Advertisement

Assessing the Validity and Clinical Utility of a Developmental Trauma Diagnosis in Ethnic Minority Adolescents

  • Alyce L. FosterEmail author
  • Wendy D’Andrea
  • Nicholas Fehertoi
  • C. J. Healy
  • Alec Miller
Original Article
  • 33 Downloads

Abstract

Developmental Trauma Disorder (DTD), a proposed diagnostic construct designed to reflect symptoms common among multiply-traumatized youth, was examined in a population of primarily female, predominantly Hispanic and African-American adolescents seeking psychiatric treatment (N = 53). The study uses a mix of interview and self-report data to test the prevalence of DTD symptoms relative to PTSD symptoms in this sample as well as to differentiate the DTD symptoms from DSM-IV and DSM-5 PTSD. DTD symptomatology was found to be as prevalent in the sample as PTSD symptomatology and further, DTD was found to be distinct from PTSD These results add to the literature suggesting the utility and need for the addition of a DTD diagnosis to the DSM, as well as offer insight into a population that has not been heavily scrutinized under a DTD framework.

Keywords

Adolescent Assessment/evaluation Mental health Race/ethnicity Trauma 

Notes

Compliance with Ethical Standards

Disclosure of Interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Ethical Standards and Informed Consent

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation [institutional and national] and with the Helsinki Declaration of 1975, as revised in 2000. All information was collected as part of routine clinical care and data were culled from charts.

