Temporal stability and state-dependence of retrospective self-reports of childhood maltreatment in major depression: a two-year longitudinal analysis of the childhood trauma questionnaire

2021 
Background: Retrospective self-reports of childhood maltreatment are widely used in research and clinical practice. However, their validity has been questioned due to potential depressive bias. Yet, systematic investigations of this matter are sparse. Thus, we investigate if and to what extent retrospective maltreatment reports vary in relation to longitudinal changes in depressive symptomatology. Methods: Two-year temporal stability of maltreatment reports was assessed via the Childhood Trauma Questionnaire (CTQ). Diagnosis and depressive symptoms were assessed using clinical interview and the Beck Depression Inventory. From two independent cohorts (MACS and MNC) we included a total of n=347 major depressive disorder (MDD) patients, n=419 healthy controls (HC), and a subsample with a lifetime first depressive episode between both assessments (n=27). Analysis plan and hypotheses were preregistered prior to data sighting. Results: Maltreatment reports were highly stable in HC and MDD patients across both cohorts (ICC=.956; 95%-CI[.949, .963] and ICC=.950; 95%-CI[.933, .963]) and temporal stability did not differ between groups. Stability was lower for cutoff-based maltreatment categorization (K=.551; 95%-CI[.479, .622] and K=.507; 95%-CI[.371, .640]). Baseline maltreatment reports were associated with concurrent and future depression severity. However, longitudinal changes in depression severity predicted variability in CTQ scores only to a small extent across cohorts (b=0.101, p=.009, R2=.021 and b=0.292, p=.320), with the effect being driven by emotional maltreatment subscales. Conclusions: Findings suggest that the CTQ provides temporally stable self-reports of childhood maltreatment in healthy and depressed populations, and are only marginally biased by depressive symptomatology. Gradual rather than categorical conceptualization of maltreatment is advised for improving psychometric quality.
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