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.

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    ABSTRACT: This article describes the effective use of physiological monitoring and biofeedback-assisted relaxation training as primary interventions for the treatment of panic disorder in a 31-year-old woman with a history of complex developmental trauma. A biopsychosocial perspective of panic disorder grounded in learning theory and informed by trauma practice was used to examine the role of multiple causational factors in the development of panic disorder and to discuss intervention strategies addressing the interconnected nature of the biological and psychosocial realms of the human experience. The client participated in 2 pretreatment (intake interview and formal testing) and 14 outpatient therapy sessions at a biofeedback clinic over a period of 6 months. Treatment-outcome data indicated a marked decrease in acute symptoms as measured by the Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), and the Minnesota Multiphasic Personality Inventory-Second Edition (MMPI-2).
    Clinical Case Studies 05/2013; 13(3):231-249. DOI:10.1177/1534650113507745
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    ABSTRACT: A plethora of research on the psychological consequences of community violence exposure among youth has conceptualized and measured community violence as a single, homogenous construct that indiscriminately gives rise to a wide range of outcomes. However, it is increasingly recognized that community violence exposure is comprised of many disparate characteristics. Thus, a more dimensional theoretical approach to the study of community violence exposure is proposed; such an approach will more precisely clarify how community violence exposure is differentially associated with specific outcomes. In particular, the dimensions of type, severity, physical proximity, relational proximity (familiarity with the persons involved), and chronicity of community violence exposure are suggested as potential moderating factors that may each, individually and in interaction, differentially impact youths' well-being. In order to account for greater contextual complexity in children's experiences of community violence, several recommendations for new methodological approaches and research directions are proposed and discussed. Such a theoretical shift is critical to advance our understanding of the processes underlying the links between community violence exposure and youth outcomes, as well as to inform more targeted and effective interventions for youth exposed to community violence.
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May 20, 2014