Developmental Trauma Disorder

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Developmental Trauma Disorder is not included in the DSM-IV but has been proposed for DSM-V (due out in 2013). Developmental Trauma Disorder incorporates and inter-weaves threads from Reactive Attachment Disorder, Oppositional Defiant Disorder, ADHD, Post Traumatic Stress Disorder, and provides a comprehensive lens through which to view the behaviors of children who have experienced trauma during their early lives.

Risk Factors: Multiple or chronic experienc of or exposure to traumatic events such as abandonment, abuse, neglect, or violence during the early years. Changes of primary caregiver in the early years.
Symptoms: Affective and Physiological Dysregulation

  • Unable to self-regulate from strong emotional states
  • Rages
  • Disturbances in regulation of bodily functions (sleeping, eating, and elimination)
  • Sensory over or under-reactivity
  • Lack of awareness of or dissociation from sensations, emotions, and bodily states
  • Lack of ability to describe emotions or bodily states

Attentional and Behavioral Dysregulation

  • Hypervigilant
  • Self-harming, risk-taking, and/or thrill-seeking behvaiors
  • Maladaptive attempts at self-soothing (e.g., rocking and other rhythmical movements, compulsive masturbation)
  • Habitual (intentional or automatic) or reactive self-harm
  • Inability to initiate or sustain goal-directed behavior

Self and Relational Dysregulation

  • Parentified behavior
  • Extreme concern over the safety and well-being of the primary caregiver
  • Persistent negative sense of self
  • Distrust of others
  • Reactive physical or verbal aggression
  • Inappropriate intimacy (physical or emotional)

Lack of empathy

For additional symptoms, see the Proposal link above.

Disorders with Similar Symptoms Reactive Attachment Disorder
Sensory Processing Disorder
Post Traumatic Stress Disorder
Therapies to Consider It may be best to consider a multi-faceted approach, including some or all of the following, depending on the symptoms and behaviors: Attachment Therapies, Beyond Consequences (Heather Forbes) – Regulatory Centered Parenting (Bryan Post), Sensorimotor Psychotherapy
Support Organizations National Child Trauma Stress Network
Web Sites: Proposal to Include Developmental Trauma Disorder in DSM-V
Trauma Center at JRI (Dr. Bessel Van der Kolk)

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