Table 1 Definitions of abuse, neglect, and household dysfunction that occurred before age 19 years

Abuse

Emotional

At least one of the following responses:

1. Often or very often a parent or other adult in the household swore at you, insulted you, or put you down.

2. Sometimes, often, or very often they acted in a way that made you think that you might be physically hurt.

Physical

At least one of the following responses:

1. Sometimes, often, or very often you were pushed, grabbed, slapped, or had something thrown at you.

2. Sometimes, often, or very often hit so hard that you had marks or were injured.

Sexual

At least one affirmative (yes) response about an adult or a person at least 5 years older:

1. Ever touched or fondled you in a sexual way.

2. Had you touch their body in a sexual way.

3. Attempted oral, anal, or vaginal intercourse with you.

4. Actually had oral, anal, or vaginal intercourse with you.

Neglect

Emotional

5 Childhood Trauma Questionnaire (CTQ) questions (Bernstein, et al., 1994) had possible responses of “never true’, “rarely true”, “sometimes true”, “often true”, or “very often true”. Responses were reverse scored on a Likert scale ranging from 5 to 1, respectively.

1. There is someone in my family who helped me feel important or special.

2. I felt loved.

3. People in my family looked out for each other.

4. People in my family felt close to each other.

5. My family was a source of strength and support.

A total cumulative score of 15 and higher (moderate to extreme on the CTQ clinical scale) defined childhood emotional neglect (Bernstein, et al., 1994).

Physical

5 Childhood Trauma Questionnaire (CTQ) questions (Bernstein, et al., 1994) had possible responses of “never true’, “rarely true”, “sometimes true”, “often true”, or “very often true”. Responses were scored on a Likert scale ranging from 1 to 5, respectively with items 2 and 5 reverse scored (5 to 1, respectively). :

1. You did not get enough to eat.

2. You knew there was someone to take care of you and protect you.

3. Your parents were too drunk or high to take care of the family.

4. You had to wear dirty clothes.

5. There was someone to take you to the doctor if you needed it.

A total cumulative score of 10 or higher (moderate to extreme on the CTQ clinical scale) defined childhood physical neglect (Bernstein, et al., 1994).

Household dysfunction

Witnessing domestic violence

At least one affirmative (yes) response to the following about your mother or stepmother:

1. Sometimes, often, or very often was pushed, grabbed, slapped, or had something thrown at her.

2. Sometimes, often, or very often was kicked, bitten, hit with a fist, or hit with something hard.

3. Was ever repeatedly hit over at least a few minutes.

4. Was ever threatened or hurt by a knife or gun.

Household substance abuse

At least one affirmative (yes) response about living with anyone (before age 18) who:

1. Was a problem drinker or alcoholic.

2. Used street drugs.

Household mental illness

At least one affirmative (yes) response about a household member who:

1. Was depressed or mentally ill.

2. Attempted suicide.

Parental separation or divorce

Parents were ever separated or divorced.

Incarcerated household member

A household member went to prison.