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. 2023 Nov 17;10(1):33.
doi: 10.1186/s40479-023-00239-8.

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

Eszter Kenézlői  1   2 , Eszter Csernela  3 , Zsófia Nemoda  4 , Krisztina Lakatos  5 , Boldizsár Czéh  6   7 , Zsolt Szabolcs Unoka  2 , Mária Simon #  3 , János M Réthelyi #  8
Affiliations

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

Eszter Kenézlői et al. Borderline Personal Disord Emot Dysregul. .

Abstract

Background: Compelling evidence supports the role of childhood traumatization in the etiology of 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 the role of early trauma in aADHD without comorbid BPD. 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 fitted the Hungarian version well after exclusion 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, but not the aADHD group showed significant differences in each CTQ domain compared with the healthy control 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, and hostility subscales.

Conclusions: Our study confirmed 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 were comparable to those of healthy control individuals. Thus, the increased level of traumatization found in previous studies of aADHD might be associated with the presence of comorbid BPD. Our findings also support the role of emotional neglect, emotional abuse and sexual abuse in the development of BPD.

Keywords: Adult attention-deficit hyperactivity disorder (aADHD); Borderline personality disorder (BPD); Childhood adversity; Childhood maltreatment; Confirmatory factor analysis; Early life traumatization; Hungarian Childhood Trauma Questionnaire Short Form (H-CTQ-SF); Personality inventory for DSM-5 (PID-5); Principal component analysis.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Differences between the clinical (n = 252) and non-clinical (n = 347) samples in terms of CTQ subscales Legend: Values represent mean + standard deviation. Statistics: Mann–Whitney U-test. *** p < .001
Fig. 2
Fig. 2
The CTQ subscales in BPD (n = 60), aADHD (n = 78) and screened control groups (n = 98) Legend: Values represent mean + standard deviation. Statistics: one-way ANOVA followed by Bonferroni post hoc tests. ** p < .01; *** p < .001
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