Traumaentwicklungsstörung: Pro und Contra
Abstract
Es wird die aktuelle Diskussion um die Aufnahme der Diagnose einer Traumaentwicklungsstörung in das DSM-V aufgegriffen und die Pro- und Contraargumente einer solchen Diagnose gegenübergestellt. Befürworter der Traumaentwicklungsstörung argumentieren, dass viele gut erforschte Traumafolgen mit der Diagnose einer Posttraumatischen Belastungsstörung nur unzureichend beschrieben werden. Gerade Opfer von schweren und sequentiellen Kindheitstraumata entwickeln häufig eine Breitbandsymptomatik mit vielen komorbiden psychischen Störungen. Die klinische Evidenz zeigt, dass diese sehr schwer zu behandelnde Patientengruppe von einem spezifischen traumatherapeutischen Zugang profitiert. Gegen diese Diagnose spricht, dass mit der Einführung einer solchen Diagnose, die in den Diagnosesystemen verlangte rein deskriptive Beschreibung von Symptomen verlassen wird und ätiologische Aspekte in den Vordergrund treten, zudem könnten komorbide Störungen mit ihren biologischen Aspekten übersehen werden. Abschließend werden Implikationen, die sich aus einer solchen Diagnose ergeben, erörtert. Dabei wird auch eine dimensionale Erfassung dieser Symptomatik angedacht.
This article takes up the current debate about the diagnosis “developmental trauma disorder” and discusses the pros and cons of this diagnosis. Victims of abuse neglect and maltreatment in childhood often develop a wide spectrum of psychopathology with different comorbid mental disorders. The proponents of this diagnosis argue that the posttraumatic stress disorder can not describe all the consequences of severe and complex traumatization. Clinical experience shows that this difficult-to-treat group of patients will benefit from trauma therapy treatment approaches. Arguments against the diagnosis of developmental trauma disorder include the fact that it would force current diagnostic systems to deviate from the present, purely descriptive basis and emphasize etiology. Furthermore, comorbidity and biological aspects the disorder could be underdiagnosed using such a complex disorder. Finally, the implications are discussed and a dimensional approach to the diagnosis of developmental trauma disorder is proposed.
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