title: Minimization of Childhood Maltreatment Is Common and Consequential: Results from a Large, Multinational Sample Using the Childhood Trauma Questionnaire.
abstract: 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.
authors.affiliation: Department of Psychiatry, University of California San Diego, San Diego, California, United States of America.
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authors.lastname: MacDonald
authors.affiliation: Department of Psychiatry, University of California San Diego, San Diego, California, United States of America.
authors.forename: Michael L
authors.initials: ML
authors.lastname: Thomas
authors.affiliation: Department of Psychiatry & Behavioral Sciences, University of California Davis, Davis, California, United States of America.
authors.forename: Andres F
authors.initials: AF
authors.lastname: Sciolla
authors.affiliation: Department of Psychiatry, University of California San Diego, San Diego, California, United States of America.
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authors.affiliation: Department of Psychiatry, University of California San Diego, San Diego, California, United States of America.
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authors.lastname: Bleijenberg
authors.affiliation: Universität Heidelberg, Central Institute of Mental Health, Heidelberg, Germany.
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authors.lastname: Carpenter
authors.affiliation: University College Dublin, Dublin, Ireland.
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authors.initials: A
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authors.forename: Martin
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authors.affiliation: Department of Psychology, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Claudia
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authors.lastname: Fahlke
authors.affiliation: Bar Ilan University, Ramat Gan, Israel.
authors.forename: Ricky
authors.initials: R
authors.lastname: Finzi-Dottan
authors.affiliation: Bar Ilan University, Ramat Gan, Israel.
authors.forename: Tobi
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authors.lastname: Karu
authors.affiliation: School of Health Sciences, Jönköping University, Jönköping, Sweden.
authors.forename: Arne
authors.initials: A
authors.lastname: Gerdner
authors.affiliation: Department of Medical Psychology and Medical, University of Leipzig, Leipzig, Germany.
authors.forename: Heide
authors.initials: H
authors.lastname: Glaesmer
authors.affiliation: Department of Psychiatry and Psychotherapy, Helios Hospital Stralsund, Stralsund, Germany.|Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany.
authors.forename: Hans Jörgen
authors.initials: HJ
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authors.affiliation: Expert Center Chronic Fatigue, Radboud University Medical Center, Nijmegen, Netherlands.
authors.forename: Marianne
authors.initials: M
authors.lastname: Heins
authors.affiliation: University of Sydney, Sydney, Australia.
authors.forename: Dianna T
authors.initials: DT
authors.lastname: Kenny
authors.affiliation: Department of Psychiatry, Hanyang University Medical School, Seoul, South Korea.
authors.forename: Daeho
authors.initials: D
authors.lastname: Kim
authors.affiliation: Expert Center Chronic Fatigue, Radboud University Medical Center, Nijmegen, Netherlands.
authors.forename: Hans
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authors.lastname: Knoop
authors.affiliation: Department of Clinical Psychology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands.
authors.forename: Jill
authors.initials: J
authors.lastname: Lobbestael
authors.affiliation: University of Stellenbosch, MRC Unit on Anxiety & Stress Disorders, Department of Psychiatry, Stellenbosch, South Africa.
authors.forename: Christine
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authors.lastname: Lochner
authors.affiliation: Norwegian Institute for Alcohol and Drug research (SIRUS), and Norwegian Centre for Addiction Research (SERAF), University of Oslo, Oslo, Norway.
authors.forename: Grethe
authors.initials: G
authors.lastname: Lauritzen
authors.affiliation: Norwegian Institute for Alcohol and Drug research (SIRUS), and Norwegian Centre for Addiction Research (SERAF), University of Oslo, Oslo, Norway.
authors.forename: Edle
authors.initials: E
authors.lastname: Ravndal
authors.affiliation: University of North Texas, Denton, Texas, United States of America.
authors.forename: Shelley
authors.initials: S
authors.lastname: Riggs
authors.affiliation: Koç University Medical School, Istanbul, Turkey.
authors.forename: Vedat
authors.initials: V
authors.lastname: Sar
authors.affiliation: Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Ingo
authors.initials: I
authors.lastname: Schäfer
authors.affiliation: Research Department, Evangelical Hospital Bielefeld, Bielefeld, Germany.
authors.forename: Nicole
authors.initials: N
authors.lastname: Schlosser
authors.affiliation: National Institute on Alcohol Abuse and Alcoholism, Bethesda, Maryland, United States of America.
authors.forename: Melanie L
authors.initials: ML
authors.lastname: Schwandt
authors.affiliation: Department of Psychiatry, University of California San Diego, San Diego, California, United States of America.
authors.forename: Murray B
authors.initials: MB
authors.lastname: Stein
authors.affiliation: Department für Psychosomatic Medicine and Psychotherapy, University Medical Center of Mainz University, Mainz, Germany.
authors.forename: Claudia
authors.initials: C
authors.lastname: Subic-Wrana
authors.affiliation: Division of Substance Use Disorders, Psychiatric Hospital of the University of Basel, Basel, Switzerland.
authors.forename: Mark
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authors.lastname: Vogel
authors.affiliation: Department of Psychiatry, Charité University Berlin, Campus Benjamin Franklin, Berlin, Germany.
authors.forename: Katja
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mesh_terms: D002648:Child; D002649:Child Abuse / Q000523:psychology / Q000706:statistics & numerical data*; D003717:Denial, Psychological; D005260:Female; D006801:Humans; D008297:Male; D011569:Psychiatric Status Rating Scales; D011795:Surveys and Questionnaires
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