Ein Screeninginstrument für Missbrauch und Vernachlässigung in der Kindheit: der Childhood Trauma Screener (CTS)

Zusammenfassung

Anliegen: Ziel war die Entwicklung eines zeitökonomischen Screeninginstruments (Childhood Trauma Screener, CTS) zur Erfassung traumatischer Ereignisse in der Kindheit und Jugend.

Methode: Auf der Basis einer Stichprobe der SHIP-LEGENDE-Studie (n = 1668) wurden 5 Items des „Childhood Trauma Questionnaire“ (CTQ, 28 Items) ermittelt, die die 5 Missbrauchs- und Vernachlässigungsdimensionen des CTQ am besten abbildeten.

Ergebnisse: In der Validierung auf der Grundlage einer klinischen Stichprobe (n = 211) zeigten sich Korrelationen der 5 CTS Items mit der jeweils zugehörigen CTQ-Dimension von r = 0,55−0,87 sowie des CTS-Gesamtwerts zum CTQ-Gesamtwert von r = 0,88. Cronbachs α lag bei 0,757 (n = 499).

Schlussfolgerungen: Der CTS ist ein reliables und sehr ökonomisches Screeninginstrument zur Erfassung traumatischer Ereignisse in Kindheit und Jugend.

Abstract

Objective: There is a lack of a psychometrically sound screening questionnaire that assesses important dimensions of traumatic experiences during childhood and adolescence in a time-efficient way. Based on the German version of the “Childhood Trauma Questionnaire” (CTQ, 28 items) we developed a five-item self-report childhood trauma screener (CTS) that covers sexual, emotional and physical abuse and emotional and physical neglect.

Method: The data set of the SHIP-LEGEND study (n = 1668) was used to extract five items of the CTQ that optimally covered the five dimensions and showed a high correlation with the total score. In two validation samples (clinical sample [n = 211] and subjects from the BiDirect study [n = 288]) the psychometric properties of the CTS were evaluated.

Results: The correlations between the five CTS Items and the corresponding dimensions from the CTQ were r = 0.55 to 0.87 (p < 0.0001) within the clinical sample. Furthermore, we found high correlations (r = 0.88; p < 0.0001) with the total CTQ score. The internal consistency was 0.757 (Cronbachs α).

Conclusion: The CTS is a reliable, valid and economic screener for the retrospective assessment of adverse childhood experiences especially in large epidemiological studies.

Schlüsselwörter

Kindesmisshandlung - Missbrauch und Vernachlässigung - Psychometrie - Selbstbeurteilungsinstrument - Reliabilität und Validität

Keywords

childhood abuse - self-rating instrument - reliability and validity

• Literatur

• 1 Dong M, Giles WH, Felitti VJ et al. Insights into causal pathways for ischemic heart disease: adverse childhood experiences study. Circulation 2004; 110: 1761-1766
• 2 Felitti VJ, Anda RF, Nordenberg D et al. Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The Adverse Childhood Experiences (ACE) Study. Am J Prev Med 1998; 14: 245-258
• 3 Anda RF, Brown DW, Dube SR et al. Adverse childhood experiences and chronic obstructive pulmonary disease in adults. Am J Prev Med 2008; 34: 396-403
• 4 Dube SR, Fairweather D, Pearson WS et al. Cumulative childhood stress and autoimmune diseases in adults. Psychosom Med 2009; 71: 243-250
• 5 Thomas C, Hypponen E, Power C. Obesity and type 2 diabetes risk in midadult life: the role of childhood adversity. Pediatrics 2008; 121: e1240-1249
• 6 Grabe HJ, Schwahn C, Appel K et al. Childhood maltreatment, the corticotropin-releasing hormone receptor gene and adult depression in the general population. Am J Med Genet B Neuropsychiatr Genet 2010; 153B: 1483-1493
• 7 Binder EB, Bradley RG, Liu W et al. Association of FKBP5 polymorphisms and childhood abuse with risk of posttraumatic stress disorder symptoms in adults. JAMA 2008; 299: 1291-1305
• 8 Enoch MA. Genetic and environmental influences on the development of alcoholism: resilience vs. risk. Ann N Y Acad Sci 2006; 1094: 193-201
• 9 Vogel M, Spitzer C, Kuwert P et al. Association of childhood neglect with adult dissociation in schizophrenic inpatients. Psychopathology 2009; 42: 124-130
• 10 Grabe HJ, Lange M, Wolff B et al. Mental and physical distress is modulated by a polymorphism in the 5-HT transporter gene interacting with social stressors and chronic disease burden. Mol Psychiatry 2005; 10: 220-224
• 11 Grabe HJ, Schwahn C. Interaction Between Psychosocial Environments and Genes – What is the Clinical Relevance?. Psychiat Prax 2011; 38: 55-57
• 12 Bernstein DP, Ahluvalia T, Pogge D et al. Validity of the Childhood Trauma Questionnaire in an adolescent psychiatric population. J Am Acad Child Adolesc Psychiatry 1997; 36: 340-348
• 13 Bernstein DP, Stein JA, Newcomb MD et al. Development and validation of a brief screening version of the Childhood Trauma Questionnaire. Child Abuse Negl 2003; 27: 169-190
• 14 Wingenfeld K, Spitzer C, Mensebach C et al. The German Version of the Childhood Trauma Questionnaire (CTQ):Preliminary Psychometric Properties. Psychother Psych Med 2010; 60: 442-450
• 15 Klinitzke G, Romppel M, Hauser W et al. Die deutsche Version des Childhood Trauma Questionnaire (CTQ) – psychometrische Eigenschaften in einer bevölkerungsrepräsentativen Stichprobe. Psychother Psych Med 2012; 62: 47-51
• 16 Bradley RG, Binder EB, Epstein MP et al. Influence of child abuse on adult depression: moderation by the corticotropin-releasing hormone receptor gene. Arch Gen Psychiatry 2008; 65: 190-200
• 17 Appel K, Schwahn C, Mahler J et al. Moderation of Adult Depression by a Polymorphism in the FKBP5 Gene and Childhood Physical Abuse in the General Population. Neuropsychopharmacology 2011; 36: 1982-1991
• 18 Wingenfeld K, Schafer I, Terfehr K et al. The reliable, valid and economic assessment of early traumatization: first psychometric characteristics of the German version of the Adverse Childhood Experiences Questionnaire (ACE). Psychother Psych Med 2011; 61: 10-14
• 19 Völzke H, Alte D, Schmidt CO et al. Cohort Profile: The Study of Health in Pomerania. Int J Epidemiol 2011; 40: 294-307
• 20 Schmidt CO, Alte D, Völzke H et al. Partial misspecification of survey design features sufficed to severely bias estimates of health-related outcomes. J Clin Epidemiol 2010; 64: 416-423
• 21 Scher CD, Stein MB, Asmundson GJ et al. The childhood trauma questionnaire in a community sample: psychometric properties and normative data. J Trauma Stress 2001; 14: 843-857
• 22 Beck AT, Steer RA. Beck Depression Inventory – Manual. San Antonio: The Psychological Corporation; 1987
• 23 Schafer I. Traumatic experiences in patients with psychosis: more arguments against the “bio-bio-bio Model”. Psychiat Prax 2009; 36: 205-207