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Clinical Significance of a Proposed Developmental Trauma Disorder Diagnosis

Results of an International Survey of Clinicians
Authors: Julian D, Ford; Damion, Grasso; Carolyn, Greene; Joan, Levine; Joseph, Spinazzola; Bessel, van der Kolk;

Clinical Significance of a Proposed Developmental Trauma Disorder Diagnosis

Abstract

Maltreatment, family violence, and disruption in primary caregiver attachment in childhood may constitute a developmental form of trauma that places children at risk for multiple psychiatric and medical diagnoses that often are refractory to well-established evidence-based mental health treatments. No integrative diagnosis exists to guide assessment and treatment for these children and adolescents. This study therefore assessed clinicians' ratings of the clinical utility of a proposed developmental trauma disorder diagnostic framework.An Internet survey was conducted with an international convenience sample of 472 self-selected medical, mental health, counseling, child welfare, and education professionals. Respondents made quantitative ratings of the clinical significance of developmental trauma disorder, developmental trauma exposure, and symptom items and also posttraumatic stress disorder (PTSD) and other Axis I internalizing and externalizing disorder symptom items for 4 clinical vignettes. Ratings of the discriminability of each developmental trauma disorder item from PTSD, other anxiety disorders, affective disorders, and externalizing behavior disorders, and of each developmental trauma disorder item's amenability to existing evidence-based treatments for those disorders, also were obtained.Respondents viewed developmental trauma disorder criteria as (1) comparable in clinical utility to criteria for PTSD and other psychiatric disorders; (2) discriminable from and not fully accounted for by other disorders; and (3) refractory to existing evidence-based psychotherapeutic treatments.The exposure and symptom criteria proposed for a developmental trauma disorder diagnosis warrant clinical dissemination and scientific field testing to determine their actual clinical utility in treating traumatized children with complex psychiatric presentations.

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Keywords

Adult, Male, Patient Care Team, Reactive Attachment Disorder, Adolescent, Attitude of Health Personnel, Data Collection, Developmental Disabilities, Mental Disorders, Comorbidity, Dissociative Disorders, Middle Aged, Diagnostic and Statistical Manual of Mental Disorders, Life Change Events, Stress Disorders, Post-Traumatic, Risk Factors, Evidence-Based Practice, Humans, Female, Child

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    This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
82
Top 10%
Top 10%
Top 10%
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