Chapter 12: Trauma- and Stressor-Related Disorders

The chapter defines child maltreatment across four primary categories—physical abuse, neglect, sexual abuse, and psychological abuse—each carrying distinct developmental consequences that extend into adolescence and adulthood. Central to the chapter are trauma-related diagnostic conditions, including Reactive Attachment Disorder characterized by emotional withdrawal and failed caregiving relationships, Disinhibited Social Engagement Disorder marked by indiscriminate social approach without appropriate boundaries, and Post-Traumatic Stress Disorder presenting with intrusive memories, avoidance behaviors, and heightened arousal states. The biological mechanisms underlying traumatic stress responses are thoroughly examined, focusing on hypothalamic-pituitary-adrenal axis dysregulation, amygdala hyperactivity, and elevated cortisol production that perpetuate chronic threat perception and impaired emotional regulation. The chapter analyzes risk factors contributing to maltreatment vulnerability, including family economic stress, parental mental illness, and the cycle-of-violence hypothesis, which posits that childhood abuse exposure increases but does not guarantee violent perpetration in adulthood. Discussed extensively are the long-term psychiatric sequelae of early trauma, including depression, anxiety disorders, substance abuse, personality pathology, and increased revictimization risk. The chapter emphasizes evidence-based interventions including Trauma-Focused Cognitive Behavioral Therapy and exposure-based approaches for symptom reduction, alongside preventive family-centered strategies and community-level child welfare initiatives. Throughout, early intervention emerges as critical for interrupting the progression from acute trauma exposure to chronic psychiatric vulnerability and promoting protective resilience factors.