Psychometric validation of the Childhood Trauma Questionnaire-Short Form (CTQ-SF) in a Danish clinical sample

BackgroundThe Childhood Trauma Questionnaire – Short Form (CTQ-SF) is a widely utilized self-report instrument in the assessment and characterization of childhood trauma. Yet, research on the instrument’s psychometric properties in clinical samples is sparse, and the Danish version of the CTQ-SF has not been previously evaluated in clinical samples.ObjectivesTo examine the structural validity, internal consistency reliability, and multi-method convergent validity of the CTQ-SF in a heterogenous clinical sample from Denmark.Participants and settingThe study was based on data from four Danish clinical samples (N = 393): 1) Outpatients diagnosed with personality disorders, 2) Patients commencing psychiatric treatment for non-affective first-episode psychosis, 3) Patients diagnosed with first-episode or prolonged depression recruited from general practitioners and an outpatient mood disorder clinic, and 4) detained delinquent boys.MethodsConfirmatory factor analysis was used to explore structural validity. Also, we calculated internal consistency and multi-method convergent validity with interview-based ratings of adverse parenting.ResultsConfirmatory factor analyses indicated that the five-factor structure described in CTQ-SF manual with three error correlated items best fitted the data, as compared to various other models. Coefficients of congruence also supported factorial similarity across countries (i.e. US substance abuser and a mixed Brazilian sample). Internal consistency reliability was acceptable and comparable to estimates previously published. Multi-method convergent validity associations further corroborated the validity of the CTQ-SF.ConclusionThese findings provide support for the reliability and validity of the Danish version of the CTQ-SF in clinical samples.     

Psychometric properties of the Chinese version of the Childhood Trauma Questionnaire-Short Form (CTQ-SF) among undergraduates and depressive patients

ObjectiveThe Childhood Trauma Questionnaire-Short Form (CTQ-SF) is a self-report questionnaire that retrospectively provides screening for a history of childhood abuse and neglect, and which is widely used throughout the world. The current study aimed to examine the psychometric properties of the Chinese version of the CTQ-SF.MethodsParticipants included 3431 undergraduates from Hunan provinces and 234 depressive patients from psychological clinics. Confirmatory factor analysis was performed to examine how well the original five-factor model fit the data and the measurement equivalence of CTQ-SF across gender. Internal consistency was also evaluated.ResultsThe five-factor model achieved satisfactory fit (Undergraduate sample TLI = 0.925, CFI = 0.936, RMSEA = 0.034, SRMR = 0.046; depressive sample TLI = 0.912, CFI = 0.923, RMSEA = 0.044, SRMR = 0.062). Measurement invariance of the five-factor model across gender was supported fully assuming different degrees of invariance. The CTQ-SF also showed acceptable internal consistency and good stability.ConclusionThe current study provides that the Chinese version of the Childhood Trauma questionnaire-short form has good reliability and validity among Chinese undergraduates and depressive samples, which also indicates that the CTQ-SF is a good tool for child trauma assessment.     

Maltreatment in childhood and intimate partner violence: A latent class growth analysis in a South African pregnancy cohort

Intimate partner violence (IPV) is a significant global problem, prevalent in low and middle-income countries (LMICs). IPV is particularly problematic during the perinatal and early postnatal period, where it is linked with negative maternal and child health outcomes. There has been little examination of profiles of IPV and early life adversity in LMIC contexts. We aimed to characterize longitudinal IPV and to investigate maternal maltreatment in childhood as a predictor of IPV exposure during pregnancy and postnatally in a low resource setting. This study was nested in the Drakenstein Child Health Study, a longitudinal birth cohort. Maternal IPV (emotional, physical and sexual) was measured at six timepoints from pregnancy to two years postpartum (n = 832); sociodemographic variables and maternal maltreatment in childhood were measured antenatally at 28–32 weeks’ gestation. Associations between maternal maltreatment in childhood and IPV latent class membership (to identify patterns of maternal IPV exposure) were estimated using multinomial and logistic regression. We observed high levels of maternal maltreatment during childhood (34%) and IPV during pregnancy (33%). In latent class analysis separating by IPV sub-type, two latent classes of no/low and moderate sexual IPV and three classes of low, moderate, and high emotional and physical IPV (separately) were detected. In combined latent class analysis, including all IPV sub-types together, a low, moderate and high exposure class emerged as well as a high antenatal/decreasing postnatal class. Moderate and high classes for all IPV sub-types and combined analysis showed stable intensity profiles. Maternal childhood sexual abuse, physical abuse and neglect, and emotional abuse predicted membership in high IPV classes, across all domains of IPV (aORs between 1.99 and 5.86). Maternal maltreatment in childhood was associated with increased probability of experiencing high or moderate intensity IPV during and around pregnancy; emotional neglect was associated with decreasing IPV class for combined model. Intervening early to disrupt this cycle of abuse is critical to two generations.     

