Symptoms of childhood trauma in adults often bear a resemblance to those of post-traumatic stress disorder (PTSD), yet they also present distinct differences, particularly in their complexity and the approach required for treatment.
While both conditions may exhibit typical symptoms such as flashbacks, anxiety, and avoidance behaviors, the effects of childhood trauma typically delve deeper, intertwining with the developmental processes.
Therefore, trauma caused by adverse childhood experiences is often referred to as complex trauma.
Here are the 20 symptoms of PTSD in trauma survivors according to the American Psychiatric Association’s (APA) Diagnostic and Statistical Manual of Mental Disorders V (DSM-V), grouped into 4 clusters.1

Cluster B – Intrusive symptoms
- Intrusive memories – Repeated, involuntary, and distressing memories of the traumatic event intruding on the individual’s mind.
- Nightmares – Recurrent dreams related to the distressing event.
- Flashbacks – Involuntary flashbacks that dissociate from reality and feel like the traumatic events are happening right now.
- Intense psychological response to trauma cues – Intense fears or prolonged mental distress when exposed to cues that symbolize or resemble aspects of their trauma.
- Significant physiological reactions to trauma cues – Extreme physical response to triggers that signify a facet of the traumatic event.
Cluster C – Persistent avoidance
- Avoidance of thoughts – Efforts to steer clear of or dodge upsetting memories, thoughts, or emotions linked to or closely related to the traumatic event.
- Avoidance of triggers (phobia) – Efforts to circumvent external triggers, fear of mundane situations or objects, such as the dark, strangers, being alone, or being in a small confined space.
Cluster D – Alterations in cognition and mood
- Memory loss (dissociative amnesia) – failure to recall a significant part of the traumatic event.
- Negative beliefs – Catastrophically pessimistic views or negative outlook about oneself, others, or the world, a lack of trust or feeling of safety.
- Blame self or others – Skewed blame regarding the cause or outcomes of the traumatic event.
- Persistent negative emotions – Continuous experience of negative emotions, such as fear, horror, anger, guilt, or shame.
- Loss of interest – Noticeably reduced enthusiasm or involvement in once enjoyable activities.
- Feeling detached – Feeling disconnected or alienated from other people.
- Inability to feel positive – Constantly sad or difficulty in feeling positive emotions, such as happiness, contentment, or affection.
Cluster E – Hyperarousal and reactivity symptoms
- Irritability or anger – Sudden, unprovoked fits of mood swing into anger, irritability, or aggression.
- Self-destructive or reckless behavior – Risky or self-harming behaviors may result from a pessimistic outlook.
- Hypervigilance – Excessively alert and constantly on guard for potential danger or threats even when it is safe.
- Startle response – An unusually strong or intense reaction to unexpected stimuli.
- Lack of focus – Difficulties in maintaining focus or attention on tasks or activities.
- Difficulty sleeping – Trouble falling asleep, staying asleep, or experiencing restless and unrefreshing sleep.
What are the signs of childhood trauma in adults?
There are 11 signs of having experienced repeated adversities in childhood besides the symptoms defined in the DSM-V. These signs are behaviors resulting from the impact of complex trauma.
- Anxiety
- Depression
- Low self-esteem
- Substance abuse
- Reenactment
- Personality disorders
- Dissociation
- Numbing
- Relationship difficulty
- Lack of emotion regulation
- Externalizing behaviors
Can childhood trauma cause anxiety disorder?
Yes, childhood trauma can cause anxiety disorder. Repeated trauma keeps the child’s nervous system perpetually on high alert.
Over time, this ongoing state chemically changes the brain’s circuitry to a consistently “active” state, leading to anxiety.
Can childhood trauma cause depression?
Yes, childhood trauma can cause depression. Individuals who have experienced prolonged stress and emotional turmoil are predisposed to enduring feelings of sadness, hopelessness, and depression later in life.
How does childhood trauma affect an individual’s self-esteem and self-image?
Traumatic childhood experiences involving abuse or neglect can lead children to internalize negative beliefs about themselves.
Children may see themselves as unworthy, flawed, or undeserving of love and respect.
Low self-esteem, a negative self-image, and a sense of inadequacy can develop and persist as children become adults.
Can childhood trauma lead to substance abuse or addiction?
