What are Trauma and Stressor-related Disorders in Children?  

Trauma and stressor-related disorders are a group of emotional and behavioral problems that may result from childhood traumatic and stressful experiences.

These traumatic and stressful experiences can include exposure to physical or emotional violence or pain, including abuse, neglect or family conflict. Observing a parent being treated violently, for example, can be a traumatic experience, as can being the victim of violence or abuse. Stressors such as parental separation or divorce or even more severe stressors such as emotional or physical neglect can cause problems when they are prolonged or not addressed by caring adults. Even a move or the birth of a sibling can be a stressor that can cause significant difficulties for some children.

Trauma and stressor-related disorders include:

Post-traumatic stress disorder (PTSD). Children and adolescents with PTSD have symptoms such as persistent, frightening thoughts and memories or flashbacks of a traumatic event or events. Other symptoms may include jumpiness, sleep problems, problems in school, avoidance of certain places or situations, depression, headaches or stomach pains.

Acute stress disorder (ASD). The symptoms of ASD are similar to PTSD, but occur within the first month after exposure to trauma. Prompt treatment and appropriate social support can reduce the risk of ASD developing into PTSD.

Adjustment disorders. Adjustment disorders are unhealthy or unhelpful reactions to stressful events or changes in a child’s life. These reactions can be emotional, such as a depressed mood or nervousness, or behavioral, such as misconduct or violating the rights of others.

Reactive attachment disorder (RAD). Children with RAD show limited emotional responses in situations where those are ordinarily expected. This might show in a lack of remorse after bad behavior or a lack of response to positive or negative emotional triggers. Children with RAD may not appear to want or need comfort from caregivers. They may not seem to care when toy is taken away from them.

Disinhibited social engagement disorder (DSED). Children with DSED are unusually open to interactions with strangers. They can be over-eager to form attachments with others, walking up to and even hugging strangers. They may wander off with strangers without checking with their parent or caregiver.

Unclassified and unspecified trauma disorders. Some emotional and behavioral reactions to trauma do not fit in the diagnostic categories above. This category is used for those cases.

Childhood stress and trauma can have health and life impacts beyond these five types of emotional disorders. Research into the effects of adverse childhood experiences (ACEs), begun with a study conducted at Kaiser Permanente with the Centers for Disease Control in the 1990s and subsequently expanded with additional data, has shown a direct relationship between ACEs and a wide range of negative outcomes later in life.

The adverse experiences considered in these studies include:

• Physical, sexual or emotional abuse
• Physical or emotional neglect
• Household violence, substance abuse or mental illness
• Parental separation or divorce
• Incarceration of a family member

Results have shown that the more ACEs a child is exposed to, the greater the likelihood of negative health and life outcomes, including:

• Heart disease
• Stroke
• Diabetes
• Asthma
• Depression
• Alcohol abuse
• Illicit drug use
• Poor academic achievement
• Unemployment

Why choose CHOP?

Children’s Hospital of Philadelphia (CHOP) has a skilled team of child and adolescent specialists who work together to diagnose, understand the causes of and treat problems such as trauma and stressor-related disorders.

The team of professionals who work with your child and your family is committed to a successful outcome, and realize that success takes time and ongoing treatment and support.