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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“Professor Bernstein and colleagues compiled the original English version (25) and Fu et al.”
Background
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Self-citation
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Method
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Background
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Method
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Measuring Child Sexual Abuse in Children and Youth
Walsh, C. A., Jamieson, E., MacMillan, H. L., & Trocmé, N. (2004) · Journal of Child Sexual Abuse · doi:10.1300/j070v13n01_03 · Cited by 24
Verbal Victimization and Changes in Hopelessness Among Elementary School Children
Hanley, A. J., & Gibb, B. E. (2011) · Journal of Clinical Child & Adolescent Psychology · doi:10.1080/15374416.2011.597086 · Cited by 24
The neuroendocrinology of childhood trauma in personality disorder
Lee, R., Hempel, J., TenHarmsel, A., Liu, T., Mathé, A. A., & Klock, A. (2011) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2011.05.006 · Cited by 25
Do Single Experiences of Childhood Abuse Increase Psychopathology Symptoms in Adulthood?
Rehan, W., Antfolk, J., Johansson, A., & Santtila, P. O. (2016) · Journal of Interpersonal Violence · doi:10.1177/0886260516647004 · Cited by 24
Childhood traumatic experiences and mental health problems in sexually offending and non-sexually offending juveniles
Boonmann, C., Grisso, T., Guy, L. S., Colins, O. F., Mulder, E. A., Vahl, P., Jansen, L. M. C., DORELEIJERS, T. A. H., & Vermeiren, R. R. J. M. (2016) · Child and Adolescent Psychiatry and Mental Health · doi:10.1186/s13034-016-0127-2 · Cited by 24
“Childhood Trauma Questionnaire‐Short Form (CTQ‐SF) The CTQ-SF [17, 18] is a 28-item self-report inventory for juveniles and adults (from age 12 and up) that provide brief, reliable, and valid screening for histories of abuse and neglect [18, 19].”
Background
A translational approach to the genetics of anxiety disorders
McGregor, N. W., Dimatelis, J. J., van Zyl, P. J., Hemmings, S. M. J., Kinnear, C. J., Russell, V. A., Stein, D. J., & Löchner, C. (2017) · Behavioural Brain Research · doi:10.1016/j.bbr.2017.12.030 · Cited by 26
“Table 2 depicts the significant results of case-control bi-allelic locus association analyses for unadjusted, adjusted and interaction with childhood trauma questionnaire (CTQ) [21], total score values for the polymorphisms considered.”
MethodInfluential
Agency notification and retrospective self-reports of childhood maltreatment in a 30-Year cohort: Estimating population prevalence from different data sources
Najman, J. M., Kisely, S. R., Scott, J. G., Strathearn, L., Clavarino, A. M., Williams, G. M., Middeldorp, C. M., & Bernstein, D. P. (2020) · Child Abuse & Neglect · doi:10.1016/j.chiabu.2020.104744 · Cited by 24
Self-citation
The Experience of Childhood Trauma and Its Influence on the Course of Illness in First-Episode Psychosis: A Qualitative Study
Jansen, J. E., Pedersen, M. B., Trauelsen, A. M., Lyse Nielsen, H.-G., Haahr, U. H., & Simonsen, E. (2016) · Journal of Nervous & Mental Disease · doi:10.1097/nmd.0000000000000449 · Cited by 23
“Self-Report Measure The Childhood Trauma Questionnaire (CTQ; Bernstein et al., 1997) was used to get reports on the experience of trauma.”
Method
Improving Parent–Child Interactions in Maltreating Families with the Attachment Video-feedback Intervention: Parental Childhood Trauma as a Moderator of Treatment Effects
van der Asdonk, S., Cyr, C., & Alink, L. (2021) · Attachment & Human Development · doi:10.1080/14616734.2020.1799047 · Cited by 23
“On the other hand, excellent reliability and validity rates of the CTQ have been reported, also in clinical samples (Bernstein et al., 1997, 1994) and in the current sample (α = .96), which suggests that this measure should provide a reasonable indication of the actual presence of childhood…”
Background
Assessment of children and youth in child protective services out-of-home care: An overview of trauma measures.
Milne, L., & Collin‐Vézina, D. (2014) · Psychology of Violence · doi:10.1037/a0037865 · Cited by 29
Attachment style moderates effects of FKBP5 polymorphisms and childhood abuse on post-traumatic stress symptoms: Results from the National Health and Resilience in Veterans Study
Tamman, A. J. F., Sippel, L. M., Han, S., Neria, Y., Krystal, J. H., Southwick, S. M., Gelernter, J. E., & Pietrzak, R. H. (2017) · The World Journal of Biological Psychiatry · doi:10.1080/15622975.2017.1376114 · Cited by 26
“…assessments is needed to evaluate the generalizability of the results reported herein, in particular a more nuanced operationalisation of childhood trauma (e.g. additive or dimensional coding as in the Childhood Trauma Questionnaire, Bernstein et al. 1997; Binder et al. 2008; Xie et al. 2010).”
