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Preliminary validation of the child abuse potential inventory in chile1
Child Abuse & Neglect, Vol. 22, No. 9, pp. 869 – 879, 1998 Copyright © 1998 Elsevier Science Ltd Printed in the USA. All rights reserved 0145-2134/98 $19.00 1 .00
Pergamon
PII S0145-2134(98)00071-4
PRELIMINARY VALIDATION OF THE CHILD ABUSE POTENTIAL INVENTORY IN CHILE ANA MARIA HAZ
AND
VALERIA RAMIREZ
Escuela de Psicologia, Pontificia Universidad Cato´lica de Chile, Santiago, Chile
ABSTRACT Objective: The objective of this work is a preliminary validation in Chile of the Child Abuse Potential (CAP) Inventory (Milner, 1986). Method: A sample of 134 participants was drawn from Santiago’s Metropolitan Area and the city of Iquique in Chile, divided into two groups: people identified as physical abusers of their own children and people identified as nonabusers. As a result of the sampling procedure, the study group was composed of 64 women and three men. This distribution was matched in the control group. A reliability analysis, a predictive and construct validity analysis, and an item analysis of the Abuse Scale proposed by Milner were performed. Results: The Abuse Scale items were tabulated both with the weighted scores proposed by Milner and with simple scores. The results were more consistent with simple scores. It correctly classified 90% of respondents (91% in the abuse group and 88% in the control group). Of the 76 items of the Abuse Scale, 55 were highly discriminatory, six of them were nonsignificant and 15 of them had differences that were not great enough so as to discriminate people well. To evaluate the dimensionality of the items, a factor analysis was carried out. The best solution (Oblimin rotation) was obtained with 6 factors, which accounts for 53.8% of the variance. Conclusion: Milner’s Abuse Scale discriminated between abusing and nonabusing individuals, and showed a factor analysis similar to the original one. Some items reflected cultural conducts in Chile instead of potential abuse: they are related with socially desirable neatness and cleanness of children and home, specially in low-income families. © 1998 Elsevier Science Ltd Key Words—Child abuse screening, Psychometric characteristics of instrument, Transcultural validation of instrument.
INTRODUCTION OVER THE LAST decade Chilean society has began to consider child abuse as a social problem and to adopt preventive and protective initiatives. In 1994 the National Congress enacted a law on intrafamily violence. The Chilean law defines physical child abuse as the use of violent acts upon children and adolescents under 18 years of age by their parents or other people responsible for them. Injury may be either intentional or not and may derive from either allegedly disciplinary actions or from negative and hostile feelings towards the child. Intervention programs have been developed in hospitals, mental health, and community centers, but their coverage is very limited in relation to the scope of the problem, and they generally undertake the abuse phenomenon when it has already occurred. Within this context, it is important to develop instruments that enable accurate child abuse assessment.
This paper was funded by Fondo Nacional de Desarrollo Cientı´fico y Tecnolo´gico (FONDECYT), project # 1930695, year 1993. Received for publication May 13, 1996; final revision received January 6, 1998; accepted January 15, 1998. Reprint requests should be addressed to Ana Marı´a Haz, Escuela de Psicologı´a, Pontificia Universidad Cato´lica de Chile, Avda. Vicun˜a Mackenna 4860, Santiago, Chile. 869
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This paper reports the preliminary adaptation of the Child Abuse Potential Inventory (CAP; Milner, 1986). The CAP was designed in the US by Joel S. Milner in 1980, in order to evaluate an individual’s personality and social and family interactional traits, so as to determine physical child abuse potential. The CAP is a screening device and is not intended to be used as a diagnostic instrument. The Inventory consists of 160 items, 77 of which constitute the Abuse Scale. It also contains items that belong to an experimental abuse scale and to a negligence scale. The CAP was designed as a self-report questionnaire and is easy to understand and administer. The respondent must answer each statement in a forced-choice, agree-disagree format. Based on beta-coefficient weights obtained in a regression analysis carried out in the US, Milner has proposed a differential weighting of the Abuse Scale items and two cut-off scores (215 and 166), that is, the value at and over which the respondent may be considered at risk for committing physical child abuse. Milner suggests the score of 215 when samples are drawn from the general population and 166 when extreme abuser and nonabuser groups are compared. Milner (1993) points out that the instrument can also be scored without weighting the items, applying values of either 1 or 0 to them, given that weighting only modestly improves the classification rates. Past analyses of the CAP have revealed appropriate discriminant validity of the instrument. In the US the CAP Abuse Scale has correctly classified between 80% and 90% of abusive and nonabusive individuals (Milner, 1986), and in Spain—Paı´s Vasco—(DePau´l, Arruabarrena, & Milner, 1991) and in Argentina (Bringiotti & Barbich, 1992), more than 90% of the participants. The internal consistency of the Abuse Scale applied in the US has yielded values between .92 and .96, estimated by KR-20 coefficient (Milner, 1989), whereas the split-half reliability was estimated at .94 (Milner & Ayoub, 1980). Several concurrent validity studies performed on the Abuse Scale report that it shows correlation with several factors which have been associated with physical child abuse, such as childhood history of abuse (Milner, Robertson, & Rogers, 1990), physiological reactivity to child-related stimuli (Pruitt & Erickson, 1985), type of locus of control (Ellis & Milner, 1981), ego-strength (Robertson & Milner, 1983), and self-esteem (Anderson & Lauderdale, 1982). On the basis of studies conducted in the US, it was possible to determine, through a factor analysis, six subscales in the Abuse Scale (Milner, 1990), which will be referred to later. In addition, the CAP Inventory contains three validity scales: a lie scale, an inconsistency scale, and a random response scale. These scales are combined to yield three response distortion indexes: a faking-good index (the respondents represent themselves “better” than they are), a faking-bad index (persons represent themselves “worse” than they are), and a random response index. These indexes allow detection of those questionnaires which have questionable validity (Milner, 1990). It was deemed convenient to adapt the CAP Inventory for Chile, given its considerable discriminant ability and high reliability and validity (Milner, 1986). It has good psychometric properties and it is the only instrument of this kind being adapted in Latin population. The main objective was to carry out a preliminary evaluation of the CAP Inventory. It was tested for discriminatory power and validity. METHOD Participants A sample of 134 persons was drawn from Santiago’s Metropolitan Region and the northern city of Iquique in Chile, divided into two groups: 1. The study group was composed of 67 parents recruited from several public hospitals and community institutions specialized in intervention with maltreating parents. Maltreatment status
