her death, framed Judd, and kidnapped Aura.

Adriana has sought vengeance against Lloyd and his nurses, who accidentally cut off her newborn son Nicolas's head during his delivery, due to clumsiness combined with a sudden power outage caused by a thunderstorm.

To cover up the accident, the nurses and Dr. Lloyd involuntarily subjected Adriana to electroshock treatment in hopes of erasing her memory of Nicolas's botched delivery and death.

Shot in and around Minneapolis, United States in August and September 1992 on a budget of $7 million,[2] Trauma is notable as Italian director Dario Argento's first feature-length American production, following his collaboration with George A. Romero in making Two Evil Eyes in 1990.

[3] The character played by Asia Argento, timing showing she was 17 during filming, is inspired by her half-sister Anna (Daria Nicolodi's daughter from a previous marriage) who actually suffered from anorexia.

[8] Slant Magazine called Trauma "a bizarre, psychologically repressive thriller that smacks of lesser De Palma" that is "convoluted to the point of distraction, worth savoring solely for Argento's excesses of gore.