Three types of symptoms occur with post-traumatic stress reactions:

Hyperarousal means that the child is nervous and jumpy, has a heightened startle response, and may react more strongly to any anxiety-producing situation.

Reexperiencing means that the child may keep seeing mental images linked to the abuse, or relive some aspects of the experience, either while awake or during sleep in the form of nightmares. A child may have other sleep disturbances, such as insomnia or frequent awakenings. Younger children are more likely to have generalized fears or nightmares about other scary things, such as monsters chasing them. With an older child, the nightmares are more likely to be directly related to the trauma. Reexperiencing also includes reactions to traumatic reminders: any thing, person, event, sight, smell, etc., connected to the abuse. For example, if the perpetrator had a beard, the child might start to feel frightened and uncomfortable, usually without knowing why, around any man with a beard. Even being touched by another person may become a traumatic reminder.

Avoidance means that a child avoids exposure to traumatic reminders, and sometimes avoids thinking about the abuse altogether. So, for example, if the abuse occurred in the basement, the child may avoid going into any basement. Reactions to—and avoidance of, traumatic reminders—can become generalized. A child may begin with fear of one particular basement that generalizes to reactions to and avoidance of all basements, and from that to any room that in any way resembles a basement. Avoidance can seriously restrict a child’s activities, which is an important reason to seek help early.

Appears in: The Impact of Abuse on Children