Lifelines participants underwent the Childhood Trauma Questionnaire (CTQ) short-form, a self-report instrument covering 28 items, to rate the severity of traumas experienced in their childhood (section: mental health).

The physical health consequences of psychosocial adversities may be as substantial as the mental health consequences. A multinational study in 10 countries showed that childhood psychosocial adversities and early-onset mental disorders have independent, broad-spectrum effects that increase the risk of diverse chronic physical conditions in later life, including heart disease, asthma, diabetes mellitus, arthritis, chronic spinal pain, and chronic headache ¹⁾.
Another multinational study showed a higher effect on myocardial infarction for psychosocial stress (OR 2.67) than for hypertension (OR 1.91), diabetes (OR 2.37) or an unhealthy lifestyle ²⁾.
Traumatic childhood events (TCEs) also constitute a key environmental exposure that should be studied in gene-environment interaction studies. It was recently shown that a variant in the MTHFR gene confers a higher risk for recurrence of depression in combination with exposure to TCEs ³⁾.

The CTQ includes 5 domains:

• emotional abuse
• emotional neglect
• physical abuse
• physical neglect
• sexual abuse

Each dimension comprises of 5 questions and additionally there are 3 questions on a minimization/denial scale. Particiants are asked in how far the statements applies to their childhood on a 5-point Likert scale with the following options: 1 Never true, 2 Rarely true, 3 Sometimes true, 4 Often true, 5 Very often true.

The CTQ has been validated in terms of psychometric test properties in various populations ⁴⁾⁵⁾⁶⁾.