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Table 1. x2 and its Significance as an Homogeneity Test of Sample Groups in the Criterion Variables Variable
x2
df
n
p
Gender of Respondent Range of Age of Respondent Marital Status of Respondent Socio-Economic Level of Family Educational Level of Respondent Gender of Child Range of Age of Child
.00 8.07 .06 .40 .83 .03 3.72
1 7 5 3 5 1 5
134 134 134 134 134 134 134
1.00 .33 1.00 .94 .97 .85 .59
was determined by a professional who worked in the treatment center. The detection system in Chile is in a preliminary stage, so that if some bias exist, it is toward the detection of the most severe cases. In the city of Iquique the study group was selected mostly from the Women’s National Service intrafamily violence program. Although parents were recruited from these institutions, they were not yet receiving a psychotherapeutical treatment, a requirement stated by the research to be included in this group. 2. The control group consisted of 67 parents who were nonabusers. They were recruited from elementary schools. In order to be included in this group, a referral from somebody close to the family was needed (child’s teacher, relative, or professional in contact with the family), attesting that the parents raised their children in a non-violent manner. Additionally, the family should not show more than one of the following risk factors: children who were either premature or born below weight; congenital defect in one of the children; nutrition, growth, or learning problems in one of the children; serious illness of one of the spouses; addiction of one of the spouses to drugs or alcohol; childhood history of abuse in one of the spouses; an unwanted pregnancy; abandonment of one of the spouses in the last year; or unemployment of the parent supporting the family. The two groups were proportionally matched, according to socioeconomic level of the family; education, gender, marital status, and age of the respondent; and gender and age of the child. All these factors have been pointed out in the literature as having correlation with child abuse, even when some of them have not always shown consistent results (Alvarez, 1992; Connelly & Straus, 1992; Garbarino & Crouter, 1978; Justice & Calvert, 1990; Starr, 1988; Straus & Kantor, 1986). Table 1 shows that the groups did not differ significantly in terms of the variables used as matching criterion. The study group consisted of 64 women and three men. Although literature reports that the proportion of women who physically maltreat their children is somewhat higher than that of men, the fact that they are over-represented in our sample is consequence of the sampling procedure and does not necessarily represent the gender distribution of abusive parents. Age of the respondents ranged from 17 to 54 years old and the modal category was 25 to 34 years (54%). People belonged mainly to a low socioeconomic level (67%) and had at least complete primary education (76%). As to their marital status, 67% had a partner and the rest were separated, single, or widowed. With respect to the children abused, 69% were men and 31% were women. Their ages ranged from 0 to 17 years old and the modal category was 3 to 5 years old (42%). Apparatus Child Abuse Potential Inventory. A translation from English into Spanish was made of the CAP to adapt it to Chileans’ everyday language. For this purpose, the original version in English and two
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previous Spanish versions were used: one made in the US for the Latin population and another made in Spain. Some items were kept unchanged, while others were rewritten because their translation into Spanish was not suitable to either our context or language usage. One item was eliminated because it was not applicable in Chile (not having the telephone number listed). Socioeconomic Level Index. An index was developed to evaluate the family’s socioeconomic level, on the basis of 16 questions related to socioeconomic and family variables: respondent’s marital status; number of people living in the household; absence or presence of the father of the respondent’s children; educational level and type of work of the respondent and her spouse or partner; the ownership status of the house; the type of dwelling; existence of running water in the house, a sewage system, and a separate cooking place; promiscuity; garbage collection frequency; and ownership of house appliances. Each question has alternatives that are scored. The variables have a different weighting and the sum of the weighted scores allows discrimination of six socioeconomic levels. Interview. A semi-structured interview was used to determine which of the aforementioned risk factors the respondents displayed. Procedure The application of the instruments and the interviews were conducted by trained undergraduate Psychology students. Participation on the research was voluntary. The applications were made on an individual basis. The items of the CAP were read aloud by the interviewer who recorded the answers. This procedure was adopted because evidence obtained in a pilot study (Ramı´rez, Haz, & Browne, 1994) suggested that the population with the characteristics of the current sample has difficulties understanding the items: although most parents have primary education, their level of reading understanding is very low. The impossibility of warranting the respondent’s anonymity may have effects on the answers, due to their social desirability. However, the fact that the evaluator reads the items may also offer advantages with respect to self-reporting since, on the one hand, respondents can not go back to compare their answers, which leads to a greater accuracy in the consistency scale results and, on the other hand, makes it easier to control how well the statements are understood.