Identification of differential item functioning by race and ethnicity in the Childhood Trauma Questionnaire

BackgroundThe accurate assessment of childhood maltreatment (CM) is important in medical and mental health settings given its association to adverse psychological and physical outcomes. Reliable and valid assessment of CM is also of critical importance to research. Due to the potential of measurement bias when comparing CM across racial and ethnic groups, invariant measurement is an important psychometric property of such screening tools.ObjectiveIn this study, differential item function (DIF) by race and ethnicity was tested. Uniform DIF refers to the influence of bias on scores across all levels of childhood maltreatment, and non-uniform DIF refers to bias in favor of one group.MethodParticipants were N=1,319 women and men (M_age=36.77, SD_age=10.37) who completed the Child Trauma Questionnaire-Short Form; 42.7% were women, 57.3% were male; 58.9% were White-American, 22.1% Black-American, and 8.0% as other; 26.3% were Hispanic.ResultsUsing empirical thresholds, non-uniform DIF was identified in five items by race, and no items by ethnicity.ConclusionsUniform DIF is less problematic given that mathematical corrections can be made to adjust scores for DIF. However, non-uniform DIF can usually only be corrected by removing the DIF items from the scale. Further methodological research is needed to minimize measurement bias to effectively assess racially diverse populations.     

Childhood adversity increases the risk of onward transmission from perinatal HIV-infected adolescents and youth in South Africa

Repeated exposure to childhood adversity (abuse, neglect and other traumas experienced before age 18) can have lifelong impacts on health. For HIV-infected adolescents and youth, such impacts may include onward transmission of HIV. To evaluate this possibility, the current study measured the burden of childhood adversity and its influence on risky health behaviors among perinatally-infected adolescents and youth. We surveyed 250 perinatally-infected adolescents and youth (13–24 years) receiving care in Soweto, South Africa. Both male and female participants reported on childhood adversity (using the ACE-IQ), sexual behavior, and psychosocial state. Viral load was also abstracted from their charts. We used logistic regressions to test the association between cumulative adversity and behavioral outcomes. Half the sample reported eight or more adversities. Overall, 72% experienced emotional abuse, 59% experienced physical abuse, 34% experienced sexual abuse, 82% witnessed domestic violence, and 91% saw someone being attacked in their community. A clear gradient emerged between cumulative adversities and behavioral risk. Having experienced one additional childhood adversity raised the odds of risky sexual behavior by almost 30% (OR 1.27, 95% CI 1.09–1.48). Viral suppression was poor overall (31% had viral loads >400 copies/ml), but was not related to adversity. Adversity showed a robust relationship to depression and substance abuse. Childhood adversity is common, influences the current health of HIV-positive adolescents and youth, and puts their sexual partners at risk for HIV infection. Greater primary prevention of childhood adversity and increased access to support services (e.g., mental health) could reduce risk taking among HIV-positive adolescents and youth.     

Attachment insecurity mediates the relationship between childhood trauma and eating disorder psychopathology in a clinical sample: A structural equation model

Objectives

Childhood maltreatment occurs often among those with an eating disorder and is considered a nonspecific risk factor. However, the mechanisms by which childhood maltreatment may lead to an eating disorder are not well understood. The current study tests a model in which attachment insecurity is hypothesized to mediate the relationship between childhood maltreatment and eating disorder psychopathology.

Method

Treatment seeking adults with eating disorders (N = 308) completed questionnaires about childhood maltreatment, eating disorder psychopathology, and adult attachment.

Results

Structural equation models indicated that childhood trauma had a direct effect on eating disorder symptoms. Also, attachment anxiety and avoidance each equally mediated the childhood maltreatment to eating disorder psychopathology relationship.

Conclusions

Attachment insecurity, characterized by affect dysregulation and interpersonal sensitivities may help to explain why eating disorder symptoms may be one consequence of childhood maltreatment in a clinical sample. Clinicians treating primarily those with trauma might assess for disordered eating as a potential manifestation of the sequelae of trauma and attachment insecurity.     

