Cited by 1,574Child Abuse and TraumaChild Welfare and AdoptionChild and Adolescent Psychosocial and Emotional Development

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Validity of the Childhood Trauma Questionnaire in an Adolescent Psychiatric Population

BERNSTEIN, DAVID P., AHLUVALIA, TARUNA, POGGE, DAVID, HANDELSMAN, LEONARD·1997·Journal of the American Academy of Child & Adolescent Psychiatry

DOI 10.1097/00004583-199703000-00012

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Abstract

Objective To present initial findings on the validity of a recently developed maltreatment inventory, the Childhood Trauma Questionnaire (CTQ), in a sample of adolescent psychiatric patients.Method Three hundred ninety-eight male and female adolescents (aged 12 to 17 years) admitted to the inpatient service of a private psychiatric hospital were given the CTQ as part of a larger test battery. Structured interviews were also conducted with the primary therapists of 190 of the patients to obtain ratings of abuse and neglect based on all available data, including clinical interviews with patients and their relatives and information from referring clinicians and agencies.Results Principal-components analysis of the CTQ items yielded five rotated factors-emotional abuse, emotional neglect, sexual abuse, physical abuse, and physical neglect-closely replicating the factor structure in an earlier study of adult patients. The internal consistency of the CTQ factors was extremely high both in the entire sample and in every subgroup examined. When CTQ factor scores were compared with therapists' ratings in a series of logistic regression analyses, relationships between the two sets of variables were highly specific, supporting the convergent and discriminant validity of the CTQ. Finally, when therapists' ratings were used as the validity criterion, the CTQ exhibited good sensitivity for all forms of maltreatment, and satisfactory or better levels of specificity.Conclusions These initial findings suggest that the CTQ is a sensitive and valid screening questionnaire for childhood trauma in an adolescent psychiatric inpatient setting.

