Studies of people who have survived traumatic events, such as combat veterans, have provided helpful analogies for work with adults who have experienced childhood abuse and neglect. Core posttraumatic symptoms include flashbacks, sleep disturbances with nightmares, high anxiety with easy startle, extreme emotional distress, shattered self-esteem, a tendency to express psychic pain in bodily terms, and multiple symptoms. Given the prevalence of child abuse and neglect, it is not surprising that studies of psychiatric patients show that histories of childhood maltreatment are even higher in this group than in the general population. In several studies, between 42 percent and 81 percent of adult psychiatric patients disclosed histories of physical or sexual abuse. This chapter organizes patterns of symptoms found years after experiences of three levels of increasingly severe childhood maltreatment. All three levels of maltreatment conform to definitions of abuse currently in use by United States child protection agencies. The discussion focuses on posttraumatic stress disorders, borderline conditions, and dissociative disorders. Other topics discussed are assessment, the facilitation of adult memory for childhood abuse and neglect, a sample history, an overview of treatment, and relevant research strategies and obstacles. A concluding legal commentary addresses issues related to abused persons, other family members, and offenders, as well as guidance for mental health professionals and practitioners. 75 references