Internalizing symptoms and affect of children with emotional and behavioral disorders: A comparative study with an urban African American sample

Self‐reported internalizing symptoms of seriously emotionally disturbed (SED) and regular education students in grades 4–6 were compared using the Internalizing Symptoms Scale for Children. All participants were African American and from an urban public school district in the Southeastern United States. Each of the two study groups consisted of 50 participants (35 boys, 15 girls) who were matched by gender and socioeconomic status. The SED group reported significantly higher levels of internalizing distress than the regular education group. In contrast to previous findings, there was no significant gender difference in self‐reported internalizing symptomatology in the present study. A discriminant function analysis found that the ISSC scores were able to correctly classify 91% of the participants into their respective educational group. Results of this study provide additional evidence of the construct validity of the ISSC, a recently developed and unique self‐report measure. Results are discussed in terms of future research needs and educational/clinical practice with students who have emotional and behavioral disorders. © 1999 John Wiley & Sons, Inc.     

Disentangling the mental health impact of childhood abuse and neglect: A replication and extension study in a Brazilian sample of high-risk youth

Childhood maltreatment is a key predictor of mental health problems across the life span. Yet, how maltreatment types independently and jointly influence the risk for psychiatric problems remains unclear. The aim of the study was two-fold: first, to replicate recent findings regarding the impact of maltreatment types on youth psychiatric symptoms, based on a Brazilian sample of high-risk adolescents (n = 347; age range = 11–17 yrs), and second, to extend existing findings by examining whether this relationship is mediated by bullying victimization and/or perpetration. Measures included self-report ratings of childhood maltreatment and peer victimization, as well as multi-informant reports of internalizing and externalizing symptoms. Consistent with prior research, we found that: (i) maltreatment types often co-occurred; (ii) there was a linear association between number of maltreatment types experienced and symptom severity (i.e. cumulative effect); and (iii) emotional abuse emerged as the most consistent independent predictor of poor mental health across domains, raters, and gender. Additionally, this study extends previous findings by showing that the influence of maltreatment on psychiatric outcomes is partially mediated by peer victimization, but not by bullying perpetration. In conclusion, these findings expand our understanding of the heterogeneity in individual responses to maltreatment as well as highlighting emotional abuse as an important predictor of poor mental health.     

Acceptability of the Predicting Abusive Head Trauma (PredAHT) clinical prediction tool: A qualitative study with child protection professionals

The validated Predicting Abusive Head Trauma (PredAHT) tool estimates the probability of abusive head trauma (AHT) based on combinations of six clinical features: head/neck bruising; apnea; seizures; rib/long-bone fractures; retinal hemorrhages. We aimed to determine the acceptability of PredAHT to child protection professionals. We conducted qualitative semi-structured interviews with 56 participants: clinicians (25), child protection social workers (10), legal practitioners (9, including 4 judges), police officers (8), and pathologists (4), purposively sampled across southwest United Kingdom. Interviews were recorded, transcribed and imported into NVivo for thematic analysis (38% double-coded). We explored participants’ evaluations of PredAHT, their opinions about the optimal way to present the calculated probabilities, and their interpretation of probabilities in the context of suspected AHT. Clinicians, child protection social workers and police thought PredAHT would be beneficial as an objective adjunct to their professional judgment, to give them greater confidence in their decisions. Lawyers and pathologists appreciated its value for prompting multidisciplinary investigations, but were uncertain of its usefulness in court. Perceived disadvantages included: possible over-reliance and false reassurance from a low score. Interpretations regarding which percentages equate to ‘low’, ‘medium’ or ‘high’ likelihood of AHT varied; participants preferred a precise % probability over these general terms. Participants would use PredAHT with provisos: if they received multi-agency training to define accepted risk thresholds for consistent interpretation; with knowledge of its development; if it was accepted by colleagues. PredAHT may therefore increase professionals’ confidence in their decision-making when investigating suspected AHT, but may be of less value in court.     