Yes, childhood trauma can lead to substance abuse or addiction.
Trauma victims often use drugs or alcohol as self-medication to cope with overwhelming emotions and memories associated with their traumatic experiences.
These substances can temporarily numb emotional pain, provide an escape from painful feelings, and offer a false sense of control.
This maladaptive coping mechanism creates a dependency that exacerbates the mental distress.
Can childhood trauma cause reenactment?
Yes, childhood trauma can cause reenactment.
Victims of child trauma often have the compulsion to repeat the trauma they experienced in childhood.
Reenacting can occur as single behaviors, repeated behaviors, or bodily responses.2
For example, those who survived abuse might frequently find themselves in abusive relationships or, conversely, become abusers themselves.
These patterns of behavior are not conscious, and they are echoes of the traumatic events they experienced as a child.
Does childhood trauma cause personality disorders?
Yes, childhood trauma can cause personality disorders. When reenactment happens often, it becomes a defining trait of a person’s personality, which might develop into a personality disorder in adulthood.3
Disorders commonly found in trauma survivors include borderline personality disorder and narcissistic personality disorder.
Can childhood trauma lead to dissociative symptoms or disorders?
Yes, childhood trauma can lead to dissociative symptoms or disorders in the victims. Frequent dissociations experienced by trauma victims sometimes evolve into dissociative identity disorder (DID), formerly known as multiple personality disorder.
This progression occurs as a defense mechanism. When faced with overwhelming trauma, the mind compartmentalizes traumatic experiences into separate identities or personality states as a way to isolate the pain and cope with the reality of the trauma.
This compartmentalization leads to the development of distinct alternate identities within the same individual.4
Can childhood trauma cause emotional numbness?
Yes, childhood trauma can cause emotional numbness.
Denial and emotional numbing are common defense mechanisms in trauma victims, acting as a shield against the intense pain of memories.
These individuals often avoid discussing their traumatic experiences or personal emotions, as delving into these areas can reopen deep emotional wounds.5
How does childhood trauma impact an individual’s ability to form relationships?
Childhood abuse can impact one’s ability to form healthy relationships because abuse by caregivers can shatter trust, leading to the development of insecure attachment styles.
Studies have found that adverse experience survivors often have trouble forming and maintaining healthy relationships, as the foundational trust necessary for these connections has been compromised.6
Can childhood trauma stunt emotional growth?
Yes, childhood trauma can stunt emotional growth in children. Traumatic experiences during the early years can disrupt the normal development of the brain’s emotional regulation systems.
Traumatized children may struggle with heightened emotional responses, difficulty calming down after being upset, or a tendency to react impulsively or inappropriately to emotional stimuli.7
How does childhood trauma affect criminal behavior?
Childhood trauma can influence an individual’s propensity toward criminal behavior by impairing their ability to self-regulate emotions and actions.
Victims of childhood maltreatment frequently exhibit externalizing behaviors, including aggression, defiance, and delinquency.
Prolonged exposure to trauma without adequate support can contribute to the development of antisocial personality disorder.
This disorder is characterized by a pervasive pattern of disregard for and violation of the rights of others.
In essence, unresolved childhood trauma can set a foundation for a trajectory that leads to criminal behavior.8,9
Can childhood trauma lead to difficulties in academic or professional settings?
Yes, childhood trauma can lead to difficulties in academic or professional settings.
Affected children often face challenges with concentration, memory, and emotional regulation, which can directly impact their learning and performance in school.
In professional settings, trauma survivors might find it challenging to cope with the pressures and responsibilities of the workplace. They may experience heightened anxiety, difficulty in forming relationships with colleagues, or challenges in handling constructive criticism or feedback.
A lack of trust, fear of authority figures, or a tendency to avoid conflict can further hinder their professional growth and success.
What are the long-term physiological effects of childhood trauma?
In addition to mental health issues, toxic stress from prolonged abuse can also have adverse health effects. Adults with childhood trauma are at increased risk of a wide range of conditions, including the following.10,11
- Chronic pain
- Heart disease
- Cancer
- Stroke
- Chronic bronchitis
- Emphysema
- Diabetes
- Skeletal fractures
- Hepatitis
What determines how childhood trauma affects individuals differently?
