Comparison of the ACE-Q and CTES: A study of childhood trauma and perinatal depression

Postpartum depression (PPD) is a major public health issue, significantly affecting the health and well-being of women and children. Research indicates a strong link between adverse childhood experiences (ACEs) and increased PPD rates. While the Adverse Childhood Experiences Questionnaire (ACE-Q) is widely used for ACE screening, the Childhood Traumatic Events Scale (CTES) may better capture trauma items not covered by the ACE-Q, along with the timing and severity of ACEs. However, the psychometric properties of the CTES in perinatal populations have not been previously assessed. We present a psychometric evaluation of the CTES among a sample of perinatal women (N = 281) and examine the relationship between ACEs identified by the CTES and PPD symptoms compared to those identified by the ACE-Q. Key findings include: (1) CTES showed low reliability, with a McDonald's omega coefficient of 0.42; (2) exploratory factor analysis of the CTES indicated a multidimensional structure with two factors; (3) the CTES and ACE-Q demonstrated convergent validity, evidenced by positive correlations for physical abuse (r = 0.70), sexual abuse (r = 0.82), and parental divorce (r = 0.91); and (4) bivariate analyses yielded inconsistent results between ACEs from the CTES and ACE-Q concerning PPD symptoms. Further confirmatory analyses are needed to examine the CTES's dimensionality and theoretical constructs that may differ from the ACE-Q. Additionally, further examination of the open-response item within the CTES may uncover ACEs particularly relevant to perinatal women, contributing to a more comprehensive understanding of the prevalence and impact of childhood adversities in this population.