RESULTS The Abuse Scale items were tabulated both with the weighted scores proposed by Milner with simple scores (0 and 1). The CAP’s performance will be shown according to both types of scoring. Reliability The internal consistency of the 76 items with weighted scores in Milner’s Abuse Scale, measured by Cronbach’s alpha coefficient, was .95 for the total sample (.88 for the study group and .90 for the control group). The internal consistency of the items with simple scoring was somewhat better: .97 for the total sample (.91 for the study group and .93 for the control group). The mean item-test correlations was r 5 .51 for the weighted scores and r 5 .56 for the unweighted scores. Four items (having a physical handicap; children having play clothes and good clothes; having good friends in the neighborhood; and being in love) had a nonsignificant item-test
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correlation (p . .05). Despite this general good outcome, 16 items have correlations lower than .40 with the total test in both versions. Item Analysis Of the 159 items included, 125 of them discriminated (p , .05) between child-abusing individuals and the control group (31 at p , .01; 82 at p , .0001). Of the 82 items with greater discriminating power (p , .0001), 55 belong to Milner’s Abuse Scale, 20 are part of the Experimental Abuse Scale, 1 item is from the Negligence Scale, 2 from the Lie Scale, 3 from the Random Response Scale and 1 is a filler item. The most discriminating items were those related to loneliness, locus of control, unhappiness, problems with the actual family, problems with the family of origin, child with problems, anxiety, self-esteem, and irritability. Six items of the Abuse Scale did not significantly discriminate between the study and the control groups (p . .05). These items are: children being always neat; children having play clothes and good clothes; the respondent having a physical handicap, having several close friends in the neighborhood, or being deeply in love. Two other items of the Abuse Scale showed significant differences between both groups, but the error probability was greater than the 55 previous ones (.01 , p , .05). They reflect the value that the population interviewed places on order and cleanliness. Finally, 18 items were significant in terms of their discriminating ability, though it was expected that they would not be. These correspond to items related to the validity scales of the instrument (9 from the lie scale and 9 from the random response scale). The hypothesis is that the sample studied tended to overlook the adverbs indicating frequency of the behavior in the statements, that makes the difference between “normal” people and abusers. Predictive Validity In the Chilean sample, the weighted-scores Abuse Scale yielded an observed range from 21 to 457 points (the theoretical range is 0 to 486 points). Figure 1 shows the score distribution of both groups. As can be seen in Figure 1, the control group has a range of values below that of the study group. However, 19% of the respondents of that group obtained scores between 215 (the cut-off point suggested by Milner for samples drawn from the general population) and 339 points. Given that this range involves an abuse risk on Milner’s Scale, a problem of false positives occurring in the control group is clearly perceived. With the 166 cut-off point, which is the one that would correspond to the sample drawn in Chile, the Abuse Scale correctly classified 83% of the participants (96% of the abuse group and 70% of the control group). In misclassification, 15% were false positives and 2% were false negatives in the whole sample. The discriminating ability is quite high for abusing parents but it loses validity in Chile for the control group. This is due to the fact that some items in the Abuse Scale are related to cultural characteristics of the Chilean population, specially those which belongs to the low socioeconomic strata, rather than to abuse correlates. Consequently, many respondents in the control group scored very high on this scale. Additionally, the weighting which Milner assigns to the items in the US does not match the discriminatory power of the items in Chile. It is to be pointed out that, in Milner’s view, the chief problem of the discriminating capacity displayed by the instrument is due to the number of false negatives it yields, that is, abusers that are classified as nonabusers. The problem in Chile is quite the opposite: some nonabusers are classified as abusers. Using a 215 cut-off point, the discriminating power of the Abuse Scale improves slightly (87%), almost retaining the discriminating power in the abuse group (94%) and increasing it in the control group (81%). Of people misclassified in the abuse and control samples taken as a whole, 3%
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Figure 1. Milner’s Abuse Scale Distribution with weighted items, by group.
corresponds to false negatives and 10% to false positives. The false positives evidently decrease somewhat when the cut-off point is increased. By using a simple score for the scale, the range obtained was 4 to 71 points in the total sample (the theoretical range is 0 to 76 points). A discriminant analysis was carried out with 76 items, and the cut-off score obtained, that is the centroids mean was 39 points. Figure 2 shows the unweighted score distribution for each group in the sample. Milner’s simple scored Abuse Scale correctly classified 90% of respondents (91% in the abuse group and 88% in the control group). Of people misclassified, 4% were false negatives and 6% false positives. As it can be appreciated, the discriminating capacity improves somewhat with unweighted items. Though it slightly loses discriminating power in the abuse group, it improves considerably in the control group. This result reinforces the idea that the weighted items are not applicable in Chile. The different results in the discrimination rates, depending on the cut-off point and the weighting used, are shown in Table 2. The correlation between the weighted scale score and the simple one is very high (r 5 .99, N 5 134, p 5 .00), although the simple scale seems to be better for the Chilean population. Construct Validity To evaluate the dimensionality of the items, Milner carried out a factor analysis of the 77 items of the Abuse Scale (Milner, Gold, & Wimberley, 1986), finding that 6 factors were the most significant. These were: distress, unhappiness, rigidity, problems from others, problems with child and self, and problems with family.
