Epidemiological, clinical, and neurobiological studies of the last 30 years suggest that traumatic attachments during the early years of life are associated to specific psychopathological ...vulnerabilities based on dissociative pathogenic processes. It has been observed that the dissociative pathogenic processes caused by these traumatic attachments either may contribute to the genesis of well-defined mental disorders (e.g., dissociative disorders) or may variably occur in many other diagnostic categories, complicating their clinical pictures and worsening their prognosis. For this reason, we proposed to define the dimension of psychopathological outcomes linked to traumatic attachments and dissociative pathogenic processes as the "traumatic-dissociative" dimension (TDD). The clinical complexity of the TDD requires specific training to enable mental health professionals to recognize the signs of traumatic developments and to implement specific treatment strategies. The present article aims to review some crucial points about the clinical meaning and treatment strategies of the TDD, the dissociative pathogenic processes characterizing the TDD, as well as of the role of attachment trauma in the TDD. We also focused on the clinical and theoretical evidence suggesting that dissociation and dis-integration may be considered two different processes but highly correlated. The usefulness of clinical reasoning in terms of psychopathological dimensions, instead of distinct diagnostic categories, as well as several therapeutic implications of these issues was finally discussed.
Experiencing psychological trauma during childhood and/or adolescence is associated with an increased risk of psychosis in adulthood. However, we lack a clear knowledge of how developmental trauma ...induces vulnerability to psychotic symptoms. Understanding the psychological processes involved in this association is crucial to the development of preventive interventions and improved treatments. We sought to systematically review the literature and combine findings using meta‐analytic techniques to establish the potential roles of psychological processes in the associations between developmental trauma and specific psychotic experiences (i.e., hallucinations, delusions and paranoia). Twenty‐two studies met our inclusion criteria. We found mediating roles of dissociation, emotional dysregulation and post‐traumatic stress disorder (PTSD) symptoms (avoidance, numbing and hyperarousal) between developmental trauma and hallucinations. There was also evidence of a mediating role of negative schemata, i.e. mental constructs of meanings, between developmental trauma and delusions as well as paranoia. Many studies to date have been of poor quality, and the field is limited by mostly cross‐sectional research. Our findings suggest that there may be distinct psychological pathways from developmental trauma to psychotic phenomena in adulthood. Clinicians should carefully ask people with psychosis about their history of developmental trauma, and screen patients with such a history for dissociation, emotional dysregulation and PTSD symptoms. Well conducted research with prospective designs, including neurocognitive assessment, is required in order to fully understand the biopsychosocial mechanisms underlying the association between developmental trauma and psychosis.
Abstract
Trauma knowledge and skills are needed to support relational safety for children in out-of-home care and birth family contact is a particular area where trauma-informed approaches are ...critical. Mixed methods were used to understand the application of trauma-informed approaches to contact in New South Wales, Australia. A total of 118 caseworkers and 15 organisational leaders took part in an anonymous survey or semi-structured interview. Descriptive statistics and thematic analysis were completed. Results indicated that caseworkers were confident in their knowledge of trauma and ability to protect children at contact but not to explain trauma to carers or manage conflict between carers and birth relatives. Confusion about how to deliver trauma-informed practice hampered knowledge-to-practice translation. Staff training and supervision were used to build workforce skills but were not evaluated and no strategies to reduce vicarious trauma were identified. Strategies to promote psychological safety and improve cultural safety for Aboriginal children and families were in their infancy. The study demonstrates that the out-of-home-care sector needs a community of practice where it can test, implement and share promising strategies for improving relational safety and where adult and child trauma survivors are empowered to inform and lead new approaches to contact.
Developmental trauma has a profound effect on people's lives. There are few studies of the perceived difficulties and treatment needs of adolescents with developmental trauma. More studies are called ...for to explore the perspectives and experiences of these patients, especially adolescents.
Semi-structured interviews were conducted with eight adolescents with developmental trauma aged 14-18 years in a Child and Adolescent Mental Health Service, Outpatient Unit. The interviews were analyzed using systematic text condensation.
A main finding in this study regards the participants' understanding of why they needed therapy: symptom alleviation and coping tools. They expressed a need for talking with a safe and reliable adult who understood their situation. Their stories of daily functioning and bodily sensations align mainly with symptoms described for adolescents with developmental trauma. The study also shows that the participants' experiences of trauma affected their lives to a greater or lesser extent, in the form of ambivalence, avoidance, regulation, and coping strategies. They also described various physical problems, especially insomnia and inner restlessness. Their subjective stories revealed insights into their experiences.
