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

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

Abstract

Objective: 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.

Methods: 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.

Results: 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.

Conclusions: 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.

Publication types

  • Research Support, Non-U.S. Gov't
  • Validation Study

MeSH terms

  • Adolescent
  • Child
  • Child Abuse / diagnosis*
  • Female
  • Humans
  • Interview, Psychological*
  • Male
  • Psychiatric Status Rating Scales / standards*
  • Psychometrics
  • Reproducibility of Results