The relationship between childhood trauma and adult psychopathology has been explored in the literature. The goal of this study is to compare existing instruments that measure retrospective interpersonal gross childhood trauma. A computerized search from 1985 to March 2003 was performed to locate instruments used to measure childhood trauma. These were divided into interview-rated and self-report measures and were compared on various parameters. Twenty-one observer-rated and 21 self-report instruments were identified. In a comparison, five observer-rated measures and three self-report measures stand out for having favorable characteristics such as assessing multiple types of trauma and reporting on psychometric properties. A number of instruments are designed to measure a single type of trauma, usually sexual abuse, but most of these do not report psychometric properties. A few instruments used to measure retrospective childhood trauma are particularly useful for systematic research in adult psychiatric disorders.

Borderline pathology of childhood (BPC) may be a precursor of personality disorders. There is a lack of data concerning outcome in adolescence. A group of 59 adolescents, who had been treated as children in a Child Psychiatry Day Hospital five to seven years earlier, was evaluated. Using the child version of the Retrospective Diagnostic Interview for Borderlines, 28 participants had been diagnosed with BPC while the remaining 31 participants who did not have a history of BPC served as the comparison group. The youth and their parents were given a battery of measures assessing current psychopathology and functional status. The group with a history of BPC was more likely than the comparison group to exhibit a combination of internalizing and externalizing behavior problems. Adolescents with a history of BPC were more impaired than the comparison group on a global measure of functional status. Compared to children with no history of BPC, children diagnosed with BPC are more likely to display poorer functioning as adolescents and continue to be at risk for psychopathology during adolescence. Future directions for research are discussed.

Systematic knowledge about patient characteristics that predict the duration of long-term psychotherapy is largely absent. We examined predictors of attrition, retention, and duration of long-term dynamic psychotherapy to delineate the naturalistic history of psychotherapy, specifically focusing on childhood emotional neglect and abuse, adult diagnosis, personality, and functioning as predictors. Fifty-three adults with depressive, anxiety, and/or personality disorders (PDs) were offered at least 3 years of long-term dynamic psychotherapy. The median duration of therapy for the study group was 110 sessions (95% confidence interval [CI] 52-141). Nondynamic characteristics (including demographics; most Axis I diagnoses; depression, anxiety, and distress scores; social and global functioning; and the five personality factors) did not predict number of sessions. Dysthymic disorder, presence of any PD (particularly dependent PD [DPD]), emotional neglect in childhood, and higher adaptive defense style scores predicted a greater number of sessions, while obsessive-compulsive PD (OCPD) predicted fewer sessions. Emotional neglect, DPD, higher adaptive defenses, and OCPD were each unique predictors of duration. A session frequency less than 0.7 sessions per week (36 sessions per year) was associated with a three-fold higher risk for intrinsic attrition (relative risk = 3.04, 95% CI 1.10-8.44). Childhood emotional neglect as well as adult dependency may predispose patients to remain in therapy for longer durations, while some adaptive defenses may allow patients to contain the distressing affects that might otherwise lead to early termination. It remains to be seen whether longer durations of treatments are associated with respectively greater improvement, other things being equal, and whether these findings generalize to other types of treatment.

The expected sex differences, the rank order of symptom prevalence, the symptom clustering, and the associations with functional impairment and treatment-seeking behaviour support the construct validity of a brief questionnaire on parental major depression.