Can developmental trauma disorder be distinguished from posttraumatic stress disorder? A symptom-level person-centred empirical approach

Julian D. Ford, Ruby Charak, Thanos Karatzias, M Shevlin, Joseph Spinazzola

Research output: Contribution to journalArticlepeer-review

7 Downloads (Pure)

Abstract

Background: Developmental Trauma Disorder (DTD) is a proposed childhood psychiatric diagnosis for psychopathological and developmental sequela of victimization and attachment trauma extending beyond posttraumatic stress disorder (PTSD).

Objective: To determine whether a sub-group of trauma-impacted children is characterized by symptoms of DTD that extend beyond, or co-occur with, the symptoms of PTSD.

Method: Person-centred Latent Class Analyses (LCA) were done with data from 507 children (ages 7-18 years, (<i>M </i>= 12.11, <i>SD</i> = 2/92); 49% female) referred to the study by mental health or paediatric clinicians.

Results: A four class solution was optimal (LMR = 398.264, <i>p </i>&lt; .001; Entropy = .93): (1) combined DTD + PTSD (<i>n</i> = 150); (2) predominant DTD (<i>n</i> = 156); (3) predominant PTSD (<i>n</i> = 54); (4) minimal symptoms (<i>n</i> = 147). Consistent with prior research, the DTD + PTSD class was most likely to have experienced traumatic emotional abuse and neglect (<i>X<sup>2</sup></i> (3)<i> </i>= 16.916 and 28.016, respectively, <i>p </i>&lt; .001), and had the most psychiatric comorbidity (<i>F</i>(3, 502)<i> </i>= 3.204, <i>p </i>&lt; .05). Predominant DTD class members were most likely to meet criteria for Oppositional Defiant Disorder (ODD) (<i>X<sup>2</sup>(3) </i>= 84.66, <i>p </i>&lt; .001).

Conclusion: Symptoms of DTD may occur with, or separately from, PTSD symptoms. Children with high DTD|+PTSD symptoms had extensive psychiatric comorbidity, while those with high DTD symptoms and minimal PTSD symptoms were highly likely to meet criteria for ODD. In clinical and research assessment and treatment of children with complex psychiatric comorbidity or disruptive behaviour problems, symptoms of DTD should be considered, both along with, and in the absence of, PTSD symptoms.

Original languageEnglish
Article number2133488
Pages (from-to)1-15
Number of pages15
JournalEuropean Journal of Psychotraumatology
Volume13
Issue number2
Early online date2 Nov 2022
DOIs
Publication statusPublished online - 2 Nov 2022

Bibliographical note

© 2022 The Author(s). Published by Informa UK Limited, trading as Taylor &amp; Francis Group.

Funding Information:
The study was funded by the Lookout Foundation, Joseph Spinazzola, Ph.D., and Julian Ford, Ph.D., Principal Investigators. No organizational or individual funder had any role in the conduct or publication of this study. The authors gratefully acknowledge the contributions of the National Child Traumatic Stress Network Developmental Trauma Disorder Work Group, co-led by Robert Pynoos, M.D. (UCLA Department of Psychiatry) and Bessel van der Kolk, M.D., to the conceptual framework and initial item development of the Developmental Trauma Disorder Semi-structured Interview (DTD-SI), and the field site coordinators and interviewers who accomplished the data collection for this study.

Funding Information:
The study was funded by the Lookout Foundation, Joseph Spinazzola, Ph.D., and Julian Ford, Ph.D., Principal Investigators. No organizational or individual funder had any role in the conduct or publication of this study. The authors gratefully acknowledge the contributions of the National Child Traumatic Stress Network Developmental Trauma Disorder Work Group, co-led by Robert Pynoos, M.D. (UCLA Department of Psychiatry) and Bessel van der Kolk, M.D., to the conceptual framework and initial item development of the Developmental Trauma Disorder Semi-structured Interview (DTD-SI), and the field site coordinators and interviewers who accomplished the data collection for this study.

Publisher Copyright:
© 2022 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

Keywords

  • Child
  • Humans
  • Female
  • Adolescent
  • Male
  • Stress Disorders, Post-Traumatic/diagnosis
  • Comorbidity
  • Mental Health
  • adolescents
  • latent class analysis
  • PTSD
  • Developmental trauma
  • children

Fingerprint

Dive into the research topics of 'Can developmental trauma disorder be distinguished from posttraumatic stress disorder? A symptom-level person-centred empirical approach'. Together they form a unique fingerprint.

Cite this