Based on the results, we recommend that adolescents with developmental trauma be allowed to express their understandings of their difficulties and their treatment expectations at an early stage of their therapy. An emphasis on patient involvement and the therapeutic relationship can increase their autonomy and control over their own lives and treatment.
Adverse Childhood Experiences (ACEs) have been associated with both Risk of Suicide (RoS) and the Vulnerable Dark Triad (VDT), the latter comprises Factor Two Psychopathy (FTP), Borderline ...Personality Disorder (BPD), and Vulnerable Narcissism (VN). In the current study, we investigated whether the relationship between ACEs and RoS was mediated by the VDT. One-thousand and sixty-four individuals completed online versions of the Self-Report Psychopathy Scale III, the McLean Screening Instrument for Borderline Personality Disorder, the Hypersensitive Narcissism Scale, the Childhood Experience Survey 17, and the Ask Suicide Screening Questionnaire. We found a strong positive association between ACEs and RoS. Further, we found that BPD and VN mediated the relationship between ACEs and RoS. These results highlight the importance of ACEs in the development of personality and RoS.
Repeated and early attachment trauma has a huge impact on children’s development, producing a wide range of psychopathology, which is included as a new diagnosis called complex posttraumatic stress ...disorder (CPTSD) in the 11th revision to the World Health Organization’s International Classification of Diseases (ICD-11). The aim of this study is to provide a review of the posttraumatic symptomatology caused by exposure to complex traumatic events and to synthesize the existing empirical evidence on CPTSD and developmental trauma disorder (DTD). The results of the reviewed studies confirm the presence of extensive and heterogeneous symptoms, as well as serious affective, cognitive, and behavioral selfregulation alterations, which correspond to complex PTSD or DTD. Therefore, the current data support the validity of these diagnostic proposals.
Children exposed to adverse childhood experiences (ACEs) and pervasive interpersonal traumas may go on to develop PTSD and, in most cases, will further undergo a significant shift in their ...developmental trajectory. This paper examines contemporary research on Developmental Trauma (DT), which is inextricably linked to disruptions in social cognition, physiological and behavioral regulation, and parent-child attachments. Developmental trauma associated with early experiences of abuse or neglect leads to multi-faceted and longstanding consequences and underscores critical periods of development, complex stress-mediated adaptations, and multilevel, trans-theoretical influences in the diagnostic formulation and treatment of traumatized children, adolescents, and adults. Psychological and medical correlates of Developmental Trauma Disorder are considered, and directions for future research are discussed.
Bullying Victimization and Trauma Idsoe, Thormod; Vaillancourt, Tracy; Dyregrov, Atle ...
Frontiers in psychiatry,
01/2021, Letnik:
11
Journal Article
Recenzirano
Odprti dostop
Bullying victimization and trauma research traditions operate quite separately. Hence, it is unclear from the literature whether bullying victimization should be considered as a form of interpersonal ...trauma. We review studies that connect bullying victimization with symptoms of PTSD, and in doing so, demonstrate that a conceptual understanding of the consequences of childhood bullying needs to be framed within a developmental perspective. We discuss two potential diagnoses that ought to be considered in the context of bullying victimization: (1) developmental trauma disorder, which was suggested but not accepted as a new diagnosis in the DSM-5 and (2) complex post-traumatic stress disorder, which has been included in the ICD-11. Our conclusion is that these frameworks capture the complexity of the symptoms associated with bullying victimization better than PTSD. We encourage practitioners to understand how exposure to bullying interacts with development at different ages when addressing the consequences for targets and when designing interventions that account for the duration, intensity, and sequelae of this type of interpersonal trauma.
Exposure to complex trauma is a prevalent and costly public health concern. Though not yet included in the formal diagnostic systems, developmental trauma disorder (DTD) was proposed to capture the ...consistent and predictable emotional, behavioral, and neurobiological sequelae observed in children exposed to complex trauma. This systematic review synthesizes and evaluates the existing empirical evidence for DTD as a reliable, valid, distinctive, and clinically useful construct. We identified 21 articles reporting on 17 non-overlapping samples that evaluated DTD symptom criteria using objective, empirical methods (e.g., factor analysis, associations with other diagnostic constructs, associations with trauma exposure type, clinician ratings of utility). Studies were largely supportive of the DTD construct and its clinical utility; however, it will be crucial for this work to be replicated in larger samples, by independent research groups, and with more rigorous methodological and analytic approaches before definitive conclusions can be drawn. Findings from this review, while preliminary, provide a promising empirical foundation for DTD and bring the field closer to improving diagnostic parsimony for children and adolescents affected by complex trauma.
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