Skip to main content
    Trauma & stress · 0 items · 0–0 · Bernstein DP, Stein JA, Newcomb MD, et al. Development and validation of a brief screening version of the Childhood Trauma Questionnaire. Child Abuse Negl. 2003;27(2):169-190.

    Licensed instrument

    CTQ: scoring, cutoffs & interpretation

    Licensed childhood trauma questionnaire (Pearson). Not available to score here.

    Use these insteadPC-PTSD-5PCL-5

    02 - The clinician's brief

    Last reviewed: · Reviewed by Lotte Kjær Svalberg

    01 - What it measures

    What this scale measures.

    The Childhood Trauma Questionnaire (CTQ) is a retrospective self-report measure of childhood maltreatment for adults and adolescents aged 12 and over. The 28-item short form (CTQ-SF) covers five domains with five items each - emotional abuse, physical abuse, sexual abuse, emotional neglect and physical neglect - plus a three-item minimisation/denial validity scale that flags possible under-reporting.

    Items are rated on a five-point frequency scale from "never true" to "very often true", giving a score of 5 to 25 per subscale. It measures exposure history, not current symptoms: it quantifies what happened, not how the person is now.

    02 - Origin & purpose

    Where it comes from.

    The CTQ was developed by David Bernstein and colleagues, first published as a 70-item questionnaire in 1994 and reduced to the 28-item short form in 2003 after exploratory and confirmatory factor analyses across four samples. The commercial manual (Bernstein & Fink, 1998) is published by Pearson (The Psychological Corporation).

    Its purpose is to provide a brief, standardised way to screen for maltreatment history in clinical and research settings, where unstructured questioning is inconsistent and prone to omission. It is widely used in psychiatry, trauma research and epidemiology.

    03 - Scoring & cutoffs

    How scoring works.

    Each of the five subscales is scored from 5 to 25, with some items reverse-scored. The manual classifies each subscale into four severity bands: none (or minimal), low (to moderate), moderate (to severe), and severe (to extreme).

    The thresholds most widely used in research to indicate at least moderate maltreatment are: emotional abuse 13 or above, physical abuse 10 or above, sexual abuse 8 or above, emotional neglect 15 or above, and physical neglect 10 or above. A total score is sometimes summed across the 25 clinical items (25 to 125), but the manual's interpretation is subscale-based. The exact band tables are part of the licensed manual.

    04 - Validation evidence

    How well it performs.

    The CTQ has been validated in psychiatric inpatients and outpatients, substance-use samples, adolescents and community samples, and translated and validated in many languages. Recent work in trauma-focused treatment samples continues to support its reliability and criterion validity.

    0.61–0.95
    CRONBACH'S α (SUBSCALES)
    0.88
    TEST–RETEST ICC (~4 MTHS)
    5 factors replicated
    FACTOR STRUCTURE
    vs clinician ratings
    CONVERGENT VALIDITY

    05 - How it compares

    How it compares to the alternatives.

    Instrument
    Items
    Time
    When to reach for it
    CTQ
    28
    ~5–10 min
    Licensed. Graded severity across five maltreatment domains plus a minimisation/denial validity scale. Measures history, not symptoms.
    20
    ~5–10 min
    Free. Current PTSD symptom severity against DSM-5 criteria.
    5
    ~1 min
    Free. Rapid PTSD screen for primary care.
    10
    ~5 min
    Free. Current perceived stress, not trauma exposure.
    ACE Questionnaire
    10
    ~2 min
    Free. Counts categories of adverse childhood experiences - a simpler exposure count than the CTQ's graded severity. No page here yet.
    LEC-5
    17
    ~5 min
    Free. Lifetime exposure to potentially traumatic events at any age of occurrence. No page here yet.

    06 - When to use it

    Right tool, wrong tool.

    Reach for it when

    • -Graded, domain-specific quantification of childhood maltreatment where a licence is held.
    • -Research requiring a standardised maltreatment measure with a validity scale.
    • -Complementing symptom measures such as the PCL-5 when formulating the role of early adversity.

    Reach for something else when

    • -Measuring current PTSD symptoms: use the PCL-5.
    • -Rapid screening in primary care: use the PC-PTSD-5 or the free ACE questionnaire.
    • -Services without a Pearson licence: use the ACE questionnaire.
    • -Forensic fact-finding: a retrospective self-report cannot establish that events did or did not occur.

    07 - Confidence & precision

    Reading the score with care.

    Retrospective self-reports are stable but imperfect: the minimisation/denial scale exists precisely because under-reporting is common. Scores are best read as bands rather than precise points, and a single-band change between administrations is more likely measurement noise than genuine change in a historical construct. No minimal clinically important difference applies, since the construct is historical exposure rather than a treatment target.

    08 - Limitations

    What it cannot tell you.

    The CTQ is a licensed instrument: items cannot be reproduced, and the forms and manual must be purchased from Pearson.

    The physical neglect subscale shows weak internal consistency, with alpha as low as about 0.61, and its items function inconsistently across cultures. Retrospective recall bias operates in both directions. The measure does not capture age of onset, duration or perpetrator, and its cutoffs derive largely from North American samples.

    09 - Licensing, explained

    How licensing works.

    The CTQ is published and licensed by Pearson. A paid licence is required to use and score it, which is why no items or interactive calculator appear on this page.

    Common questions from clinicians

    FAQ

    References

    Source literature.

    1. [1]Bernstein DP, Fink L, Handelsman L, et al. Initial reliability and validity of a new retrospective measure of child abuse and neglect. American Journal of Psychiatry (1994)
    2. [2]Bernstein DP, Fink L Childhood Trauma Questionnaire: a retrospective self-report manual. San Antonio: The Psychological Corporation (1998)
    3. [3]Bernstein DP, Stein JA, Newcomb MD, et al. Development and validation of a brief screening version of the Childhood Trauma Questionnaire. Child Abuse & Neglect (2003)
    4. [4]Scher CD, Stein MB, Asmundson GJG, McCreary DR, Forde DR The Childhood Trauma Questionnaire in a community sample: psychometric properties and normative data. Journal of Traumatic Stress (2001)
    5. [5]Hoeboer CM, Bodor N, Oprel DAC, et al. Validation of the Childhood Trauma Questionnaire (CTQ) in the context of trauma-focused treatment. Child Maltreatment (2026)

    Scale without compromise

    See how Aisel removes friction where it costs most. A 20-minute walkthrough tailored to your clinic.