Wednesday, January 27, 2016

Minimization of Childhood Maltreatment Is Common and Consequential

Childhood maltreatment has diverse, lifelong impact on morbidity and mortality. The Childhood Trauma Questionnaire (CTQ) is one of the most commonly used scales to assess and quantify these experiences and their impact. Curiously, despite very widespread use of the CTQ, scores on its Minimization-Denial (MD) subscale—originally designed to assess a positive response bias—are rarely reported. Hence, little is known about this measure. If response biases are either common or consequential, current practices of ignoring the MD scale deserve revision. 

Therewith, we designed a study to investigate 3 aspects of minimization, as defined by the CTQ’s MD scale: 1) its prevalence; 2) its latent structure; and finally 3) whether minimization moderates the CTQ’s discriminative validity in terms of distinguishing between psychiatric patients and community volunteers. Archival, item-level CTQ data from 24 multinational samples were combined for a total of 19,652 participants. Analyses indicated: 1) minimization is common; 2) minimization functions as a continuous construct; and 3) high MD scores attenuate the ability of the CTQ to distinguish between psychiatric patients and community volunteers. 

Overall, results suggest that a minimizing response bias—as detected by the MD subscale—has a small but significant moderating effect on the CTQ’s discriminative validity. Results also may suggest that some prior analyses of maltreatment rates or the effects of early maltreatment that have used the CTQ may have underestimated its incidence and impact. 

We caution researchers and clinicians about the widespread practice of using the CTQ without the MD or collecting MD data but failing to assess and control for its effects on outcomes or dependent variables.

Below:  Percentages of Clinical and Community Samples in CTQ Severity Quartiles

Full article at:

Kai MacDonald, Michael L. Thomas, Beacher Schneider, Katherine Pappas, Murray B Stein
Department of Psychiatry, University of California San Diego, San Diego, California, United States of America

Andres F. Sciolla
Department of Psychiatry & Behavioral Sciences, University of California Davis, Davis, California, United States of America

Gijs Bleijenberg, Marianne Heins, Hans Knoop
Expert Center Chronic Fatigue, Radboud University Medical Center, Nijmegen, Netherlands

Martin Bohus
Universität Heidelberg, Central Institute of Mental Health, Heidelberg, Germany

Bradley Bekh
Atlanta VA Medical Center, Atlanta, Georgia, United States of America

Bradley Bekh
Department of Psychiatry, Emory University, Atlanta, Georgia, United States of America

Linda Carpenter
Brown University, Providence, Rhode Island, United States of America

Alan Carr
University College Dublin, Dublin, Ireland

Udo Dannlowski
Department of Psychiatry, University of Münster, Münster, Germany

Martin Dorahy
Department of Psychology, University of Canterbury, Christchurch, New Zealand

Claudia Fahlke
Department of Psychology, University of Gothenburg, Gothenburg, Sweden

Ricky Finzi-Dottan, Tobi Karu
Bar Ilan University, Ramat Gan, Israel

Arne Gerdner
School of Health Sciences, Jönköping University, Jönköping, Sweden

Heide Glaesmer
Department of Medical Psychology and Medical, University of Leipzig, Leipzig, Germany

Hans Jörgen Grabe
Department of Psychiatry and Psychotherapy, Helios Hospital Stralsund, Stralsund, Germany

Hans Jörgen Grabe
Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany

Dianna T Kenny
University of Sydney, Sydney, Australia

Daeho Kim
Department of Psychiatry, Hanyang University Medical School, Seoul, South Korea

Jill Lobbestael
Department of Clinical Psychology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands

Christine Lochner
University of Stellenbosch, MRC Unit on Anxiety & Stress Disorders, Department of Psychiatry, Stellenbosch, South Africa

Grethe Lauritzen, Edle Ravndal
Norwegian Institute for Alcohol and Drug research (SIRUS), and Norwegian Centre for Addiction Research (SERAF), University of Oslo, Oslo, Norway

Shelley Riggs
University of North Texas, Denton, Texas, United States of America

Vedat Sar
Koç University Medical School, Istanbul, Turkey

Ingo Schäfer
Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany

Nicole Schlosser
Research Department, Evangelical Hospital Bielefeld, Bielefeld, Germany

Melanie L Schwandt
National Institute on Alcohol Abuse and Alcoholism, Bethesda, Maryland, United States of America

Claudia Subic-Wrana
Department für Psychosomatic Medicine and Psychotherapy, University Medical Center of Mainz University, Mainz, Germany

Mark Vogel
Division of Substance Use Disorders, Psychiatric Hospital of the University of Basel, Basel, Switzerland

Katja Wingenfeld
Department of Psychiatry, Charité University Berlin, Campus Benjamin Franklin, Berlin, Germany

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