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Figure 2. Milner’s Abuse Scale Distribution with unweighted items, by group.
In this study, an exploratory factor analysis was performed with the 76 unweighted items of the Abuse Scale. The factors were extracted using the method of principal components and an oblique rotation (Oblimin, SPSS-PC) was performed because the factors were expected to be correlated. Different analysis were performed drawing from 5 to 8 factors. The best solution was also obtained with 6 factors, accounting for 53.8% of the variance. Factor 1 was designated Loneliness and Sadness: Almost all of the items belong to the dimension “Distress” as specified by Milner, and it explains 35.7% of the variance. Factor 2 was denominated Rigidity: All the items of this factor grouped well in Milner’s “Rigidity” dimension. This factor explains 4.9% of the variance. Factor 3 was denominated Unhappiness and Problems with family: All of the items belong to Milner’s “Unhappiness” and “Problems with Family” subscales. It accounts for 4.2% of the variance. Factor 4 was denominated Problems with child: Some of the items belong to Milner’s “Rigidity” subscale, referred specially with rigidity with children, and others to the subscale “Problems with child and self.” It explains 3.6% of the variance. Factor 5 was denominated Irritability, Impulsiveness, and
Table 2. Chilean Sample: Discrimination Rate of Milner’s Abuse Scale, According to Scoring and Cut-off Points Group Abuse Scale
Total
Study
Control
Weighted Scale (166 Cut-Off Point) Weighted Scale (215 Cut-Off Point) Scale With Simple Scoring
82.8 87.3 89.6
95.5 94.0 91.0
70.1 80.6 88.1
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Anxiety: Although the items with the greatest communalities belong to Milner’s “Distress” subscale, several items in this Milner’s subscale concentrated in Factor 1. This factor explains 2.8% of the variance. Factor 6 was denominated Unhappiness Due to External Locus of Control and Problems with Others. The items of this factor appear in “Distress” and “Problems with Others” Milner’s subscales, and it explains 2.7% of the variance. Validity Scales The Lie Scale. The lie scale is made up of 18 items. A score of “1” is assigned when respondents answer to the item in a manner which would make them appear socially acceptable. The score “0” is granted to the responses more frequently given by people and which do not reflect social desirability. In studies carried out in the US, the mean of heterogeneous groups with respect to demographic characteristics (N 5 836) was 3.5 points (SD 5 3.1) and P95 5 was 7 points for respondents having 12 or more years of education and 8 for those with less than 12 years (Milner, 1986). The studies carried out in Spain and Argentina showed higher indexes on this scale. In Spain the mean was 9.5 points (N 5 829), with a normal distribution (DePau´l et al., 1991), and in Argentina the P95 (N 5 80) was 13 points (Bringiotti & Barbich, 1992). In this study the mean was 6.7 points (SD 5 3.2). The P95 was 12 points (N 5 134). Its distribution is normal. When compared to the samples from the studies conducted in the US, this distribution shows higher scores, and when comparing it with those from Spain and Argentina, it shows lower ones. The difference with the values obtained in the US is too large, so it makes a further revision of this scale necessary. Due to the results already obtained in Spain and Argentina, Milner has suggested not to use this scale with the Latin population (Milner, 1994). The research findings in Chile support this proposal. For the Chilean population the greatest problem is the grasp of the items, tending to omit frequency adverbs, which must necessarily be considered in this scale. The Random Scale. The random scale has 18 items. A score of “1” is assigned when people give an answer infrequently chosen and “0” when a frequent answer is given. The items of this scale showed low correlation in the US with the Abuse Scale (Milner, 1986). In the studies conducted by Milner in the US this scale had an average mean (N 5 735) of 2.2 points (SD 5 1.4) and the P95 is 6. In the Chilean study the mean was 4.0 points (SD 5 1.7), with a positive skewed distribution. The P95 was 7 points (N 5 134). The revision of this scale is also necessary, due to the correlation that some items showed with the Abuse Scale and to the fact that an important number of its items discriminated between the study and control groups. The Internal Inconsistency Scale. This scale was developed as a complementary one to the random response scale, in order to reduce false-positive classifications. Inconsistency was operationally defined as contradictory responses in two items with a similar content, and similar responses to items with an opposite content. This scale has 20 item-pairs. A score of “1” is assigned when respondents answer inconsistently and “0” when they answer consistently. The cut-off score suggested by Milner (1986) for this scale is 6 points. In studies carried out in the US (N 5 735), Milner (1986) found an average mean of 2.8 points (SD 5 2.1). In the Chilean pilot study (N 5 56) half of the items of the original version showed a high degree of inconsistency (in more than 30% of the sample; Ramı´rez et al., 1994). In this research practically the same item-pairs were responded inconsistently by a considerable percentage of the sample, even though some modification in the wording was introduced to some of the items. Malfunctioning was due, in most cases, to the fact that one of the items did not discriminate and its pair did.
