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J Clin Psychiatry. 2018 Sep 11;79(5). pii: 17m11675. doi: 10.4088/JCP.17m11675.

Toward an Empirically Based Developmental Trauma Disorder Diagnosis for Children: Factor Structure, Item Characteristics, Reliability, and Validity of the Developmental Trauma Disorder Semi-Structured Interview.

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UCHC Department of Psychiatry MC1410, 263 Farmington Ave, Farmington, CT 06030.
Department of Psychiatry, University of Connecticut School of Medicine, Farmington, Connecticut, USA.
The Foundation Trust, Melrose, Massachusetts, USA.
Boston University School of Medicine, Boston, Massachusetts, USA.



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.

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