University teaching and social cohesion in the age of AIDS: A South African case study

In the context of ongoing social divisions, lack of coherent leadership by government, and even divisiveness over medical advances and public health mandates, how might universities respond? What university actions can support social cohesion in a society splintered by class, race, gender, colonial legacies, the history of apartheid, and HIV/AIDS? More specifically, what approaches to university teaching of HIV/AIDS might foster social cohesion? During 2006, I interviewed 22 instructors at the University of KwaZulu-Natal (UKZN) at three campuses. The interviewees were faculty members in education, sociology, history, psychology, theology, gender studies, and theater. I observed numerous classes that focused on HIV/AIDS and interviewed approximately 40 undergraduate, honours (4th year), and graduate students. I found that the curriculum and teaching went beyond the technical, individualistic, rational, self-interested assumptions and approaches (such as how to distribute information and condoms) typical of much safe-sex education. The courses explicitly critiqued assumptions, beliefs, and stereotypes that contribute to social divisions and stigma. The teaching efforts consciously included cultural understandings, specifically Zulu cultural understandings of health, community responses, and individuals within communal relationships. The approaches explicitly connected HIV/AIDS with social divisions and inequities of power. The teaching promoted an awareness that public health initiatives (and church or counseling responses) are fraught and controversial. Thus, the teaching tried to place its own ideas within history and society, offering a post-colonial/critical understanding of knowledge, theories, and social “solutions.” In foregrounding social divisions in relation to AIDS, these programmes promoted a critical-edged social cohesion.     

Shared reading as a practice for fostering early learning in an Early Childhood Education and Care centre: a naturalistic,comparative study of one infant's experiences with two educators

Early childhood educators are encouraged to read with infants, yet little is known about the educator–infant book‐focused interactions that occur in Early Childhood Education and Care (ECEC) centres. This study provides a systematic linguistic analysis of the naturally occurring interactions between one focal child Charlie (aged 21 months and 13 days) and two of his educators, as they each engaged in shared reading with Charlie and one or more of his peers during a typical day in his infant room. While both educators engaged in shared reading for pedagogical purposes, the meanings realised in their talk differed in subtle ways, providing Charlie and his peers with tacit and sometimes contradictory messages about how to make meaning from words and pictures. One educator's proportionally greater use of mental processes and polar questions construed shared reading primarily as an interpretive activity, while the other educator's proportionally greater use of WH questions and directives construed shared reading primarily as an instructional activity. Differences were also observed in Charlie's verbal participation during the two shared readings. The findings reveal how educators, through their own talk, create particular contexts in which infants may or may not participate during shared reading experiences.     

The “A” factor: Coming to terms with the question of legacy in South African education

This paper attempts to offer an alternative framework for assessing education delivery in South Africa. Its purpose is to develop an analytic approach for understanding education delivery in South Africa in the last 11 years and to use this framework to pose a set of strategic questions about how policy might be framed to deal with delivery. The paper begins with a quick review of the country's achievements and challenges in education and shows that a failure to produce a high quality education system remains the country's primary challenge. The broad approach that is taken is to suggest that dominant approaches for understanding this lack of performance underplay the specificity of the country's context and specifically so its apartheid legacy. This legacy, it is argued, continues to be determinative in shaping, and accounting for the character of current social behaviour in the country, including the performance of children in schools.     

整数的一条性质及其在数据加密中的应用

本文利用组合数学中有关整数的一个结论给出了数据加密、解密的一种方法，并证明了该方法的可行性及有效性，给出了用该方法加、解密文件的算法．     

Growing up in a Mainstream World: A Retrospective Enquiry into the Childhood Experiences of Young Adults with a Physical Disability

Children with disabilities are at greater risk of developing mental health problems than their peers, yet the emotional well-being of this group is largely overlooked and there is scant literature about children with a mobility disability. This study examined the retrospective experiences of growing up with mobility disability. The sample comprised 16–25 year olds with mobility disability. A thematic analysis, informed by grounded theory was used. Themes identified included a common socio-educational journey, conflict between care and independence in school and the impact of being singled out because of disability outside school. The result was a range of psychosocial issues that affected participants’ view of themselves and the world around them. The study also looked at what the participants found helpful in dealing with the emotional impact of their disability. Whilst some sought help through talking therapies, others found involvement in disability sport was helpful.     

Staff perceptions of professional development and empowerment as long-term leadership tasks of school principals in South African schools: an exploratory study

This article reports on the perceptions of school staff of professional development and empowerment as part of the long-term leadership task of principals. The long-term leadership model was used as a theoretical framework to quantitatively determine the perceptions of 118 teachers and education managers in approximately 100 schools throughout South Africa. The findings indicated how principals perform, and indicated those aspects in need of attention in improving the quality of leadership relating to professional development and empowerment. A further finding was that there was a positive, and statistically significant, relationship between the respondents’ sense of empowerment and their perceptions of professional development.     

