The proposed diagnosis of developmental trauma disorder (DTD) is not completely firmed up yet. But in broad brush form, here is what children must show to be considered to have the disorder, according to a May 2005 article in Psychiatric Annals (Vol. 35, No. 5, pages 401-408) by Boston University Medical Center psychiatrist Bessel van der Kolk, MD, a leader of the National Child Traumatic Stress Network interest group that is spearheading the effort:

  • Exposure: Exposure to one or more forms of developmentally adverse interpersonal traumas such as abandonment, betrayal, physical or sexual abuse and emotional abuse. May also experience subjective feelings in relation to this trauma, such as rage, betrayal, fear, resignation, defeat and shame.

  • Dysregulation: Dysregulated development in response to trauma cues, including disturbances in emotions, health, behavior, cognition, relationships and self-attributions. Behavioral manifestation could be self-injury, for example; cognitive manifestation might appear as confusion or dissociation.

  • Negative attributions and expectations: Negative beliefs in line with experience of interpersonal trauma. May stop expecting protection from others and believe that future victimization is inevitable.

  • Functional impairments: Impairment in any or all arenas of life, including school, friendship, family relations, and the law.

-T. DeAngelis