Complex Trauma and Developmental Trauma Disorder in Adolescence

Background: Complex trauma involves prolonged or repeated exposure during critical developmental windows or transitions (including adolescence) to intentional interpersonal victimization that is inescapable and causes profound insecurity. Developmental Trauma Disorder is a clinical framework for describing heterogeneous sequelae of complex trauma. Objective: To review the conceptual, diagnostic, clinical, and scientific issues and evidence with regard to the nature and sequelae of complex trauma in adolescence. Method: Variants of posttraumatic stress disorder in adulthood that foreshadow Developmental Trauma Disorder are described, including Disorders of Extreme Stress Not Otherwise Specified and Enduring Personality Change Associated with Catastrophic Experiences. The clinical and developmental rationale for Developmental Trauma Disorder, and results of research supporting the clinical utility of Developmental Trauma Disorder as a distinct diagnostic construct and an integrative parsimonious framework for clinical assessment and treatment, are described with a focus on adolescence. Emergent empirically supported psychotherapy models designed to enhance self-regulation in youth with complex trauma histories are described. Results and Conclusion: Complex trauma and Developmental Trauma Disorder provide a self-regulation framework that can advance research and clinical psychiatric assessment and treatment of highly complex trauma-related forms of adolescent psychopathology.