Article

Developmental trauma disorder: pros and cons of including formal criteria in the psychiatric diagnostic systems.

BMC Psychiatry (Impact Factor: 2.24). 01/2013; 13(1):3. DOI: 10.1186/1471-244X-13-3
Source: PubMed

ABSTRACT BACKGROUND: This article reviews the current debate on developmental trauma disorder (DTD) with respect to formalizing its diagnostic criteria. Victims of abuse, neglect, and maltreatment in childhood often develop a wide range of age-dependent psychopathologies with various mental comorbidities. The supporters of a formal DTD diagnosis argue that post-traumatic stress disorder (PTSD) does not cover all consequences of severe and complex traumatization in childhood. DISCUSSION: Traumatized individuals are difficult to treat, but clinical experience has shown that they tend to benefit from specific trauma therapy. A main argument against inclusion of formal DTD criteria into existing diagnostic systems is that emphasis on the etiology of the disorder might force current diagnostic systems to deviate from their purely descriptive nature. Furthermore, comorbidities and biological aspects of the disorder may be underdiagnosed using the DTD criteria. SUMMARY: Here, we discuss arguments for and against the proposal of DTD criteria and address implications and consequences for the clinical practice.

Full-text

Available from: Franz Petermann, Jun 13, 2015
2 Followers
 · 
127 Views
  • [Show abstract] [Hide abstract]
    ABSTRACT: Abstract The current definition of a traumatic event in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5; APA, 2013 ) may be too narrow to describe the myriad of difficult childhood experiences. Furthermore, youth may develop a distinct pattern of symptoms in relation to complex or multiple childhood trauma, the proposed "developmental trauma disorder" (DTD; van der Kolk, 2005 ). Researchers in the present study developed and utilized a new measure, the Potentially Traumatic Experiences Questionnaire (PTEQ), to assess patterns in childhood trauma exposure. Two item formats (open-ended vs. closed-ended) were used in order to explore potential differences in reporting. Further, the present study assessed for symptoms associated with DTD following exposure to complex childhood trauma in a sample of adolescents. Participants were 186 eighteen- and nineteen-year-olds who were asked to report retrospectively on their difficult childhood experiences. The results showed that participants reported multiple events that would not be considered 'traumatic' by the DSM-V PTSD Criterion A, and those who completed the PTEQ with closed-ended items reported more differentiated trauma types than participants who completed the open-ended questionnaire. Also, participants who reported multiple or chronic events were more likely to endorse symptoms associated with DTD. This study has implications for the diagnosis and treatment of complex trauma experiences in youth.
    Journal of Trauma & Dissociation 01/2014; 15(2). DOI:10.1080/15299732.2014.867577 · 1.72 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Youth behavioral disorders are not only considered widespread and costly in terms of financial, human, and societal impact into adulthood, but also resistant to interventions, especially when related to childhood trauma and accompanied by continued social distress and comorbid conditions such as personality, mood, and substance use disorders. Mode Deactivation Therapy (MDT), a third wave contextual therapy approach derived from cognitive therapy principles, was developed in recognition of the need for this population. The MDT theoretical framework and methodology contains elements of mindfulness, Acceptance and Commitment Therapy (ACT), and Dialectical Behavior Therapy (DBT), but it is the unique Validation-Clarification-Redirection process (VCR) step that sets it apart from other contextual approaches. VCR is considered to be the core process component in MDT to affect therapeutic change by validating core beliefs as reasonable responses to past experiences, but exploring functional alternative beliefs. The main objectives of this study is to review evidence of the effectiveness of family-based MDT (FMDT) compared to standard treatment, and provide a preliminary randomized controlled group study of the mediation effects that VCR and other components have on the overall treatment mechanisms and outcomes. Recommendations for further study conclude the current scope.
    04/2014; 9(1):1-13. DOI:10.1037/h0101009