Every year, there are ten times as many children in the US reported to be victims of domestic violence, neglect and abuse than combat soldiers from Iraq and Afghanistan diagnosed with PTSD. However, these children live in a diagnostic void because the current DSM-IV® conceptualization of PTSD does not reflect the symptoms experienced by the vast majority of these children. So, instead, abused and neglected children receive such widely disparate diagnoses as bipolar disorder, conduct disorder, ADHD, borderline personality disorder, and other anxiety disorders. All of these diagnoses are etiologically unrelated to trauma and lead to pharmacological and behavioural control at the expense of dealing with the fear, shame, terror and rage that derive from real threats to these children’s survival.
The lack of proper diagnosis also has profound implications on insurance reimbursement, treatment development and clinical research. Thus these children are condemned to receive treatments that are likely to be ineffective and therefore put them at risk to grow up to be unproductive, expensive, potentially dangerous, and long-suffering members of our society.
In response to this neglect of our nation’s greatest public health threat, the National Child Traumatic Stress Network’s DSM-5® Task Force has proposed a new clinical syndrome, Developmental Trauma Disorder (DTD), based on a literature review of about 100,000 chronically traumatized children and direct systematic observations of 20,000 traumatized children. This diagnosis describes the five clusters of symptoms that characterize many children who have suffered repeated trauma in an interpersonal context:
- Affect and impulse dysregulation
- Disturbances of attention, cognition, and consciousness
- Distortions in self-perception and systems of meaning
- Interpersonal difficulties
- Somatization and biological dysregulation
- This presentation will review the development of DTD in the DSM-5® as a diagnosis and its implications for assessment, diagnosis and treatment.
Disclaimer: DSM® and DSM 5® are registered trademarks of the American Psychiatric Association. The American Psychiatric Association is not affiliated with nor endorses this seminar. For further information, please visit www.dsm5.org.
- Describe the development of Developmental Trauma Disorder.
- Explain the current DSM-5® position on DTD.
- Summarize the five clusters of symptoms that characterize many children who have suffered repeated trauma.
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Bessel A. van der Kolk, M.D., is a clinical psychiatrist who has studied the impact and resolution of trauma on human beings for the past 40 years. His research has ranged from developmental impact of trauma to neuroimaging and from memory processes to the use of EMDR and theatre groups in PTSD. He is professor of psychiatry at Boston University School of Medicine and medical director of the Trauma Centre in Boston, where he also serves as director of the National Centre for Child Traumatic Stress Complex Trauma Network. He is past president of the International Society for Traumatic Stress Studies. He has taught at universities and hospitals throughout the world. He is author of over a hundred scientific articles, author of Psychological Trauma and co-editor of Traumatic Stress.
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Individual Training Pack CPD 2 hours – £46.00