Exploring psychopathology in early childhood: PTSD and attachment disorders in DC: 0–3 and DSM-IV

Abstract

Standard nosologies of psychiatric disorders have made preliminary efforts to accommodate developmental differences in symptom manifestation by young children. Significant gaps remain in the validation of disorders for this age group. The DC: 0–3 represents an alternative nosology for disorders of infancy that attempts to complement existing approaches and assist clinicians and researchers. In this commentary we review research on two disorders of early childhood—Posttraumatic Stress Disorder (PTSD), and Reactive Attachment Disorder (RAD)—to illustrate the promises and problems of the DSM-IV and DC: 0–3 approach to definition and conceptualization of these disorders. In addition we review what is known about RAD and PTSD with regard to key areas of controversy in early childhood psychopathology: (1) continuous versus categorical conceptualization, (2) developmental considerations, and (3) the relationship context. Recommendations are made for future editions of the DSM-IV and DC: 0–3, as well as for validity research in early childhood disorders. ©2003 Michigan Association for Infant Mental Health.