Survivors of early childhood trauma: evaluating a two-dimensional diagnostic model of the impact of trauma and neglect.
BACKGROUND
A two-dimensional diagnostic model for (complex) trauma-related and personality disorders has been proposed to assess the severity and prognosis of the impact of early childhood trauma and emotional neglect. An important question that awaits empirical examination is whether a distinction between trauma-related disorders and personality disorders reflects reality when focusing on survivors of early childhood trauma. And, is a continuum of trauma diagnoses a correct assumption and, if yes, what does it look like?


OBJECTIVE
We describe the design of a cross-sectional cohort study evaluating this two-dimensional model of the impact of trauma and neglect. To provide the rationale of our study objectives, we review the existing literature on the impact of early childhood trauma and neglect on trauma-related disorders and personality disorders. Aims of the study are to: (1) quantify the two-dimensional model and test the relation with trauma and neglect; and (2) compare the two study groups.


METHODS
A total of 200 consecutive patients referred to two specific treatment programs (100 from a personality disorder program and 100 from a trauma-related disorder program) in the north of Holland will be included. Data are collected at the start of treatment. The assessments include all DSM-5 trauma-related and personality disorders, and general psychiatric symptoms, trauma history, and perceived emotional neglect.


CONCLUSIONS
The results will provide an evaluation of the model and an improvement of the understanding of the relationship between trauma-related disorders and personality disorders and early childhood trauma and emotional neglect. This may improve both diagnostic as well as indication procedures. We will discuss possible strengths and limitations of the design.
GGZ Friesland, Leeuwarden, The Netherlands.
Marleen
M
Wildschut
Bascous, France.
Willemien
W
Langeland
Department of Psychiatry and EMGO Institute, Vrije University Medical Center/GGZinGeest, Amsterdam, The Netherlands ; Department of Research, GGZinGeest, Amsterdam, The Netherlands.
Jan H
JH
Smit
Department of Psychiatry and EMGO Institute, Vrije University Medical Center/GGZinGeest, Amsterdam, The Netherlands ; Department of Research, GGZinGeest, Amsterdam, The Netherlands.
Nel
N
Draijer
diagnostics; early childhood trauma; emotional neglect; personality disorders; trauma-related disorders; treatment indication