Factorial Structure Analysis of the Childhood Trauma Questionnaire among Thai Psychiatric Patients An Exploratory Factor Analysis (EFA)
Article Sidebar
Main Article Content
Abstract
Purpose: To examine the factorial structure of the Thai version of the Childhood Trauma Questionnaire by an Exploratory Factor Analysis among Thai psychiatric patients.
Design: A methodological research design.
Method: The sample consisted of 182 psychiatric inpatients aged 18–59 years who were diagnosed with psychiatric disorders according to the ICD-10 criteria. All participants exhibited violent behavior as a chief complaint requiring emergency psychiatric services and were admitted for inpatient treatment for at least two weeks. Data were collected using a demographic questionnaire and the Thai version of the Childhood Trauma Questionnaire. Descriptive statistics were used for data analysis, along with assessments of content validity, internal consistency (Cronbach’s alpha), and construct validity via exploratory factor analysis.
Main findings: The scale-level content validity index was .93, and Cronbach’s alpha for the 25-items Thai CTQ was .92. EFA using varimax rotation yielded a Kaiser-Meyer-Olkin (KMO) measure of .87 and a statistically significant Bartlett’s test of sphericity (p < .001). Five factors were extracted, explaining 70.3% of the total variance, with factor loadings ranging from .45 to .89.
Conclusion and recommendations: The Thai version of the Childhood Trauma Questionnaire demonstrates acceptable validity and reliability. It is appropriate for use in assessing childhood trauma experiences among Thai psychiatric patients.
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Copyright Notice: Nursing Science Journal of Thailand has exclusive rights to publish and distribute the manuscript and all contents therein. Without the journal’s permission, the dissemination of the manuscript in another journal or online, and the reproduction of the manuscript for non-educational purpose are prohibited.
Disclaimer: The opinion expressed and figures provided in this journal, NSJT, are the sole responsibility of the authors. The editorial board bears no responsibility in this regard.
References
World Health Organization. World mental health report: transforming mental health for all. Geneva: WHO; 2022. 272 p.
Bureau of Policy and Strategy, Ministry of Public Health. National mental health situation report 2023. Bangkok: Ministry of Public Health; 2023. 227 p. (in Thai).
World Health Organization. Child maltreatment [Internet]. Geneva: WHO; 2024 [cited 2025 Apr 16]. Available from: https://www.who.int/news-room/fact-sheets/detail/child-maltreatment.
Koss KJ, Gunnar MR. Annual research review: early adversity, the hypothalamic–pituitary–adrenocortical axis, and child psychopathology. J Child Psychol Psychiatry. 2018;59(4):327-46. doi: 10.1111/jcpp.12784.
Zannas AS, Chrousos GP. Epigenetic programming by stress and glucocorticoids along the human lifespan. Mol Psychiatry. 2017;22(5):640-6. doi: 10.1038/mp.2017.31.
Mothersill O, Tangney N, Morris DW, McCarthy H, Frodl T, Gill M, et al. Further evidence of alerted default network connectivity and association with theory of mind ability in schizophrenia. Schizophr Res. 2017;184:52-8. doi: 10.1016/j.schres.2016.11.043.
Herzog JI, Schmahl C. Adverse childhood experiences and the consequences on neurobiological, psychosocial, and somatic conditions across the lifespan. Front Psychiatry. 2018;9:420. doi: 10.3389/fpsyt.2018.00420.
McLaughlin KA, Weissman D, Bitran D. Childhood adversity and neural development: a systematic review. Annu Rev Dev Psychol. 2019;1:277-312. doi: 10.1146/annurev-devpsych-121318-084950.
Dierkhising CB, Luthar SS, Shoum K, Nitkin D. A longitudinal study of the effects of childhood trauma on the development of borderline personality disorder. J Pers Disord. 2019;33 Suppl:6-25. doi: 10.1521/pedi.2019.33.supp.6.
Afifi TO, Henriksen CA, Asmundson GJG, Sareen J. The relationship between child abuse, parental divorce, and lifetime mental disorders and suicidality in a nationally representative adult sample. Child Abuse Negl. 2009;33(3):139-47. doi: 10.1016/j.chiabu.2008.12.009.