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Influential
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Method
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Method
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“, lower cut-off for sexual abuse as compared to emotional neglect) ● Associations in a full sample may differ from associations in the group of exposed individuals only which is a challenge for interpretation of data ● Multiple cut-offs published (Bernstein et al. 1997; Bernstein & Fink, 1998) ● Specific challenges re…”
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“[24], has been repeatedly criticized [26,72–75].”
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Background
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Method
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“Abbreviations: AIM, affective intensity measure; ALS, affective lability scale; BDI, self-rated Beck Depression Inventory; BHS, Beck hopelessness scale; BIS, Barratt impulsiveness scale; BSSI, Beck Scale for Suicide Ideation; CTQ, childhood trauma questionnaire; ESUL, University of California, Los Angeles Loneliness S…”
MethodInfluential
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Method
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“(23) reported the reliability of different factors of CTQ by two methods of re-testing and Cronbach’s alpha to be between 0.”
BackgroundMethod
Psychometric characteristics of the German adaptation of the Traumatic Experiences Checklist (TEC).
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Reliability of self-report of health in juvenile offenders
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Variation in CACNA1C is Associated with Amygdala Structure and Function in Adolescents
Sumner, J. A., Sheridan, M. A., Drury, S. S., Esteves, K. C., Walsh, K., Koenen, K. C., & McLaughlin, K. A. (2015) · Journal of Child and Adolescent Psychopharmacology · doi:10.1089/cap.2015.0047 · Cited by 11
“Participants who reported physical or sexual abuse during the CECA interview or who had a score on any of the three CTQ abuse subscales (physical, sexual, and emotional abuse) above a previously identiﬁed threshold (Walker et al. 1999) were classiﬁed as having experienced childhood trauma.”
Liens entre maltraitance pendant l’enfance ou l’adolescence et consommations de substances à risque chez les jeunes adultes
Wendland, J., Lebert-Charron, A., de Oliveira, C., & Boujut, É. (2016) · L Évolution Psychiatrique · doi:10.1016/j.evopsy.2016.06.011 · Cited by 10
Self-Reported Childhood Maltreatment and Erotic Target Identity Inversions Among Men with Paraphilic Infantilism
Fuß, J., Jais, L., Grey, B. T., Guczka, S. R., Briken, P., & Biedermann, S. V. (2019) · Journal of Sex & Marital Therapy · doi:10.1080/0092623x.2019.1623355 · Cited by 12
Association of childhood trauma, social support, cognition, and suicidality in females with bipolar disorder
Yang, M., Li, J., Fu, Y., Wang, G., Liu, M., Chen, J., & Liu, J. (2024) · BMC Psychiatry · doi:10.1186/s12888-024-05672-9 · Cited by 11
Aberrant functional connectivity of the globus pallidus in the modulation of the relationship between childhood trauma and major depressive disorder
Xia, J., Lin, X., Yu, T., Yu, H., Zou, Y., Luo, Q., & Peng, H. (2024) · Journal of Psychiatry and Neuroscience · doi:10.1503/jpn.240019 · Cited by 9
Altered dynamic functional connectivity of nucleus accumbens subregions in major depressive disorder: the interactive effect of childhood trauma and diagnosis
Zou, Y., Yu, T., Zhu, L., Xu, Q., Li, Y., Chen, J., Luo, Q., & Peng, H. (2024) · Social Cognitive and Affective Neuroscience · doi:10.1093/scan/nsae053 · Cited by 10
“(iv) The abnormal dFC pattern between the left NAc-shell and right MOG showed positive correlations with the total CTQ and subscale scores.”
MethodInfluential
Childhood Maltreatment and Adolescent Eating Disorders’ Symptoms: A Moderated Mediation Model of Social Anxiety and Physical Activity
Li, S., Luo, X., Song, L., Gao, X., & Shen, Y. (2024) · Psychology Research and Behavior Management · doi:10.2147/prbm.s489186 · Cited by 11
“52,53 The previous studies demonstrated that the Chinese adaptation of the CTQ exhibits strong reliability and validity for evaluating childhood trauma.”
The Relationship Between Insufficient Sleep and Depressive Symptoms in Chinese Adolescents: A National Survey of Contributing Factors
Yan, C., Zheng, W., Du, Y., Li, Y., Wang, M., & Qu, M. (2025) · Nature and Science of Sleep · doi:10.2147/nss.s491714 · Cited by 10
“Childhood maltreatment was evaluated using the Childhood Trauma Questionnaire (CTQ), 28 with total scores ranging from 25 to 125.”
Reduced neural responsiveness to looming stimuli is associated with increased aggression
Blair, J., Zhang, R., Bashford‐Largo, J., Bajaj, S., Mathur, A., Ringle, J. L., Schwartz, A., Elowsky, J., Dobbertin, M. D., Blair, K. S., et al. (2021) · Social Cognitive and Affective Neuroscience · doi:10.1093/scan/nsab058 · Cited by 9
Erstellung und Validierung einer Kurzversion des Fragebogens zur Erfassung aversiver und protektiver Kindheitserfahrung (APK-18)
Volz, M., Zimmermann, J., Schauenburg, H., Dinger, U., Nikendei, C., Friederich, H., & Ehrenthal, J. C. (2021) · Diagnostica · doi:10.1026/0012-1924/a000276 · Cited by 9
Prevalence Rates and Evolution of Psychiatric Disorders Among Incarcerated Youths in Comparison With Non-incarcerated Youths
Heller, P., Morosan, L., Badoud, D., Laubscher, M., Jimenez Olariaga, L., Debbané, M., Wolff, H. J., & Baggio, S. (2022) · doi:10.48350/164926 · Cited by 9
Neural effects of childhood maltreatment on dynamic large-scale brain networks in major depressive disorder
