Research has found that the physical symptoms of pain, fatigue, sleep disturbance, anxiety, depression, and cognitive dysfunction are associated with experiencing stress. Debilitating physical symptoms that stem from stress result from alterations of the systems responsible for adaptation to stress, including the hypothalamic-pituitary-adrenal axis and autonomic nervous system. Exposure to violence and abuse is linked to altered biological stress-adaptation systems. Patients with stress-related physical symptoms have reported higher levels of exposure to violence and abuse than nonexposed individuals. The evaluation of patients who report stress-related physical symptoms should include inquiry into a history of past and ongoing abuse. For women who report intimate partner abuse, there should be screening and treatment for stress-related physical symptoms. Children exposed to violence and abuse may be at higher risk for stress-related physical symptoms than adults exposed to maltreatment. Research on prevention strategies for stress resulting from child abuse should be explored. Additional research should explore the complex interactions of exposure to violence and abuse, other factors that shape coping and behaviors, and stress-related physical symptoms. The relationship between genetic factors and the development of stress-related physical symptoms after exposure to abuse has yet to be determined. As with other medical conditions, there is likely to be a complex interaction between genetic characteristics and environment that determines clinical manifestations. 102 references