Developmental trauma disorder: An attachment-based perspective

Abstract

Despite the evidence linking chronic early trauma with psychological distress, the latest edition of the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5) has excluded developmental trauma disorder from its taxonomy. This article considers developmental trauma from an attachment-based perspective and raises some of the difficulties professionals may experience conceptualising the trauma–attachment relationship. It explores the impact of the decision to exclude the diagnosis from DSM-5 on professionals, those who have had traumatic early experiences and their carers. Finally, it presents formulation as an alternative proposition which may better suit those who present to mental health services with attachment- and trauma-linked difficulties.

Keywords

Developmental trauma attachment DSM-5 diagnosis formulation

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References

Ackerman

P. T.

Newton

J. E.

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, 759–774.

American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th text revision). Washington, DC: Author.

Andrulis

D. P.

(1998). Access to care is the centerpiece in the elimination of socioeconomic disparities in health. Annals of Internal Medicine, 129, 412–416.

Avery

A. M.

Hellman

R. E.

Sudderth

L. K.

(2001). Satisfaction with mental health services among sexual minorities with major mental illness. American Journal of Public Health, 91, 990–991.

Bentall

R. P.

(2010). Doctoring the mind: Why psychiatric treatments fail. London, England: Penguin.

Bradley

(2009). The Bradley Report: Lord Bradley’s review of people with mental health problems or learning disabilities in the criminal justice system. Department of Health, London, England.

Breslau

Kessler

R. C.

(1998). Trauma and posttraumatic stress disorder in the community: The 1996 Detroit area survey of trauma. Archives of General Psychiatry, 55, 626–632.

British Psychological Society (BPS). (2011). Good practice guidelines on the use of psychological formulation. Leicester, UK: Author.

British Psychological Society (BPS). (2013, May). Division of Clinical Psychology Position Statement on the classification of behaviour and experience in relation to functional psychiatric diagnoses: Time for a paradigm shift. Retrieved from http://www.madinamerica.com/wp-content/uploads/2013/05/DCP-Position-Statement-on-Classification.pdf

10.

Brown

L. S.

Pantalone

(2011). Lesbian, gay, bisexual, and transgender issues in trauma psychology: A topic comes out of the closet. Traumatology, 17, 1–3.

11.

Burns

B. J.

Phillips

S. D.

Wagner

H. R.

Barth

R. P.

Kolko

D. J.

Campbell

Landsverk

(2004). Mental health need and access to mental health services by youths involved with child welfare: A national survey. Journal of the American Academy of Child & Adolescent Psychiatry, 43, 960–970.

12.

Cappelletty

G. G.

Brown

M. M.

Shumate

S. E.

(2005). Correlates of the Randolph Attachment Disorder Questionnaire (RADQ) in a sample of children in foster placement. Child & Adolescent Social Work Journal, 22, 71–84.

13.

Chiesa

Fonagy

(2000). Cassel personality disorder study methodology and treatment effects. British Journal of Psychiatry, 176, 485–491.

14.

Chiesa

Fonagy

(2003). Psychosocial treatment for severe personality disorder 36-month follow-up. British Journal of Psychiatry, 183, 356–362.

15.

Cook

Spinazzola

Ford

Lanktree

Blaustein

Cloitre

. . . van der Kolk

(2005). Complex trauma in children and adolescents. Psychiatric Annals, 35, 390–398.

16.

Costello

Compton

S. N.

(2003). Relationships between poverty and psychopathology: A natural experiment. Journal of the American Medical Association, 290, 2023–2029.

17.

Crisma

Bascelli

Paci

Romito

(2004). Adolescents who experienced sexual abuse: Fears, needs and impediments to disclosure. Child Abuse & Neglect, 28, 1035–1048.

18.

Department of Health (DoH). (2012). NHS constitution. London, England: Author.

19.

Felitti

V. J.

Anda

R. F.

Nordenberg

Williamson

D. F.

Spitz

A. M.

Edwards

. . . Marks

J. S.

(1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: The Adverse Childhood Experiences (ACE) Study. American Journal of Preventive Medicine, 14, 245–258.

20.

Flannery

D. J.

Singer

M. I.

Wester

(2001). Violence exposure, psychological trauma, and suicide risk in a community sample of dangerously violent adolescents. Journal of the American Academy of Child & Adolescent Psychiatry, 40, 435–442.

21.

Frances

(2012, December 17). DSM-5 is a guide, not a bible: Simply ignore its 10 worst changes. Huffington Post. Retrieved from http://www.huffingtonpost.com/allen-frances/dsm-5_b_2227626.html

22.

Freedman

Lewis

D. A.

Michels

Pine

D. S.

Schultz

S. K.

Tamminga

C. A.

. . . Yager

(2013). The initial Field Trials of DSM-5: New blooms and old thorns. The American Journal of Psychiatry, 170, 1–5.

23.

Green

McGinnity

Meltzer

Ford

Goodman

(2004). Mental health of children and young people in Great Britain. London, England: Office of National Statistics.

24.

Grohol

J. M.

(2012). Final DSM 5 approved by American Psychiatric Association. Psych Central.com. Retrieved from http://psychcentral.com/blog/archives/2012/12/02/final-dsm-5-approved-by-american-psychiatric-association/ (accessed 20 January 2013).

25.