Background
5-HTTLPR–brain-derived neurotrophic factor (BDNF) gene interactions and early adverse life events effect on impulsivity in suicide attempters
Jiménez-Treviño, L., Sáiz, P. A., García‐Portilla, M. P., Blasco-Fontecilla, H., Carli, V., Iosue, M., Jaussent, I., López‐Castromán, J., Vaquero‐Lorenzo, C., Sarchiapone, M., et al. (2017) · The World Journal of Biological Psychiatry · doi:10.1080/15622975.2017.1376112 · Cited by 28
“CTQ has demonstrated excellent test–retest reliability and convergent validity (Fink et al. 1995).”
Background
The Differential Role of Narcissism in the Relations Between Childhood Sexual Abuse, Dissociation, and Self-Harm
Talmon, A., & Ginzburg, K. (2018) · Journal of Interpersonal Violence · doi:10.1177/0886260518799450 · Cited by 25
Corticolimbic circuit structure moderates an association between early life stress and later trait anxiety
Kim, M. J., Farber, M. J., Knodt, A. R., & Hariri, A. R. (2019) · NeuroImage Clinical · doi:10.1016/j.nicl.2019.102050 · Cited by 23
“The Childhood Trauma Questionnaire (CTQ) was used to assess exposure to childhood stress in five categories: emotional abuse, physical abuse, sexual abuse, emotional neglect, and physical neglect (Bernstein et al., 1997).”
Method
Alexithymia, Emotion‐Regulation Strategies, and Traumatic Experiences in Prenatally Cocaine‐Exposed Young Adults
Morie, K. P., Zhai, Z. W., Potenza, M. N., & Mayes, L. C. (2020) · American Journal on Addictions · doi:10.1111/ajad.13056 · Cited by 29
Differences in Influencing Factors Between Non-suicidal Self-Injury and Suicide Attempts in Chinese Adolescents: The Role of Gender
Xu, H., Jiang, Z., Li, S., Zhang, X., Xu, S., Wan, Y., & Tao, F. (2022) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2022.870864 · Cited by 23
“The Cronbach’s α for the CTQ in this study was 0.748.”
MethodInfluential
Mindful self-compassion intervention among young adults with a history of childhood maltreatment: Reducing psychopathological symptoms, shame, and self-criticism
Sajjadi, M., Noferesti, A., & Abbasi, M. (2022) · Current Psychology · doi:10.1007/s12144-022-03761-0 · Cited by 26
“It includes five aspects: sexual abuse, emotional abuse, physical abuse, emotional neglect, and physical neglect (Bernstein et al., 1997).”
Background
Substance Use Outcomes For Sexual and Gender Minority Adults With a History of Adverse Childhood Experiences: A Scoping Review
Dowling, B. A., Grigsby, T. J., Ziomek, G. J., & Schnarrs, P. W. (2022) · Drug and Alcohol Dependence Reports · doi:10.1016/j.dadr.2022.100129 · Cited by 23
Buried Above Ground: A University-Based Study of Risk/Protective Factors for Suicidality Among Sexual Minority Youth in Canada
Peter, T., & Taylor, C. L. (2014) · Journal of LGBT Youth · doi:10.1080/19361653.2014.878563 · Cited by 24
Impact of childhood maltreatment on physical health-related quality of life in U.S. active duty military personnel and combat veterans
Aversa, L. H., Lemmer, J. A., Nunnink, S. E., McLay, R. N., & Baker, D. G. (2014) · Child Abuse & Neglect · doi:10.1016/j.chiabu.2014.03.004 · Cited by 23
The mediating effects of childhood neglect on the association between schizotypal and autistic personality traits and depression in a non-clinical sample
Liu, J., Gong, J., Nie, G., He, Y., Xiao, B., Shen, Y., & Luo, X. (2017) · BMC Psychiatry · doi:10.1186/s12888-017-1510-0 · Cited by 24
“The prevalence of childhood abuse was evaluated according to the methodology of Bernstein (1997) [30].”
Method
Effects of familial risk and stimulant drug use on the anticipation of monetary reward: an fMRI study
Just, A. L., Meng, C., Smith, D. G., Bullmore, E. T., Robbins, T. W., & Ersche, K. D. (2019) · Translational Psychiatry · doi:10.1038/s41398-019-0399-4 · Cited by 23
Deliberate Self-Harm in Psychiatric Outpatients Aged 14-35 Years in Singapore
Shahwan, S., Abdin, E., Zhang, Y., Sambasivam, R., Fauziana, R., Mahesh, M. V., Ong, S. H., Chong, S. A., & Subramaniam, M. (2018) · Annals of the Academy of Medicine Singapore · doi:10.47102/annals-acadmedsg.v47n9p360 · Cited by 23
The relationship between childhood maltreatment and benign/malicious envy among Chinese college students: the mediating role of emotional intelligence
Zhao, J., Xiang, Y., Zhao, J., Li, Q., Dong, X., & Zhang, W. (2020) · The Journal of General Psychology · doi:10.1080/00221309.2020.1743229 · Cited by 25
African American and Caucasian attempters compared for suicide risk factors: a preliminary study.
