Multiple informants and data sources were used to obtain a best estimate of children’s trauma history (24). An index of total trauma exposure was created for all subjects. Experiences assessed included the following: physical abuse, sexual abuse, domestic violence exposure, multiple out-of-home placements, and community violence exposure. Each adversity was rated on a 0–2 point scale and summed to create the TTES (see Table 2). In general, scores of 0 indicate the child was not exposed to this experience, scores of 1 indicate mild or subthreshold experiences, and scores of 2 indicate clinically significant experiences—experiences of sufficient severity to warrant state intervention. Measures reviewed to derive the TTES for maltreated and control children included the following: state child protective service records, the Child Trauma Questionnaire (25), the Partner Violence Inventory (26), and the posttraumatic stress disorder (PTSD) trauma screen from the psychiatric interview administered in this study (27). The TTES scales are the same as the 0- to 4-point Child Maltreatment Rating Scales we previously published (24), but given that the control subjects were also being rated with these scales,
