CoChat
Sign Up
Cited by 325Child Abuse and TraumaPosttraumatic Stress Disorder ResearchPsychoanalysis and Psychopathology Research

The DOI matches its Crossref record; 105 of the 105 references it cites were found in a registry or an index.

Recognizing the importance of childhood maltreatment as a critical factor in psychiatric diagnoses, treatment, research, prevention, and education

Open access
Teicher, Martin H., Gordon, Jeoffry B., Nemeroff, Charles B.·2022·Molecular Psychiatry
DOI 10.1038/s41380-021-01367-9PMC PMC8567985
Open this paper in CoChat — free accountOpen PDF

Abstract

Childhood maltreatment is the most important preventable risk factor for psychiatric disorders. Maltreated individuals typically develop psychiatric disorders at an earlier age, have a more pernicious course, more comorbidities, greater symptom severity, and respond less favorably to treatments than non-maltreated individuals with the same primary DSM-5 diagnosis. Furthermore, maltreated individuals have alterations in stress-susceptible brain regions, hypothalamic-pituitary-adrenal response, and inflammatory marker levels not discernible in their non-maltreated counterparts. Hence, maltreated and non-maltreated individuals with the same primary DSM-5 diagnoses appear to be clinically and neurobiologically distinct. The failure to embody this distinction in DSM-5 has interfered with our ability to discover novel treatments, to recommend currently available treatments most likely to be efficacious, and has been a largely unrecognized confound that has thwarted our ability to identify the biological basis for major psychiatric disorders. Incorporating this distinction into DSM will help transform this sign and symptom-based classification system to a more etiologically informed nosology. We discuss several diagnostic alternatives and recommend the inclusion of a Developmental Trauma Disorder diagnosis for severely dysregulated individuals, of all ages, with numerous comorbidities, who experienced interpersonal victimization and disruptions in attachment, such as emotional maltreatment or neglect. For less severely affected maltreated individuals, we suggest using conventional diagnostic categories, such as major depression, but with an essential modifier indicating a history of childhood maltreatment, or early life stress, to delineate the ecophenotypic variant. Implementing this strategy should improve our ability to effectively diagnose and treat individuals with psychiatric disorders and to accelerate discovery.

Overview

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1038/s41380-021-01367-9

Cites

105 of 105 references verified0 citation errors · 0 not checkable

Statistics

Verification

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Citations

Cites

Flagged first, then by citations

Show all 104 references

Cited by

Sorted by citations

Items 101–200 of 325

Related

See all

Metadata

Authors
Teicher, M. H., Gordon, J. B., & Nemeroff, C. B.
Affiliations
  • Harvard University (US)
  • California Department of Social Services (US)
  • The University of Texas at Austin (US)
Corresponding author
Nemeroff, Charles B.
ORCID
Venue
Molecular Psychiatry
Publisher
Springer Science and Business Media LLC
Published
2021-11-04
Volume
27
Issue
3
Pages
1331-1338
ISSN
  • 1359-4184 (ISSN-L)
  • 1476-5578
DOI
10.1038/s41380-021-01367-9
PMC
PMC8567985
OpenAlex
W3211215709
Cited by
325
References
104
Citations by year
2026: 59 · 2025: 84 · 2024: 89 · 2023: 57 · 2022: 35 · 2021: 1
FWCI
6.04
Type
journal article
Language
en
Open access
Licence
Locations
  • Molecular Psychiatry (publishedVersion, public-domain)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • U.S. Department of Health & Human Services | National Institutes of Health (MH-117293, AA-024933, HD-079484, DA-017846)
  • ANS Foundation
Topics
  • Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
  • Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
  • Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
Keywords
child abuse, developmental trauma disorder, DSM-5, psychiatric classification, early life stress, psychological maltreatment, attachment disruption, hypothalamic-pituitary-adrenal axis, neuroinflammation, comorbidities, treatment response, major depressive disorder, ecophenotypes
MeSH terms
Mental Disorders, Brain, Child, Child Abuse, Major Depressive Disorder, Depressive Disorder, Major, Humans, Diagnostic and Statistical Manual of Mental Disorders

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review