People who experience a highly stressful event may have trouble returning to a normal state of mind afterwards. In some cases, they develop a mental health disorder related to the experience. This is known as a trauma disorder, and there are 7 different types:
- Post-Traumatic Stress Disorder (PTSD)
- Acute Stress Disorder (ASD)
- Secondhand Trauma
- Reactive Attachment Disorder (RAD)
- Disinhibited Social Engagement Disorder (DSED)
- Adjustment Disorders
- Other and Unspecified Trauma- and Stressor-Related Disorders
Post-Traumatic Stress Disorder (PTSD)
PTSD is one of the most well-known trauma disorders. It’s estimated to affect around 8 million U.S. adults in a given year. Individuals develop PTSD following a traumatic event. While it’s common for initial symptoms to begin in the days following a traumatic event, symptoms can even begin to surface months later. Symptoms can be grouped into four categories:
- Intrusive thoughts about the event, including nightmares and flashbacks
- Avoidance of anything that reminds you of the trauma
- Behavioral changes such as insomnia, withdrawing from loved ones, and engaging in reckless or self-destructive behaviors
- Cognitive disturbances like irritability, negative thoughts about self or others, and fear/paranoia
In order to receive a PTSD diagnosis, you must experience a certain number of symptoms from each category for over one month.
Learn more about the signs, symptoms, and treatment for PTSD
Complex PTSD
When individuals are exposed to repeated or prolonged trauma, such as childhood abuse, they develop a slightly different condition known as complex PTSD (C-PTSD). This shares many similarities to post-traumatic stress disorder, but also has some unique symptoms including:
- Poor emotional regulation, which manifests as outbursts of extreme emotions like rage and depression
- Negative view of self
- Trouble forming healthy relationships
- Behavioral difficulties like substance abuse, impulsivity, and self-destructive actions
- Detaching from self (depersonalization) or reality (derealization)
- Forgetting the trauma
- Losing core values and beliefs
Although some mental health professionals treat complex PTSD as a distinct condition, the Diagnostic and Statistical Manual of Mental Disorders (DSM) categorizes the symptoms under PTSD.
Acute Stress Disorder (ASD)
Acute stress disorder is very similar to PTSD, but is shorter in duration. ASD symptoms develop immediately after a traumatic event and last three days to one month. If symptoms persist beyond a month, the individual has developed PTSD.
Secondhand Trauma
Secondhand trauma is also known as trauma exposure response or secondary traumatic stress disorder. It results from exposure to the firsthand trauma of other people. Symptoms of secondary traumatic stress include:
- A sense of hopelessness or helplessness
- Feeling like you can never do enough to help
- Hypervigilance
- Guilt
- Fear
- Anger
- Negativity/cynicism
- Chronic fatigue
Secondhand trauma can happen to anyone, but it commonly affects professionals who work with trauma victims such as counselors, social workers, first responders, doctors, nurses and other healthcare workers.
Reactive Attachment Disorder (RAD)
Reactive attachment disorder occurs in children who cannot form stable attachments to their caregivers. If a child’s basic needs are not met or they are frequently placed with new caregivers, they are at increased risk of developing RAD. Symptoms may include:
- Emotional withdrawal or inhibition
- Lack of response to comfort from caregivers
- Impaired emotional response to others
- Limited ability to experience positive emotions
- Episodes of irritability, sadness, or fearfulness, often without cause
Although rare, this condition can be devastating to a child’s normal development and may affect their lives into adulthood. However, treatment can help.
Disinhibited Social Engagement Disorder (DSED)
Children who were unable to form healthy attachments to their caregivers may develop disinhibited social engagement disorder instead of reactive attachment disorder. While these two conditions have the same roots, symptoms are completely different.
DSED causes children to exhibit culturally inappropriate behavior. This often takes the form of familiarity with strangers. Children with DSED feel no fear around strangers, and may even be comfortable getting into a car with someone they’ve just met. This disorder poses a serious threat to safety. Caregivers should seek immediate treatment for a child who displays this kind of behavior.
Adjustment Disorders
Adjustment disorders are usually temporary and triggered by stressful life events such as divorce, job loss, being diagnosed with an illness, or losing a loved one. Some people are able to cope with the stress of these situations on their own, but others need help from a doctor or mental health professional.
Symptoms of an adjustment disorder may include:
- Frequent sadness or hopelessness
- Crying often
- Withdrawing from family and friends
- Not enjoying your favorite activities and hobbies anymore
- Lack of appetite
- Insomnia
- Neglecting your responsibilities at home or work
- Having trouble focusing
- Difficulty functioning in daily life
- Suicidal thoughts or behaviors
If you notice some of these symptoms following a major event, talk to your primary care provider or a mental health specialist. Treatment for adjustment disorders is usually temporary. However, for chronic life events like an ongoing illness or relationship problems, you might need long-term treatment.
Other and Unspecified Trauma- and Stressor-Related Disorders
You might have some of the symptoms of a trauma disorder, but not meet the criteria for one of the recognized types. Or, you might not be able to provide enough information for a specific diagnosis. In these cases, professionals often make a diagnosis of “other or unspecified trauma- and stressor-related disorder.”
This diagnosis is not any less serious than other trauma disorders. People with other or unspecified disorders have a legitimate mental health condition that is diminishing their quality of life. Treatment can help you gain control over your symptoms.
Trauma- and Stressor-Related Disorders Treatment
If you are experiencing mental health symptoms that seem to be connected to trauma or stressful life events, the good news is that you can be treated. It may take a combination of different things, including traditional talk therapy, holistic therapies, and medications. Talk to your doctor or a mental health provider to see what might be the best treatment option for you.
If you’re seeking treatment for a trauma disorder in New Jersey, consider High Focus Centers. We offer a trauma-focused outpatient program at our Cranford, Lawrenceville, Paramus, and Freehold locations, or online through teletherapy. Treatment involves group and individual therapy, plus medication management and sessions with a psychiatrist. Call our admissions line at (800) 877-3628 or reach out through our online contact form to enroll.
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.