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The rest of the cases were related to the meaning of the sentences, which seemed to mean different things to the participants. DISCUSSION Using a simple score, the Abuse Scale discriminated between abusing and nonabusing individuals. It correctly classified 90% of the respondents. The factor analysis was similar to that obtained by Milner (1986). The items which had the greatest discriminating power in Chile between people abusing their children and those who do not were those related to feelings of depression, loneliness, anxiety, and problems with family. The items in Milner’s Abuse Scale which were not discriminatory are associated mainly with conducts related to neatness and appearance of children and home, which would reveal the presence of some cultural elements in Milner’s Abuse Scale. This fact doesn’t mean that people in Chile is cleaner than people in the US; it means, maybe, that neatness and appearance are more socially desirable in Chile, especially in low-income families. As the three validity scales proved not to be very efficient in Chile, changes to them should be tested in future research. Regarding the lie scale, it seems necessary to change the wording of some items and to add others, so that they distinctly discriminate between those who tell the truth and those who do not. As to the random scale, it is necessary to replace some items with others that didn’t discriminate and which were answered in the same sense by many people. Finally, new pairs of items must be added in the inconsistency scale, to replace some of them. Some limitations of the study are worth mentioning. The main limitation is related to the sample design, which contemplated extreme populations: cases of severe physical child abuse and cases of reportedly nonabusive parents with a positive attitude towards their children. The design was developed precisely in this manner so as to test the degree of discrimination of the items. However, the items should also be able to discriminate between physical abusers and the general population, taking into account its cultural heritage. Moreover, the sample was almost exclusively made up by women, which could have biased some of the items. Finally, in order to fully verify the properties of the Inventory for the Chilean population, it is necessary to use a larger-sized and a more representative sample. A new research project is being developed, taking into account the limitations mentioned above. This new validation study will include new items to replace those with low discriminant properties in the present study. The final goal is to develop a version of the CAP appropriate for the Chilean population, so as to delineate with a greater degree of precision the more relevant personality traits which are at the base of the conduct and risk of physical child abuse. Acknowledgment—The authors wish to thank Joel Milner, author of the Child Abuse Potential Inventory, for all the assistance given to this research; his interest, support, and information were a very significant contribution to the study.
REFERENCES Alvarez, P. (1992). Maltrato infantil y contexto social: Una perspectiva siste´mica (Child abuse and social context: A systemic perspective). Revista Salud y Cambio, 3, 23–28. Anderson, S. C., & Lauderdale, M. L. (1982). Characteristics of abusive parents: A look at self-esteem. Child Abuse & Neglect, 6, 285–293. Bringiotti, M. I., & Barbich, A. (1992). Adaptacio´n y validacio´n del Child Abuse Potential Inventory-CAP. Versio´n preliminar para la Argentina (Adaptation and validation of the Child Abuse Potential Inventory-CAP. A preliminary version for Argentina). Unpublished manuscript. Subsecretarı´a de Investigaciones, Facultad de Psicologı´a, Buenos Aires, Argentina. Connelly, C. D., & Straus, M. A. (1992). Mother’s age and risk for physical abuse. Child Abuse & Neglect, 16, 709 –718. DePau´l, J., Arruabarrena, I., & Milner, J. S. (1991). Validacio´n de una versio´n espan˜ola del Child Abuse Potential Inventory
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para su uso en Espan˜a (Validation of a Spanish version of the Child Abuse Potential Inventory for its use in Spain). Child Abuse & Neglect, 15, 495–504. Ellis, R. H., & Milner, J. S. (1981). Child abuse and locus of control. Psychological Reports, 48, 507–510. Garbarino, J., & Crouter, A. (1978). Defining the community context for parent-child relations: The correlates of child maltreatment. Child Development, 49, 604 – 616. Justice, B., & Calvert, A. (1990). Family environment factors associated with child abuse. Psychological Reports, 66, 458 – 461. Milner, J. S. (1986). The Child Abuse Potential Inventory: Manual (2nd ed.). Webster, NC: Psytec Inc. Milner, J. S. (1989). Applications and limitations of the Child Abuse Potential Inventory. Early Child Development and Care, 42, 85–97. Milner, J. S. (1990). An interpretative manual for the Child Abuse Potential Inventory. Webster, NC: Psytec Inc. Milner, J. S. (1993). Social information processing and physical child abuse. Clinical Psychology Review, 13, 275–294. Milner, J. S. (1994). Assessing physical child abuse risk: The Child Abuse Potential Inventory. Clinical Psychology Review, 14, 547–583. Milner, J. S., & Ayoub, C. (1980). Evaluation of “at risk” parents using the Child Abuse Potential Inventory. Journal of Clinical Psychology, 36, 945–948. Milner, J. S., Gold, R. G., & Wimberley, R. C. (1986). Prediction and explanation of child abuse: Cross-validation of the Child Abuse Potential Inventory. Journal of Consulting and Clinical Psychology, 54, 865– 866. Milner, J. S., Robertson, K. R., & Rogers, D. L. (1990). Childhood history of abuse and adult child abuse potential. Journal of Family Violence, 5, 15–34. Pruitt, D. L., & Erickson, M. T. (1985). The Child Abuse Potential Inventory: A study of concurrent validity. Journal of Clinical Psychology, 41, 104 –111. Ramı´rez, V., Haz, A. M., & Browne, B. (1994). Adaptacio´n de un instrumento para detectar riesgo de maltrato fı´sico infantil: resultados de una aplicacio´n piloto (Adaptation of an instrument to detect risk of physical child abuse: Findings of a pilot application). Psykhe, 3, 87–96. Robertson, K. R., & Milner, J. S. (1983). Construct validity of the Child Abuse Potential Inventory. Journal of Clinical Psychology, 39, 426 – 429. Starr, R. H. (1988). Physical abuse of children. In V. Van Hasselt, R. Morrison, A. S. Bellack, & M. Hersen (Eds.), Handbook of family violence (pp. 119 –150). New York: Plenum. Straus, M. A., & Kantor, G. (1986). Stress and physical child abuse. Child Abuse & Neglect, 4, 75– 88.
