Background: Complex trauma involves prolonged or repeated exposure during
critical developmental windows or transitions (including adolescence) to intentional
interpersonal victimization that is inescapable and causes profound insecurity.
Developmental Trauma Disorder is a clinical framework for describing heterogeneous
sequelae of complex trauma.
Objective: To review the conceptual, diagnostic, clinical, and scientific issues and evidence
with regard to the nature and sequelae of complex trauma in adolescence.
Method: Variants of posttraumatic stress disorder in adulthood that foreshadow
Developmental Trauma Disorder are described, including Disorders of Extreme Stress Not
Otherwise Specified and Enduring Personality Change Associated with Catastrophic
Experiences. The clinical and developmental rationale for Developmental Trauma Disorder,
and results of research supporting the clinical utility of Developmental Trauma Disorder as a
distinct diagnostic construct and an integrative parsimonious framework for clinical
assessment and treatment, are described with a focus on adolescence. Emergent empirically
supported psychotherapy models designed to enhance self-regulation in youth with complex
trauma histories are described.
Results and Conclusion: Complex trauma and Developmental Trauma Disorder provide a
self-regulation framework that can advance research and clinical psychiatric assessment and
treatment of highly complex trauma-related forms of adolescent psychopathology.