Toward an Empirically Based Developmental Trauma Disorder Diagnosis for Children: Factor Structure, Item Characteristics, Reliability, and Validity of the Developmental Trauma Disorder Semi-Structured Interview
Abstract
OBJECTIVE: Developmental trauma disorder (DTD) is an integrative syndrome for assessing the biopsychosocial sequelae of early life traumatization and attachment disruption. The psychometrics of a DTD Semi-Structured Interview (DTD-SI) and the validity and structure of the DTD construct were tested. METHODS: The DTD-SI was administered by research clinicians at 5 sites between September 2011 and August 2013 to a convenience sample of 236 children ages 7-17 years (50% female, 47% black or Latino/Hispanic, 91% with trauma histories) and/or a parent, recruited in pediatric or mental health services. Validity data were obtained from structured interviews for traumatic stressor and attachment disruption history (Traumatic Events Screening Instrument), DSM-IV disorders (Kiddie Schedule for Affective Disorders and Schizophrenia, Present/Lifetime Version), and potential alternative DSM-5 disorders; parent ratings on the Child Behavior Checklist; and child self-report on measures of emotion dysregulation and quality of life. RESULTS: Statistical analyses confirmed (a) the DTD-SI's item-level temporal and interrater reliability, informativeness, and absence (with 1 exception) of demographic bias and (b) DTD construct factor structure, unidimensionality, and convergent and discriminant validity. CONCLUSIONS: The DTD-SI yielded reliable, structurally meaningful, and valid item- and criterion-level data for the proposed DTD syndrome. Further clinical and scientific investigation of the clinical utility of DTD as a childhood psychiatric syndrome and diagnosis is warranted.
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The six core components of complex trauma treatment include strategies for alleviating the symptoms of DTD and Complex PTSD and are utilized in the Differential Treatment Planning Guide to provide therapists with options to offer to youths and families in collaborative treatment planning.
“These components include strategies for alleviating the symptoms of DTD (Ford et al., 2018) and Complex PTSD (ICD-11) and are utilized in the Differential Treatment Planning Guide to provide therapists with options to offer to youths and families in collaborative treatment planning.”
From Development of a Differential Assessment Guide to Improve Engagement with Youths & Families Living with Chronic Trauma (2023) · cites this paper as Ford et al., 2018
DTD highlights the impact of disrupted attachment relationships and caregiving systems, and the importance of assessing chronicity of trauma over time through a youth's and family's development (past, present, and future).
“DTD (Ford et al., 2018) highlights the impact of disrupted attachment relationships and caregiving systems, and the importance of assessing chronicity of trauma over time through a youth's and family's development (past, present, and future).”
From Development of a Differential Assessment Guide to Improve Engagement with Youths & Families Living with Chronic Trauma (2023) · cites this paper as Ford et al., 2018
Empirically validated cPTSD interview guides have been developed, including the International Trauma Questionnaire (ITQ) for adults and children, and the Developmental Trauma Disorder Semi-structured Interview (DTD-SI) for children and adolescents.
“Empirically validated cPTSD interview guides have been developed, including the International Trauma Questionnaire (ITQ) for adults [21] and children [66], and the Developmental Trauma Disorder Semi-structured Interview (DTD-SI) for children and adolescents [46, 174].”
From Complex PTSD and borderline personality disorder (2021) · cites this paper as [46]
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- Authors
- Ford, J. D., Spinazzola, J., van der Kolk, B., & Grasso, D. J.
- Affiliations
- University of Connecticut (US)
- ORCID
- Grasso, Damion J.
- Venue
- The Journal of Clinical Psychiatry
- Publisher
- Physicians Postgraduate Press, Inc
- Published
- 2018-09-11
- Volume
- 79
- Issue
- 5
- ISSN
- 0160-6689 (ISSN-L)
- 1555-2101
- OpenAlex
- W2890790159
- Cited by
- 59
- References
- 0
- Citations by year
- 2026: 3 · 2025: 5 · 2024: 5 · 2023: 3 · 2022: 13 · 2021: 15 · 2020: 8 · 2019: 6 · 2018: 1
- FWCI
- 8.81
- 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, early trauma, attachment disruption, diagnostic validity, construct validity, factor structure, inter-rater reliability, children, emotional dysregulation, quality of life, DSM-5
- MeSH terms
- Adolescent, Child, Child Abuse, Female, Humans, Interview, Psychological, Male, Psychiatric Status Rating Scales, Psychometrics, Reproducibility of Results
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