Psychometric properties of the Hungarian Childhood Trauma Questionnaire Short Form and its validity in patients with adult Attention-Deficit Hyperactivity Disorder or Borderline Personality Disorder

Abstract

Abstract Background A convincing body of research has identified childhood traumatization as an important etiological factor for psychiatric disorders, including adult attention-deficit hyperactivity disorder (aADHD) and borderline personality disorder (BPD). The aim of this study was to examine the psychometric properties of the Hungarian version of the Childhood Trauma Questionnaire Short Form (H-CTQ-SF) and to investigate the differences between patients diagnosed with aADHD and BPD in terms of early traumatization. Methods Altogether 765 (mean age = 32.8 years, 67.7% women) patients and control subjects were enrolled from different areas of Hungary. Principal component analysis and confirmatory factor analysis were carried out to explore the factor structure of H-CTQ-SF, and test the validity of the five-factor structure. Discriminative validity was assessed by comparing clinical and non-clinical samples. Subsequently, aADHD and BPD subgroups were compared with healthy controls to test for alterations in aADHD not attributable to comorbid BPD, by excluding comorbid cases. Convergent validity was explored by measuring correlations with subscales of the Personality Inventory for DSM-5 (PID-5). Results The five scales of the H-CTQ-SF demonstrated adequate internal consistency and reliability values. The five-factor model fit the 27-item Hungarian version well, after the removal of one item from the physical neglect scale because of its cross loading onto the emotional neglect subscale. The H-CTQ-SF effectively differentiated between the clinical and non-clinical samples. The BPD group showed significant differences in each CTQ domain compared to the healthy control group, while there were no such differences in the aADHD group. All CTQ domains, except for physical abuse, demonstrated medium to high correlations with PID-5 emotional lability, anxiousness, separation insecurity, withdrawal, intimacy avoidance, anhedonia, depressivity, suspiciousness, hostility subscales. Conclusions This study provides data about the psychometric properties of the H-CTQ-SF, an easy-to-administer, non-invasive, ethically sound questionnaire. In aADHD patients without comorbid BPD, low levels of traumatization in every CTQ domain are demonstrated comparable to healthy control individuals. Thus, elevated level of traumatization found in former studies of aADHD might be a consequence of comorbid BPD. Our findings also support the role of emotional neglect, emotional abuse and sexual abuse in the development of BPD.