Volume 38, No. 3 March 2007
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Monitor on Psychology Volume 38, No. 3 March 2007 |
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What the new diagnosis would include
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 |
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