The following 9 factors determine how childhood trauma affects an individual.
- Nature of the Trauma: The trauma’s type, severity, and duration can influence its impact. Physical and sexual abuse is associated with more symptom complexity than other forms of child trauma.
- Number of ACEs: The cumulative effects of multiple trauma exposures are more complex than fewer exposures.
- Developmental Stage: Younger children are more vulnerable as their brains develop.
- Genetic predispositions: Genetic predispositions and gene expression related to stress pathways can shape individual trauma responses. These biological factors can also influence a person’s susceptibility to mental health disorders.
- Coping abilities: Some individuals develop more coping mechanisms that help them manage trauma more effectively.
- Support Systems: A strong and supportive network of family and friends can significantly mitigate the effects of trauma. Access to therapy and other resources can provide more psychological support.
- Subsequent Life Experiences: Positive or negative experiences following the trauma can influence its long-term impact. Further adverse events can re-traumatize an individual, while positive experiences foster healing and resilience.
- Cultural and Social Factors: Cultural beliefs and social environments can affect how trauma is perceived and dealt with. Stigma, societal attitudes towards mental health, and cultural coping mechanisms can all influence the impact of trauma.
- Meaning-making: The ability to integrate trauma into one’s life story and find purpose after adversity determines post-traumatic growth trajectories.
Final Thoughts
The effects of trauma are profound and complex. However, healing childhood trauma is achievable.
It is vital to seek help from mental health professionals if you suffer from symptoms of trauma.
Therapy for childhood trauma isn’t necessarily expensive. In the United States, most healthcare insurance is required by law to carry coverage for mental health.
Free therapies can also be found in many local communities and on government websites.
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References
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- 2.Davies JM, Frawley MG. Dissociative processes and transference‐countertransference paradigms in the psychoanalytically oriented treatment of adult survivors of childhood sexual abuse. Psychoanalytic Dialogues. Published online January 1992:5-36. doi:10.1080/10481889209538920
- 3.Trippany RL, Helm HM, Simpson L. Trauma Reenactment: Rethinking Borderline Personality Disorder When Diagnosing Sexual Abuse Survivors. Journal of Mental Health Counseling. Published online March 30, 2006:95-110. doi:10.17744/mehc.28.2.ef384lm8ykfujum5
- 4.Dorahy MJ, Brand BL, Şar V, et al. Dissociative identity disorder: An empirical overview. Aust N Z J Psychiatry. Published online May 2014:402-417. doi:10.1177/0004867414527523
- 5.Etherington K. Supervising counsellors who work with survivors of childhood sexual abuse. Counselling Psychology Quarterly. Published online December 2000:377-389. doi:10.1080/713658497
- 6.Reyome ND. Childhood Emotional Maltreatment and Later Intimate Relationships: Themes from the Empirical Literature. Journal of Aggression, Maltreatment & Trauma. Published online February 25, 2010:224-242. doi:10.1080/10926770903539664
- 7.Dvir Y, Ford JD, Hill M, Frazier JA. Childhood Maltreatment, Emotional Dysregulation, and Psychiatric Comorbidities. Harvard Review of Psychiatry. Published online May 2014:149-161. doi:10.1097/hrp.0000000000000014
- 8.Shi Z, Bureau J, Easterbrooks MA, Zhao X, Lyons‐Ruth K. Childhood maltreatment and prospectively observed quality of early care as predictors of antisocial personality disorder features. Infant Mental Health Journal. Published online January 2012:55-69. doi:10.1002/imhj.20295
- 9.Fox BH, Perez N, Cass E, Baglivio MT, Epps N. Trauma changes everything: Examining the relationship between adverse childhood experiences and serious, violent and chronic juvenile offenders. Child Abuse & Neglect. Published online August 2015:163-173. doi:10.1016/j.chiabu.2015.01.011
- 10.Kendall-Tackett K. The health effects of childhood abuse: four pathways by which abuse can influence health. Child Abuse & Neglect. Published online June 2002:715-729. doi:10.1016/s0145-2134(02)00343-5
- 11.Dye H. The impact and long-term effects of childhood trauma. Journal of Human Behavior in the Social Environment. Published online February 7, 2018:381-392. doi:10.1080/10911359.2018.1435328