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Cited by 102Child Abuse and TraumaPosttraumatic Stress Disorder ResearchPsychoanalysis and Psychopathology Research

Clinical Significance of a Proposed Developmental Trauma Disorder Diagnosis: Results of an International Survey of Clinicians

Ford, Julian D., Grasso, Damion, Greene, Carolyn, Levine, Joan, Spinazzola, Joseph, van der Kolk, Bessel·2013·The Journal of Clinical Psychiatry
DOI 10.4088/jcp.12m08030
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Abstract

OBJECTIVE: Maltreatment, family violence, and disruption in primary caregiver attachment in childhood may constitute a developmental form of trauma that places children at risk for multiple psychiatric and medical diagnoses that often are refractory to well-established evidence-based mental health treatments. No integrative diagnosis exists to guide assessment and treatment for these children and adolescents. This study therefore assessed clinicians' ratings of the clinical utility of a proposed developmental trauma disorder diagnostic framework. METHOD: An Internet survey was conducted with an international convenience sample of 472 self-selected medical, mental health, counseling, child welfare, and education professionals. Respondents made quantitative ratings of the clinical significance of developmental trauma disorder, developmental trauma exposure, and symptom items and also posttraumatic stress disorder (PTSD) and other Axis I internalizing and externalizing disorder symptom items for 4 clinical vignettes. Ratings of the discriminability of each developmental trauma disorder item from PTSD, other anxiety disorders, affective disorders, and externalizing behavior disorders, and of each developmental trauma disorder item's amenability to existing evidence-based treatments for those disorders, also were obtained. RESULTS: Respondents viewed developmental trauma disorder criteria as (1) comparable in clinical utility to criteria for PTSD and other psychiatric disorders; (2) discriminable from and not fully accounted for by other disorders; and (3) refractory to existing evidence-based psychotherapeutic treatments. CONCLUSIONS: The exposure and symptom criteria proposed for a developmental trauma disorder diagnosis warrant clinical dissemination and scientific field testing to determine their actual clinical utility in treating traumatized children with complex psychiatric presentations.

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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 [45]

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Authors
Ford, J. D., Grasso, D., Greene, C., Levine, J., Spinazzola, J., & van der Kolk, B.
ORCID
Venue
The Journal of Clinical Psychiatry
Publisher
Physicians Postgraduate Press, Inc
Published
2013-08-15
Volume
74
Issue
08
Pages
841-849
ISSN
0160-6689 (ISSN-L)
DOI
10.4088/jcp.12m08030
OpenAlex
W2080748942
Cited by
102
References
0
Citations by year
2026: 6 · 2025: 6 · 2024: 6 · 2023: 4 · 2022: 11 · 2021: 11 · 2020: 6 · 2019: 7 · 2018: 6 · 2017: 9 · 2016: 12 · 2015: 11 · 2014: 5 · 2013: 2
FWCI
11.11
Type
journal article
Language
en
Open access
closed
Locations
  • The Journal of Clinical Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
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
developmental trauma disorder, child abuse, domestic violence, attachment disruption, diagnostic criteria, clinical utility, discriminability, post-traumatic stress disorder, internalizing disorders, externalizing disorders, evidence-based treatment, children and adolescents, clinician ratings
MeSH terms
Adolescent, Adult, Attitude of Health Personnel, Mental Disorders, Child, Developmental Disabilities, Data Collection, Dissociative Disorders, Female, Humans, Life Change Events, Male, Middle Aged, Patient Care Team, Risk Factors, Stress Disorders, Post-Traumatic, Comorbidity, Reactive Attachment Disorder, Diagnostic and Statistical Manual of Mental Disorders, Evidence-Based Practice

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