Development of a Childhood Attachment and Relational Trauma Screen (CARTS): a relational-socioecological framework for surveying attachment security and childhood trauma history

Abstract

Background: Current psychometric measures of childhood trauma history generally fail to assess the relational-socioecological context within which childhood maltreatment occurs, including the relationship of abusers to abused persons, the emotional availability of caregivers, and the respondent's own thoughts, feelings, and actions in response to maltreatment.

Objective: To evaluate a computerized approach to measuring the relational-socioecological context within which childhood maltreatment occurs.

Method: The psychometric properties of a Childhood Attachment and Relational Trauma Screen (CARTS) were evaluated as a retrospective survey of childhood maltreatment history designed to be appropriate for completion by adults. Participants were undergraduates (n=222), an internet sample (n=123), and psychiatric outpatients (n=30).

Results: The internal reliability, convergent, and concurrent validity of the CARTS were supported across samples. Paired differences in means and correlations between rated item-descriptiveness to self, mothers, and fathers also accorded with findings of prior attachment and maltreatment research, illustrating the utility of assessing the occurrence and effects of maltreatment within a relational-socioecological framework.

Conclusions: Results preliminarily support a new survey methodology for assessing childhood maltreatment within a relational-socioecological framework. Further psychometric evaluation of the CARTS is warranted.

Keywords: Child abuse and neglect; attachment; child maltreatment; family relationships; scale development; trauma.

Fig. 1

Illustration of the CARTS survey methodology. In this example, a respondent has been presented with the test item “I liked this person very much”, and each of the figures and labels would have initially been shown in black ink. That the majority of the figures and labels are presently in red ink illustrates that the respondent has indicated, by clicking on the following respective figures/labels that, when growing up as a child and adolescent, he liked himself, both of his parents, his older siblings (sister “Sarah” and brother “Joe”), and his grandparents (all denoted in red). However, the respondent has indicated, in omitting clicking “Uncle Gerald” (still denoted black), that he did not like his uncle very much. Should the respondent have wished to indicate that he did not like any of these persons, including her/himself, she/he would have clicked the brown box marked by an “X” and labeled “Not Applicable”. Clicking the “Next” button would occasion the presentation of a new test item, with all figures and labels returning to the default black ink. Different types of items were presented. For example, presented with an item indicative of “Physically Abusive” behavior (e.g., “This person slapped, smacked, or hit me”), the participant might have clicked on a different set of individuals, or indicating that “Physically Abusive” behavior had not occurred at all during his/her childhood by clicking “Not Applicable”.

Fig. 2

Structural equation model associating CARTS parental emotional availability with self-rated negative affect. Note: Errors not shown; errors for identical items between mother and father ratings (e.g., Mom-Sad, Dad-Sad) were permitted to correlate (not shown). Sample 1: Chi-square (21)=11.06, p=0.96. CFI>0.999. RMSEA<0.001 (PCLOSE>0.99). Sample 2: Chi-square (21)=20.92, p=0.46. CFI>0.999. RMSEA<0.001 (PCLOSE=0.78). Item numbers in brackets (see Table 1).