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Trauma includes emotional as well as physical experiences and injuries. Emotional injury is essentially a normal response to an extreme event. It involves the creation of emotional memories, which arise through a long-lasting effect on structures deep within the brain. The more direct the exposure to the traumatic event, the higher the risk for emotional harm. Thus in a school shooting, the student who is injured probably will be most severely affected emotionally. And the student who sees a classmate shot, even killed, probably will be more emotionally affected than the student who was in another part of the school when the violence occurred. But even second-hand exposure to violence can be traumatic. For this reason, all children and adolescents exposed to violence or a disaster, even if only through graphic media reports, should be watched for signs of emotional distress. child and adolescent violence
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