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How Trauma Shows Up at Different Stages of Life?

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Traumatic events can deeply affect us regardless of our age. They shake our inner world and challenge the ideas we hold about ourselves and the world. Yet the way we express that impact, whether through words, behavior, or physical symptoms, and the consequences it leaves on our lives, can look very different depending on the developmental stage we are in. As we move through different stages of life, our emotional capacities, relationships, and ways of making sense of difficult experiences continue to evolve. Because of this, trauma does not affect everyone in the same way. A child, an adolescent, an adult, and an older person may all respond differently to a traumatic event. That’s why understanding how trauma interacts with development can help us better recognize its effects and approach healing in ways appropriate to each stage of life. In this therapy sketch, we will examine how different developmental stages (childhood, adolescence, adulthood, and the elderly) affect the impact of trauma, trauma reactions, and implications for the therapeutic process.

Childhood

Childhood is the period when we develop in every sense, where both psychological and physical development continue at full speed. At this age, we are largely dependent on our caregivers for survival, our emotional regulation skills are limited, our attachment formation continuously shapes our personality, and our sense of safety towards ourselves and the world is open to external influences. Because children don’t yet have the tools to understand and cope with a traumatic event, it can greatly overwhelm our capacities, and we may be left with long-lasting effects.  Such experiences can have wide-ranging impacts on different domains of development.

  • Impact of Trauma in Childhood

Trauma during childhood can affect many areas of development, including how the body responds to stress, how beliefs about the self and the world are formed, and how relationships are experienced. Exposure to significant stress can make our bodies become more attuned to hypervigilance and threat monitoring, and we may find it hard to feel safe in our bodies. It can affect how our identities and worldviews are formed, and we might develop deep, unconscious beliefs, such as that the world is an unsafe place and people cannot be trusted, or that we are the cause of these situations, which can carry over into later stages of our lives. If a traumatic event involves caregivers or previously considered safe adults, such as when neglect or abuse occurs, we may experience disruptions in our attachment formation, which can later affect how we trust, relate, and experience closeness in our future relationships. 

  • Post-traumatic Expression in Childhood

The fact that development is ongoing and that we have not yet reached our full potential in cognitive, linguistic, and social abilities may also affect how children experience and express the impact of traumatic events. We may lack opportunities to symbolize and integrate the events we experience, which can lead to symptoms and expressions different from those of an adult. For example, limited linguistic and verbalization abilities may lead us to express the effects of traumatic events through somatic and behavioral symptoms rather than clearly articulating them. We may not be able to clearly describe the details of what we experienced or the effects of that stress, but we may express them in more behavioral and physical ways, such as sleep and appetite problems, or hyperarousal, or withdrawal (Holley et al., 2016; Schønning et al., 2022). In younger children, the details of a traumatic event or its effects may appear in play themes (Parker et al., 2020), and we may notice changes in attitudes towards school and family (Perfect et al., 2016).

  • Therapeutic Implications for Childhood Trauma

The developmental vulnerability of children also affects how we approach handling the effects of a traumatic event. Whereas in adults, therapeutic options rely more on communication, for children, it may involve play, drawing, and storytelling to help us accommodate their developing linguistic capacities. Similarly, therapy with children would also need to consider supporting healthy development in addition to helping them heal from the effects of traumatic events. In addition, depending on the situation, caregiver involvement may be important in supporting the healing process.

Adolescence

Adolescence has its own unique stressors, just as early childhood does. Even though our use of verbalization and other cognitive functioning increases compared to childhood, important developmental tasks such as identity formation and a sense of autonomy can still take up much of our inner resources. 

  • Impact of Trauma in Adolescence

At this stage, our self-concepts, such as self-esteem, self-worth, and self-confidence, are fragile and susceptible to external influences, even in the absence of major traumatic events. Adolescence is also when important peer relationships introduce additional stressors such as social evaluation and fear of rejection. Because of this transformative nature of adolescence, the effects of traumatic events likely interfere with identity formation and autonomy experienced by young people (De Moor et al., 2019; Melamed et al., 2024)

  • Post-traumatic Expression in Adolescence

During adolescence, many cognitive processes, such as understanding other people’s thoughts and intentions, as well as our own emotions, become more developed compared to childhood. This cognitive maturing may allow us to internalize and express the effects of traumatic events in different ways. For example, because we have a better chance of understanding what we experienced and assigning meaning to it, we may feel more shame, anger, and rumination when exposed to trauma as adolescents (Fletcher, 2011). Due to our increased autonomy and physical capabilities, coping mechanisms such as self-harm or substance use may also become available to us, compared to childhood (McEvoy et al., 2023). Similar to posttraumatic reactions experienced during childhood and late adulthood, strong and intense emotions such as fear and sadness, as well as changes in emotional regulation and behavior, may also be observed during adolescence (Briere & Scott, 2015). 

