Childhood Attachment and Relational Trauma Screen
PI: Paul Frewen, PhD, C.Psych, Western University, Canada, e-mail: pfrewen-AT-gmail.com
Dean Ajdukovic, Anne Bakker, Doug Brewer, Marylene Cloitre, Grete Dyb, Paul Frewen, Juli Lanza, Brigitte Lueger Schuester, Gladys Mwiti, Misari Oe, Miranda Olff, Janaina Pinto, Rita Rosner, Carolina Salgado, Ingo Schaefer, Julia Schellong, Ueli Schnyder, Jun Shigemura, Kitty Wu.
Childhood maltreatment is an unfortunately common occurrence. The World Health Organization reports that nearly 3 in every 4 children experience physical punishment and psychological violence from caregivers in the early years of life and nearly one in every five girls and one in every 13 boys are sexually abused the world over. Childhood abuse and neglect are widely known to be serious risk factors for mental and physical health problems throughout lifetime.
In brief, the CARTS administering face valid items to determine the “who done it” aspect of childhood traumatic occurrences; for example, “This person punched and kicked me” is either referred to one or more persons (e.g., caregivers, siblings, non-family members) or is instead considered “not applicable”. In addition to querying about overt childhood maltreatment, CARTS assesses the general affective quality of familial relationships (e.g., by presenting the survey description “This person loved me” and querying whether the description applies to various family members.
The CARTS is a "computer-based self-report measure designed to assess overt instances of childhood maltreatment, as well as the general warmth, security and supportiveness of individuals within the respondents’ family and external environment" (Simonelli et al., 2017). It is a computerized survey of individuals’ recollections of the quality of their relationships with their family members during childhood, and of relational traumatic experiences occurring during childhood (Frewen et al., 2013, 2015).
The available assessment tools tend to overlook the socio-ecological and relational context of childhood trauma. For this reason developed the CARTS, as "an innovative assessment tool designed to measure instances of child abuse as well as warmth, security and support within the family, thus providing a socio-ecological relational perspective. This feature enables the evaluation of the subjective perception of the traumatic relational context, rather than only the frequency and severity of such experiences " (Simonelli et al., 2017), see also Olff et al., 2020).
We are investigating the use of a novel online survey methodology assessing childhood trauma history called the Childhood Attachment and Relational Trauma Screen (CARTS) in several different languages and cultures.
Participants were invited to complete the CARTS as a survey about individuals’ recollections of the quality of their relationships with their family members during childhood, and of relational traumatic experiences occurring during childhood.
We are pleased to write that, as of the September 2021, the CARTS has been accessed online by over 8500 participants. A recent publication attests to the validation of data so far collected in the German language similar to prior findings collected for responses in Italian (Leuchter et al, 2021). Further, data continues to accumulate in multiple other languages including Dutch, Spanish, French, Turkish, Croatian, Japanese, Chinese, and Russian; for example, nearly 1000 responses have been collected in Greek.
The data collection has been finalized and data analysis comparing responses collected in various languages with eye toward understanding not only describing the immediate familial but also broader social and cultural contexts of childhood trauma is ongoing.
Hopefully with better assessments, education, and interventions we can limit the occurrences of childhood trauma for future generations, and reduce their long term consequences for PTSD and other mental health outcomes.
CARTS has been translated in several languages and will be made available through this website as well as a summary of the study's findings.
Frewen, P. A., Evans, B., Goodman, J., Halliday, A., Boylan, J., Moran, G., … Lanius, R. A. (2013). Development of a childhood attachment and relational trauma screen (CARTS): Arelational-socioecological framework for surveying attachment security and childhood trauma history. European Journal of Psychotraumatology, 4, 1–17. doi:10.3402/ejpt.v4i0.20232
Frewen, P. A., Brown, M. F. D., De Pierro, J., D’Andrea, W., & Schore, A. (2015). Assessing the family dynamics of childhood maltreatment history with the childhood attachment and relational trauma screen (CARTS). European Journal of Psychotraumatology, 6(1), doi: 10.3402/ejpt.v6.27792.
Olff, M., Bakker, A., Frewen, P., Aakvaag, H., Ajdukovic, D., Brewer, D., Elmore Borbon, D.L., Cloitre, M., Hyland, P., Kassam-Adams, N., Knefel, M., Lanza, J.A., Lueger-Schuster, B., Nickerson, A., Oe, M., Pfaltz, M.C., Salgado, C., Seedat, S., Wagner, A., Schnyder, U. & Global Collaboration on Traumatic Stress (GC-TS) (2020). Screening for consequences of trauma – an update on the global collaboration on traumatic stress. European Journal of Psychotraumatology, 11(1), 1752504 https://doi.org/10.1080/20008198.2020.1752504
Leuchter, L., Frewen, P., & Lueger-Schuster, B. (2021). Validation and cross-cultural comparisons of the German Childhood Attachment and Relational Trauma Screen (CARTS). European journal of psychotraumatology, 12(1), 1918901. https://doi.org/10.1080/20008198.2021.1918901
Simonelli, A., Sacchi, C., Cantoni, L., Brown, M., & Frewen, P. A. (2017). Italian translation and cross-cultural comparison with the Childhood Attachment and Relational Trauma Screen (CARTS). European Journal of Psychotraumatology, 8(1). doi: 10.1080/20008198.2017.1375839