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Open Access Highly Accessed Debate

Developmental trauma disorder: pros and cons of including formal criteria in the psychiatric diagnostic systems

Marc Schmid1*, Franz Petermann2 and Joerg M Fegert3

Author Affiliations

1 Department of child and adolescent psychiatry University Basel, Schanzenstrasse 13, CH-4056, Basel, Switzerland

2 Center of clinical psychology and rehabilitation University Bremen, Grazer Strasse 6, DE-28329, Bremen, Germany

3 Department of Child and Adolescent Psychiatry and Psychotherapy, University of Ulm, Steinhövelstrasse 5, DE-89075, Ulm, Germany

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BMC Psychiatry 2013, 13:3  doi:10.1186/1471-244X-13-3

Published: 3 January 2013

Abstract

Background

This article reviews the current debate on developmental trauma disorder (DTD) with respect to formalizing its diagnostic criteria. Victims of abuse, neglect, and maltreatment in childhood often develop a wide range of age-dependent psychopathologies with various mental comorbidities. The supporters of a formal DTD diagnosis argue that post-traumatic stress disorder (PTSD) does not cover all consequences of severe and complex traumatization in childhood.

Discussion

Traumatized individuals are difficult to treat, but clinical experience has shown that they tend to benefit from specific trauma therapy. A main argument against inclusion of formal DTD criteria into existing diagnostic systems is that emphasis on the etiology of the disorder might force current diagnostic systems to deviate from their purely descriptive nature. Furthermore, comorbidities and biological aspects of the disorder may be underdiagnosed using the DTD criteria.

Summary

Here, we discuss arguments for and against the proposal of DTD criteria and address implications and consequences for the clinical practice.

Keywords:
Comorbidity; Developmental psychopathology; Developmental trauma disorder (DTD); Dissociation, Post-traumatic stress disorder (PTSD)