![]() ![]() Department of Health & Human Services, 2017 Witt et al., 2017, 2018). Department of Health & Human Services, 2017): for this reason, it has also been proposed as the expression “attachment trauma” ( Isobel et al., 2017).Įven if emotional, physical, and sexual abuse constitutes typical forms of developmental traumatization, neglect constitutes the major form of developmental trauma ( Woller et al., 2012 U.S. Cumulative developmental trauma (CDT), also known as early relational trauma due to the interpersonal nature of the traumatic experiences ( Isobel et al., 2017), refers to different types of stressful and traumatic events that occur repeatedly and cumulatively, usually over a period of time, and within specific relationships and contexts ( Sar, 2011), which are in most cases (about 80%) perpetrated by parents or other caregivers ( U.S. Over the last 30 years, an increasing body of experimental data highlighted both the importance of developmental trauma and, at the same time, the difficulty of current international diagnostic systems in describing the clinical consequences of cumulative traumatic childhood experiences in the adult population ( Van der Kolk et al., 1996 Cloitre et al., 2009 Bryant, 2010). ![]() The usefulness of clinical reasoning in terms of psychopathological dimensions, instead of distinct diagnostic categories, as well as several therapeutic implications of these issues was finally discussed. We also focused on the clinical and theoretical evidence suggesting that dissociation and dis-integration may be considered two different processes but highly correlated. The present article aims to review some crucial points about the clinical meaning and treatment strategies of the TDD, the dissociative pathogenic processes characterizing the TDD, as well as of the role of attachment trauma in the TDD. The clinical complexity of the TDD requires specific training to enable mental health professionals to recognize the signs of traumatic developments and to implement specific treatment strategies. For this reason, we proposed to define the dimension of psychopathological outcomes linked to traumatic attachments and dissociative pathogenic processes as the “traumatic-dissociative” dimension (TDD). It has been observed that the dissociative pathogenic processes caused by these traumatic attachments either may contribute to the genesis of well-defined mental disorders (e.g., dissociative disorders) or may variably occur in many other diagnostic categories, complicating their clinical pictures and worsening their prognosis.
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