References

  1. Ackerman, P. T., Newton, J. E. O., McPherson, W. B., Jones, J. G., & Dykman, R. A. (1998). Prevalence of post-traumatic stress disorder and other psychiatric diagnoses in three groups of abused children (sexual, physical and both). Child Abuse & Neglect, 22(8), 759–774.Google Scholar
  2. Ambrosini, P. J. (2000). Historical development and present status of the schedule for affective disorders and schizophrenia for school-age children (K-SADS). Journal of the American Academy of Child & Adolescent Psychiatry, 39(1), 49–58.Google Scholar
  3. American Psychiatric Association. (2000). Diagnostic and Statistical Manual of Mental Disorders (4th ed. Text rev.). Washington, D.C: Author.Google Scholar
  4. American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.Google Scholar
  5. Anda, R. F., Croft, J. B., Felitti, V. J., Nordenberg, D., Giles, W. H., Williamson, D. F., & Giovino, G. A. (1999). Adverse childhood experiences and smoking during adolescence and adulthood. JAMA: The Journal of the American Medical Association, 282(17), 1652–1658.Google Scholar
  6. Arvidson, J., Kinniburgh, K., Howard, K., Spinazzola, J., Strothers, H., Evans, M., Andres, B., Cohen, C., & Blaustein, M. E. (2011). Treatment of complex trauma in young children: Developmental and cultural considerations in application of the ARC intervention model. Journal of Child & Adolescent Trauma, 4(1), 34–51.Google Scholar
  7. Brewin, C. R., Andrews, B., & Gotlib, I. H. (1993). Psychopathology and early experience: A reappraisal of retrospective reports. Psychological Bulletin, 113(1), 82–98.Google Scholar
  8. Burns, B. J., Hoagwood, K., Maultsby, L. T., Epstein, M. H., Kutash, K., & Duchnowski, A. (1998). Improving outcomes for children and adolescents with serious emotional and behavioral disorders: Current and future directions. Outcomes for children and youth with emotional and behavioral disorders and their families: Programs and evaluation best practices, 685–707.Google Scholar
  9. Cicero, S. D., Nooner, K., & Silva, R. (2011). Vulnerability and Resilience in Childhood Trauma and PTSD. In Vulnerability and resilience in childhood trauma and PTSD: Wiley-Blackwell.Google Scholar
  10. Cloitre, M., Koenen, K. C., Cohen, L. R., & Han, H. (2002). Skills training in affective and interpersonal regulation followed by exposure: A phase-based treatment for PTSD related to childhood abuse. Journal of Consulting and Clinical Psychology, 70(5), 1067–1074.Google Scholar
  11. Cloitre, M., Stolbach, B. C., Herman, J. L., Kolk, B. V. D., Pynoos, R., Wang, J., & Petkova, E. (2009). A developmental approach to complex PTSD: Childhood and adult cumulative trauma as predictors of symptom complexity. Journal of Traumatic Stress, 22(5), 399–408.Google Scholar
  12. Cloitre, M., Courtois, C. A., Charuvastra, A., Carapezza, R., Stolbach, B. C., & Green, B. L. (2011). Treatment of complex PTSD: Results of the ISTSS expert clinician survey on best practices. Journal of Traumatic Stress, 24(6), 615–627.Google Scholar
  13. Cloitre, M., Courtois, C. A., Ford, J. D., Green, B. L., Alexander, P., Briere, J., et al. (2012). The ISTSS expert consensus treatment guidelines for complex PTSD in adults. Retrieved November, 5, 2012.Google Scholar
  14. Cloitre, M., Garvert, D. W., Weiss, B., Carlson, E. B., & Bryant, R. A. (2014). Distinguishing PTSD, complex PTSD, and borderline personality disorder: A latent class analysis. European Journal of Psychotraumatology, 5, 25097.Google Scholar
  15. Cohen, J. A., Mannarino, A. P., Kliethermes, M., & Murray, L. A. (2012). Trauma-focused CBT for youth with complex trauma. Child Abuse & Neglect, 36(6), 528–541.Google Scholar
  16. Cook, A., Spinazzola, J., Ford, J., Lanktree, C., Blaustein, M., Cloitre, M., et al. (2005). Complex Trauma. Psychiatric Annals, 35(5), 390–398.Google Scholar
  17. Copeland, W. E., Keeler, G., Angold, A., & Costello, E. J. (2007). Traumatic events and post-traumatic stress in childhood. Archives of General Psychiatry, 64(5), 577.Google Scholar
  18. Courtois, C. A. (2004). Complex trauma, complex reactions: Assessment and treatment. Psychotherapy: Theory, Research, Practice, Training, 41(4), 412–425.Google Scholar
  19. Covell, K., & Becker, J. (2011). Five years on: A global update on violence against children. New York: NGO Advisory Council for the UN Secretary General’s study on violence against children.Google Scholar
  20. D'Andrea, W., Ford, J., Stolbach, B., Spinazzola, J., & van der Kolk, B. A. (2012). Understanding interpersonal trauma in children: Why we need a developmentally appropriate trauma diagnosis. American Journal of Orthopsychiatry, 82(2), 187–200.Google Scholar
  21. Finkelhor, D., Ormrod, R., Turner, H., & Hamby, S. L. (2005). The victimization of children and youth: A comprehensive, national survey. Child maltreatment,10(1), 5-25.Google Scholar
