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Types of Traumatic Stress

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.

Community Violence

Community violence can be defined as exposure to intentional acts of interpersonal violence committed in public areas by individuals who are not intimately related to the victim.  Common types of community violence that affect youth include individual and group conflicts (e.g., bullying, fights among gangs and other groups, shootings in public areas such as schools and communities, civil wars in foreign countries or “war-like” conditions in U.S. cities, spontaneous or terrorist attacks, etc.).  Although there are warnings for some types of traumas, community violence can happen with a sudden and terrifying shock.  Consequently, youth and families that suffer from community violence often experience increased fears and feelings that the world is unsafe and harm could come at any time.  In addition, although some types of trauma are accidental, community violence is an intentional attempt to hurt one or more people, including homicides, sexual assaults, robberies, and weapons attacks (bats, knives, guns, etc.).

School Violence

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."

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.

Refugee Trauma

Refugee trauma include exposure to war, political violence, or torture. Refugee trauma can be the result of living in a region affected by bombing, shooting, or looting, as well as forced displacement to a new home due to political reasons. Some young refugees have served as soldiers, guerrillas, or other combatants in their home countries, and their traumatic experiences may closely resemble those of combat veterans.

Complex Trauma

The term complex trauma describes both children’s exposure to multiple traumatic events, often of an invasive, interpersonal nature, and the wide-ranging, long-term impact of this exposure.

These events are severe and pervasive, such as abuse or profound neglect. They usually begin early in life and can disrupt many aspects of the child’s development and the very formation of a self. Since they often occur in the context of the child’s relationship with a caregiver, they interfere with the child’s ability to form a secure attachment bond. Many aspects of a child’s healthy physical and mental development rely on this primary source of safety and stability.

Many children with complex trauma histories suffer a variety of traumatic events, such as physical and sexual abuse, witnessing domestic and community violence, separation from family members, and revictimization by others. Complex trauma can have devastating effects on a child’s physiology, emotions, ability to think, learn, and concentrate, impulse control, self-image, and relationships with others. Across the life span, complex trauma is linked to a wide range of problems, including addiction, chronic physical conditions, depression and anxiety, self-harming behaviors, and other psychiatric disorders. 

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.

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.

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.

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.

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.

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.

More information and resources on trauma from the National Traumatic Stress Network