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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Nobile, B., Gourguechon-Buot, E., Olié, É., & Courtet, P. (2025) · Journal of Affective Disorders · doi:10.1016/j.jad.2025.119854 · Cited by 20
Emotional abuse interacts with borderline personality in adolescent inpatients with binge-purging eating disorders
Spiegel, J., Arnold, S., Salbach, H., Gotti, E. G., Pfeiffer, E. F., Lehmkuhl, U., Correll, C. U., & Jaite, C. (2021) · Eating and Weight Disorders - Studies on Anorexia Bulimia and Obesity · doi:10.1007/s40519-021-01142-3 · Cited by 18
Redefining the Cut-Off Ranges for TSH Based on the Clinical Picture, Results of Neuroimaging and Laboratory Tests in Unsupervised Cluster Analysis as Individualized Diagnosis of Early Schizophrenia
Śmierciak, N., Szwajca, M., Popiela, T. J., Bryll, A., Karcz, P., Donicz, P., Turek, A., Krzyściak, W., & Pilecki, M. W. (2022) · Journal of Personalized Medicine · doi:10.3390/jpm12020247 · Cited by 18
“2022, 12, 247 14 of 36 (1) 0–2.5 mU/L; (2) >2.5 mU/L; _1—results during the first week of hospitalization; _12—results three months after admission to the hospital; BDI—Beck Depression Inventory; Calgary—Calgary Depression Scale for Schizophrenia; CTQ—Childhood Trauma Questionnaire; CTQ_EA—emotional abuse; CTQ_EN—emot…”
MethodInfluential
Predictive models for first-onset and persistence of depression and anxiety among university students
Ballester, L., Alayo, I., Vilagut, G., Mortier, P., Almenara, J., Cebrià, A. I., Echeburúa, E., Gabilondo, A., Gili, M., Lagares, C., et al. (2022) · Journal of Affective Disorders · doi:10.1016/j.jad.2021.10.135 · Cited by 21
Association between perimenopausal age and greater posttraumatic stress disorder and depression symptoms in trauma-exposed women
Michopoulos, V., Huibregtse, M. E., Chahine, E. B., Smith, A. K., Fonkoue, I. T., Maples‐Keller, J. L., Murphy, A., Taylor, L., Powers, A. D., & Stevens, J. S. (2023) · Menopause The Journal of The North American Menopause Society · doi:10.1097/gme.0000000000002235 · Cited by 18
Childhood maltreatment patterns and suicidal ideation: mediating roles of depression, hope, and expressive suppression
Ye, Y., Chen, B., Zhen, R., Li, Y., Liu, Z., & Zhou, X. (2024) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-024-02442-6 · Cited by 18
“At T1, we used the revised version of the Childhood Trauma Questionnaire (CTQ), developed by Zhou and Zhen [24] based on the original version by Bernstein et al. [43], to assess the childhood maltreatment experiences that occurred during the growing-up process before the age of 18 years.”
What are the factors associated with depressive symptoms among orphans and vulnerable children in Cambodia?
Ong, K. I. C., Yi, S., Tuot, S., Chhoun, P., Shibanuma, A., Yasuoka, J., & Jimba, M. (2015) · BMC Psychiatry · doi:10.1186/s12888-015-0576-9 · Cited by 18
“Bernstein DP, Stein JA, Newcomb MD, Walker E, Pogge D, Ahluvalia T, et al. Development and validation of a brief screening version of the Childhood Trauma Questionnaire.”
Method
‘Give Me a Reason to Live!’ Examining Reasons for Living Across Levels of Suicidality
Rieger, S. J., Peter, T., & Roberts, L. W. (2014) · Journal of Religion and Health · doi:10.1007/s10943-014-9893-4 · Cited by 19
“The CTQ consists of 20 items asking respondents about emotional abuse, emotional neglect, sexual abuse, physical abuse, and physical neglect (Bernstein et al. 1997).”