Wang, Q., He, C., Fan, D., Liu, X., Zhang, H., Zhang, H., Zhang, Z., & Xie, C. (2022) · Psychiatry Research · doi:10.1016/j.psychres.2022.114870 · Cited by 9
Examination of the importance of anger/irritability and limited prosocial emotion/callous-unemotional traits to understand externalizing symptoms and adjustment problems in adolescence: A 10-year longitudinal study
Urben, S., Habersaat, S., Palix, J., Fegert, J. M., Schmeck, K., Bürgin, D., Seker, S., Boonmann, C., & Schmid, M. (2022) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2022.939603 · Cited by 10
“Early adversities (i.e., physical abuse, emotional abuse, physical neglect, emotional neglect, and sexual abuse) were collected at follow-up using the short form of the Child Trauma Questionnaire (CTQ-SF) (48), a 28-item self-report questionnaire.”
Method
Racial discrimination, childhood adversity, and depression among Black men: Tests of stress sensitization hypotheses
Kwon, E., Fisher, S. D., Lin, H., & Kogan, S. M. (2023) · Psychiatry Research · doi:10.1016/j.psychres.2023.115257 · Cited by 10
The impact of adversities across the lifespan on psychological symptom profiles in late adulthood: a latent profile analysis
Hilberdink, C. E., van Zuiden, M., Olff, M., Roseboom, T. J., & de Rooij, S. R. (2023) · Journal of Developmental Origins of Health and Disease · doi:10.1017/s2040174423000181 · Cited by 10
GDNF and miRNA-29a as biomarkers in the first episode of psychosis: uncovering associations with psychosocial factors
Szwajca, M., Kazek, G., Śmierciak, N., Mizera, J., Pomierny-Chamioło, L., Szwajca, K., Biesaga, B., & Pilecki, M. W. (2024) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2024.1320650 · Cited by 9
“CTQ is a retrospective self-assessment tool providing a description of trauma experienced in childhood and adolescence (67, 68).”
Validation of the Spanish Childhood Trauma Questionnaire-Short Form in adolescents with suicide attempts
García-Fernández, A., Martínez-Cao, C., Sánchez-Fernández-Quejo, A., Bobes-Bascarán, T., Andreo-Jover, J., Ayad‐Ahmed, W., Cebrià, A. I., Díaz‐Marsá, M., Torres, N. G., Gómez‐Vallejo, S., et al. (2024) · Frontiers in Psychology · doi:10.3389/fpsyg.2024.1378486 · Cited by 9
Effects of MAOA genotype and childhood experiences of physical and emotional abuse on aggressive behavior in adulthood
Rehan, W., Sandnabba, N. K., Johansson, A., Westberg, L., & Santtila, P. O. (2015) · Nordic Psychology · doi:10.1080/19012276.2015.1026922 · Cited by 9
“92 across a range of samples (Bernstein & Fink, 1998), convergent validity with both a clinical-rated interview if childhood abuse and therapists’ ratings of abuse, and a consistent five-factor structure (Bernstein et al., 1997; Bernstein & Fink, 1998).”
BackgroundInfluential
Mental health and drug use severity: the role of substance P, neuropeptide Y, self-reported childhood history of trauma, parental bonding and current resiliency
Roviš, D., Vasiljev, V., Pražnikar, Z. J., Petelin, A., Drevenšek, G., Peruč, D., & Černelič-Bizjak, M. (2019) · Journal of Mental Health · doi:10.1080/09638237.2019.1644492 · Cited by 9
Effects of childhood trauma experience and COMT Val158Met polymorphism on brain connectivity in a multimodal MRI study
Tian, T., Li, J., Zhang, G., Wang, J., Liu, D., Wan, C., Fang, J., Wu, D., Zhou, Y., & Zhu, W. (2020) · Brain and Behavior · doi:10.1002/brb3.1858 · Cited by 9
“In the present study, maltreatment experience during childhood was assessed by administering the Chinese version of the CTQ that assesses childhood experience of abuse or neglect in adults (Bernstein et al., 1997).”
Method
Associations between early life stress and anterior pituitary gland volume development – A novel index of long‐term hypothalamic‐pituitary‐adrenal axis functioning
Díaz‐Arteche, C., Simmons, J. G., Ganella, D. E., Schwartz, O., Kim, J. H., Farrow, P., & Whittle, S. (2020) · Developmental Psychobiology · doi:10.1002/dev.22047 · Cited by 8
Childhood maltreatment, subjective social status, and health disparities in bereavement
Chen, M. A., Brown, R. L., Chen, J. Y., de Dios, M. A., Green, C. E., Heijnen, C. J., & Fagundes, C. P. (2021) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2021.105595 · Cited by 10
Understanding intergenerational transmission of early maladaptive schemas from a memory perspective: Moderating role of overgeneral memory on adverse experiences
Alaftar, İ., & Uzer, T. (2022) · Child Abuse & Neglect · doi:10.1016/j.chiabu.2022.105539 · Cited by 10
Does Childhood Maltreatment Lead to Low Life Success? Comparing Agency and Self-Reports
Najman, J. M., Scott, J. G., Farrington, D. P., Clavarino, A. M., Williams, G. M., McGee, T. R., & Kisely, S. R. (2022) · Journal of Interpersonal Violence · doi:10.1177/08862605221090565 · Cited by 9
“The Child Trauma Questionnaire (CTQ) with subscales based upon a factor analysis (Bernstein et al., 1997, 2003).”
Method
Adaptación del Cuestionario de Experiencias Adversas en la infancia en muestras mexicanas
Mendoza, B., & Ochoa-Meza, G. (2022) · Psicología y Salud · doi:10.25009/pys.v32i2.2742 · Cited by 10
Associations of Non-suicidal Self-Injury and Psychological Symptoms With Suicide Attempt in Adolescents: Are There Any Gender Differences?
Xu, H., Wang, R., Li, R., Jin, Z., Wan, Y., & Tao, F. (2022) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2022.894218 · Cited by 9
“5th ed; MDD, Major Depressive Disorder; ACEs, adverse childhood experiences; CTQ, Child Trauma Questionnaire; MSQA, Multidimensional Sub-health Questionnaire of Adolescents; SPSS, Statistical Product and Service Solutions; SD, standard deviation; OR, odds ratio.”
BackgroundMethod