RE´SUME´ Objectif: Cette e´tude a voulu valider au Chili l’instrument Child Abuse Potential Inventory (Milner, 1986). Me´thode: On a retenu un e´chantillon de 134 participants (64 femmes et 3 hommes) dans la re´gion me´tropolitaine de Santiago et la ville de Iquique et on les a divise´s en deux groupes: ceux qui avaient agresse´s leur enfants et ceux qui n’e´taient pas des agresseurs. On a mene´ une analyse de fiabilite´, une analyse pour mesurer la vlidite´ de la construction de l’instrument et de sa capacite´ a` pre´dire et une analyse de chaque composante de l’instrument. Re´sultats: On a attribue´ aux composantes de l’e´chelle Milner les valeurs propose´es par Milner, puis on leur a aussi assigne´ une valeur simple. Les re´sultats e´taient plus consistents lorsqu’on se servait de la deuxie`me modalite´. L’instrument a classe´ correctement 90% des participants (91% dans le groupe des abuse´s et 88% dans le groupe controˇle). Parmi les 76 composantes de l’e´chelle, 55 e´taient tre`s capables de discriminer, six e´taient sans ve´ritable importance et 15 de´montraient des diffe´rences qui n’e´taient pas suffisamment conside´rables pour apporter des distinctions utiles entre les participants. Pour e´valuer la dimension de chaque composante, on a mene´ une analyse factorielle. C’est en ayant recours a` six facteurs qu’on a obtenu les meilleurs re´sultats, represe´ntant une variance de 53,8%. Conclusions: L’e´chelle de Milner a su discriminer entre les participants abuseurs et ceux qui ne l’e´taient pas et a de´montre´ une analyse factorielle semblable a` l’originale. Certaines des composantes refle`tent des comportements culturels propres au Chili plutoˇt que de de´noter un risque d’agression, comme par exemple, la proprete´ des enfants, surtout dans les familles pauvres, laquelle est une caracte´ristique conside´re´e fort de´sirable dans ce milieu.
RESUMEN Objetivo: El objetivo de este trabajo es una validacio´n preliminar en Chile del Inventario del Potencial de Abuso Infantil (Milner, 1986). Me´todo: Se utilizo´ una muestra de 134 participantes del a´rea Metropolitana de Santiago y la ciudad de Iquique en Chile, dividida en dos grupos: personas identificadas como abusadores fı´sicos de sus propios hijos y personas identificadas como no-abusadores. Como resultado del procedimiento para el muestreo, el grupo de estudio estaba compuesto de 64 mujeres
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y tres hombres. En el grupo control se duplico´ e´sta distribucio´n. Se realizo´ un ana´lisis de confiabilidad, un analisis predictivo y de construccio´n, y un ana´lisis de items, de la Escala de Abuso propuesta por Milner. Resultados: Los items de la Escala de Abuso se tabularon ambos con los puntajes ponderados propuestos por Milner y con scores simples. Los resultados fueron ma´s consistentes con los scores simples. Clasificaron correctamente el 90% de los participantes (91% en el grupo abusado y 88% en el grupo control). De los 76 items de la Escala de Abuso, 55 eran altamente discriminatorios, seis de ellos no eran significativos y 15 de ellos tenı´an diferencias que no eran lo suficientemente grande para discriminar bien a las personas. Para evaluar la dimensionalidad de los items, se llevo´ a cabo un ana´lisis factorial. La mejor solucio´n (rotacio´n Oblimin) se obtuvo con seis factores que dan cuenta de 53.8% de la varianza. Conclusio´n: La Escala de Abuso de Milner discrimino´ entre personas abusivas y no-abusivas, y presento´ un ana´lisis factorial similar al original. Algunos items reflejaban conductas relacionadas con la cultura de Chile en lugar del potencial de abuso: estaban relacionadas con la limpieza y la pulcritud socialmente deseables en los nin˜os y en sus casas, especialmente en familias de bajos ingresos.
This article is being published without benefit of the authors’ review of the corrected proof as this was not available at press time.
