Everson, D.M., Smith, B.J., Hussey, M.J., English, D., Litrownik, J.A., Dubowitz, H., et al. (2008). Concordance between adolescent reports of childhood abuse and child protective service determinations in an at-risk sample of young adolescents. Child Maltreatment, 13(1), 14-26.
Retrospective self-reports are commonly used to assess childhood maltreatment. This study examined the validity of retrospective adolescent self-reports of childhood maltreatment in two ways: 1) by identifying a sample of adolescents who were identified prior to age 2 as being at elevated risk of childhood maltreatment; and 2) by assessing the use of audio computer-assisted self-interviews (A-CASI) in identifying adolescent history of childhood maltreatment. The adolescent interviews assessed behaviour-related questions regarding past abusive experiences. Child protective services (CPS) case records were also used as a source of reported childhood maltreatment data. The results indicate that adolescents’ reported prevalence rates of childhood maltreatment were 4 to 6 times higher than those documented on CPS case records.
Twenty one percent of the adolescents reported physical abuse, 9% reported sexual abuse, and 39% reported psychological abuse by parents or caregivers. Concordance between adolescents’ self-reports and CPS records varied from 63% for psychological abuse, to 78% for physical abuse, and 92% for sexual abuse. The high concordance rate for physical and sexual abuse was a result of cases in which adolescents and CPS records agreed that no abuse occurred.
Retrospective self-reports of childhood maltreatment showed poor concordance with CPS case records of documented childhood maltreatment. This was because the adolescents disclosed high rates of previously undocumented childhood maltreatment during their interviews. Forty-four percent of adolescents interviewed did not disclose childhood maltreatment in cases where CPS agencies determined that physical, sexual, or psychological abuse likely occurred. The high rates of nondisclosure suggest the presence of motivational factors that may have influenced self-reporting of childhood maltreatment.
The findings suggest that the A-CASI instrument is successful in identifying childhood maltreatment with adolescents, and that the use of both adolescent self-reports of childhood maltreatment and CPS records provides the greatest accuracy for measuring childhood maltreatment.
The study data were generated from two Longitudinal Studies of Child Abuse and Neglect (LONGSCAN) consortium sites (N=350). One sample (n=186) was recruited from urban, university-based pediatric clinics when the recipients were younger than age 2 and receiving services for failure to thrive. The other sample (n=164) were children who were identified by the state public health program as being at high risk for poor medical and developmental outcomes. Adolescents were asked about their possible childhood maltreatment using the LONGSCAN self-report of physical, sexual, and psychological abuse based on the A-CASI format. Their caregivers completed the Child Behavior Checklist (CBCL) assessing their perceptions of the adolescents’ behavioral problems. Regression analyses examined: 1) prevalence rates of childhood maltreatment reported by adolescents during the A-CASI interview, the rates documented in the CPS records, and the concordance between them; 2) the rate of adolescent self-reports of childhood maltreatment compared to CPS findings of maltreatment; and 3) the comparative predictive validity of adolescent self-reports with CPS findings. Limitations of this study include a small sample size for a study of this type, the need to examine the characteristics and motivation of adolescents who fail to report documented childhood maltreatment, and the use of dichotomous categorization of occurrence and non-occurrence of childhood maltreatment.