Developmental trauma disorder (DTD) and posttraumatic stress disorder (PTSD) have been found to have both shared and unique traumatic antecedents. The present study was an independent replication, with the DTD Structured Interview and the Traumatic Events Screening Instrument administered to 271 children in mental health treatment in six U.S. sites. On an unadjusted basis, DTD (27.3% prevalence, N = 74) and PTSD (40.2% prevalence, N = 109) both were associated with traumatic physical assault or abuse, family violence, emotional abuse, caregiver separation or impairment, and polyvictimization. After controlling for PTSD, DTD was associated emotional abuse, OR = 2.9, 95% CI [1.19, 6.95], and traumatic separation from a primary caregiver, OR = 2.2, 95% CI [1.04. 4.60], both of which also were associated with caregiver impairment, physical assault/abuse, and witnessing family/community violence. Three traumatic antecedents associated with PTSD were not associated with DTD: noninterpersonal trauma, sexual trauma, and traumatic loss. Children exposed to both traumatic victimization and attachment trauma (36.2%) or attachment trauma alone (32.5%) were more likely than children exposed only to victimization (17.5%) or those with no history of victimization or attachment trauma (8.1%) to meet the symptom criteria for DTD, χ²(3, N = 271) = 17.68, p < .001. Study findings replicate and extend prior DTD field trial study results, showing that, although PTSD and DTD share traumatic antecedents, DTD is uniquely associated with traumatic emotional abuse and caregiver separation. Further research is needed to examine how specific trauma types contribute to the risk, course, and severity of DTD.

中文翻译：

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发育性创伤障碍：受害儿童依恋创伤的遗产

已发现发育性创伤障碍 (DTD) 和创伤后应激障碍 (PTSD) 具有共同且独特的创伤前因。本研究是一项独立复制，对美国六个地点的 271 名接受心理健康治疗的儿童进行了 DTD 结构化访谈和创伤事件筛查工具。在未经调整的基础上，DTD（27.3% 患病率，N = 74）和 PTSD（40.2% 患病率，N = 109）都与创伤性身体攻击或虐待、家庭暴力、情感虐待、照顾者分离或损伤以及多重受害有关。控制 PTSD 后，DTD 与情绪虐待相关，OR = 2.9，95% CI [1.19, 6.95]，以及与主要照顾者的创伤性分离，OR= 2.2, 95% CI [1.04. 4.60]，这两者都与照顾者的损伤、身体攻击/虐待以及目睹家庭/社区暴力有关。与 PTSD 相关的三个创伤前因与 DTD 无关：非人际创伤、性创伤和创伤性丧失。暴露于创伤受害和依恋创伤 (36.2%) 或仅遭受依恋创伤 (32.5%) 的儿童比仅暴露于受害 (17.5%) 或没有受害或依恋创伤史的儿童 (8.1%) 更有可能满足DTD 的症状标准，χ²(3, N = 271) = 17.68, p< .001。研究结果复制并扩展了先前的 DTD 现场试验研究结果，表明虽然 PTSD 和 DTD 共享创伤前因，但 DTD 与创伤性情绪虐待和照顾者分离具有独特的关联。需要进一步的研究来检查特定的创伤类型如何影响 DTD 的风险、病程和严重程度。