  • Therapeutic Implications for Trauma during Adolescence

In terms of therapeutic approach, our maturing linguistic and cognitive capacities during adolescence allow for more communication-based therapy. Depending on our age and the applicable laws, we become less dependent on our caregivers for support than in childhood, and sessions may require less involvement from them, depending on the modality used (e.g., family therapy vs. individual therapy). However, because our individuation from family and other systems is not complete, our healing journey still presents complex challenges. That is why understanding the unique challenges young people face, in addition to the common stressors they may share with people at other stages, is an important goal when supporting them.

Adulthood

Although adulthood is often associated with more independence, stability, and psychological maturity, traumatic experiences can still significantly disrupt our sense of safety, identity, and emotional balance. At this stage of life, we usually carry multiple roles and responsibilities, such as work, partnerships, caregiving, or parenting. When a traumatic event occurs, it can interfere with these roles and the structures that organize our daily lives.

  • Effects of Trauma in Adulthood

Trauma in adulthood may arise from a wide range of experiences, including accidents, violence, medical events, sudden losses, or exposure to disaster. Trauma can also develop in more gradual ways through ongoing relational stress, betrayal, emotional neglect, or repeated experiences of instability. These events can challenge our previously held assumptions about control, predictability, and safety in the world. According to trauma theory, such events may disrupt fundamental beliefs about the self and others, leading to difficulties in trust, emotional regulation, and meaning-making (Ponting et al., 2023).

  • Expression of Post-traumatic Effects in Adulthood

Compared to earlier developmental stages, as adults, we typically have developed cognitive and linguistic capacities that may allow us to articulate our experiences and emotional responses more clearly. However, this does not necessarily make trauma easier to process. Instead, trauma may be expressed across several interconnected domains.

Adults exposed to trauma may experience intrusive memories, rumination, persistent fear, guilt, or shame, as well as negative changes in beliefs about the self or the world. Trauma may influence how we interact with others, leading some of us to withdraw socially or struggle with trust and intimacy, while others to become more irritable or reactive in relationships (Ressler et al., 2022). However, the effects of trauma are not limited to psychological experiences. Many adults report physical symptoms such as sleep disturbances, chronic tension, fatigue, or heightened physiological arousal. (Koffel et al., 2016; Ravyts et al., 2025)

  • Approach to therapy

When supporting adults exposed to trauma, therapy often focuses on helping individuals process traumatic memories, regulate emotional responses, and rebuild a sense of safety and meaning. Because adults usually have stronger verbal and reflective capacities than children, many therapeutic approaches rely on dialogue-based methods that support narrative integration and emotional processing. Evidence-based treatments such as trauma-focused cognitive behavioral therapy, EMDR, and other trauma-informed approaches aim to help individuals gradually process traumatic memories while strengthening coping skills and emotional regulation (Bisson et al., 2013).

Trauma in the Elderly

Trauma is often thought of as something that mainly occurs in childhood or adulthood, yet research shows that the majority of older adults experience at least one traumatic event during their lifetime. Despite this high exposure, the rate of post-traumatic stress disorder diagnosed according to ICD-11 criteria is relatively low among the elderly. This does not necessarily mean that trauma is less common in later life. Instead, we may find that many older individuals experience trauma-related symptoms that do not meet full diagnostic criteria but still significantly affect daily functioning and psychological well-being. Trauma in later life may arise from recent stressful or traumatic events, such as bereavement, illness, or injury, or from the long-term psychological effects of earlier life trauma that persist or re-emerge in old age.

  • Impact of Trauma in Older Adults

From a developmental perspective, later adulthood involves an important psychological process of life review. During this stage, we may find ourselves reflecting more deeply on our lives and evaluating the experiences that have shaped us. According to traditional developmental theories, such as Erik Erikson’s (1950s), this stage is characterized by a conflict between integrity and despair. As we reflect, we may attempt to integrate both achievements and regrets into a coherent life narrative. Successfully resolving this process can lead to a sense of meaning, acceptance, and psychological well-being. However, if integrating past experiences becomes difficult, we may instead experience regret, dissatisfaction, or despair. 

