Survivors of early childhood trauma: evaluating a two-dimensional diagnostic model of the impact of trauma and neglect

Wildschut, Marleen; Langeland, Willie; Smit, Jan; Draijer, Nel

doi:10.3402/ejpt.v5.21824

Cited by 9 publications

(11 citation statements)

References 53 publications

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“…We didn´t find a difference between cases and controls in relation to sexual abuse because this measure is probably underestimated in our study. It is known that among substance abusers, sexual abuse is a major issue with a high prevalence, [34,35]. Previous studies indicate that childhood trauma could influence the severity, prognosis and evolution of crack cocaine consumption [36].…”

Section: Discussionmentioning

confidence: 99%

Childhood Trauma and Resilience: Vulnerabilities to Develop Crack/Cocaine Dependence

Sordi¹,

Hauck²,

Laitano³

et al. 2015

J Alcohol Drug Depend

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Section: Discussionmentioning

confidence: 99%

Childhood Trauma and Resilience: Vulnerabilities to Develop Crack/Cocaine Dependence

Sordi¹,

Hauck²,

Laitano³

et al. 2015

J Alcohol Drug Depend

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“…The only exclusion criterion was insufficient mastery of the Dutch language. The reason for choosing these patient groups is explained in more detail elsewhere (Wildschut et al, 2014). In short, we assumed that a wide range of trauma-related disorders and a reported history of trauma, both in childhood and adulthood, were present within these groups.…”

Section: Methodsmentioning

confidence: 99%

“…This range of severity of psychopathology has important implications for treatment. The problems facing survivors of early childhood trauma and/or emotional neglect can be viewed both from a symptom-oriented, as well as a person-oriented approach (Wildschut, Langeland, Smit, & Draijer, 2014). Therefore, a more dimensional approach in patients reporting early childhood trauma and/or emotional neglect has promise to characterize clinically relevant, transdiagnostic psychopathology (Galatzer-Levy & Bryant, 2013).…”

mentioning

confidence: 99%

“…In line with the idea of precision medicine, Draijer (2003) has developed a two-dimensional model that might serve as a guide for treatment for survivors of early childhood trauma and/or emotional neglect (see Figure 1; Wildschut et al, 2014). The model takes into account both the influence of trauma and the influence of emotional neglect on the development of trauma-related disorders, DD and PD, and the spectrum gives an indication of treatability.…”

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confidence: 99%

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Profiling psychopathology of patients reporting early childhood trauma and emotional neglect: Support for a two-dimensional model?

Wildschut¹,

Swart

Langeland³

et al. 2019

Psychological Trauma: Theory, Research, Practice, and Policy

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Objective: Profiling patients who report early childhood trauma and emotional neglect may be useful for treatment planning. This study attempts to quantify a two-dimensional “trauma-neglect model” (Draijer, 2003) proposed to distinguish clinical profiles in terms of trauma-related, dissociative, and personality pathology. Method: A sample of patients referred to a trauma program (n = 49) and a personality disorders program (n = 101) was extensively assessed. Cluster analysis was used to discriminate patients in terms of “psychiatric disease burden,” based on symptom severity scores, type of disorder, and level of maladaptive personality functioning. Clusters that differed in psychiatric disease burden were mapped in the trauma-neglect space and their positions were evaluated. Results: We found three clusters and labeled them as “mildly impaired” (26% of patients), “moderately impaired” (43% of patients), and “severely impaired” (31% of patients). The mean scores on trauma and neglect for the mild and severe groups differed significantly. Conclusions: These findings indicate that further investigation of the validity of the model, which may be used to plan treatment, is useful. Patients experiencing a wide range of trauma-related disorders, dissociative disorders (DD), and personality disorders (PD), combined with a high level of psychiatric symptoms and a maladaptive style of personality functioning, report a range of traumatic experiences in combination with a lack of maternal care, and can be profiled as “severely impaired.”

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“…In the present study, we describe the two-year course of (comorbid) TRDs, DDs and PDs in a cohort of patients referred to a specialized mental health facility. This study is part of a larger project on survivors of early childhood trauma and emotional neglect (Wildschut, Langeland, Smit, & Draijer, 2014). At baseline comorbid psychiatric disorders of patients who were referred to treatment for PDs and patients who were referred to treatment for TRDs or DDs had been assessed.…”

mentioning

confidence: 99%

The course of (comorbid) trauma-related, dissociative and personality disorders: two year follow up of the Friesland study cohort

Swart

Wildschut

Draijer

et al. 2020

European Journal of Psychotraumatology

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Background: There is substantial comorbidity between trauma-related disorders (TRDs), dissociative disorders (DDs) and personality disorders (PDs), especially in patients who report childhood trauma and emotional neglect. However, little is known about the course of these comorbid disorders, despite the fact that this could be of great clinical importance in guiding treatment.Objective: This study describes the two-year course of a cohort of patients with (comorbid) TRDs, DDs and PDs and aims to identify possible predictors of course. Possible gender differences will be described, as well as features of non-respondents. Method: Patients (N = 150) referred to either a trauma treatment program or a PD treatment program were assessed using five structured clinical interviews for diagnosing TRDs, DDs, PDs and trauma histories. Three self-report questionnaires were used to assess general psychopathology, dissociative symptoms and personality pathology in a more dimensional way. Data on demographics and received treatment were obtained using psychiatric records. We described the cohort after a two-year follow-up and used t-tests or chi-square to test possible differences between respondents and non-respondents and between women and men. We used regression analysis to identify possible course predictors. Results: A total of 85 (56.7%) of the original 150 patients participated in the follow-up measurement. Female respondents reported more sexual abuse than female nonrespondents. Six patients (4.0%; all women) died because of suicide. Levels of psychopathology significantly declined during the follow-up period, but only among women. Gender was the only significant predictor of change. Conclusions: Comorbidity between TRDs, DDs and PDs was more the rule than the exception, pleading for a more dimensional and integrative view on pathology following childhood trauma and emotional neglect. Courses significantly differed between men and women, advocating more attention to gender in treatment and future research.

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Survivors of early childhood trauma: evaluating a two-dimensional diagnostic model of the impact of trauma and neglect

Cited by 9 publications

References 53 publications

Childhood Trauma and Resilience: Vulnerabilities to Develop Crack/Cocaine Dependence

Childhood Trauma and Resilience: Vulnerabilities to Develop Crack/Cocaine Dependence

Profiling psychopathology of patients reporting early childhood trauma and emotional neglect: Support for a two-dimensional model?

The course of (comorbid) trauma-related, dissociative and personality disorders: two year follow up of the Friesland study cohort

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