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Cited by 108Child Abuse and TraumaPosttraumatic Stress Disorder ResearchChild and Adolescent Psychosocial and Emotional Development

Comorbidity of developmental trauma disorder (DTD) and post-traumatic stress disorder: findings from the DTD field trial

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van Der Kolk, Bessel, Ford, Julian D., Spinazzola, Joseph·2019·European Journal of Psychotraumatology
DOI 10.1080/20008198.2018.1562841PMC PMC6352932
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Abstract

Background: Developmental trauma disorder (DTD) has been proposed to describe the biopsychosocial sequelae of exposure to interpersonal victimization in childhood that extend beyond the symptoms of post-traumatic stress disorder (PTSD).Objective: To characterize the psychopathology comorbid with DTD and to determine whether this comorbidity is distinct from, and extends beyond, comorbidities of PTSD.Method: DTD was assessed by structured interview, and probable Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) psychiatric disorders were identified with screening modules on the Kiddie Schedule for Affective Disorders and Schizophrenia, Present/Lifetime version (K-SADS-PL), in a multi-site sample of 236 children (7–18 years old; 50% female) referred by paediatric or mental health providers.Results: DTD (N = 80, 34%) and PTSD (N = 69, 29%) were highly comorbid and shared several DSM-IV internalizing disorder and DSM, 5th Edition (DSM-5) dysregulation disorder comorbidities. However, DTD, but not PTSD, was associated with comorbid panic disorder and disruptive behaviour disorders. On a multivariate basis including all probable DSM-IV disorders and DSM-5 dysregulation disorders, DTD was associated with separation anxiety disorder and attention deficit hyperactivity disorder after controlling for PTSD, while PTSD was associated with major depression and generalized anxiety disorder after controlling for DTD.Conclusions: DTD’s comorbidities overlap with but extend beyond those of PTSD to include panic, separation anxiety, and disruptive behaviour disorders. DTD warrants further investigation as a potential diagnosis or a complex variant of PTSD in children, similar to the adult symptoms of disturbances of self-organization in the proposed International Classification of Diseases, 11th revision (ICD-11) complex post-traumatic stress disorder subtype.

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  • Developmental trauma disorder (DTD) was formulated as a pediatric variant of cPTSD based on research on childhood sequelae of maltreatment and poly-victimization, an international survey of clinicians, and a field trial study with children.

    “Based on research on the childhood sequelae of maltreatment and poly-victimization [25] on an international survey of clinicians [45], and results from a field trial study with both clinical and non-clinical samples of children [160, 174], developmental trauma disorder (DTD) was formulated as a pediatric variant of cPTSD.”

    From Complex PTSD and borderline personality disorder (2021) · cites this paper as [174]

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Authors
van Der Kolk, B., Ford, J. D., & Spinazzola, J.
Affiliations
  • Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
  • Department of Psychiatry, University of Connecticut School of Medicine, Farmington, CT, USA
  • The Foundation Trust, Melrose, MA, USA
Venue
European Journal of Psychotraumatology
Publisher
Informa UK Limited
Published
2019-01-29
Volume
10
Issue
1
Pages
1562841-1562841
ISSN
2000-8066 (ISSN-L)
DOI
10.1080/20008198.2018.1562841
PMC
PMC6352932
OpenAlex
W2912598357
Cited by
108
References
97
Citations by year
2026: 8 · 2025: 17 · 2024: 9 · 2023: 20 · 2022: 13 · 2021: 24 · 2020: 12 · 2019: 5
FWCI
15.77
Type
journal article
Language
en
Open access
Licence
Locations
  • European Journal of Psychotraumatology (publishedVersion, cc-by-nc)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
Justice Resource Institute by organizations and individuals
Topics
  • Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
  • Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
  • Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
Keywords
developmental trauma disorder, post-traumatic stress disorder, comorbidities, childhood trauma, interpersonal victimization, panic disorder, separation anxiety disorder, disruptive behavior disorders, attention deficit hyperactivity disorder, major depressive disorder, generalized anxiety disorder, complex PTSD, ICD-11, children

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