Types of Traumatic Stress

Children can be exposed to a range of traumatic experiences.

Page Contents:

• Community and School Violence
• Complex Trauma
• Domestic Violence
• Early Childhood Trauma
• Medical Trauma
• Natural Disasters
• Neglect
• Physical Abuse
• Refugee and War Zone Trauma
• Sexual Abuse
• Terrorism
• Traumatic Grief

Community and School Violence

Community violence includes predatory violence (robbery, for example) and violence that comes from personal conflicts between people who are not family members. It may include brutal acts such as shootings, rapes, stabbings, and beatings. Children may experience trauma as victims, withnesses, or perpetrators.

School violence includes fatal and nonfatal student or teacher victimization, threats to or injury of students, fights at school, and students carrying weapons to school. Formal definitions of school violence range from very narrow to very broad. The Center for the Prevention of School Violence, for example, defines it broadly as "any behavior that violates a school's educational mission or climate of respect or jeopardizes the intent of the school to be free of aggression against persons or property, drugs, weapons, disruptions, and disorder."

Learn about the effects of trauma on a child's education on the Network's pages For School Personnel.

Consult an NCTSN reading list of research on community and school violence.

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Complex Trauma

The term complex trauma describes the problem of children's exposure to multiple or prolonged traumatic events and the impact of this exposure on their development. Typically, complex trauma exposure involves the simultaneous or sequential occurrence of child maltreatment—including psychological maltreatment, neglect, physical and sexual abuse, and domestic violence—that is chronic, begins in early childhood, and occurs within the primary caregiving system. Exposure to these initial traumatic experiences—and the resulting emotional dysregulation and the loss of safety, direction, and the ability to detect or respond to danger cues—often sets off a chain of events leading to subsequent or repeated trauma exposure in adolescence and adulthood.

Click here for more NCTSN resources on complex trauma.

Consult an NCTSN reading list of research on complex childhood trauma.

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Domestic Violence

Domestic violence—sometimes called intimate partner violence, domestic abuse, or battering—includes actual or threatened physical or sexual violence or emotional abuse between adults in an intimate relationship. This clinical definition is broader than the legal definition, which may be restricted to acts of physical harm. Domestic violence can be directed toward a current or former spouse or partner, whether they are heterosexual or same-sex partners.

Anywhere from 3 to 10 million children are exposed to domestic violence in the United States every year. Studies suggest that the majority of children who are exposed to domestic violence are young-under the age of 8.

Click here for more NCTSN resources on domestic violence

Consult an NCTSN reading list of research on domestic violence and childhood trauma.

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Early Childhood Trauma

Early childhood trauma generally refers to the traumatic experiences that occur to children aged 0-6. These traumas can be the result of intentional violence—such as child physical or sexual abuse, or domestic violence—or the result of natural disaster, accidents, or war. Young children also may experience traumatic stress in response to painful medical procedures or the sudden loss of a parent/caregiver.

Click here for more information on early childhood trauma

Consult an NCTSN reading list of research on early childhood trauma.

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Medical Trauma

Pediatric medical traumatic stress refers to reactions that children and their families may have to pain, injury, and serious illness; or to "invasive" medical procedures (such as surgery) or treatments (such as burn care) that are sometimes frightening. Reactions can affect the mind as well as the body. For example, children and their families may become anxious, irritable, or on edge. They may have unwanted thoughts or nightmares about the illness, injury, or the hospital. Some people may avoid going to the doctor or the hospital, or lose interest in being with friends and family and in things they used to enjoy. As a result, they may not do well at school, work, or home. How children and families cope with these changes is related to the person's own thoughts and feelings about the illness, injury, or the hospital; reactions can vary, even within the same family.

Click here for the Pediatric Medical Traumatic Stress Toolkit for Health Care Providers.

Click here for more NCTSN resources on medical trauma.

Consult an NCTSN reading list of research on medical trauma.

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Natural Disasters

A disaster is any natural catastrophe (for example, tornadoes, hurricanes, and earthquakes) or any fire, flood, or explosion that causes enough damage that local, state, or federal agencies and disaster relief organizations are called into action. Disasters can result from a man-made event (such as a nuclear reactor explosion), but if the damage is caused intentionally, it is classified as an act of terrorism.

Click here for more NCTSN resources on disasters.

Consult an NCTSN reading list of research on natural disasters and childhood trauma.

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Neglect

Child neglect occurs when a parent or caregiver does not give a child the care he or she needs according to its age, even though that adult can afford to give that care or is offered help to give that care. Neglect can mean not giving food, clothing, and shelter. It can mean that a parent or caregiver is not providing a child with medical or mental health treatment or not giving prescribed medicines the child needs. Neglect can also mean neglecting the child's education. Keeping a child from school or from special education can be neglect. Neglect also includes exposing a child to dangerous environments. It can mean poor supervision for a child, including putting the child in the care of someone incapable of caring for children. It can also mean abandoning a child or expelling it from home. Neglect is the most common form of abuse reported to child welfare authorities.

Click here to read Child Neglect: A Guide for Prevention, Assessment and Intervention, a publication from the Office on Child Abuse and Neglect within the US Department of Health and Human Services.

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Physical Abuse

Physical abuse means causing or attempting to cause physical pain or injury. It can result from punching, beating, kicking, burning, or harming a child in other ways. Sometimes, an injury occurs when a punishment is not appropriate for a child's age or condition. Physical abuse can consist of a single act or several acts. In extreme cases, it can result in death.

Click here for more NCTSN resources on physical abuse.

Consult an NCTSN reading list of research on child physical abuse .

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Refugee and War Zone Trauma

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Sexual Abuse

Child sexual abuse includes a wide range of sexual behaviors that take place between a child and an older person or alternatively between a child and another child/adolescent. Behaviors that are sexually abusive often involve bodily contact, such as sexual kissing, touching, fondling of genitals, and intercourse. However, behaviors may be sexually abusive even if they do not involve contact, such as of genital exposure ("flashing"), verbal pressure for sex, and sexual exploitation for purposes of prostitution or pornography.

Click here for more NCTSN resources on child sexual abuse.

Consult an NCTSN reading list of research on child sexual abuse.

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Terrorism

Terrorism is defined in a variety of formal, legal ways, but the essential element is the intent to inflict psychological damage on an adversary. The US Department of Defense defines terrorism as "the calculated use of violence or the threat of violence to inculcate fear, intended to coerce or to intimidate governments or societies in the pursuit of goals that are generally political, religious, or ideological." Terrorism includes attacks by individuals acting in isolation (for example, sniper attacks) as well as attacks by groups or people acting for groups.

Click here for more NCTSN resources on terrorism.

Consult an NCTSN reading list of research on terrorism and childhood trauma.

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Traumatic Grief

Childhood traumatic grief may occur following a death of someone important to the child when the child perceives the experience as traumatic. The death may have been sudden and unexpected (e.g., through violence or an accident), or anticipated (e.g., illness or other natural causes).

The distinguishing feature of childhood traumatic grief is that the trauma symptoms interfere with the child's ability to go through the typical process of bereavement. The child experiences a combination of trauma and grief symptoms so severe that any thoughts or reminders, even happy ones, about the person who died can lead to frightening thoughts, images, and/or memories of how the person died

Click here for more NCTSN resources on childhood traumatic grief.

Consult an NCTSN reading list of research on childhood traumatic grief.

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