Why We Need a Developmentally Appropriate Trauma Diagnosis for Children: a 10-Year Update on Developmental Trauma Disorder

Abstract

Developmental Trauma Disorder (DTD) was proposed almost two decades ago as a psychiatric diagnosis for children who have been traumatically victimized and whose attachment bonding with primary caregivers has been compromised. DTD was designed to complement and extend post-traumatic stress disorder (PTSD) by addressing forms of trauma-related biopsychosocial dysregulation not included in PTSD, many of which are attributed to other psychiatric disorders. In the past decade, evidence from clinician surveys and research field trial studies has provided evidence of DTD's validity and potential clinical utility. The growing evidence base for DTD is summarized and clinical rationales for the proposed DTD symptoms are described. DTD shows promise as a developmentally-attuned traumatic stress diagnosis for traumatized children.

Temporal Alpha Power in Resting-State EEG as Neuromarker of Complex Childhood Trauma in Institutionalized Adolescents

“…Research suggests that current diagnostic criteria for PTSD / C-PTSD may not adequately identify how adolescents express (C)-PTSD symptoms in response to childhood and adolescent complex trauma [46,47]. A developmental trauma framework was proposed to offer a broader perspective on the mental health of adolescents affected by CCT [48,49]. This framework highlights the importance of considering symptoms as reactions to trauma rather than as separate mental health issues.…”

Temporal–Posterior Alpha Power in Resting-State Electroencephalography as a Potential Marker of Complex Childhood Trauma in Institutionalized Adolescents

“…Research suggests that current diagnostic criteria for PTSD/CPTSD may not adequately identify how adolescents express PTSD symptoms in response to childhood and adolescent complex trauma [ 68 , 69 ]. A developmental trauma framework was proposed to offer a broader perspective on the mental health of adolescents affected by CCT [ 70 , 71 ]. This framework highlights the importance of considering symptoms to be reactions to trauma rather than as separate mental health issues.…”

Developmental trauma: Conceptual framework, associated risks and comorbidities, and evaluation and treatment

“…However, individuals exposed to ACEs, pervasive interpersonal traumas, and polyvictimization [multiple, repeated ACEs; (4)(5)(6)(7)(8)] may not only go on to develop PTSD, but may also undergo significant shifts in their developmental trajectories. The changes are often widespread, adversely affecting their biological, social, cognitive, emotional, and spiritual/existential development (1,(9)(10)(11).…”

“…Empirically validated treatments for children and adolescents with DTD are limited in scope. However, there is growing evidence for integrative treatment approaches and relationally focused interventions as effective treatments for DTD [e.g., (4,199)]. Two such approaches include the Attachment, Regulation, and Competency (ARC) model and dyadic-developmental psychotherapy, which include individual and family counseling sessions designed to enhance interpersonal communication, attachment security, and emotion regulation, and co-regulation between the parent and child; (200,201).…”