Metzner Franka, Dahm Kristina, Richter-Appelt Hertha, Pawils Silke, Moulaa-Edmondson Miriam Juliane, Stellermann-Strehlow Kerstin
1 Universitätsklinikum Hamburg-Eppendorf, Institut und Poliklinik für Medizinische Psychologie, Hamburg.
2 Universitätsklinikum Hamburg-Eppendorf, Poliklinik und Institut für Sexualwissenschaft und Forensik, Hamburg.
Z Kinder Jugendpsychiatr Psychother. 2019 Jul;47(4):300-312. doi: 10.1024/1422-4917/a000578. Epub 2018 Apr 23.
Developmental trauma disorder (DTD) in children and adolescents - results from a patient population at the special consultation hour for traumatized children and adolescents Children and adolescents who have experienced interpersonal Type-II-trauma often develop symptoms going far beyond the Post-Traumatic Stress Disorder (PTSD). Van der Kolk (2009) suggested the Developmental Trauma Disorder (DTD) to define the extensive symptomatology; however, research on DTD is limited. Frequency and group differences of DTD were examined based on physicians' letters of = 161 patients between one and 18 years (61 % female) from an out-patient unit for traumatized patients at a paediatric and adolescent psychiatry. Physicians' letters were rated and analysed using an adapted DTD algorithm. In total, 77 % of the patients experienced interpersonal Type-II-trauma, 6 % met the criteria for the adapted DTD diagnosis. DTD criteria were found more frequently in interpersonal Type-II-trauma victims than in patients with accidental or Type-I-trauma, but group differences only reached statistical significance for the DTD criteria B (affective and physiological dysregulation) and G (impairments) at the adjusted 0,2 % significance level. No statistically significant differences for age or gender were found. The posttraumatic symptoms of children younger than seven years were analysed descriptively. The results show that, although many children and adolescents have developed symptoms beyond the PTSD, only a small proportion have met the DTD diagnosis. In view of the partially unspecific and contradictory findings, further studies on DTD considering larger samples, the complete DTD criteria, and diagnosis-specific instruments seem to be reasonable and necessary.
儿童和青少年的发育性创伤障碍(DTD)——来自受创伤儿童和青少年特殊咨询时段的患者群体的结果 经历人际II型创伤的儿童和青少年常常出现远远超出创伤后应激障碍(PTSD)的症状。范德科尔克(2009年)提出用发育性创伤障碍(DTD)来定义这种广泛的症状表现;然而,关于DTD的研究有限。基于来自一家儿童和青少年精神病科受创伤患者门诊单元的161名1至18岁患者(61%为女性)的医生信件,对DTD的发生率和组间差异进行了研究。使用一种经过调整的DTD算法对医生信件进行评分和分析。总体而言,77%的患者经历了人际II型创伤,6%符合调整后的DTD诊断标准。在人际II型创伤受害者中发现DTD标准的频率高于意外创伤或I型创伤患者,但在调整后的0.2%显著性水平上,仅DTD标准B(情感和生理失调)和G(功能损害)的组间差异具有统计学意义。未发现年龄或性别方面的统计学显著差异。对7岁以下儿童的创伤后症状进行了描述性分析。结果表明,尽管许多儿童和青少年出现了超出PTSD的症状,但只有一小部分符合DTD诊断。鉴于部分结果不具特异性且相互矛盾,考虑到更大样本、完整的DTD标准以及特定诊断工具,对DTD进行进一步研究似乎是合理且必要的。