Roy, A. (2003) · Suicide and Life-Threatening Behaviour · doi:10.1521/suli.33.4.443.25228 · Cited by 24
A prospective look at substance use and criminal behavior in urban ADHD youth: what is the role of maltreatment history on outcome?
De Sanctis, V. A., Newcorn, J. H., & Halperin, J. M. (2014) · ADHD Attention Deficit and Hyperactivity Disorders · doi:10.1007/s12402-013-0124-8 · Cited by 22
A meta-analysis of interparental aggression with adolescent and young adult physical and psychological dating aggression.
Goncy, E. A. (2020) · Psychology of Violence · doi:10.1037/vio0000266 · Cited by 25
Experiences of (young) women after out of home placement: An examination of personality disorder symptoms through the lens of child maltreatment
Scheffers, F., van Vugt, E., Lanctôt, N., & Lemieux, A. (2019) · Child Abuse & Neglect · doi:10.1016/j.chiabu.2019.03.022 · Cited by 27
Omega-3 Fatty Acids as a Treatment for Pediatric Depression. A Phase III, 36 Weeks, Multi-Center, Double-Blind, Placebo-Controlled Randomized Superiority Study
Häberling, I. S., Berger, G. E., Schmeck, K., Held, U., & Walitza, S. (2019) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2019.00863 · Cited by 25
Childhood neglect is associated with corticostriatal circuit dysfunction in bipolar disorder adults
Hsieh, Y., Wu, R., Tseng, H., Wei, S., Huang, M., Chang, H. H., Yang, Y. K., & Chen, P. S. (2020) · Psychiatry Research · doi:10.1016/j.psychres.2020.113550 · Cited by 22
Intergenerational Transmission of Childhood Maltreatment Mediated by Maternal Emotion Dysregulation
Rodriguez, V. J., Are, F. G., Madden, A. R., Shaffer, A. E., & Suveg, C. M. (2021) · Journal of Child and Family Studies · doi:10.1007/s10826-021-02020-3 · Cited by 23
Bayesian causal network modeling suggests adolescent cannabis use accelerates prefrontal cortical thinning
Owens, M. M., Albaugh, M. D., Allgaier, N., Yuan, D., Robert, G., Cupertino, R. B., Spechler, P. A., Juliano, A., Hahn, S., Banaschewski, T., et al. (2022) · Translational Psychiatry · doi:10.1038/s41398-022-01956-4 · Cited by 22
“The Childhood Trauma Questionnaire (CTQ) is an assessment of adverse experiences occurring during childhood with good validity and internal consistency [21].”
The impact of maternal childhood maltreatment on child externalizing behaviour and the mediating factors underlying this association: a three-level meta-analysis and systematic review
Loheide‐Niesmann, L., Riem, M. M. E., & Cima, M. (2022) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-022-02117-0 · Cited by 25
“Maternal childhood maltreatment was mostly measured with the Childhood Trauma Questionnaire [49], which assesses child sexual, physical, and emotional abuse and physical and emotional neglect; or with the ACE questionnaire [50], which assesses ten adverse childhood events, including the five types…”
Childhood trauma and differential response to long-term psychoanalytic versus cognitive–behavioural therapy for chronic depression in adults
Krakau, L., Ernst, M., Hautzinger, M., Beutel, M. E., & Leuzinger‐Bohleber, M. (2024) · The British Journal of Psychiatry · doi:10.1192/bjp.2024.112 · Cited by 25
Psychotic disorder and educational achievement: a family-based analysis
GROUP Investigators, Frissen, A., Lieverse, R., Marcelis, M. C., Drukker, M., & Delespaul, P. (2015) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-015-1082-6 · Cited by 22
“The percentage of non-whites was higher in the patient group and the overall CTQ score and childhood urbanicity score were higher in the patient group.”
MethodInfluential
Childhood Adversity and Suicidal Ideation in a Clinical Military Sample: Military Unit Cohesion and Intimate Relationships as Protective Factors
Skopp, N. A., Luxton, D. D., Bush, N. E., & Sirotin, A. P. (2011) · Journal of Social and Clinical Psychology · doi:10.1521/jscp.2011.30.4.361 · Cited by 24
The Interaction of Childhood Maltreatment, Sex, and Borderline Personality Features in the Prediction of the Cortisol Awakening Response in Adolescents
Kaess, M., Whittle, S., Simmons, J., Jovev, M., Allen, N., & Chanen, A. (2017) · Psychopathology · doi:10.1159/000456549 · Cited by 22
Structural covariance network centrality in maltreated youth with posttraumatic stress disorder
Sun, D., Peverill, M., Swanson, C. A., McLaughlin, K. A., & Morey, R. A. (2017) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2017.12.015 · Cited by 22
“The CTQ assesses frequency of physical, sexual, and emotional abuse during childhood and has excellent psychometric properties including internal consistency, test–retest reliability, and convergent and discriminant validity with interviews and clinician reports of maltreatment (Bernstein et al., 1997).”

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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