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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BackgroundMethodInfluential
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Background
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Method
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Method
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“of LTCs (%) 0 41,593 (41) 10,690 (36) 8459 (35) 4767 (35) 2831 (32) 1 34,657 (34) 9899 (33) 8031 (33) 4353 (32) 2913 (33) 2 17,158 (17) 5359 (18) 4588 (19) 2533 (19) 1758 (20) 3 6384 (6) 2356 (8) 2018 (8) 1161 (9) 855 (10) 4 2843 (3) 1411 (5) 1365 (6) 794 (6) 610 (7) Missing 163 84 91 39 38”
Ratings of family functioning of suicidal and nonsuicidal African American women.
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Self-citation
Peripheral telomere length and hippocampal volume in adolescents with major depressive disorder
Henje Blom, E., Han, L. K. M., Connolly, C. G., Ho, T. C., Lin, J., LeWinn, K. Z., Simmons, A. N., Sacchet, M. D., Mobayed, N., Luna, M. E., et al. (2015) · Translational Psychiatry · doi:10.1038/tp.2015.172 · Cited by 51
The Impact of Psychosocial Stress from Life Trauma and Racial Discrimination on Epigenetic Aging—A Systematic Review
Lim, S., Nzegwu, D., & Wright, M. L. (2022) · Biological Research For Nursing · doi:10.1177/10998004211060561 · Cited by 58
“…are a number of CDEs for life trauma assessment including the Traumatic Life Events Questionnaire (TLEQ) (for adults), Adverse Life Events Scale (for children), and Childhood Trauma Questionnaire (CTQ) (https://www.phenxtoolkit.org/) (Bernstein et al., 1997; Dohrenwend, 2006; Tiet et al., 2001).”
Background
Aftermath of sexual abuse history on adult patients suffering from chronic functional pain syndromes: An fMRI pilot study
Noll‐Hussong, M., Otti, A., Läer, L., Wohlschlaeger, A. M., Zimmer, C., Lahmann, C., Henningsen, P., Toelle, T. R., & Guendel, H. O. (2010) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2010.01.020 · Cited by 53
False memory for trauma-related Deese–Roediger–McDermott lists in adolescents and adults with histories of child sexual abuse
Goodman, G. S., Ogle, C. M., Block, S. D., Harris, L. S., Larson, R. P., Augusti, E., Cho, Y. I., Beber, J., Timmer, S. G., & Urquiza, A. J. (2011) · Development and Psychopathology · doi:10.1017/s0954579411000150 · Cited by 54
Epigenetic Meta-Analysis Across Three Civilian Cohorts Identifies NRG1 and HGS as Blood-Based Biomarkers for Post-Traumatic Stress Disorder
Uddin, M., Ratanatharathorn, A. D., Armstrong, D. L., Kuan, P. F., Aiello, A. E., Bromet, E. J., Galea, S., Koenen, K. C., Luft, B. J., Ressler, K. J., et al. (2018) · Epigenomics · doi:10.2217/epi-2018-0049 · Cited by 54
“…but did not meet criteria for lifetime or current PTSD. Childhood maltreatment was assessed in the DNHS using questions from the Conﬂict Tactics Scale [28] , the Childhood Trauma Questionnaire [29] , and Wyatt’s eight-item interview guide as implemented in the Nurse’s Health Study II [30] .”
Method
Childhood trauma and neural responses to personalized stress: favorite-food and neutral-relaxing cues in adolescents
Elsey, J., Coates, A., Lacadie, C. M., McCrory, E. J., Sinha, R., Mayes, L. C., & Potenza, M. N. (2015) · Neuropsychopharmacology · doi:10.1038/npp.2015.6 · Cited by 52
Childhood maltreatment predicts subsequent anxiety symptoms among Chinese adolescents: the role of the tendency of coping styles
Guo, L., Wang, W., Li, W., Zhao, M., Wu, R., & Lu, C. (2021) · Translational Psychiatry · doi:10.1038/s41398-021-01463-y · Cited by 57
Child maltreatment and nonsuicidal self-injury among Chinese adolescents: The mediating effect of psychological resilience and loneliness
He, N., & Xiang, Y. (2021) · Children and Youth Services Review · doi:10.1016/j.childyouth.2021.106335 · Cited by 56
CRHR1 genotype and history of maltreatment predict cortisol reactivity to stress in adolescents
Sumner, J. A., McLaughlin, K. A., Walsh, K., Sheridan, M. A., & Koenen, K. C. (2014) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2014.02.002 · Cited by 52
A multi-site single blind clinical study to compare the effects of prolonged exposure, eye movement desensitization and reprocessing and waiting list on patients with a current diagnosis of psychosis and co morbid post traumatic stress disorder: study protocol for the randomized controlled trial Treating Trauma in Psychosis
de Bont, P. A. J. M., van den Berg, D. P. G., van der Vleugel, B. M., de Roos, C., Mulder, C. L., Becker, E. S., de Jongh, A., van der Gaag, M., & van Minnen, A. (2013) · Trials · doi:10.1186/1745-6215-14-151 · Cited by 52
Assessing childhood maltreatment on the population level in Germany: findings and methodological challenges
Glaesmer, H. (2016) · Child and Adolescent Psychiatry and Mental Health · doi:10.1186/s13034-016-0104-9 · Cited by 52
“72 for sexual abuse [17].”
