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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Hengartner, M. P., Müller, M., Rodgers, S., Wulf Rössler, A., & Ajdacic‐Gross, V. (2013) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2013.05.005 · Cited by 30
Exploration of trauma, dissociation, maladaptive schemas and auditory hallucinations in a French sample
Bortolon, C., Seillé, J., & Raffard, S. (2017) · Cognitive Neuropsychiatry · doi:10.1080/13546805.2017.1387524 · Cited by 36
A Model for Brief Assessment of Attachment and Its Application to Women in Inpatient Treatment for Trauma-Related Psychiatric Disorders
Allen, J. G., Huntoon, J., Fultz, J., Stein, H., Fonagy, P., & Evans, R. B. (2001) · Journal of Personality Assessment · doi:10.1207/s15327752jpa7603_05 · Cited by 31
Childhood Trauma and Attempted Suicide in Alcoholics
Roy, A. (2001) · The Journal of Nervous and Mental Disease · doi:10.1097/00005053-200102000-00008 · Cited by 31
Corrigendum to “Gender in obsessive–compulsive disorder: clinical and genetic findings” [Eur. Neuropsychopharmacol. 14/2 (2004) 105–113]
Löchner, C., Hemmings, S. M. J., Kinnear, C. J., Moolman‐Smook, J. C., Corfield, V. A., Knowles, J. A., Niehaus, D. J. H., & Stein, D. J. (2004) · European Neuropsychopharmacology · doi:10.1016/j.euroneuro.2004.05.002 · Cited by 33
Effect of childhood emotional abuse on depression and anxiety in adulthood is partially mediated by neuroticism: Evidence from a large online sample.
Alnassar, J. S., Juruena, M., Macare, C., Perkins, A., & Young, A. H. (2024) · Journal of Affective Disorders · doi:10.1016/j.jad.2024.05.040 · Cited by 24
Domestic minor sex trafficking among adjudicated male youth: prevalence and links to treatment
O’Brien, J. E., Li, W., Givens, A., & Leibowitz, G. S. (2017) · Children and Youth Services Review · doi:10.1016/j.childyouth.2017.09.026 · Cited by 30
A randomised, double‐blind study investigating the relationship between early childhood trauma and the rewarding effects of morphine
Carlyle, M., Broomby, R., Simpson, G., Hannon, R., Fawaz, L., Mollaahmetoğlu, Ö. M., Drain, J., Mostazir, M., & Morgan, C. J. A. (2021) · Addiction Biology · doi:10.1111/adb.13047 · Cited by 31
Parent-Child Relationship Quality, Childhood Maltreatment, and Psychological Symptoms in Chinese Adolescent
Jiang, Z., Xu, H., Wang, S., Gao, X., Li, S., Zhang, S., Tao, F., & Wan, Y. (2021) · Journal of Interpersonal Violence · doi:10.1177/08862605211035869 · Cited by 30
“Childhood maltreatment was evaluated using the Chinese version of the Child Trauma Questionnaire (CTQ-SF; Bernstein et al., 1997; Zhao et al., 2005).”
Method
Misshandlungs- und Vernachlässigungserfahrungen in der Kindheit: Ein Risikofaktor für die soziale Teilhabe ehemals außerfamiliär platzierter junger Erwachsener
Schmid, M., Fegert, J. M., Clemens, V., Seker, S., d’Huart, D., Binder, M., Schröder, M., Friden, L., Boonmann, C., Jenkel, N., et al. (2022) · Kindheit und Entwicklung · doi:10.1026/0942-5403/a000366 · Cited by 31
“…Misshandlungs-und Vernachlässi-gungserfahrungen wurde der „ Childhood Trauma Questionnaire-Short Form “ (CTQ-SF) als retrospektive Selbstbeurteilung im Online-Screening verwendet (Ba-der, Hänny, Schäfer, Neuckel & Kuhl, 2009; Bernstein, Ahluvalia, Pogge & Handelsman, 1997; Bernstein et al., 2003).”
Background
Long‐term effects of childhood trauma subtypes on adult brain function
Cai, J., Li, J., Liu, D., Gao, S., Zhao, Y., Zhang, J., & Liu, Q. (2023) · Brain and Behavior · doi:10.1002/brb3.2981 · Cited by 30
“In the present study, maltreatment experiences during childhood were assessed by administering the Chinese version of the Childhood Trauma Questionnaire (CTQ) that assesses childhood experiences of abuse or neglect in adults (Bernstein et al., 1997).”