Hildyard

K. L.

Wolfe

D. A.

(2002). Child neglect: Developmental issues and outcomes. Child Abuse & Neglect, 26, 679–695.

26.

James

D. V.

Harlow

(2000). Increasing the power of psychiatric court diversion: A new model of supra-district diversion centre. Medicine, Science and the Law, 40, 52–60.

27.

Johnson

J. G.

Cohen

Brown

Smailes

E. M.

Bernstein

D. P.

(1999). Childhood maltreatment increases risk for personality disorders during early adulthood. Archives of General Psychiatry, 56, 600–606.

28.

Johnson

J. G.

Smailes

E. M.

Cohen

Brown

Bernstein

D. P.

(2000). Associations between four types of childhood neglect and personality disorder symptoms during adolescence and early adulthood: Findings of a community-based longitudinal study. Journal of Personality Disorders, 14, 171–187.

29.

Jones

K. D.

(2012). A critique of the DSM-5 Field Trials. The Journal of Nervous and Mental Disease, 200, 517–519.

30.

Kraemer

H. C.

Kupfer

D. J.

Clarke

D. E.

Narrow

W. E.

Regier

D. A.

(2012). DSM-5: How reliable is reliable enough? The American Journal of Psychiatry, 169, 13–15.

31.

Kutchins

Kirk

S. A.

(1999). Making us crazy: DSM – The psychiatric bible and the creation of mental disorders. London, England: Constable.

32.

Lawler

J. M.

Hostinar

C. E.

Milner

S. B.

Gunnar

M. R.

(2014). Disinhibited social engagement in postinstitutionalized children: Differentiating normal from atypical behavior. Development and Psychopathology, 26, 451–464.

33.

LeFever

G. B.

Dawson

K. V.

Morrow

A. L.

(1999). The extent of drug therapy for attention deficit-hyperactivity disorder among children in public schools. American Journal of Public Health, 89, 1359–1364.

34.

Marsh

Fox

(2008). The benefit and cost of prison in the UK. The results of a model of lifetime re-offending. Journal of Experimental Criminology, 4, 403–423.

35.

NCCMH. (2005). Post-traumatic stress disorder (PTSD): Full guideline, including appendices 1–13. London, England: Gaskell and the British Psychological Society. Retrieved from http://guidance.nice.org.uk/CG26/Guidance/pdf/English

36.

NIMHE. (2003). Personality disorder. No longer a diagnosis of exclusion. London, England: Department of Health.

37.

Pilowsky

(1995). Psychopathology among children placed in family foster care. Psychiatric Services (Washington, D.C.), 46, 906–910.

38.

Romano

De Luca

R. V.

(1997). Exploring the relationship between childhood sexual abuse and adult sexual perpetration. Journal of Family Violence, 12, 85–98.

39.

Sanders

J. L.

Morgan

S. B.

(1997). Family stress and adjustment as perceived by parents of children with autism or Down Syndrome: Implications for intervention. Child & Family Behavior Therapy, 19, 15–32.

40.

Sedlak

A. J.

Broadhurst

D. D.

(1996). The third national incidence study of child abuse and neglect. Washington, DC: US Department of Health and Human Services.

41.

Tarren-Sweeney

(2013). An investigation of complex attachment- and trauma-related symptomatology among children in foster and kinship care. Child Psychiatry & Human Development, 44, 727–741.

42.

Teplin

L. A.

Abram

K. M.

McClelland

G. M.

Dulcan

M. K.

Mericle

A. A.

(2002). Psychiatric disorders in youth in juvenile detention. Archives of General Psychiatry, 59, 1133–1143.

43.

Van der Kolk

B. A.

(2005). Developmental trauma disorder: Toward a rational diagnosis for children with complex trauma histories. Psychiatric Annals, 35, 401–408.

44.

Van der Kolk

B. A.

Roth

Pelcovitz

Sunday

Spinazzola

(2005). Disorders of extreme stress: The empirical foundation of a complex adaptation to trauma. Journal of Traumatic Stress, 18, 389–399.

45.

Van der Kolk

Pynoos

Cicchetti

Cloitre

D’Andrea

Ford

. . . Teicher

(2009). Proposal to include a developmental trauma disorder diagnosis for children and adolescents in DSM-V. Retrieved from http://www.traumacenter.org/announcements/DTD_papers_Oct_09.pdf

46.

Varese

Smeets

Drukker

Lieverse

Lataster

Viechtbauer

. . . Bentall

R. P.

(2012). Childhood adversities increase the risk of psychosis: A meta-analysis of patient-control, prospective- and cross-sectional cohort studies. Schizophrenia Bulletin, 38, 661–671.

47.

Waxman

H. A.

Stupak

(2010). Coverage denials for pre-existing conditions in the individual health insurance market. Washington, DC: Committee on Energy and Commerce. Retrieved from http://democrats.energycommerce.house.gov/Press_111/20101012/Memo.Pre-existing.Condition.Denials.Individual.Market.2010.10.12.pdf

48.

Widom

C. S.

(1989). Child abuse, neglect, and adult behavior: Research design and findings on criminality, violence, and child abuse. American Journal of Orthopsychiatry, 59, 355–367.

49.

Widom

C. S.

Maxfield

M. G.

(1996). A prospective examination of risk for violence among abused and neglected children. Annals of the New York Academy of Sciences, 794, 224–237.