Gene–Environment Correlation Between the Dopamine Transporter Gene (DAT1) Polymorphism and Childhood Experiences of Abuse
Rehan, W., Antfolk, J., Johansson, A., Aminoff, M., Sandnabba, N. K., Westberg, L., & Santtila, P. O. (2016) · Journal of Interpersonal Violence · doi:10.1177/0886260515622299 · Cited by 8
“…including test–retest reliability coefficients ranging from .79 to .86 over an average of 4 months, convergent validity with both a clinicalrated interview if childhood abuse and therapists’ ratings of abuse, and a consistent five-factor structure (Bernstein et al., 1997; Bernstein & Fink, 1998).”
BackgroundMethod
Heart Rate Variability Reactivity Moderates the Indirect Link Between Child Maltreatment and Young Adult Alcohol Use Problems Via Depressive Symptoms
Liu, S., Oshri, A., & Duprey, E. B. (2020) · American Journal on Addictions · doi:10.1111/ajad.13004 · Cited by 10
Sexual Abuse Victimization and Psychological Distress Among Adolescent Offenders
Phan, D., & Kingree, J. B. (2002) · Journal of Child Sexual Abuse · doi:10.1300/j070v10n04_06 · Cited by 9
Lost in fragmentation. Schema modes, childhood trauma, and anger in borderline and antisocial personality disorder
Lobbestael, J. (2008) · doi:10.26481/dis.20080612jl · Cited by 9
Authenticity, Vulnerability, and Shame in Peer Relationships among Marginalized Youth Living with Mood and Anxiety Disorders
Sapiro, B., & Quiroz, S. R. (2022) · Journal of Child and Family Studies · doi:10.1007/s10826-022-02358-2 · Cited by 9
“Data from the Child Trauma Questionnaire (Bernstein et al., 1997) included in the Cornerstone assessment revealed that 85% of the young women (n= 11) reported a history of at least one form of child maltreatment (physical abuse, emotional abuse, sexual abuse, or neglect).”
Method
The Chinese version of the Maltreatment and Abuse Chronology of Exposure (MACE) scale: Psychometric properties in a sample of young adults
Chen, Y., Wang, Z., Zheng, X., Wu, Z., & Zhu, J. (2022) · PLoS ONE · doi:10.1371/journal.pone.0270709 · Cited by 9
Resilience to stress across the lifespan: Childhood maltreatment, heart rate variability, and bereavement.
Chen, M. A., Suchting, R., Thayer, J. F., & Fagundes, C. P. (2023) · Psychology and Aging · doi:10.1037/pag0000738 · Cited by 9
Adverse Childhood Experience, Parental Bonding, and Fatherhood as Parenting Vulnerabilities to Social Anxiety Severity
Heshmati, R., Abbasoghli, P. H., Pour, N. S. Y., & Habibi, M. (2024) · European Journal of Investigation in Health Psychology and Education · doi:10.3390/ejihpe14070137 · Cited by 11
“The CTQ was developed by Bernstein [90] and consists of 28 items (including 25 clinical and 3 validity items) that assess the severity of different types of childhood trauma.”
Method
Identifying cognitive, affective, and developmental mechanisms linking threat and deprivation with adolescent psychopathology
Sadikova, E., Weissman, D. G., Rosen, M. L., Robinson, E., Lengua, L. J., Sheridan, M. A., Tiemeier, H. W., & McLaughlin, K. A. (2024) · Journal of Child Psychology and Psychiatry · doi:10.1111/jcpp.14067 · Cited by 8
Cognitive presentation at psychosis onset through premorbid deterioration and exposure to environmental risk factors
Ferraro, L., Forti, M. D., Barbera, D. L., Cascia, C. L., Morgan, C., Tripoli, G., Jongsma, H. E., Seminerio, F., Sartorio, C., Sideli, L., et al. (2025) · Psychological Medicine · doi:10.1017/s0033291724003507 · Cited by 10
“We assessed childhood adversities by using two instruments: the Childhood Trauma Questionnaire (CTQ) (Bernstein, Ahluvalia, Pogge, & Handelsman, 1997), a 28-item self-report tool that rates the presence of physical, sexual, and emotional abuse, physical and emotional neglect, and the Childhood…”
Effects of childhood trauma on depression and cognitive function in first-diagnosed, drug-naïve depressed patients: an observational case-control study
Zhao, N., Tang, M., Wang, L., Liu, T., Zhao, T., Xie, K., Xue, Y., & Zeng, W. (2025) · BMC Psychiatry · doi:10.1186/s12888-025-06764-w · Cited by 11
“Higher scores indicate more severe trauma experiences [42–44].”
Childhood maltreatment and suicide ideation in Chinese college students: The chain mediating role of self-compassion and depressive symptoms
Liu, M., Yu, X., Liu, A., Wu, X., & Lin, W. (2025) · Child Abuse & Neglect · doi:10.1016/j.chiabu.2025.107475 · Cited by 8
Avoidant restrictive food intake disorder, traumatic events and PTSD in adolescents and adults admitted to residential treatment
Brewerton, T. D., Suro, G., Fernandez, N., Tulga, K., Gavidia, I., & Perlman, M. M. (2025) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2025.05.022 · Cited by 9
Emotional neglect, hikikomori behaviors and internet gaming disorder in adolescents: A three-wave longitudinal study
Calaresi, D., Verrastro, V., Giordano, F., & Saladino, V. (2025) · Journal of Affective Disorders · doi:10.1016/j.jad.2025.119850 · Cited by 9
Measurement invariance of the Childhood Trauma Questionnaire by gender, poverty level, and HIV status
Rodriguez, V. J., Radusky, P. D., Kumar, M., Nemeroff, C. B., & Jones, D. L. (2018) · Personalized Medicine in Psychiatry · doi:10.1016/j.pmip.2018.10.002 · Cited by 8
“Childhood Trauma Questionnaire—The Childhood Trauma Questionnaire – Short Form (CTQ-SF) [19,20], a 28-item Likert scale (1 = never true, 2 = rarely true, 3 = sometimes true, 4 = often true, 5 = very often), assesses emotional abuse, physical abuse, sexual abuse, emotional neglect, physical neglect, and denial and mini…”
BackgroundMethod
The Role of Attachment in Intergenerational Trauma Transmission: A Structured Literature Review
Kaur, S., & Békés, V. (2025) · Journal of Aggression, Maltreatment & Trauma · doi:10.1080/10926771.2025.2574315 · Cited by 3

