Developmental Trauma Disorder: On the advisability of introducing a new diagnostic category

Abstract

The term Developmental Trauma Disorder (DTD) can be distinguished from various other descriptions employed to delineate psychological conditions and disorders stemming from stress and trauma. DTD specifically denotes the repercussions arising from prolonged exposure of a child to multifarious forms of maltreatment, including violence and neglect inflicted by primary caregivers. These consequences manifest in the affected individual’s incapacity to process and assimilate traumatic encounters, impediments in the formation of their own identity, as well as disorders related to emotional and physical self-regulation, attention, and behaviour. Additionally, these consequences pose challenges in the establishment and cultivation of interpersonal relationships. Violence and neglect are frequently associated with the transgenerational perpetuation of dysfunctional family patterns. Common risk factors contributing to child maltreatment encompass economic disadvantage or the family’s lower socioeconomic status, community violence, and structural and institutional forms of violence that disproportionately affect minority populations in a given society. Research on DTD justifies the distinction between the consequences of exposure to maltreatment in childhood and the consequences of traumatic events to which the victim is exposed later in life. The consequences are more often manifested in DTD symptomatology in the former group and in PTSD symptomatology in the latter. The DTD represents a developmentally sensitive diagnostic complement for children with multiple mental disorders, which until now have not been linked by many experts to early trauma as a key causal factor. In addition to more accurate diagnosis, the definition of DTD allows for the development of more effective clinical practice to help children with DTD and for research on children’s traumatisation and resilience. At the same time it is important to avoid excessive pathologization and psychiatrization, even with the introduction of a new diagnostic category such as DTD.