Background
An Examination of Pathways from Childhood Maltreatment to Adolescent Binge Drinking
Shin, S. H., Hong, H. G., & Wills, T. A. (2012) · American Journal on Addictions · doi:10.1111/j.1521-0391.2012.00227.x · Cited by 20
HIGH AND LOW THRESHOLD FOR STARTLE REACTIVITY ASSOCIATED WITH PTSD SYMPTOMS BUT NOT PTSD RISK: EVIDENCE FROM A PROSPECTIVE STUDY OF ACTIVE DUTY MARINES
Glenn, D. E., Acheson, D. T., Geyer, M. A., Nievergelt, C. M., Baker, D. G., Risbrough, V. B., & MRS Team (2016) · Depression and Anxiety · doi:10.1002/da.22475 · Cited by 18
“Traumatic experiences during childhood were assessed at predeployment with a modified Childhood Trauma Questionnaire (CTQ),[45] a 34-item questionnaire (25–170 range) with strong discriminant and convergent validity.[46, 47] Deployment Stress and Combat Exposure.”
Method
Bipolar Disorder and Early Affective Trauma.
de Codt, A., Monhonval, P., Bongaerts, X., Belkacemi, I., & Tecco, J. M. (2016) · PubMed · Cited by 19
Effect of CRHR1 and CRHR2 gene polymorphisms and childhood trauma in suicide attempt
Sanabrais‐Jiménez, M. A., Sotelo-Ramírez, C. E., Ordoñez-Martínez, B., Pavón, J. J., Ahumada-Curiel, G., Piana-Diaz, S., Flores‐Flores, G., Flores‐Ramos, M., Jiménez‐Anguiano, A., & Camarena, B. (2019) · Journal of Neural Transmission · doi:10.1007/s00702-019-01991-4 · Cited by 18
A preliminary study of the child abuse and central sensitization in adolescent patients with chronic non-organic chest pain and an overlooked condition: juvenile fibromyalgia syndrome
Mansız-Kaplan, B., Ayhan, F. F., Mihriban, C., Atík, F., & Ece, İ. (2020) · Pediatric Rheumatology · doi:10.1186/s12969-020-00421-0 · Cited by 18
“If not identified early, it can have chronic consequences [16].”
Background
Measuring Adverse Childhood Experiences: Comparing Individual, Composite, Score-based and Latent Profile-based Scoring Schemas Among Gay, Bisexual, and Other Men Who Have Sex with Men
Noor, S. W. B., Sutherland, J. E., Vernon, J. R. G., Adam, B. D., Brennan, D. J., & Hart, T. A. (2020) · Archives of Sexual Behavior · doi:10.1007/s10508-020-01719-6 · Cited by 18
Mediating Effects of Specific Types of Coping Styles on the Relationship between Childhood Maltreatment and Depressive Symptoms among Chinese Undergraduates: The Role of Sex
Song, X., Wang, S., Wang, R., Xu, H., Jiang, Z., Li, S., Zhang, S., & Wan, Y. (2020) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph17093120 · Cited by 18
“Childhood maltreatment was evaluated using the Child Trauma Questionnaire (CTQ) [26], a widely used 28-item measure that assesses five different forms of childhood trauma (including physical abuse, sexual abuse, emotional abuse, physical neglect, and emotional neglect).”
