PTSD (post-traumatic stress disorder) is a mental health disorder that sometimes occurs in the aftermath of situations that involve some type of violence or physical harm, or alternatively, situations that contain an imminent threat of violence or harm. Partly due to America's continuous involvement in combat situations throughout the 2000s, many people associate PTSD with the direct experience of wartime conditions. However, the disorder can also appear in the aftermath of circumstances that include kidnappings, automobile accidents, earthquakes, civilian bombings, floods, train wrecks, and rapes. PTSD symptoms can also appear in the aftermath of child sexual abuse. PTSD Basics PTSD belongs to a larger group of mental health conditions known as anxiety disorders. As its name implies, by definition, people develop this particular form of anxiety in response to traumatic situations. While the types of trauma that lead to PTSD are usually physical, the long-term impact of the disorder is mental. However, in their own way, mental disorders can produce symptoms just as debilitating as physical injury. Common examples of potential post-traumatic symptoms include frequent reliving of the traumatic event(s) through nightmares and\/or waking experiences called "flashbacks"; physical or mental avoidance of any reminders of the traumatic event(s); and the onset of hyperarousal, a condition characterized by sleeping difficulties, general jumpiness, uncontrolled emotional outbursts and an unusual susceptibility to being startled. In most cases, PTSD symptoms appear within roughly three months following a traumatic event; however, some people don't develop symptoms for a year or longer. Some people recover from the disorder in as little as half a year, while others struggle with it for years, decades or a lifetime. According to the National Institute of Mental Health, almost eight million American adults have some form of PTSD. The condition also affects unknown numbers of children. Traumatic Effects of Child Sexual Abuse Child sexual abuse (CSA) can involve a wide array of activities that purposefully expose children to adult sexual behaviors and sexual perspectives. In some cases-such as instances of voyeurism, exhibitionism or use of pornographic imagery on the part of an adult-this exposure does not involve actual physical contact with a child. However, in other cases-such as various acts involving groping, genital contact, or intercourse-physical contact is heavily involved. Because children don't understand the sexual perspectives and behaviors of adults, any intentional exposure to these aspects of adult life can produce some sort of trauma. Generally speaking, the least traumatic forms of CSA involve no physical contact and occur only once or a very small number of times. Conversely, the most traumatic forms of CSA typically involve a violent or extreme invasion of physical space, occur repeatedly for months or years, and happen at the hands of parents or other close family members. However, this hierarchy of traumatic effect is not ironclad, and any given child can develop a serious traumatic response to any type, degree, or frequency of child sexual abuse. Unique Manifestations of Abuse-Related PTSD in Children PTSD in young children can manifest in unique ways, the American Academy of Child & Adolescent Psychiatry explains. These manifestations can include losing interest in activities that used to bring joy or pleasure; repeating or acting out some form of the behaviors perpetrated against them; regressing to thumbsucking, bedwetting or other age-inappropriate behaviors; developing unusual fears about an early death; losing the ability to talk; developing unusually strong attachments to a parent or other authority figure; and developing concentration problems that interfere with learning or social activities. In addition to the PTSD symptoms found in adults, potential symptoms in older sexually abused children and teenagers include disrespectful attitudes toward authority figures and the appearance of other destructive or disruptive attitudes or actions. Other Manifestations of CSA in Adults In addition to PTSD, untreated adult victims of CSA can develop a broad range of serious problems, including severe anxiety regarding adult expressions of sexuality, poor self-esteem, difficulty sustaining intimate relationships, depression, difficulty establishing appropriate social boundaries, involvement in sexually risky behaviors, or a poor or distorted body image. Additional potential consequences include suicidal thinking, active engagement in suicidal behaviors and the onset of addictive relationships to food, alcohol or drugs. Considerations Despite the links between physically invasive CSA and post-traumatic stress disorder, no one can predict which abused children will develop trauma-related symptoms, even in the aftermath of more or less identical forms of abuse. In addition, child sexual abuse victims who develop the disorder can experience different specific symptoms, or varying degrees of symptom severity. Children and adults with CSA-related PTSD can recover with the help of treatments that include medications and psychotherapy.