Cay Mariesa, Chouinard Virginie-Anne, Hall Mei-Hua, Shinn Ann K
Schizophrenia and Bipolar Disorder Program, Psychotic Disorders Division, McLean Hospital, Belmont, MA, USA; Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Boston, MA, USA.
Schizophrenia and Bipolar Disorder Program, Psychotic Disorders Division, McLean Hospital, Belmont, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA.
J Psychiatr Res. 2022 Dec;156:78-83. doi: 10.1016/j.jpsychires.2022.09.053. Epub 2022 Oct 5.
Childhood trauma is common and associated with worse psychiatric outcomes. Yet, clinicians may not inquire about childhood trauma due to a misconception that patients cannot provide reliable reports. The goal of this study was to examine the reliability of self-reports of childhood trauma in psychotic disorders.
We examined the test-retest reliability of the Childhood Trauma Questionnaire (CTQ) in schizophrenia (SZ, n = 19), psychotic bipolar disorder (BD, n = 17), and healthy control (HC, n = 28) participants who completed the CTQ on ≥2 occasions over variable time periods (mean 19.6 months). We calculated the intraclass correlation (ICC) for the total CTQ score, each of the five CTQ domains, and the minimization/denial subscale for the three groups. For any CTQ domains showing low test-retest reliability (ICC < 0.61), we also explored whether positive, negative, depressive, and manic symptom severity were associated with CTQ variability.
We found high ICC values for the total CTQ score in all three groups (SZ 0.82, BD 0.85, HC 0.88). The ICC values for CTQ subdomains were also high with the exceptions of scores for sexual abuse in BD (0.40), emotional neglect in SZ (0.60), and physical neglect in BD (0.51) and HC (0.43). In exploratory analyses, self-reports of sexual abuse in BD were associated with greater severity of depressive symptoms (β = 0.108, p = 0.004).
Patients with SZ and BD can provide reliable self-reports of childhood trauma, especially related to physical and emotional abuse. The presence of psychosis should not deter clinicians from asking patients about childhood trauma.
儿童期创伤很常见,且与更差的精神科预后相关。然而,临床医生可能不会询问儿童期创伤,因为他们存在一种误解,认为患者无法提供可靠的报告。本研究的目的是检验精神病性障碍中儿童期创伤自我报告的可靠性。
我们检验了儿童创伤问卷(CTQ)在精神分裂症(SZ,n = 19)、精神病性双相情感障碍(BD,n = 17)和健康对照(HC,n = 28)参与者中的重测信度,这些参与者在不同时间段(平均19.6个月)内≥2次完成了CTQ。我们计算了三组的CTQ总分、五个CTQ领域中每个领域以及最小化/否认分量表的组内相关系数(ICC)。对于任何重测信度较低(ICC < 0.61)的CTQ领域,我们还探讨了阳性、阴性、抑郁和躁狂症状严重程度是否与CTQ变异性相关。
我们发现三组中CTQ总分的ICC值都很高(SZ为0.82,BD为0.85,HC为0.88)。CTQ子领域的ICC值也很高,但BD组中性虐待得分(0.40)、SZ组中情感忽视得分(0.60)以及BD组(0.51)和HC组(0.43)中身体忽视得分除外。在探索性分析中,BD组中性虐待的自我报告与抑郁症状更严重相关(β = 0.108,p = 0.004)。
精神分裂症和双相情感障碍患者能够提供可靠的儿童期创伤自我报告,尤其是与身体和情感虐待相关的报告。精神病的存在不应阻止临床医生询问患者有关儿童期创伤的情况。