  22. Finkelhor, D., Ormrod, R. K., & Turner, H. A. (2009). Lifetime assessment of poly-victimization in a national sample of children and youth. Child Abuse & Neglect, 33(7), 403–411.Google Scholar
  23. Fleming, C. E., & Resick, P. A. (2015). Predicting three types of dissociation in female survivors of intimate partner violence. Journal of Trauma & Dissociation, (just-accepted).Google Scholar
  24. Ford, J. D. (2012). Ethnoracial and educational differences in victimization history, trauma-related symptoms, and coping style. Psychological Trauma: Theory, Research, Practice, and Policy, 4(2), 177.Google Scholar
  25. Ford, J. D., & Courtois, C. A. (2009). Defining and understanding complex trauma and complex traumatic stress disorders. Treating complex traumatic stress disorders: An evidence-based guide, 13–30.Google Scholar
  26. Ford, J. D., & Kidd, P. (1998). Early childhood trauma and disorders of extreme stress as predictors of treatment outcome with chronic post-traumatic stress disorder. Journal of Traumatic Stress, 11(4), 743–761.Google Scholar
  27. Ford, J. D., & Russo, E. (2006). Trauma-focused, present-centered, emotional self-regulation approach to integrated treatment for posttraumatic stress and addiction: Trauma Adapative recovery group education and therapy (TARGET). American Journal of Psychotherapy, 60, 335–355.Google Scholar
  28. Ford, J. D., Grasso, D., Greene, C., Levine, J., Spinazzola, J., & van der Kolk, B. (2013). Clinical significance of a proposed developmental trauma disorder diagnosis: Results of an international survey of clinicians. The Journal of Clinical Psychiatry, 74(8), 841–849.Google Scholar
  29. Ford, J. D., Spinazzola, J., van der Kolk, B., & Grasso, D. J. (2018). Toward an Empirically Based Developmental Trauma Disorder Diagnosis for Children: Factor Structure, Item Characteristics, Reliability, and Validity of the Developmental Trauma Disorder Semi-Structured Interview. The Journal of clinical psychiatry, 79(5).Google Scholar
  30. Ghosh-Ippen, C. G., Ford, J., Racusin, R., Acker, M., Bosquet, M., Rogers, K., . . . Edwards, J. (2002). Traumatic events screening inventory--child-report (TESCI-C).Google Scholar
  31. Giannopoulou, I., Strouthos, M., Smith, P., Dikaiakou, A., Galanopoulou, V., & Yule, W. (2006). Post-traumatic stress reactions of children and adolescents exposed to the Athens 1999 earthquake. European Psychiatry, 21(3), 160–166.Google Scholar
  32. Hardt, J., & Rutter, M. (2004). Validity of adult retrospective reports of adverse childhood experiences: Review of the evidence. Journal of Child Psychology and Psychiatry, 45(2), 260–273.Google Scholar
  33. Herman, J. L. (1992a). Complex PTSD: A syndrome in survivors of prolonged and repeated trauma. Journal of Traumatic Stress, 5, 377–391.Google Scholar
  34. Herman, J. L. (1992b). Trauma and recovery. New York, NY, U.S.: Basic Books.Google Scholar
  35. Kaess, M., Brunner, R., & Chanen, A. (2014). Borderline personality disorder in adolescence. Pediatrics, 134(4), 782–793.Google Scholar
  36. Kagan, R., Douglas, A. N., Hornik, J., & Kratz, S. L. (2008). Real life heroes pilot study: Evaluation of a treatment model for children with traumatic stress. Journal of Child & Adolescent Trauma, 1(1), 5–22.Google Scholar
  37. Kauffman, J., Birmaher, B., Brent, D. A., Rao, U., Flynn, C., Moreci, P., et al. (1997). Schedule for affective disorders and schizophrenia for school-aged children- present and lifetime version (K-SADS-PL). Initial reliability and validity data. Journal of the American Academy of Child & Adolescent Psychiatry, 36, 980–988.Google Scholar
  38. Kilpatrick, D. G., Saunders, B. E., & Resnick, H. S. (1998). Violence, history and comorbidity among a national sample of adolescents. Paper presented at the Lake George research conference on post-traumatic stress disorder program. NY: Bolton Landing.Google Scholar
  39. Klasen, F., Gehrke, J., Metzner, F., Blotevogel, M., & Okello, J. (2013). Complex trauma symptoms in former Ugandan child soldiers. Journal of Child & Adolescent Trauma. Google Scholar
  40. Lewinsohn, P. M., Rohde, P., Klein, D. N., & Seeley, J. R. (1999). Natural course of adolescent major depressive disorder: I. Continuity into young adulthood. Journal of the American Academy of Child & Adolescent Psychiatry, 38(1), 56–63.Google Scholar
  41. McLean, L. M., & Gallop, R. (2003). Implications of childhood sexual abuse for adult borderline personality disorder and complex post-traumatic stress disorder. American Journal of Psychiatry, 160(2), 369–371.Google Scholar
  42. North Shore-Long Island Jewish Health System (NSLIJHS) Trauma History Checklist. (2006). Unpublished instrument.Google Scholar
  43. Ozurk, E., & Sar, V. (2005). Apparently normal family: A contemporary agent of transgenerational trauma and dissociation. Journal of Trauma Practice, 4(3–4), 287–303.Google Scholar
  44. Pearlman, L. A., & Courtois, C. A. (2005). Clinical applications of the attachment framework: Relational treatment of complex trauma. Journal of Traumatic Stress, 18(5), 449–459.Google Scholar