A Prospective Examination of the Relations Between Emotional Abuse and Anxiety: Moderation by Distress Tolerance
Banducci, A. N., Lejuez, C. W., Dougherty, L. R., & MacPherson, L. (2016) · Prevention Science · doi:10.1007/s11121-016-0691-y · Cited by 55
“The CTQ has good sensitivity and satisfactory specificity compared to child welfare records and family/clinician reports (Bernstein et al. 1997).”
Posttraumatic stress disorder: the missed diagnosis.
Grasso, D. J., Boonsiri, J., Lipschitz, D. S., Guyer, A. E., Houshyar, S., Douglas-Palumberi, H., Massey, J., & Kaufman, J. (2009) · PubMed · Cited by 52
A Comparison of Adolescent Inpatients With and Without a History of Violence Perpetration
Fehon, D. C., Grilo, C. M., & Lipschitz, D. S. (2005) · The Journal of Nervous and Mental Disease · doi:10.1097/01.nmd.0000165294.41091.fc · Cited by 52
Gender in Suicide Attempt Rates and Childhood Sexual Abuse Rates: Is There an Interaction?
Roy, A., & Janal, M. N. (2006) · Suicide and Life-Threatening Behavior · doi:10.1521/suli.2006.36.3.329 · Cited by 51
Reported history of childhood trauma and stress‐related vulnerability: Associations with emotion regulation, executive functioning, daily hassles and pre‐sleep arousal
Tinajero, R., Williams, P., Cribbet, M. R., Rau, H., Silver, M. A., Bride, D. L., & Suchy, Y. (2020) · Stress and Health · doi:10.1002/smi.2938 · Cited by 55
Childhood trauma and cognitive functioning in mood disorders: A systematic review
Barczyk, Z. A., Foulds, J., Porter, R., & Douglas, K. M. (2023) · Bipolar Disorders · doi:10.1111/bdi.13321 · Cited by 60
Parents’ Potential for Child Abuse: An Intergenerational Perspective
Finzi‐Dottan, R., & Harel, G. (2014) · Journal of Family Violence · doi:10.1007/s10896-014-9592-7 · Cited by 51
Extending models of deliberate self-harm and suicide attempts to substance users: Exploring the roles of childhood abuse, posttraumatic stress, and difficulties controlling impulsive behavior when distressed.
Bornovalova, M. A., Tull, M. T., Gratz, K. L., Levy, R., & Lejuez, C. W. (2011) · Psychological Trauma Theory Research Practice and Policy · doi:10.1037/a0021579 · Cited by 56
Etiological Role of Childhood Emotional Trauma and Neglect in Adolescent Anorexia Nervosa: A Cross-Sectional Questionnaire Analysis
Jaite, C., Schneider, N., Hilbert, A., Pfeiffer, E. F., Lehmkuhl, U., & Salbach‐Andrae, H. (2011) · Psychopathology · doi:10.1159/000328580 · Cited by 51
Practitioner Review: Adolescent alcohol use disorders: assessment and treatment issues
Perepletchikova, F., Krystal, J. H., & Kaufman, J. (2008) · Journal of Child Psychology and Psychiatry · doi:10.1111/j.1469-7610.2008.01934.x · Cited by 55
The Relationship Between Child Maltreatment and Dispositional Envy and the Mediating Effect of Self-Esteem and Social Support in Young Adults
Xiang, Y., Wang, W., & Guan, F. (2018) · Frontiers in Psychology · doi:10.3389/fpsyg.2018.01054 · Cited by 54
Altered development of hippocampus-dependent associative learning following early-life adversity
Lambert, H. K., Peverill, M., Sambrook, K., Rosen, M. L., Sheridan, M. A., & McLaughlin, K. A. (2019) · Developmental Cognitive Neuroscience · doi:10.1016/j.dcn.2019.100666 · Cited by 55
“We also administered the Childhood Trauma Questionnaire (CTQ), a self-report questionnaire that assesses the frequency of child maltreatment exposure, including physical and sexual abuse, and has sound psychometric properties (Bernstein et al., 1997).”