Pergamon
PII S0145-2134(98)00071-4
PRELIMINARY VALIDATION OF THE CHILD ABUSE POTENTIAL INVENTORY IN CHILE ANA MARIA HAZ
AND
VALERIA RAMIREZ
Escuela de Psicologia, Pontificia Universidad Cato´lica de Chile, Santiago, Chile
ABSTRACT Objective: The objective of this work is a preliminary validation in Chile of the Child Abuse Potential (CAP) Inventory (Milner, 1986). Method: A sample of 134 participants was drawn from Santiago’s Metropolitan Area and the city of Iquique in Chile, divided into two groups: people identified as physical abusers of their own children and people identified as nonabusers. As a result of the sampling procedure, the study group was composed of 64 women and three men. This distribution was matched in the control group. A reliability analysis, a predictive and construct validity analysis, and an item analysis of the Abuse Scale proposed by Milner were performed. Results: The Abuse Scale items were tabulated both with the weighted scores proposed by Milner and with simple scores. The results were more consistent with simple scores. It correctly classified 90% of respondents (91% in the abuse group and 88% in the control group). Of the 76 items of the Abuse Scale, 55 were highly discriminatory, six of them were nonsignificant and 15 of them had differences that were not great enough so as to discriminate people well. To evaluate the dimensionality of the items, a factor analysis was carried out. The best solution (Oblimin rotation) was obtained with 6 factors, which accounts for 53.8% of the variance. Conclusion: Milner’s Abuse Scale discriminated between abusing and nonabusing individuals, and showed a factor analysis similar to the original one. Some items reflected cultural conducts in Chile instead of potential abuse: they are related with socially desirable neatness and cleanness of children and home, specially in low-income families. © 1998 Elsevier Science Ltd Key Words—Child abuse screening, Psychometric characteristics of instrument, Transcultural validation of instrument.
INTRODUCTION OVER THE LAST decade Chilean society has began to consider child abuse as a social problem and to adopt preventive and protective initiatives. In 1994 the National Congress enacted a law on intrafamily violence. The Chilean law defines physical child abuse as the use of violent acts upon children and adolescents under 18 years of age by their parents or other people responsible for them. Injury may be either intentional or not and may derive from either allegedly disciplinary actions or from negative and hostile feelings towards the child. Intervention programs have been developed in hospitals, mental health, and community centers, but their coverage is very limited in relation to the scope of the problem, and they generally undertake the abuse phenomenon when it has already occurred. Within this context, it is important to develop instruments that enable accurate child abuse assessment.
This paper was funded by Fondo Nacional de Desarrollo Cientı´fico y Tecnolo´gico (FONDECYT), project # 1930695, year 1993. Received for publication May 13, 1996; final revision received January 6, 1998; accepted January 15, 1998. Reprint requests should be addressed to Ana Marı´a Haz, Escuela de Psicologı´a, Pontificia Universidad Cato´lica de Chile, Avda. Vicun˜a Mackenna 4860, Santiago, Chile. 869
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This paper reports the preliminary adaptation of the Child Abuse Potential Inventory (CAP; Milner, 1986). The CAP was designed in the US by Joel S. Milner in 1980, in order to evaluate an individual’s personality and social and family interactional traits, so as to determine physical child abuse potential. The CAP is a screening device and is not intended to be used as a diagnostic instrument. The Inventory consists of 160 items, 77 of which constitute the Abuse Scale. It also contains items that belong to an experimental abuse scale and to a negligence scale. The CAP was designed as a self-report questionnaire and is easy to understand and administer. The respondent must answer each statement in a forced-choice, agree-disagree format. Based on beta-coefficient weights obtained in a regression analysis carried out in the US, Milner has proposed a differential weighting of the Abuse Scale items and two cut-off scores (215 and 166), that is, the value at and over which the respondent may be considered at risk for committing physical child abuse. Milner suggests the score of 215 when samples are drawn from the general population and 166 when extreme abuser and nonabuser groups are compared. Milner (1993) points out that the instrument can also be scored without weighting the items, applying values of either 1 or 0 to them, given that weighting only modestly improves the classification rates. Past analyses of the CAP have revealed appropriate discriminant validity of the instrument. In the US the CAP Abuse Scale has correctly classified between 80% and 90% of abusive and nonabusive individuals (Milner, 1986), and in Spain—Paı´s Vasco—(DePau´l, Arruabarrena, & Milner, 1991) and in Argentina (Bringiotti & Barbich, 1992), more than 90% of the participants. The internal consistency of the Abuse Scale applied in the US has yielded values between .92 and .96, estimated by KR-20 coefficient (Milner, 1989), whereas the split-half reliability was estimated at .94 (Milner & Ayoub, 1980). Several concurrent validity studies performed on the Abuse Scale report that it shows correlation with several factors which have been associated with physical child abuse, such as childhood history of abuse (Milner, Robertson, & Rogers, 1990), physiological reactivity to child-related stimuli (Pruitt & Erickson, 1985), type of locus of control (Ellis & Milner, 1981), ego-strength (Robertson & Milner, 1983), and self-esteem (Anderson & Lauderdale, 1982). On the basis of studies conducted in the US, it was possible to determine, through a factor analysis, six subscales in the Abuse Scale (Milner, 1990), which will be referred to later. In addition, the CAP Inventory contains three validity scales: a lie scale, an inconsistency scale, and a random response scale. These scales are combined to yield three response distortion indexes: a faking-good index (the respondents represent themselves “better” than they are), a faking-bad index (persons represent themselves “worse” than they are), and a random response index. These indexes allow detection of those questionnaires which have questionable validity (Milner, 1990). It was deemed convenient to adapt the CAP Inventory for Chile, given its considerable discriminant ability and high reliability and validity (Milner, 1986). It has good psychometric properties and it is the only instrument of this kind being adapted in Latin population. The main objective was to carry out a preliminary evaluation of the CAP Inventory. It was tested for discriminatory power and validity. METHOD Participants A sample of 134 persons was drawn from Santiago’s Metropolitan Region and the northern city of Iquique in Chile, divided into two groups: 1. The study group was composed of 67 parents recruited from several public hospitals and community institutions specialized in intervention with maltreating parents. Maltreatment status
