Members Clinical Corner

Measuring Trauma: Considerations for assessing complex and non-PTSD criterion for childhood trauma

In the “tradition” of having tested this format once before, this column presents three brief commentaries on the same article of the JTD. I am pleased to notice that the three commentaries are from different, even opposite angles.

Happy reading!

Pam Stavropoulos
Editor

Focus article:

McDonald, M.K., Brontrager, C.F. & Rostad, W. (2014) Measuring Trauma: Considerations for assessing complex and non-PTSD criterion for childhood trauma, Journal of Trauma and Dissociation, Vol.15 pp184-203

Expert ContributorsNa’ama Yehuda, Richard Hohfeler, Andreas Laddis

Commentary 1
Commentary by: Na’ama Yehuda

Many stressful experiences do not qualify as traumatic events according to the DSM-5’s PTSD diagnostic criteria, yet may be considered traumatic by those who have endured them (D’Andrea et al 2012, Felitti et al 1998). PTSD criteria for children and adolescents fail to account for attachment disruptions, verbal abuse, bullying, and other experiences, which led to the proposed diagnosis of Developmental Trauma Disorder (DTD). DTD aims to capture the emotional, behavioral, and neurological outcomes in children exposed to multiple traumatic experiences .…Click here for the full text version of the MCC commentary.

Dissociation as a Defining Element of Traumatic Experience?
Commentary by: Richard Hohfeler

This study challenges the rather limited view of what the DSM-5 considers to qualify as a traumatic experience, i.e. “exposure to actual or threatened death, serious injury, or sexual violence.” The authors (McDonald et al, 2014) suggest that this definition of trauma is not “broad enough” as it misses a wide array of stressful experiences in children who are exposed to significant disruptions in attachment relationships and other relationally based traumata. Therefore an attempt is made to subjectively determine a broader categorization of traumatic experience which is retrospectively derived via questionnaires…Click here for the full text version of the MCC commentary.

How we can transcend the limitations of Criterion A

In this article, McDonald and colleagues aim to address the concern that Criterion A for the diagnosis of PTSD in the DSM-5 is too narrow, particularly for children and adolescents. Criterion A consists of a list of adversities that are potentially traumatic (such as threat of death or of serious injury, sexual violence, witnessing severe violence inflicted on others, especially family or close friends). Several DSM editions have required Criterion A for the diagnosis of PTSD: symptoms (flashbacks, avoidance, etc.) must pertain to an event named in the DSM, which has in fact anteceded their onset…Click here for the full text version of the MCC commentary.

For more full text versions of the featured commentaries, the focus article, and contributor information, please see the MCC webpage
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