UCHC Department of Psychiatry MC1410, 263 Farmington Ave, Farmington, CT 06030.
Department of Psychiatry, University of Connecticut School of Medicine, Farmington, Connecticut, USA.
J Clin Psychiatry. 2018 Sep 11;79(5):17m11675. doi: 10.4088/JCP.17m11675.
Developmental trauma disorder (DTD) is an integrative syndrome for assessing the biopsychosocial sequelae of early life traumatization and attachment disruption. The psychometrics of a DTD Semi-Structured Interview (DTD-SI) and the validity and structure of the DTD construct were tested.
The DTD-SI was administered by research clinicians at 5 sites between September 2011 and August 2013 to a convenience sample of 236 children ages 7-17 years (50% female, 47% black or Latino/Hispanic, 91% with trauma histories) and/or a parent, recruited in pediatric or mental health services. Validity data were obtained from structured interviews for traumatic stressor and attachment disruption history (Traumatic Events Screening Instrument), DSM-IV disorders (Kiddie Schedule for Affective Disorders and Schizophrenia, Present/Lifetime Version), and potential alternative DSM-5 disorders; parent ratings on the Child Behavior Checklist; and child self-report on measures of emotion dysregulation and quality of life.
Statistical analyses confirmed (a) the DTD-SI's item-level temporal and interrater reliability, informativeness, and absence (with 1 exception) of demographic bias and (b) DTD construct factor structure, unidimensionality, and convergent and discriminant validity.
The DTD-SI yielded reliable, structurally meaningful, and valid item- and criterion-level data for the proposed DTD syndrome. Further clinical and scientific investigation of the clinical utility of DTD as a childhood psychiatric syndrome and diagnosis is warranted.
发育性创伤障碍（DTD）是一种综合综合征，用于评估生命早期创伤和依恋破裂的生物心理社会后果。对 DTD 半结构式访谈（DTD-SI）的心理测量学以及 DTD 结构的有效性和结构进行了测试。
2011 年 9 月至 2013 年 8 月，研究临床医生在 5 个地点对 236 名 7-17 岁的儿童（50%为女性，47%为黑人和拉丁裔/西班牙裔，91%有创伤史）和/或父母进行了 DTD-SI 评估，这些儿童是在儿科或心理健康服务机构中招募的。有效性数据来自创伤性应激源和依恋破裂史（创伤事件筛查工具）、DSM-IV 障碍（儿童情绪障碍和精神分裂症日程表，现在/终身版）以及潜在的替代 DSM-5 障碍的结构化访谈；父母对儿童行为检查表的评分；以及儿童对情绪失调和生活质量测量的自我报告。
统计分析证实了（a）DTD-SI 在项目层面的时间和评分者间可靠性、信息量以及缺乏（有 1 个例外）人口统计学偏差；（b）DTD 结构的因子结构、单维性以及收敛和区分效度。
DTD-SI 为拟议的 DTD 综合征提供了可靠、结构合理且有效的项目和标准水平数据。需要进一步对 DTD 作为儿童精神科综合征和诊断的临床实用性进行临床和科学研究。