Method
Childhood maltreatment is associated with depression but not with hypochondriasis in later life
Bailer, J., Witthöft, M., Wagner, H., Mier, D. U., Diener, C., & Rist, F. (2014) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2014.06.004 · Cited by 35
Screening for Trauma in Children and Adolescents: The Validity of the Traumatic Stress Disorder Scale of the Screen for Child Anxiety Related Emotional Disorders
Muris, P., Merckelbach, H. L. G. J., Korver, P., & Meesters, C. M. G. (2000) · Journal of Clinical Child Psychology · doi:10.1207/s15374424jccp2903_11 · Cited by 30
How Do Different Types of Childhood Maltreatment Relate to Adult Personality Pathology?
Cohen, L. J., Foster, M., Nesci, C., Tanis, T., Halmi, W., & GALYNKER, I. I. (2013) · The Journal of Nervous and Mental Disease · doi:10.1097/nmd.0b013e3182848ac4 · Cited by 30
Factorial Validity of the Short Form of the Childhood Trauma Questionnaire (CTQ—SF) in German Psychiatric Patients, Inmates, and University Students
Dudeck, M., Vasić, N., Otte, S., Streb, J., Wingenfeld, K., Grabe, H. J., Freyberger, H. J., Schröder, T., von Schönfeld, C.-E., Drießen, M., et al. (2015) · Psychological Reports · doi:10.2466/16.03.pr0.116k27w5 · Cited by 30
Demographic factors, childhood maltreatment and psychological functioning among university students' in Ghana: A retrospective study
Adjorlolo, S., Adu‐Poku, S., Andoh–Arthur, J., Botchway, I., & Mlyakado, B. P. (2015) · International Journal of Psychology · doi:10.1002/ijop.12248 · Cited by 30
Serotonin transporter gene expression predicts the worsening of suicidal ideation and suicide attempts along a long-term follow-up of a Major Depressive Episode
Consoloni, J.-L., Ibrahim, E. C., Lefebvre, M., Zendjidjian, X. Y., Olié, É., Mazzola‐Pomietto, P., Desmidt, T., Samalin, L., Llorca, P., Abbar, M., et al. (2017) · European Neuropsychopharmacology · doi:10.1016/j.euroneuro.2017.12.015 · Cited by 30
Evidence that the association of childhood trauma with psychosis and related psychopathology is not explained by gene-environment correlation: A monozygotic twin differences approach
Lecei, A., Decoster, J., Binder, M. D., Derom, C. A., Jacobs, N., Menne‐Lothmann, C., van Os, J., Thiery, E. W., Rutten, B. P. F., Wichers, M., et al. (2018) · Schizophrenia Research · doi:10.1016/j.schres.2018.05.025 · Cited by 30
“Childhood trauma was assessed with the Dutch translation of the short version of the Childhood Trauma Questionnaire (CTQ; Bernstein et al., 1997).”
Method
Extinction Learning as a Potential Mechanism Linking High Vagal Tone with Lower PTSD Symptoms among Abused Youth
Jenness, J. L., Miller, A. B., Rosen, M. L., & McLaughlin, K. A. (2018) · Research on Child and Adolescent Psychopathology · doi:10.1007/s10802-018-0464-0 · Cited by 31
History of childhood maltreatment augments dorsolateral prefrontal processing of emotional valence in PTSD
Fonzo, G. A., Huemer, J., & Etkin, A. (2016) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2015.12.015 · Cited by 33
“Participants with PTSD were permitted to meet diagnostic criteria for comorbid mood and anxiety disorders secondary to PTSD, and history of substance dependence was permitted, given that abstinence had been maintained for more than three months.”
BackgroundMethodInfluential
Childhood trauma and internalizing and externalizing behavior problems among adolescents: Role of executive function and life events stress
Wei, X., & Lu, W. D. (2023) · Journal of Adolescence · doi:10.1002/jad.12150 · Cited by 31
Childhood Trauma Questionnaire-Short Form: Evaluation of Factor Structure and Measurement Invariance
Cruz, D. (2023) · Journal of Child & Adolescent Trauma · doi:10.1007/s40653-023-00556-8 · Cited by 29
“Scores from the CTQ-SF have been shown to positively correlate with confirmed reports of abuse, neglect, and violence (Bernstein et al., 1997; Liebschutz et al., 2018; Saadi et al., 2022).”