Positive childhood experiences predict less psychopathology and stress in pregnant women with childhood adversity: A pilot study of the benevolent childhood experiences (BCEs) scale

This pilot study examined the psychometric properties of the Benevolent Childhood Experiences (BCEs) scale, a new instrument designed to assess positive early life experiences in adults with histories of childhood maltreatment and other adversities. A counterpart to the Adverse Childhood Experiences (ACEs) questionnaire, the BCEs was developed to be multiculturally-sensitive and applicable regardless of socioeconomic position, urban-rural background, or immigration status. Higher levels of BCEs were hypothesized to predict lower levels of psychopathology and stress beyond the effects of ACES in a sample of ethnically diverse, low-income pregnant women. BCEs were also expected to show adequate internal validity across racial/ethnic groups and test-retest stability from the prenatal to the postnatal period. Participants were 101 pregnant women (M = 29.10 years, SD = 6.56, range = 18–44; 37% Latina, 22% African-American, 20% White, 21% biracial/multiracial/other; 37% foreign-born, 26% Spanish-speaking) who completed the BCEs and ACEs scales; assessments of prenatal depression and post-traumatic stress disorder (PTSD) symptoms, perceived stress, and exposure to stressful life events (SLEs) during pregnancy; and demographic information. Higher levels of BCEs predicted less PTSD symptoms and SLEs, above and beyond ACEs. The BCEs showed excellent test-retest reliability, and mean levels were comparable across racial/ethnic and Spanish-English groups of women. Person-oriented analyses also showed that higher levels of BCEs offset the effects of ACEs on prenatal stress and psychopathology. The BCEs scale indexes promising promotive factors associated with lower trauma-related symptomatology and stress exposure during pregnancy and illuminates how favorable childhood experiences may counteract long-term effects of childhood adversity.     

Evaluation of a short version of the Illinois Loneliness and Social Satisfaction Scale in a sample of students with and without special educational needs – an empirical study with primary and secondary students in Austria

The first aim of this study was to evaluate the appropriateness of a short version of the Illinois Loneliness and Social Satisfaction Scale with children with special educational needs. The second aim was to explore loneliness in relation to self‐perceived social integration, school well‐being and the social self‐concept of students from primary and secondary schools, in both inclusive and regular classes. This study had 1,115 student participants (408 fourth graders and 707 seventh graders), of whom 126 were diagnosed as having special educational needs. Factor analyses confirmed a unidimensional latent factor structure. The scale showed satisfactory reliability and the validity coefficients indicated that the scale is suitable for surveys including students with special educational needs. Generally speaking, the level of self‐rated loneliness is low. Nevertheless, students with special educational needs in inclusive classes felt significantly lonelier than students without special educational needs in inclusive classes.     

Childhood maltreatment and the persistence of smoking: A longitudinal study among adults in the US

The current study examined the relationship between childhood maltreatment—emotional, physical, and severe physical maltreatment—and the initiation and persistence of smoking. Data were drawn from the Midlife Development in the United States (MIDUS) Survey Waves 1 and 2. Frequency of childhood emotional, physical, and severe physical maltreatment (never, rare, intermittent, frequent) reported at Wave 1 was examined in relation to ever smoking, smoking daily, and persistent daily smoking at Waves 1 and 2. Logistic regression analyses were used to calculate odds ratios (with 95% confidence intervals), which were then adjusted for potential confounders. Childhood emotional, physical, and severe physical maltreatment were associated with increased odds of ever smoking, smoking daily, and persistent smoking at Waves 1 and 2. The majority of these associations remained significant after adjusting for confounding variables. These results suggest a history of trauma may play a prominent role in recalcitrant cigarette smoking and suggest that the success rates of treatments for smoking cessation may be improved by integrating trauma treatment where appropriate.     

当代汉越家庭称谓语面称对比研究

汉语和越语都有着复杂的亲属称谓系统。汉越家庭成员在面称时都表现出上下有别、长幼有序的特点。但夫妻之间、长辈和晚辈之间以及兄弟姐妹之间的面称还存在着很多差异,如人称代词的使用情况不同,亲疏之别的程度不同,男女有别的程度不同。