Authors: BERNSTEIN, D. P., AHLUVALIA, T., POGGE, D., & HANDELSMAN, L.
Affiliations: Icahn School of Medicine at Mount Sinai (US)
Fairleigh Dickinson University (US)
Corresponding author: BERNSTEIN, DAVID P.
ORCID: BERNSTEIN, DAVID P.
Venue: Journal of the American Academy of Child & Adolescent Psychiatry
Publisher: Elsevier BV
Published: 1997-03
Volume: 36
Issue: 3
Pages: 340-348
ISSN: 0890-8567 (ISSN-L)
DOI: 10.1097/00004583-199703000-00012
OpenAlex: W2009780891
Cited by: 1,574
References: 25
Citations by year: 2026: 66 · 2025: 107 · 2024: 112 · 2023: 105 · 2022: 131 · 2021: 93 · 2020: 105 · 2019: 97 · 2018: 76 · 2017: 69 · 2016: 69 · 2015: 59 · 2014: 67 · 2013: 60 · 2012: 47
FWCI: 15.25
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
Locations: Journal of the American Academy of Child & Adolescent Psychiatry (publishedVersion)
PubMed (publishedVersion)
Topics: Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
Social Sciences › Sociology and Political Science › Child Welfare and Adoption
Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
Keywords: Childhood Trauma Questionnaire, child abuse, adolescent psychiatric inpatients, factor structure, convergent and discriminant validity, emotional abuse, emotional neglect, sexual abuse, physical abuse, physical neglect, abuse screening, therapist ratings
MeSH terms: Adolescent, Mental Disorders, Child, Child Abuse, Child Abuse, Sexual, Female, Humans, Male, Surveys and Questionnaires, Sensitivity and Specificity, Reproducibility of Results, Logistic Models

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Validity of the Childhood Trauma Questionnaire in an Adolescent Psychiatric Population

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