Childhood Maltreatment on the Adverse Childhood Experiences (ACEs) Scale versus the Childhood Trauma Questionnaire (CTQ) in a Perinatal Sample

Abstract

ABSTRACTThe Adverse Childhood Experiences (ACEs) scale and the Childhood Trauma Questionnaire (CTQ) are among the most widely used instruments for assessing childhood maltreatment, yet the convergent validity and concordance of their maltreatment subscales has only been examined in one previous non-U.S. study. This study represents the first replication and extension study to address the strengths and weaknesses of relying on the five-item ACEs maltreatment scale versus the 28-item CTQ. Participants were 77 low-income, ethnically-diverse women (M = 29.19, SD = 6.55, range = 18–44 years; 34% Latina, 24% White, 22% African-American, 20% biracial/multiracial/other; 18% Spanish-speaking) who completed the ACEs scale during pregnancy and the CTQ at three months post-partum. We hypothesized that total childhood maltreatment scores and maltreatment subtypes would be significantly associated, indicating concordance across instruments. We also conducted sensitivity and specificity analyses to determine the extent to which ACEs maltreatment subtypes correctly predicted corresponding CTQ subtypes and performed exploratory analyses on minimization/denial (MD) and inconsistent responding across instruments. Results supported generally good convergent validity of total childhood maltreatment and most subtype scores across instruments. Sexual abuse had the highest sensitivity and specificity, while physical neglect was most prone to underreporting on the ACEs scale. A small subset of women were characterized by high MD, reflecting tendencies to minimize their maltreatment histories across both instruments and also report significantly lower contemporaneous depression and PTSD symptoms than women with low MD. This study informs strengths and tradeoffs of two well-known instruments for assessing retrospectively-reported childhood maltreatment in low-income, vulnerable populations.