Psychometric validation of the Childhood Trauma Questionnaire-Short Form (CTQ-SF) in a Danish clinical sample.

BACKGROUND: The Childhood Trauma Questionnaire - Short Form (CTQ-SF) is a widely utilized self-report instrument in the assessment and characterization of childhood trauma. Yet, research on the instrument's psychometric properties in clinical samples is sparse, and the Danish version of the CTQ-SF has not been previously evaluated in clinical samples. OBJECTIVES: To examine the structural validity, internal consistency reliability, and multi-method convergent validity of the CTQ-SF in a heterogenous clinical sample from Denmark. PARTICIPANTS AND SETTING: The study was based on data from four Danish clinical samples (N = 393): 1) Outpatients diagnosed with personality disorders, 2) Patients commencing psychiatric treatment for non-affective first-episode psychosis, 3) Patients diagnosed with first-episode or prolonged depression recruited from general practitioners and an outpatient mood disorder clinic, and 4) detained delinquent boys. METHODS: Confirmatory factor analysis was used to explore structural validity. Also, we calculated internal consistency and multi-method convergent validity with interview-based ratings of adverse parenting. RESULTS: Confirmatory factor analyses indicated that the five-factor structure described in CTQ-SF manual with three error correlated items best fitted the data, as compared to various other models. Coefficients of congruence also supported factorial similarity across countries (i.e. US substance abuser and a mixed Brazilian sample). Internal consistency reliability was acceptable and comparable to estimates previously published. Multi-method convergent validity associations further corroborated the validity of the CTQ-SF. CONCLUSION: These findings provide support for the reliability and validity of the Danish version of the CTQ-SF in clinical samples.

Psychological Flexibility as a Buffer against Caregiver Distress in Families with Psychosis.

Background: Research has shown that caregivers of persons with psychosis play an invaluable role in recovery, but unfortunately, often report high levels of distress. While cognitive models of caregiver distress have been well-supported, there is still limited knowledge of the psychological factors involved. Recent advances in cognitive behavioral therapy seem to converge on the importance of acceptance- and mindfulness based processes. Aim: To examine the impact of psychological flexibility on caregiver distress in the early phases of psychosis, while controlling for known predictors of caregiver distress. Method: Within a cross-sectional design, 101 caregivers of 38 persons with first-episode psychosis in a clinical epidemiological sample completed a series of self-report measures. Results: A linear mixed model analysis found that, after controlling for caregiver socio-demographic factors, service user symptoms, drug use and global functioning, psychological flexibility was a significant predictor of caregiver distress. Conclusion: Greater level of psychological flexibility in caregivers, seems to be related to lower levels of caregiver distress. This finding corresponds to studies within a broad range of emotional disorders. There may be important clinical implications in terms of facilitating the process of acceptance through interventions from the 'third-wave' or contextual cognitive behavioral therapies.

Positive and negative caregiver experiences in first-episode psychosis: emotional overinvolvement, wellbeing and metacognition.

OBJECTIVES: While caregivers of persons with first-episode psychosis often report a range of negative experiences, little is known about what psychological factors are involved. The aim of this study was to examine how caregivers' general wellbeing, emotional overinvolvement and metacognition influenced their reports of both positive and negative caregiving experiences. DESIGN: A prospective consecutive cross-sectional study. METHODS: Forty caregivers of patients with first-episode psychosis were interviewed using semi-structured interview and questionnaires. RESULTS: Greater levels of distress and overinvolvement were associated with more negative experiences of caregiving while greater metacognitive capacity was associated with more positive experiences of caregiving. CONCLUSIONS: The experience of positive and negative aspects of caregiving seems to be associated with different variables. Greater metacognitive capacity does not necessarily alleviate the suffering and distress, which is a healthy and normal reaction to having a close one suffering from psychosis. But it might help broaden the perspective, allowing for both negative and positive experiences. Clinical implications in terms of expanding the range of therapeutic interventions are discussed. PRACTITIONER POINTS: Assessing the capacity for metacognition in a non-clinical population. Understanding what factors are involved in positive and negative caregiver experiences in first-episode psychosis. A broadening of family interventions by encompassing the concept of metacognition.