Misiak B, Krefft M, Bielawski T, Moustafa AA, Sasiadek MM, Frydecka D. Toward a unified theory of childhood trauma and psychosis: a comprehensive review of epidemiological, clinical, neuropsychological and biological findings. Neurosci Biobehav Rev. 2017;75:393-406. doi: 10.1016/j.neubiorev.2017.02.015.
Bernstein DP, Fink L, Handelsman L, Foote J, Lovejoy M, Wenzel K, et al. Initial reliability and validity of a new retrospective measure of child abuse and neglect. Am J Psychiatry. 1994;151(8):1132-6. doi: 10.1176/ajp.151.8.1132.
Kongerslev MT, Bach B, Rossi G, Trauelsen AM, Ladegaard N, Løkkegaard SS, et al. Psychometric validation of the Childhood Trauma Questionnaire-Short Form (CTQ-SF) in a Danish clinical sample. Child Abuse Negl. 2019;94:104026. doi: 10.1016/j.chiabu.2019.104026.
Charoenchip P, Pornchaikate Au Yeong A, Kesornsri S. Factors predicting depressive symptoms among prisoners [master’s thesis]. Nakhon Pathom: Mahidol University; 2025. 197 p. (in Thai).
Uttachat B, Kesornsri S, Seeherunwong A, Lin EC. Factors predicting violent behavior of psychiatric patients receiving services in the emergency department of the psychiatric hospital [master’s thesis]. Nakhon Pathom: Mahidol University; 2025. 227 p. (in Thai)
Nunnally JC. Psychometric theory. New York: McGraw-Hill; 1978. 701 p.
Crocker L, Algina J. Introduction to classical and modern test theory. New York: Holt, Rinehart and Winston; 1986. 527 p.
Overall JE, Gorham DR. The brief psychiatric rating scale. Psychol Rep. 1962;10:799-812. doi: 10.2466/pr0.1962.10.3.799.
Kittirattanapaiboon P. The use and interpretation of the Brief Psychiatric Rating Scale (BPRS). Chiang Mai: Suanprung Hospital; 2001. (in Thai).
Benjehma R, Upasen R. Predicting factor of remission in persons with schizophrenia, Srithaya Hospital. Nursing Journal. 2020;47(4):66-75. (in Thai).
Brislin RW. Back-translation for cross-cultural research. J Cross Cult Psychol. 1970;1(3):185-216. doi: 10.1177/135910457000100301.
MacDonald K, Thomas ML, Sciolla AF, Schneider B, Pappas K, Bleijenberg G, et al. Minimization–denial and response bias on the Childhood Trauma Questionnaire: a meta-analytic review. Psychol Trauma. 2016;8(4):367-74. doi: 10.1037/tra0000073.
Hair JF, Black WC, Babin BJ, Anderson RE. Multivariate data analysis. 7th ed. Upper Saddle River (NJ): Pearson Education; 2010. 761 p.
Tabachnick BG, Fidell LS. Using multivariate statistics. 6th ed. Boston: Pearson; 2013. 983 p.
Watkins MW. Exploratory factor analysis: a guide to best practice. J Black Psychol. 2018;44(3):219-46. doi: 10.1177/0095798418771807.
Polit DF, Beck CT. The content validity index: Are you sure you know what's being reported? Critique and recommendations. Res Nurs Health. 2006;29(5):489-97. doi: 10.1002/nur.20147.
Paivio SC, Cramer KM. Factor structure and reliability of the Childhood Trauma Questionnaire in a Canadian undergraduate student sample. Child Abuse Negl. 2004;28(8):889-904. doi: 10.1016/j.chiabu.2004.01.011.
Scroope C. Thai culture - communication [Internet]. Perth, WA: Cultural Atlas; 2016 [cited 2025 Apr 16]. Available from: https://culturalatlas.sbs.com.au/thai-culture/thai-culture-communication.
van de Vijver FJR, Tanzer NK. Bias and equivalence in cross-cultural assessment: an overview. Eur Rev Appl Psychol. 2004;54(2):119-35. doi: 10.1016/j.erap.2003.12.004.
Beaton DE, Bombardier C, Guillemin F, Ferraz MB. Guidelines for the process of cross-cultural adaptation of self-report measures. Spine (Phila Pa 1976). 2000;25(24):3186-91. doi: 10.1097/00007632-200012150-00014.