Trauma in older adulthood can also arise from recent life events, and the sources of trauma at this stage are quite diverse (Cook et al., 2014; Thorp et al., 2017). Some of us may carry earlier life traumas such as war experiences, childhood abuse, or natural disasters, while for others, trauma may emerge later in life. Serious medical events, such as falls or fracture-related injuries, may be experienced as traumatic because they involve sudden threats to physical integrity, health, or survival. In such situations, we may feel fear, helplessness, and a loss of control. Chronic illnesses may also lead to declines in functioning and can result in loss of autonomy, changes in identity, and increased dependence on others, which may significantly affect psychological well-being.

Similarly, dependence on care may result from age-related changes in physical functioning, even in the absence of a specific chronic illness. When we begin to need assistance with daily activities, this can be difficult because it may involve a loss of independence and reduced control over our own lives. In addition, the loss of loved ones is a significant life stressor in later adulthood. According to the grieving brain perspective, the loss of a loved one disrupts deeply encoded attachment representations in the brain, requiring individuals to gradually update their internal expectations about that person’s presence. During this process, we may experience intense emotional pain, longing, and cognitive difficulties. When multiple losses accumulate in older age, this may increase vulnerability to depression, prolonged grief, or trauma-related symptoms.

  • Post-traumatic Expression in Older Adults

The expression of symptoms in older adults can share commonalities with that of individuals in other developmental stages. When we are exposed to trauma, we may develop symptoms similar to those of Post-Traumatic Stress Disorder (Kaiser et al., 2018), which may be expressed through:

  • Intrusive memories and thinking patterns, 
  • Avoidance of reminders, 
  • Negative mood or cognition changes, and
  • Hyperarousal 

Following exposure to traumatic events, we may also experience feelings of fear, shame, guilt, anger, and emotional numbing, or somatic complaints, such as sleep disturbances and irritability.

  • Therapeutic Implications for Trauma in Late Adulthood

Treatment approaches when working with older adults exposed to trauma can benefit from being reflective in terms of life review and the potentially accumulated effects of various events, as well as considering the effects of existing health issues and physical limitations that we may be experiencing as a result of aging.

As a result…

Trauma can affect us at any stage of life, yet its impact and expression often differ depending on where we are in our developmental journey. In childhood, trauma may shape developing systems such as attachment, emotional regulation, and beliefs about safety. During adolescence, trauma can intersect with identity formation, autonomy, and intense emotional experiences. In adulthood, trauma may disrupt established roles, relationships, and assumptions about control and stability. In later life, both new stressors and the reactivation of earlier experiences may influence psychological well-being.

Understanding these developmental differences is essential when supporting individuals exposed to trauma. While many core reactions to trauma, such as fear, avoidance, and emotional distress, can appear across the lifespan, the way they are experienced and expressed often reflects the developmental capacities and challenges of each stage. A lifespan perspective, therefore, allows us to better understand how trauma unfolds over time and how therapeutic approaches can be adapted to meet the needs of individuals at different ages.

Takeaways

  • Trauma can affect people at any stage of life, but the way it is experienced and expressed often changes with development.
  • In childhood, trauma may influence core developmental systems such as attachment, emotional regulation, and beliefs about safety and trust.
  • During adolescence, trauma can intersect with identity formation, autonomy, and peer relationships, often leading to intense emotional and behavioral responses.
  • In adulthood, trauma may affect daily functioning, relationships, and one’s sense of stability or control, and earlier life trauma may also influence how stressful events are experienced.
  • In later adulthood, trauma may arise from new life stressors such as health challenges, loss, or increased dependence, while earlier unresolved experiences may also resurface during life reflection.
  • Looking at trauma from a lifespan perspective can help us better recognize its impact and support healing in ways appropriate to each stage of life.

