trauma may appear immediately after the
traumatic event or days and even weeks
later. Loss of trust in adults and fear of
the event occurring again are responses seen
in many children and adolescents who have
been exposed to traumatic events. Other
reactions vary according to age:4-7
For children 5 years of
age and younger, typical reactions
can include a fear of being separated from
the parent, crying, whimpering, screaming,
immobility and/or aimless motion, trembling,
frightened facial expressions and excessive
clinging. Parents may also notice children
returning to behaviors exhibited at earlier
ages (these are called regressive
behaviors), such as thumb-sucking,
bedwetting, and fear of darkness. Children
in this age bracket tend to be strongly
affected by the parents' reactions to the
Children 6 to 11
years old may show extreme
withdrawal, disruptive behavior, and/or
inability to pay attention. Regressive
behaviors, nightmares, sleep problems,
irrational fears, irritability, refusal to
attend school, outbursts of anger and
fighting are also common in traumatized
children of this age. Also the child may
complain of stomachaches or other bodily
symptoms that have no medical basis.
Schoolwork often suffers. Depression,
anxiety, feelings of guilt and emotional
numbing or "flatness" are often present as
Adolescents 12 to 17
years old may exhibit responses
similar to those of adults, including
flashbacks, nightmares, emotional numbing,
avoidance of any reminders of the traumatic
event, depression, substance abuse, problems
with peers, and anti-social behavior. Also
common are withdrawal and isolation,
physical complaints, suicidal thoughts,
school avoidance, academic decline, sleep
disturbances, and confusion. The adolescent
may feel extreme guilt over his or her
failure to prevent injury or loss of life,
and may harbor revenge fantasies that
interfere with recovery from the trauma.
Some youngsters are more vulnerable to
trauma than others, for reasons scientists
don't fully understand. It has been shown
that the impact of a traumatic event is
likely to be greatest in the child or
adolescent who previously has been the
victim of child abuse or some other form of
trauma, or who already had a mental health
And the youngster who lacks family support
is more at risk for a poor recovery.12
JD. The effects of
exposure to violence
on young children.
1995; 50(9): 782-8.
[to top of second column]
RS, Steinberg AM, Goenjian AK. Traumatic stress in childhood and
adolescence: recent developments and current controversies. In: Van
der Kolk BA, McFarlane AC, Weisaeth L, eds.
stress: the effects of overwhelming experience on mind, body, and
society. New York: Guilford Press, 1996; 331-58.
S, Adelman A.
violence in a
context. In: Osofsky
JD, et al., eds.
Children in a
New York: Guilford
Press, 1997; 202-22.
JM, Vernberg EM.
children to natural
Journal of Clinical
1993; 22(4): 464-84.
J, Kostelny K,
Dubrow N. What
children can tell us
about living in
1991; 46(4): 376-83.
RD, Saunders BE,
Hanson RF, Resnick
physical assault as
a risk factor for
and substance abuse:
findings from a
1996; 66(3): 437-48.
S, Finkelhor D.
a risk factor for
child sexual abuse
and for PTSD-related
Abuse and Neglect,
SH, Newman E,
Pelcovitz D, Van der
Kolk BA, Mandel FS.
Complex PTSD in
victims exposed to
sexual and physical
abuse: results from
the DSM-IV Field
Journal of Traumatic
to chronic community
Violence, and Abuse:
A Review Journal,
2000; 1(4); 299-320.
The information in this series has been made
available through the
Institute of Mental Health.
Articles to come:
Friday, April 27
Saturday, April 28
Monday, April 30
[Text copied from
National Institute of Mental