Method
How adverse childhood experiences get under the skin: A systematic review, integration and methodological discussion on threat and reward learning mechanisms
(2024) · doi:10.7554/elife.92700 · Cited by 29
Associations between childhood maltreatment and non‐medical use of prescription drugs among Chinese adolescents
Guo, L., Xu, Y., Deng, J., Gao, X., Huang, G., Huang, J., Deng, X., Zhang, W., & Lu, C. (2017) · Addiction · doi:10.1111/add.13850 · Cited by 29
“Zhao X. F., Zhang Y. L., Li L. F., Zhou Y. F., Li H. Z., Yang S. C. Reliability and validity of the Chinese version of childhood trauma questionnaire.”
MethodInfluential
Childhood sexual abuse as a potential predictor of psychotic like experiences in Tunisian college students
Fekih‐Romdhane, F., Tira, S., & Cheour, M. (2019) · Psychiatry Research · doi:10.1016/j.psychres.2019.03.034 · Cited by 29
Childhood trauma, earlier pubertal timing, and psychopathology in adolescence: The role of corticolimbic development
Colich, N. L., Hanford, L. C., Weissman, D. G., Allen, N. B., Shirtcliff, E. A., Lengua, L. J., Sheridan, M. A., & McLaughlin, K. A. (2022) · Developmental Cognitive Neuroscience · doi:10.1016/j.dcn.2022.101187 · Cited by 31
“Physical and Sexual Abuse subscales (Bernstein et al., 1997).”
Comprehensive Self-Management Reduces the Negative Impact of Irritable Bowel Syndrome Symptoms on Sexual Functioning
Eugenio, M. D., Jun, S., Cain, K. C., Jarrett, M. E., & Heitkemper, M. M. (2012) · Digestive Diseases and Sciences · doi:10.1007/s10620-012-2047-1 · Cited by 29
Child Abuse and Neglect as Risk Factors for Comorbidity Between Depression and Chronic Pain in Adulthood
Macedo, B. B. D., Baes, C. V. W., Menezes, I. C., & Juruena, M. F. (2019) · The Journal of Nervous and Mental Disease · doi:10.1097/nmd.0000000000001031 · Cited by 31
Gender commonalities and differences in risk and protective factors of suicidal thoughts and behaviors: A cross‐sectional study of Spanish university students
Miranda-Mendizábal, A., Castellví, P., Alayo, I., Vilagut, G., Blasco, M. J., Torrent, A., Ballester, L., Almenara, J., Lagares, C., Roca, M., et al. (2019) · Depression and Anxiety · doi:10.1002/da.22960 · Cited by 33
Mindsets: Investigating resilience
Boullion, A., Withers, M. C., & Lippmann, M. (2021) · Personality and Individual Differences · doi:10.1016/j.paid.2021.110669 · Cited by 32
Examining Pathways of Childhood Maltreatment and Emotional Dysregulation Using Self-Compassion
Reffi, A. N., Boykin, D. M., & Orcutt, H. K. (2018) · Journal of Aggression Maltreatment & Trauma · doi:10.1080/10926771.2018.1485810 · Cited by 35
Anomalous self-experiences are strongly associated with negative symptoms in a clinical high-risk for psychosis sample
Værnes, T. G., Røssberg, J. I., & Møller, P. (2019) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2019.07.003 · Cited by 29
“It comprises 28 items, yielding scores on 5 subscales of trauma: physical abuse, sexual abuse, emotional abuse, emotional neglect, and physical neglect [40].”
Background
Childhood Physical and Sexual Abuse as a Predictor of Reoffending: A Systematic Review
Dalsklev, M., Cunningham, T., Dempster, M., & Hanna, D. (2019) · Trauma Violence & Abuse · doi:10.1177/1524838019869082 · Cited by 28
Measuring childhood maltreatment: Psychometric properties of the Norwegian version of the Maltreatment and Abuse Chronology of Exposure (MACE) scale
Fosse, R., Skjelstad, D. V., Schalinski, I., Thekkumthala, D., Elbert, T. R., Aanondsen, C. M., Greger, H. K., & Jozefiak, T. (2020) · PLoS ONE · doi:10.1371/journal.pone.0229661 · Cited by 29
“Existing scales to assess adverse childhood experiences, including the gold standard instruments Childhood Trauma Questionnaire (CTQ) [13, 14] and the Adverse Childhood Experience scale (ACE) [1], have several limitations.”
Method
Impact of Comorbid Affective Disorders on Longitudinal Clinical Outcomes in Individuals at Ultra-high Risk for Psychosis
Schirmbeck, F. N., van der Burg, N. C., Blankers, M., Vermeulen, J. M., McGuire, P. K., Valmaggia, L., Kempton, M. J., van der Gaag, M., Riecher‐Rössler, A., Bressan, R. A., et al. (2021) · Schizophrenia Bulletin · doi:10.1093/schbul/sbab088 · Cited by 29

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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