References

  • Briere, J., & Scott, C. (2015). Complex trauma in adolescents and adults. Psychiatric Clinics of North America, 38(3), 515–527. https://doi.org/10.1016/j.psc.2015.05.004 
  • Cook, J. M., Spiro, A. III, & Kaloupek, D. G. (2014). Trauma in older adults. In M. J. Friedman, T. M. Keane, & P. A. Resick (Eds.), Handbook of PTSD: Science and practice (2nd ed., pp. 351–366). The Guilford Press.
  • De Moor, E. L., Van Der Graaff, J., Van Dijk, M. P., Meeus, W., & Branje, S. (2019). Stressful life events and identity development in early and mid‐adolescence. Journal of Adolescence, 76(1), 75–87. https://doi.org/10.1016/j.adolescence.2019.08.006
  • Erikson, E. H. (1950). Childhood and society. W W Norton & Co.
  • Erikson, Erik H. (1959). Identity and the Life Cycle. New York: International Universities Press.
  • Fletcher, K. E. (2011). Understanding and Assessing Traumatic Responses of Guilt, Shame, and Anger among Children, Adolescents, and Young Adults. Journal of Child & Adolescent Trauma, 4(4), 339–360. https://doi.org/10.1080/19361521.2011.623146 
  • Holley, A., Wilson, A., Noel, M., & Palermo, T. (2016). Post‐traumatic stress symptoms in children and adolescents with chronic pain: A topical review of the literature and a proposed framework for future research. European Journal of Pain, 20(9), 1371–1383. https://doi.org/10.1002/ejp.879 
  • Kaiser, A. P., Cook, J. M., Glick, D. M., & Moye, J. (2018). Posttraumatic Stress disorder in Older Adults: A Conceptual review. Clinical Gerontologist, 42(4), 359–376. https://doi.org/10.1080/07317115.2018.1539801 
  • Koffel, E., Khawaja, I. S., & Germain, A. (2016). Sleep Disturbances in Posttraumatic Stress Disorder: Updated review and Implications for treatment. Psychiatric Annals, 46(3), 173–176. https://doi.org/10.3928/00485713-20160125-01
  • Lupien, S. J., McEwen, B. S., Gunnar, M. R., & Heim, C. (2009). Effects of stress throughout the lifespan on the brain, behaviour and cognition. Nature Reviews. Neuroscience, 10(6), 434–445. https://doi.org/10.1038/nrn2639 
  • Melamed, D. M., Botting, J., Lofthouse, K., Pass, L., & Meiser-Stedman, R. (2024). The Relationship Between Negative Self-Concept, Trauma, and Maltreatment in Children and Adolescents: A Meta-Analysis. Clinical Child and Family Psychology Review, 27(1), 220–234. https://doi.org/10.1007/s10567-024-00472-9
  • McEvoy, D., Brannigan, R., Cooke, L., Butler, E., Walsh, C., Arensman, E., & Clarke, M. (2023). Risk and protective factors for self-harm in adolescents and young adults: An umbrella review of systematic reviews. Journal of Psychiatric Research, 168, 353–380. https://doi.org/10.1016/j.jpsychires.2023.10.017 
  • Parker, M. M., Hergenrather, K., Smelser, Q., & Kelly, C. T. (2020). Exploring child-centered play therapy and trauma: A systematic review of literature. International Journal of Play Therapy, 30(1), 2–13. https://doi.org/10.1037/pla0000136 
  • Pasteuning, J., Broeder, C., Broeders, T., Busby, R., Gathier, A., Kuzminskaite, E., Linsen, F., Souama, C., Verhoeven, J., Sep, M., & Vinkers, C. (2025). Mechanisms of childhood trauma: an integrative review of a multimodal, transdiagnostic pathway. Neurobiology of Stress, 37, 100737. https://doi.org/10.1016/j.ynstr.2025.100737 
  • Perfect, M. M., Turley, M. R., Carlson, J. S., Yohanna, J., & Gilles, M. P. S. (2016). School-Related Outcomes of Traumatic Event Exposure and Traumatic Stress Symptoms in Students: A Systematic Review of Research from 1990 to 2015. School Mental Health, 8(1), 7–43. https://doi.org/10.1007/s12310-016-9175-2
  • Ponting, C., Bond, M., Rogowski, B., Chu, A., & Lieberman, A. (2023). Childhood and adulthood trauma exposure: Associations with perinatal mental health and psychotherapy response. Journal of Traumatic Stress, 37, 178 – 186. https://doi.org/10.1002/jts.22989.
  • Ravyts, S. G., Hall, R., Vandine, D., Woods, O., Harris, R., Dudeney, J., & Aaron, R. V. (2025). PTSD and chronic pain: A systematic review and meta-analysis of mediation studies. Journal of Pain, 38, 105589. https://doi.org/10.1016/j.jpain.2025.105589
  • Ressler, K., Berretta, S., Bolshakov, V., Rosso, I., Meloni, E., Rauch, S., & Carlezon, W. (2022). Post-traumatic stress disorder: clinical and translational neuroscience from cells to circuits. Nature Reviews Neurology, 18, 273 – 288. https://doi.org/10.1038/s41582-022-00635-8.
  • Schønning, V., Sivertsen, B., Hysing, M., Dovran, A., & Askeland, K. G. (2022). Childhood maltreatment and sleep in children and adolescents: A systematic review and meta-analysis. Sleep Medicine Reviews, 63, 101617. https://doi.org/10.1016/j.smrv.2022.101617 
  • Thorp, S. R., Wells, S. Y., & Cook, J. M. (2017). Trauma-focused therapy for older adults. In S. N. Gold (Ed.), APA handbook of trauma psychology: Trauma practice (pp. 431–448). American Psychological Association. https://doi.org/10.1037/0000020-020
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