The Childhood Trauma Questionnaire (CTQ)

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Self-Report Measures, Screenings and Assessments

The Childhood Trauma Questionnaire (CTQ)

THC Editorial Team September 11, 2022
Photo by Juan Davila on Unsplash (article on the Childhood Trauma Questionnaire - CTQ)
Photo by Juan Davila on Unsplash

Contents

Introduction

In a given year, one billion children (ages 2–17) are estimated to have been exposed to some form of trauma.1 Traumatic experiences, including abuse, neglect, parental separation, and familial violence, can have a detrimental impact on children’s emotional health.2

The Childhood Trauma Questionnaire (CTQ), a self-report measure for mental health, seeks to identify and classify different types of childhood trauma and abuse experienced by adolescents and adults.3,4,5

What is the Childhood Trauma Questionnaire (CTQ)?

The Childhood Trauma Questionnaire (CTQ) is a widely used tool by psychologists to identify and measure the prevalence of retrospective childhood trauma.5 The original CTQ featured 70 questions4 and was later shortened to 28 questions in a short-form version of the Childhood Trauma Questionnaire (the CTQ-SF).6 The questionnaires are self-administered, and respondents choose answers based on a five-point Likert scale; responses range from Never True to Very Often True.4 Most respondents take around 5 minutes to complete the short form version of the Childhood Trauma Questionnaire.6

What Does the Childhood Trauma Questionnaire Measure?

Of the 28 questions on the CTQ-SF, 25 items are split into five subscales: Emotional Abuse, Physical Abuse, Sexual Abuse, Physical Neglect, and Emotional Neglect. The questions ask respondents to make statements about their childhood and their understanding of their trauma as an adolescent or adult. For example, on the Emotional Abuse scale, respondents are asked to respond to statements such as “People in my family said hurtful or insulting things to me.” The other subscales have similar statements that relate to that specific scale. Respondents use a Likert scale from 1 to 5 to indicate the applicability of those statements relative to their own childhood experiences.

The following definitions for abuse and neglect are provided in the Childhood Trauma Questionnaire:7

  • Emotional Abuse: “verbal assaults on a child’s sense of worth or well-being or any humiliating or demeaning behavior directed toward a child by an adult or older person.”
  • Sexual Abuse: “sexual contact or conduct between a child younger than 18 years of age and an adult or older person.”
  • Physical Abuse: “bodily assaults on a child by an adult or older person that posed a risk of or resulted in injury.”
  • Physical Neglect: “the failure of caretakers to provide for a child’s basic physical needs, including food, shelter, clothing, safety, and health care” (poor parental supervision was also included in this definition if it places children’s safety in jeopardy).
  • Emotional Neglect: “the failure of caretakers to meet children’s basic emotional and psychological needs, including love, belonging, nurturance, and support.”

The three remaining questions make up a Minimization/Denial (M/D) scale, which is used to help determine if respondents are underreporting their childhood trauma.

When Is the Childhood Trauma Questionnaire Used?

This questionnaire is commonly used to screen various populations, especially when childhood abuse or neglect is suspected. The CTQ has been used with female sex workers, cannabis users, people diagnosed with depression and eating disorders, and many others. It is a retrospective survey, which means that teenagers or adults are asked to think back to the events of their childhood. It can be given again months after the first time to help verify the results from individual respondents.

The Childhood Trauma Questionnaire has been used with various populations, cultures, and languages.5

Childhood Trauma Questionnaire Scoring Guidelines

The Childhood Trauma Questionnaire (CTQ-SF) divides the 25 main items into five subscales. There are five statements under each subscale. Respondents are asked to give a number rating of between 1 and 5 for each statement. These numbers correspond to truth statements, with 1 being Never True and 5 being Very Often True.6

Each subscale’s five questions range from 5 to 25, with four score categories. Each subscale is given a determination based on responses, including none to low trauma exposure, low to moderate trauma exposure, moderate to severe trauma exposure, and severe to extreme trauma exposure.6

Validity and Reliability of the Childhood Trauma Questionnaire

The Childhood Trauma Questionnaire has shown high validity and performed consistently across different populations with various abuse histories.6,8,9 These include having good convergent validity with structured interviews that assess childhood trauma.9

Summary/Outlook

The Childhood Trauma Questionnaire is a valuable, reliable, and widely used measure of the traumatic childhood experiences of adults and adolescents.

References

  1. Hughes, K., Bellis, M. A., Hardcastle, K. A., Sethi, D., Butchart, A., Mikton, C., Jones, L., & Dunne, M. P. (2017). The effect of multiple adverse childhood experiences on health: A systematic review and meta-analysis. The Lancet. Public health, 2(8), e356–e366.
    https://doi.org/10.1016/S2468-2667(17)30118-4
  2. THC Editorial Team. (October 30, 2021). Adverse Childhood Experiences: Impact, Prevention, and Treatment. The Human Condition.
    https://thehumancondition.com/adverse-childhood-experiences/
  3. Fink, L., & Bernstein, D. (1998). Childhood Trauma Questionnaire. A retrospective self-report. Manual.
  4. Bernstein, D. P., Fink, L., Handelsman, L., & Foote, J. (1994). Childhood Trauma Questionnaire (CTQ) [Database record]. APA PsycTests.
    https://doi.org/10.1037/t02080-000
  5. Grassi-Oliveira, R., Cogo-Moreira, H., Salum, G. A., Brietzke, E., Viola, T. W., Manfro, G. G., Kristensen, C. H., & Arteche, A. X. (2014). Childhood Trauma Questionnaire (CTQ) in Brazilian samples of different age groups: findings from confirmatory factor analysis. PloS one, 9(1), e87118.
    https://doi.org/10.1371/journal.pone.0087118
  6. Bernstein, D. P., Stein, J. A., Newcomb, M. D., Walker, E., Pogge, D., Ahluvalia, T., Stokes, J., Handelsman, L., Medrano, M., Desmond, D., & Zule, W. (2003). Development and validation of a brief screening version of the Childhood Trauma Questionnaire. Child abuse & neglect, 27(2), 169–190.
    https://doi.org/10.1016/s0145-2134(02)00541-0
  7. Spinner, S., & Rudolph, B. D. (2019). Screening for Body Image Concerns, Eating Disorders, and Sexual Abuse in Adolescents: Concurrent Assessment to Support Early Intervention and Preventative Treatment. In Adolescent Health Screening: an Update in the Age of Big Data (pp. 151-163). Elsevier.
    https://doi.org/10.1016/B978-0-323-66130-0.00012-0
  8. Liebschutz, J. M., Buchanan-Howland, K., Chen, C. A., Frank, D. A., Richardson, M. A., Heeren, T. C., Cabral, H. J., & Rose-Jacobs, R. (2018). Childhood trauma questionnaire (CTQ) correlations with prospective violence assessment in a longitudinal cohort. Psychological Assessment, 30(6), 841–845.
    https://doi.org/10.1037/pas0000549
  9. Wright, K. D., Asmundson, G. J., McCreary, D. R., Scher, C., Hami, S., & Stein, M. B. (2001). Factorial validity of the Childhood Trauma Questionnaire in men and women. Depression and anxiety, 13(4), 179–183.

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