Trauma complejo o trastorno traumático del desarrollouna nueva propuesta diagnóstica para la comprensión de las reacciones postraumáticas graves en la infancia y adolescencia

Zusammenfassung

Repeated and early attachment trauma has a huge impact on children’s development, producing a wide range of psychopathology, which is included as a new diagnosis called complex posttraumatic stress disorder (CPTSD) in the 11th revision of the World Health Organization’s International Classification of Diseases (ICD-11). Attachment trauma includes all situations of violence and neglect to which a child is exposed in the context of his or her basic primary care (e.g., physical and emotional abuse, sexual abuse, neglect, abandonment, or direct witnessing of violence between parents). Aims The main aim of this study was to study complex posttraumatic reactions in minors who had suffered severe abuse by primary caregivers, and in another group of children who experienced other types of trauma, not complex ones, and to compare the resulting posttraumatic symptoms in both groups. Another aim was also to analyze the validity of the diagnosis of Developmental Trauma Disorder (DTD) to explain the psychopathological manifestations resulting from these complex traumatic events. Method The design of our study was cross-sectional and quasi-experimental. The study sample consisted of children who had experienced intra-familial abuse and children who had suffered other types of trauma. Different scales were administered to minors, caregivers and clinicians to assess the posttraumatic symptoms (PTSD and CPTSD/DTD): Child Posttraumatic Stress Scale (CPSS, Foa et al., 2001; Adapt. GUIIA-PC, 2014) and List of DTD Symptoms (GUIIA-PC, 2014). Results and conclusions A high percentage of minors who had suffered intra-familial abuse (77.4% of children in care and 80.5% of minors exposed exposed to violence against their mothers by their partners or ex-partners, compared to 28.4% of the control children) presented serious affective, cognitive, and behavioral selfregulation alterations, which corresponded to Complex PTSD or DTD. Higher rates of PTSD were also found in the groups of abused minors (49.1% of children in care and 36.8% in minors exposed to gender violence) compared to those who were not abused (16.1%). Therefore, the results confirm a relationship between the number and type of traumatic events suffered and the severity of posttraumatic stress symptoms that develop later (attachment trauma increase the probability of presenting complex posttraumatic symptoms). In addition, data support the validity of the C-PTSD and DTD diagnoses.