Validation of the Childhood Trauma Questionnaire (CTQ) in the Context of Trauma-Focused Treatment

Background: The Childhood Trauma Questionnaire (CTQ) is widely used, but retrospective self-report measures may be susceptible to bias especially in the context of pathology. Therefore, we aimed to validate the CTQ in the context of reduced psychopathology following trauma-focused treatment. Methods: We analyzed 149 outpatients with posttraumatic stress disorder (PTSD) related to childhood abuse. Participants received one of three variants of prolonged exposure. The CTQ was administered at baseline and six months later. The internal consistency of the CTQ was assessed using Cronbach's alpha, inter-item and item-total correlations. Convergent validity was assessed with the clinician administered PTSD Scale for DSM-5 (CAPS-5). The consistency of CTQ scores over time was analyzed using linear mixed models and intra-class correlation coefficients. Results: Most CTQ subscales demonstrated high internal consistency and satisfactory inter-item and item-total correlations except for physical neglect and minimization/denial subscales. CTQ subscales physical and sexual abuse exhibited adequate convergent validity with the CAPS-5. None of the CTQ subscales mean score changed significantly from baseline to follow-up. Agreement between the baseline and follow-up assessment within-persons was moderate at item-level but good at subscale-level except for subscale minimization/denial. Minimization/denial at baseline and change in symptomatology during treatment were not significantly related to change in CTQ subscale scores. Conclusions: These findings support the use of the CTQ subscales to retrospectively assess childhood maltreatment.