Emotional and behavioral signs or changes are more common than physical signs and can include:

• Anxiety and depression

• Sleep disturbances, including nightmares or night terrors

• Change in eating habits

• Unusual fear of certain people or places; reluctance to be alone with a certain person

• Changes in mood that could include anger, aggressiveness towards parents, siblings, friends, pets

• Rebellion or withdrawal; runaway behavior

• Change in attitude towards school or academic performance; lack of interest in friends, sports, or other activities

• Unexplained or frequent health problems like headaches or stomach aches

• Poor self-esteem; avoidance of relationships

• Self-mutilation or change in body perception, like thinking of self or body as dirty or bad; suicidal thoughts

• Regression to previously outgrown behaviors, for example, bedwetting or thumb sucking

• Abnormal sexual behaviors or knowledge of advanced sexual language and behaviors

• Too “perfect” behavior or overly compliant behavior