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Can Developmental Trauma Disorder be Distinguished from Posttraumatic Stress Disorder? A Symptom-Level Person-Centered Empirical Approach

Ford, Julian; Charak, Ruby; Karatzias, Thanos; Shevlin, Mark; Spinazzola, Joseph


Julian Ford

Ruby Charak

Mark Shevlin

Joseph Spinazzola


Background: Developmental Trauma Disorder (DTD) is a proposed childhood psychiatric diagnosis for psychopathological and developmental sequela of victimization and attachment trauma extending beyond posttraumatic stress disorder (PTSD). Objective: To determine whether a sub-group of trauma-impacted children is characterized by symptoms DTD that extend beyond, or co-occur with, the symptoms of posttraumatic stress disorder (PTSD). Method: Person-centered Latent Class Analyses (LCA) were done with data from 507 children (ages 7-18years, ( M = 12.11, SD = 2.92; 49% female) referred to the study by mental health or pediatric clinicians. Results: A four class solution was optimal (LMR = 398.264, p < .001; Entropy = .93): (1) combined DTD+PTSD ( n = 150); (2) predominant DTD ( n = 156); (3) predominant PTSD ( n = 54); (4) minimal symptoms ( n = 147). Consistent with prior research, the DTD+PTSD class was most likely to have experienced traumatic emotional
abuse and neglect ( X 2 (3) = 16.916 and 28.016, respectively, p < .001), and had the most psychiatric comorbidity ( F (3, 502) = 3.204, p < .05). Predominant DTD class members were most likely to meet criteria for Oppositional Defiant Disorder (ODD) ( X 2 (3) = 84.66, p < .001). Conclusion: Symptoms of DTD may occur with, or separately from, PTSD symptoms. Children with high DTD|+PTSD symptoms had extensive psychiatric comorbidity, while those with high DTD symptoms and minimal PTSD symptoms were highly likely meet criteria for ODD. In clinical and research assessment and treatment of children with complex psychiatric comorbidity or disruptive behavior problems, symptoms of DTD should be considered, both along with, and in the absence of, PTSD symptoms.

Journal Article Type Article
Acceptance Date Sep 24, 2022
Online Publication Date Nov 2, 2022
Publication Date 2022
Deposit Date Sep 27, 2022
Publicly Available Date Nov 2, 2022
Print ISSN 2000-8198
Publisher Co-Action Publishing
Peer Reviewed Peer Reviewed
Volume 13
Issue 2
Article Number 2133488
Keywords developmental trauma; PTSD; children; adolescents; latent class analysis
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