Developmental Trauma Disorders: Understanding Symptoms And Treatment

Experiencing any trauma can be challenging. However, trauma in childhood may have unique impacts due to the developmental milestones children go through. A proposed mental illness called developmental trauma disorder (DTD) describes these unique symptoms that people who have experienced childhood trauma might confront. Although rejected in its submission to the DSM-5, developmental trauma disorder can have real mental health symptoms and may be connected to post-traumatic stress disorder (PTSD) in adults and children.

What is developmental trauma disorder?

Developmental trauma disorder (DTD) was proposed as a condition to describe the type of trauma response that can develop as a result of repeated traumatic events during a developmental phase of childhood, often around the ages of four to nine.

As an example of different types of trauma disorders, consider five-year-old Samantha. Samantha survived a severe car accident and broke several bones, resulting in mental as well as physical trauma. Five-year-old Ben lived in a neighborhood with frequent gun violence. Ben's mother used substances to cope with her fears of violence, and Ben's father was physically abusive. In both cases, children of the same age were traumatized in a way that affected their development. However, Samantha's incident was a singular trauma, while Ben's situation was chronic. Over time, Ben developed developmental trauma disorder due to repeated exposure to distressing scenarios that resulted in childhood trauma.

What is the difference between DTD and PTSD?

Post-traumatic stress disorder (PTSD) often occurs after a single life-threatening or traumatic event, like Samantha's car accident. Samantha developed anxiety and other PTSD symptoms triggered by the accident scene, sights, sounds, and smells. Samantha was also afraid to get in a vehicle afterwards and needed professional help via exposure or play therapy to explore and sort through these fears safely. By slowly exposing Samantha to riding in a vehicle again, a therapist showed her that they could be safe. 

In contrast, the proposed model of DTD is similar to complex PTSD (C-PTSD), which involves repeated exposure to traumas and traumatic stress over a lifetime. However, unlike complex PTSD, DTD is specific to the developmental period in childhood in which children may be most impacted. In the example of Ben, more time was required to recover, and Ben's developmental trauma became a significant part of his personality. He may also have developed additional illnesses, like oppositional defiant disorder or another mental health condition. Ben's circumstances were different because the trauma was ongoing, he could not leave the environment where he was experiencing complex trauma, and he did not receive adequate support. 

Many people with conditions like DTD or complex PTSD use substances or dissociative compulsions to cope, but it may be possible to treat complex traumas like DTD or C-PTSD in children and adults and help individuals find healthier coping methods. After being removed from a traumatic environment, individuals will typically require intensive care and professional support to heal. 

If you are struggling with substance use, contact the SAMHSA National Helpline at (800) 662-4357 to receive support and resources. Support is available 24/7.

What are the effects of developmental trauma disorders?

Developmental traumas are also referred to as adverse childhood experiences (ACEs), which include neglect and different forms of abuse (physical, emotional, or sexual). ACEs also include any experience of significant household dysfunction, such as domestic violence, substance use, divorce, and mental illness.

Children's brains develop throughout childhood and into their young adult years. Children under five are especially susceptible to trauma because their brains develop more rapidly at that age than the brains of older children do. That’s why the results of developmental trauma can be devastating for children. For example, those with developmental trauma disorder often experience symptoms of PTSD and may struggle with mood control, anger, aggression, and a need for control.

Changes in the brain affect children's development and ability to trust adult caregivers. A study by Kaiser Permanente and the Centers for Disease Control found that almost a third of adults who had symptoms related to DTD had a parent or caregiver in their home as children who demonstrated symptoms of a substance use disorder. The study also found that 26% of these individuals were exposed to physical abuse as children. 

Common behaviors in those with developmental trauma disorder

Children who have experienced chronic abuse or neglect learn that adults cannot provide for basic needs, such as food, clothing, warmth, love, and shelter. In this case, they may learn from an early age to provide for themselves, becoming self-reliant and hesitant to trust others. They also learn that they must be in control of their surroundings to survive and carry this need for control into their adult life. 

Some adults or children with symptoms of developmental trauma disorder or other signs of complex trauma may resort to lying, stealing, manipulation, destructiveness, and cruelty to gain control over a situation when they feel trapped or triggered by their traumas. Or, they may distance themselves from others, making it difficult to feel connected and build healthy relationships. 

It’s also possible for an individual to develop other conditions besides or in addition to post-traumatic stress disorder or DTD. For example, children and adolescents may experience conditions like oppositional defiant disorder. Oppositional defiant disorder is a behavior disorder. Over the long term, individuals could also be at increased risk of illnesses like personality disorders (such as borderline personality disorder), bipolar disorder, and others in addition to post-traumatic stress disorder.

If you've gone through trauma, know that these behaviors are not part of your personality. Instead, they're symptoms of the challenges you've faced in the past. With professional help, you may be able to move past these symptoms and work toward healing.

Treatment for developmental trauma disorder

Treatment can take time, but with support and consistency, children may be able to find healing from trauma. Other factors, including case management, removal from the unsafe environment, emotional support, love, and a support team, may also be necessary. 

Treatments for developmental trauma disorder (DTD) often focus on establishing safety and helping children build trust. For example, play therapy with a trauma-informed mental health professional may help children process emotional responses in a safe, predictable environment. Children can then learn to transfer their skills to their relationships with adult caregivers and other people in their lives. 

In addition, this type of treatment can teach children self-control skills and help them see how they've managed the trauma they've experienced. Once they understand how they've responded in the past, a therapist can help them identify creative ways to meet life's struggles by getting out of survival mode and using healthier coping mechanisms. 

Support for adults with developmental trauma

Adults can receive support for developmental trauma disorder (DTD), post-traumatic stress disorder (PTSD), C-PTSD, and/or other illnesses that may be related to trauma, such as borderline personality disorder. Even if you do not have a diagnosis, therapy can be a safe space for you to discuss your childhood and other past experiences. No matter how long it’s been since your trauma occurred, including if it’s still happening, you can talk to a professional about moving forward.

When you work with a licensed mental health professional, they can create a unique treatment plan for your situation, which will typically involve cognitive behavioral therapy, another type of behavioral therapy, or other modalities designed to treat post-traumatic stress disorder and other trauma-related effects. They can also offer techniques, expertise, and resources to help you recover and cope. A therapist can help you process past trauma in healthy ways so that you can use cognitive behavioral therapy techniques or others to manage symptoms as they arise. 

If you’re not able to attend in-person therapy sessions, you might explore online therapy options. Research suggests that online therapy can be an effective treatment method for post-traumatic stress disorder and other signs of trauma, often offering comparable effects to in-person treatment.

Using an online therapy platform, you may avoid sitting in traffic or taking time out of your day to drive to a provider’s office. Instead, you can speak to your counselor from the comfort of home or any location with a reliable internet connection. Many platforms can also match you with a therapist in as little as 48 hours.