Method
High vagal tone and rapid extinction learning as potential transdiagnostic protective factors following childhood violence exposure
Susman, E. S., Weissman, D. G., Sheridan, M. A., & McLaughlin, K. A. (2021) · Developmental Psychobiology · doi:10.1002/dev.22176 · Cited by 15
“…interview (Bifulco et al., 1994), PTSD Reaction Index (PTSD-RI) trauma screen, or above the validated Child Trauma Questionnaire (CTQ) threshold (Bernstein et al., 1997; Walker et al., 1999), or by parent on the Juvenile Victimization Questionnaire (JVQ; Finkelhor et al., 2005), or PTSD-RI…”
Method
Examining the Contemporaneous, Short-Term, and Long-Term Effects of Secondary Exposure to Violence on Adolescent Substance Use
Zimmerman, G. M., & Kushner, M. (2017) · Journal of Youth and Adolescence · doi:10.1007/s10964-017-0694-4 · Cited by 20
“…identification and screening tools for exposure to violence and its consequences, including: TeenScreen; the Childhood Trauma Questionnaire (CTQ) (Bernstein et al. 1998); the Adverse Childhood Experiences Study Scale (ACE); the Conflict Tactics Scale (CTS); and more recently, the Family…”
MethodInfluential
A Link Between Childhood Adversity and Trait Anger Reflects Relative Activity of the Amygdala and Dorsolateral Prefrontal Cortex
Kim, M. J., Scult, M. A., Knodt, A. R., Radtke, S. R., d’Arbeloff, T. C., Brigidi, B. D., & Hariri, A. R. (2018) · Biological Psychiatry Cognitive Neuroscience and Neuroimaging · doi:10.1016/j.bpsc.2018.03.006 · Cited by 18
“The Childhood Trauma Questionnaire (CTQ) was used to assess exposure to childhood adversity in five categories: emotional abuse, physical abuse, sexual abuse, emotional neglect, and physical neglect (16).”
Method
The pathway from childhood maltreatment to adulthood obesity: The role of mediation by adolescent depressive symptoms and BMI
O’Neill, A. H., Beck, K. H., Chae, D. H., Dyer, T. V., He, X., & Lee, S. (2018) · Journal of Adolescence · doi:10.1016/j.adolescence.2018.05.010 · Cited by 18
Childhood Trauma and Drug Addiction
Bernstein, D. P. (2000) · Alcoholism Treatment Quarterly · doi:10.1300/j020v18n03_03 · Cited by 18
Self-citation
Pregnant Latina teenagers: Psychosocial and developmental determinants of how they select and perceive the men who father their children.
Goodyear, R. K., Newcomb, M. D., & Locke, T. F. (2002) · Journal of Counseling Psychology · doi:10.1037/0022-0167.49.2.187 · Cited by 18
Childhood trauma, alexithymia, and mental states recognition among individuals with alcohol use disorder and healthy controls
Kopera, M., Zaorska, J., Trucco, E. M., Suszek, H., Kobyliński, P., Zucker, R. A., Nowakowska, M., Wojnar, M., & Jakubczyk, A. (2020) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2020.108301 · Cited by 18
Reimagining Racial Trauma as a Barrier to Breastfeeding Versus Childhood Trauma and Depression Among African American Mothers
Johnson, A. M., Menke, R. A., Handelzalts, J. E., Green, K., & Muzik, M. (2021) · Breastfeeding Medicine · doi:10.1089/bfm.2020.0304 · Cited by 17
Key factors selection on adolescents with non-suicidal self-injury: A support vector machine based approach
Yang, J., Chen, Y., Yao, G., Wang, Z., Fu, X., Tian, Y., & Li, Y. (2022) · Frontiers in Public Health · doi:10.3389/fpubh.2022.1049069 · Cited by 20
“(47) and translated into Chinese by Fu et al.”
Background
Maternal history of maltreatment and offspring's emotional and behavioral problems in adolescence: Do family factors contribute to the intergenerational risk transmission?
Bravo, P., Kim, Y., Xerxa, Y., Koopman‐Verhoeff, M. E., Cárcamo, R. A., Oldehinkel, A. J., Hillegers, M. H. J., & Jansen, P. W. (2023) · Child Abuse & Neglect · doi:10.1016/j.chiabu.2023.106228 · Cited by 17
Childhood trauma is prevalent and associated with co-occurring depression, anxiety, mania and psychosis in young people attending Australian youth mental health services
Bendall, S., Eastwood, O., Spelman, T. D., McGorry, P. D., Hickie, I. B., Yung, A. R., Amminger, G. P., Wood, S. J., Pantelis, C., Purcell, R., et al. (2023) · Australian & New Zealand Journal of Psychiatry · doi:10.1177/00048674231177223 · Cited by 17
“The CTQ is a widely used measure, and its psychometric properties have been extensively assessed (Bernstein et al., 1997).”