  45. Pelcovitz, D. (2004). Structured interview of disorders of extreme stress NOS-adolescent version (SIDES-A). Unpublished professional manual.Google Scholar
  46. Pelcovitz, D., van der Kolk, B., Roth, S., Mandel, F., Kaplan, S., & Resick, P. (1997). Development of a criteria set and a structured interview for disorders of extreme stress (SIDES). Journal of Traumatic Stress, 10(1), 3–16.Google Scholar
  47. Putnam, F. W. (2003). Ten-year research update review: Child sexual abuse. Journal of the American Academy of Child & Adolescent Psychiatry, 42(3), 269–278.Google Scholar
  48. Putnam, F. W., Perry, M., Putnam, K., & Harris, W. (2008). Childhood antecedents of clinical complexity. In Paper presented at the 24th annual meeting of the International Society for Truamatic Stress Studies. Chicago: IL.Google Scholar
  49. Pynoos, R. S., Fairbank, J. A., Briggs-King, E. C., Steinberg, A., Layne, C., Stolbach, B., & Ostrowski, S. (2008). Trauma exposure, adverse experiences and diverse symptom profiles in a nationa lsample of traumatized children. In Paper presented at the 24th annual meeting of the International Society for Traumatic Stress Studies. Chicago: IL.Google Scholar
  50. Roussos, A., Goenjian, A. K., Steinberg, A. M., Sotiropoulou, C., Kakaki, M., Kabakos, C., Karagianni, S., & Manouras, V. (2005). Post-traumatic stress and depressive reactions among children and adolescents after the 1999 earthquake in Ano Liosia, Greece. American Journal of Psychiatry, 162(3), 530–537.Google Scholar
  51. Scheeringa, M., & Zeanah, C. (2001). A relational perspective of PTSD in early childhood. Journal of Traumatic Stress, 14(799–816), 799–815.Google Scholar
  52. Shalev, A. Y., Freedman, S., Peri, T., Brandes, D., Sahar, T., Orr, S. P., & Pitman, R. K. (2014). Prospective study of posttraumatic stress disorder and depression following trauma. American Journal of Psychiatry. Google Scholar
  53. Sisk, R. (2010). South Bronx is poorest district in nation, US Census Bureau finds: 38% live below poverty line. Daily News, 29.Google Scholar
  54. Spinazzola, J., Ford, J. D., Zucker, M., van der Kolk, B. A., Silva, S., Smith, S. F., & Blaustein, M. (2005). Survey evaluates complex trauma exposure, outcomes and intervention among children and adolescents. Psychiatric Annals, 35(5), 433–439.Google Scholar
  55. Stolbach, B. C., Minshew, R., Rompala, V., Dominguez, R. Z., Gazibara, T., & Finke, R. (2013). Complex trauma exposure and symptoms in urban traumatized children: A preliminary test of proposed criteria for developmental trauma disorder. Journal of Traumatic Stress, 26(4), 483–491.Google Scholar
  56. Storr, C. L., Ialongo, N. S., Anthony, J. C., & Breslau, N. (2007). Childhood antecedents of exposure to traumatic events and posttraumatic stress disorder. The American Journal of Psychiatry, 164(1), 119–125.Google Scholar
  57. Thornberry, T. P., Ireland, T. O., & Smith, C. A. (2001). The importance of timing: The varying impact of childhood and adolescent maltreatment on multiple problem outcomes. Development and Psychopathology, 13(04), 957–979.Google Scholar
  58. U.S. Department of Health and Human Services, Administration on Children, Youth and Families. (2016). Child maltreatment 2014. Washington, DC: U.S. Government Printing Office. Available at: http://www.acf.hhs.gov/programs/cb/resource/child-maltreatment-2014
  59. van der Kolk, B. A. (2005). Developmental trauma disorder. Psychiatric Annals, 35(5), 401–408.Google Scholar
  60. van der Kolk, B. A., Roth, S., Pelcovitz, D., Sunday, S., & Spinazzola, J. (2005). Disorders of extreme stress: The empirical foundation of a complex adaptation to trauma. Journal of Traumatic Stress, 18(5), 389–399.Google Scholar
  61. Wang, C. T., & Holton, J. (2007). Total estimated cost of child abuse and neglect in the United States. Economic Impact Study, 1, 1–5.Google Scholar
  62. Wren, A. & Miller, A. (2010). The Montefiore exposure to trauma screener (METS). Unpublished instrument.Google Scholar
  63. Zatzick, D. F., Jurkovich, G. J., Fan, M., Grossman, D., Russo, J., Katon, W., & Rivara, F. P. (2008). Association between post-traumatic stress and depressive symptoms and functional outcomes in adolescents followed up longitudinally after injury hospitalization. Archives of Pediatrics & Adolescent Medicine, 162(7), 642.Google Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Alyce L. Foster
    • 1
    • 2
    Email author
  • Wendy D’Andrea
    • 2
  • Nicholas Fehertoi
    • 2
  • C. J. Healy
    • 2
  • Alec Miller
    • 3
    • 4
  1. 1.NYU School of Medicine WTC Health Program Clinical Center of ExcellenceNew YorkUSA
  2. 2.Department of PsychologyThe New School for Social ResearchNew YorkUSA
  3. 3.Albert Einstein College of MedicineNew YorkUSA
  4. 4.Department of PsychologyMontefiore Medical CenterBronxUSA

Personalised recommendations