Touch aversion in patients with interpersonal traumatization
Strauß, T., Rottstädt, F., Sailer, U., Schellong, J., Hamilton, J. P., Raue, C., Weidner, K., & Croy, I. (2019) · Depression and Anxiety · doi:10.1002/da.22914 · Cited by 50
“As part of the clinical routine, all patients answered a number of self‐report questionnaires: (a) the Childhood Trauma Questionnaire (CTQ; Bernstein et al., 1997, German version by Gast et al. 2001), which retrospectively assesses traumatization due to emotional, physical and sexual neglect and…”
Background
Association between posttraumatic stress disorder severity and amygdala habituation to fearful stimuli
Kim, Y. J., van Rooij, S. J. H., Ely, T. D., Fani, N., Ressler, K. J., Jovanović, T., & Stevens, J. S. (2019) · Depression and Anxiety · doi:10.1002/da.22928 · Cited by 55
“The Childhood Trauma Questionnaire (CTQ) is a 28-item self-reported inventory assessing five types of maltreatment (sexual abuse, physical abuse, emotional abuse, emotional neglect, and physical neglect; Bernstein, Ahluvalia, Pogge, & Handelsman, 1997; Bernstein et al., 1994).”
Method
Characteristics of Juvenile Offenders Admitting to Sexual Activity with Nonhuman Animals
Jory, B., Fleming, W. M., & Burton, D. (2002) · Society and Animals · doi:10.1163/156853002760030860 · Cited by 51
Suicide attempts and ideation in African-American type 1 diabetic patients
Roy, A., Roy, M. S., & Janal, M. N. (2010) · Psychiatry Research · doi:10.1016/j.psychres.2010.06.004 · Cited by 51
The Relationship Between Mental Pain, Suicide Risk, and Childhood Traumatic Experiences: Results From a Multicenter Study
Pompili, M., Erbuto, D., Innamorati, M., Luciano, M., Sampogna, G., Abbate-Daga, G., Barlati, S., Carmassi, C., Castellini, G., Fazio, P. D., et al. (2022) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.21m14176 · Cited by 51
Childhood trauma and childhood urbanicity in relation to psychotic disorder
GROUP Investigators, Frissen, A., Lieverse, R., Drukker, M., van Winkel, R., & Delespaul, P. (2015) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-015-1049-7 · Cited by 81
“Childhood trauma was assessed with the Dutch version of the Childhood Trauma Questionnaire Short Form (CTQ) [21].”
Network analysis of the relationship between non-suicidal self-injury, depression, and childhood trauma in adolescents
Lei, H., Yang, Y., Zhu, T., Zhang, X., & Dang, J. (2024) · BMC Psychology · doi:10.1186/s40359-024-01729-2 · Cited by 61
Psychosocial Variables as Mediators of the Relationship Between Childhood History of Emotional Maltreatment, Codependency, and Self-Silencing
Reyome, N. D., Ward, K. S., & Witkiewitz, K. A. (2010) · Journal of Aggression Maltreatment & Trauma · doi:10.1080/10926770903539375 · Cited by 54
A protective genetic variant for adverse environments? The role of childhood traumas and serotonin transporter gene on resilience and depressive severity in a high-risk population
Carli, V., Mandelli, L., Zaninotto, L., Roy, A., Recchia, L., Stoppia, L., Gatta, V., Sarchiapone, M., & Serretti, A. (2011) · European Psychiatry · doi:10.1016/j.eurpsy.2011.04.008 · Cited by 54
The Association Among Childhood Maltreatment, Somatic Symptom Intensity, Depression, and Somatoform Dissociative Symptoms in Patients with Fibromyalgia Syndrome: A Single-Center Cohort Study
Bohn, D., Bernardy, K., Wolfe, F., & Häuser, W. (2012) · Journal of Trauma & Dissociation · doi:10.1080/15299732.2012.736930 · Cited by 50
Self-Criticism Mediates the Link between Childhood Emotional Maltreatment and Young Adults' Romantic Relationships
Lassri, D., & Shahar, G. (2012) · Journal of Social and Clinical Psychology · doi:10.1521/jscp.2012.31.3.289 · Cited by 50
Use of Multiple Psychotropic Medications Among Adolescents Aging Out of Foster Care
Raghavan, R., & McMillen, J. C. (2008) · Psychiatric Services · doi:10.1176/appi.ps.59.9.1052 · Cited by 50

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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