BackgroundMethodInfluential
Metabolic syndrome after childhood trauma: a 9-year longitudinal analysis
Souama, C., Milaneschi, Y., Lamers, F., Vinkers, C. H., Giltay, E. J., Liemburg, E. J., & Penninx, B. W. J. H. (2023) · Psychological Medicine · doi:10.1017/s0033291723003264 · Cited by 17
Risk factors of suicide re-attempt: A two-year prospective study
Nobile, B., Jaussent, I., Kahn, J. P., Leboyer, M., Risch, N., Olié, É., & Courtet, P. (2024) · Journal of Affective Disorders · doi:10.1016/j.jad.2024.04.058 · Cited by 18
Child Sexual Abuse History and Feminine Gender-Role Identity
Krause, E. D., & Roth, S. (2010) · Sex Roles · doi:10.1007/s11199-010-9855-6 · Cited by 17
Research performance and trends in child sexual abuse research: a Science Citation Index Expanded-based analysis
Vega-Arce, M., Salas, G., Núñez-Ulloa, G., Pinto-Cortez, C. G., Fernández, I. T., & Ho, Y. (2019) · Scientometrics · doi:10.1007/s11192-019-03267-w · Cited by 17
How is childhood maltreatment linked to benign envy/malicious envy? The mediating role of self‐esteem, authentic pride and hubristic pride
Li, Q., & Xiang, Y. (2020) · Personality and Mental Health · doi:10.1002/pmh.1492 · Cited by 17
Childhood Maltreatment Affects Depression and Anxiety: the Mediating Role of Emotional Intelligence
Zhao, J., Xiang, Y., Zhang, W., Dong, X., Zhao, J., & Li, Q. (2020) · International Journal of Mental Health and Addiction · doi:10.1007/s11469-020-00297-x · Cited by 17
“CTQ was established by Bernstein et al. (1997).”
The buffering effect of parent social support in the longitudinal associations between cyber polyvictimization and academic outcomes
Wright, M. F., & Wachs, S. (2021) · Social Psychology of Education · doi:10.1007/s11218-021-09647-6 · Cited by 17
Childhood maltreatment and self‐hatred as distinguishing characteristics of psychiatric patients with self‐harm: A comparison with clinical and healthy controls
NILSSON, M. H. L., Lundh, L., & Westling, S. (2022) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.2744 · Cited by 23
“The scale has a Cronbach's alpha of 0.97 and correlation coefficients between therapist's perception and CTQ-scores span between 0.42 and 0.72 for the five aspects (Bernstein et al., 1997).”
BackgroundInfluential
Earlier age of onset is associated with a pro-inflammatory state in major depressive disorder
Anzolin, A. P., Feiten, J. G., Bristot, G., Possebon, G. M. P., Fleck, M. P. D. A., Caldieraro, M. A., & Kauer‐Sant’Anna, M. (2022) · Psychiatry Research · doi:10.1016/j.psychres.2022.114601 · Cited by 17
Mentalizing Based on External Features in Borderline Personality Disorder Compared With Healthy Controls: The Role of Attachment Dimensions and Childhood Trauma
Heel, M. V., Luyten, P., Meulemeester, C. D., Vanwalleghem, D., Vermote, R., & Lowyck, B. (2019) · Journal of Personality Disorders · doi:10.1521/pedi_2019_33_373 · Cited by 18
Intergenerational Risk of Parentification and Infantilization to Externalizing Moderated by Child Temperament
Nuttall, A. K., Zhang, Q., Valentino, K., & Borkowski, J. G. (2019) · Journal of Marriage and the Family · doi:10.1111/jomf.12562 · Cited by 17

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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