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Table 1. x2 and its Significance as an Homogeneity Test of Sample Groups in the Criterion Variables Variable
x2
df
n
p
Gender of Respondent Range of Age of Respondent Marital Status of Respondent Socio-Economic Level of Family Educational Level of Respondent Gender of Child Range of Age of Child
.00 8.07 .06 .40 .83 .03 3.72
1 7 5 3 5 1 5
134 134 134 134 134 134 134
1.00 .33 1.00 .94 .97 .85 .59
was determined by a professional who worked in the treatment center. The detection system in Chile is in a preliminary stage, so that if some bias exist, it is toward the detection of the most severe cases. In the city of Iquique the study group was selected mostly from the Women’s National Service intrafamily violence program. Although parents were recruited from these institutions, they were not yet receiving a psychotherapeutical treatment, a requirement stated by the research to be included in this group. 2. The control group consisted of 67 parents who were nonabusers. They were recruited from elementary schools. In order to be included in this group, a referral from somebody close to the family was needed (child’s teacher, relative, or professional in contact with the family), attesting that the parents raised their children in a non-violent manner. Additionally, the family should not show more than one of the following risk factors: children who were either premature or born below weight; congenital defect in one of the children; nutrition, growth, or learning problems in one of the children; serious illness of one of the spouses; addiction of one of the spouses to drugs or alcohol; childhood history of abuse in one of the spouses; an unwanted pregnancy; abandonment of one of the spouses in the last year; or unemployment of the parent supporting the family. The two groups were proportionally matched, according to socioeconomic level of the family; education, gender, marital status, and age of the respondent; and gender and age of the child. All these factors have been pointed out in the literature as having correlation with child abuse, even when some of them have not always shown consistent results (Alvarez, 1992; Connelly & Straus, 1992; Garbarino & Crouter, 1978; Justice & Calvert, 1990; Starr, 1988; Straus & Kantor, 1986). Table 1 shows that the groups did not differ significantly in terms of the variables used as matching criterion. The study group consisted of 64 women and three men. Although literature reports that the proportion of women who physically maltreat their children is somewhat higher than that of men, the fact that they are over-represented in our sample is consequence of the sampling procedure and does not necessarily represent the gender distribution of abusive parents. Age of the respondents ranged from 17 to 54 years old and the modal category was 25 to 34 years (54%). People belonged mainly to a low socioeconomic level (67%) and had at least complete primary education (76%). As to their marital status, 67% had a partner and the rest were separated, single, or widowed. With respect to the children abused, 69% were men and 31% were women. Their ages ranged from 0 to 17 years old and the modal category was 3 to 5 years old (42%). Apparatus Child Abuse Potential Inventory. A translation from English into Spanish was made of the CAP to adapt it to Chileans’ everyday language. For this purpose, the original version in English and two
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previous Spanish versions were used: one made in the US for the Latin population and another made in Spain. Some items were kept unchanged, while others were rewritten because their translation into Spanish was not suitable to either our context or language usage. One item was eliminated because it was not applicable in Chile (not having the telephone number listed). Socioeconomic Level Index. An index was developed to evaluate the family’s socioeconomic level, on the basis of 16 questions related to socioeconomic and family variables: respondent’s marital status; number of people living in the household; absence or presence of the father of the respondent’s children; educational level and type of work of the respondent and her spouse or partner; the ownership status of the house; the type of dwelling; existence of running water in the house, a sewage system, and a separate cooking place; promiscuity; garbage collection frequency; and ownership of house appliances. Each question has alternatives that are scored. The variables have a different weighting and the sum of the weighted scores allows discrimination of six socioeconomic levels. Interview. A semi-structured interview was used to determine which of the aforementioned risk factors the respondents displayed. Procedure The application of the instruments and the interviews were conducted by trained undergraduate Psychology students. Participation on the research was voluntary. The applications were made on an individual basis. The items of the CAP were read aloud by the interviewer who recorded the answers. This procedure was adopted because evidence obtained in a pilot study (Ramı´rez, Haz, & Browne, 1994) suggested that the population with the characteristics of the current sample has difficulties understanding the items: although most parents have primary education, their level of reading understanding is very low. The impossibility of warranting the respondent’s anonymity may have effects on the answers, due to their social desirability. However, the fact that the evaluator reads the items may also offer advantages with respect to self-reporting since, on the one hand, respondents can not go back to compare their answers, which leads to a greater accuracy in the consistency scale results and, on the other hand, makes it easier to control how well the statements are understood.
RESULTS The Abuse Scale items were tabulated both with the weighted scores proposed by Milner with simple scores (0 and 1). The CAP’s performance will be shown according to both types of scoring. Reliability The internal consistency of the 76 items with weighted scores in Milner’s Abuse Scale, measured by Cronbach’s alpha coefficient, was .95 for the total sample (.88 for the study group and .90 for the control group). The internal consistency of the items with simple scoring was somewhat better: .97 for the total sample (.91 for the study group and .93 for the control group). The mean item-test correlations was r 5 .51 for the weighted scores and r 5 .56 for the unweighted scores. Four items (having a physical handicap; children having play clothes and good clothes; having good friends in the neighborhood; and being in love) had a nonsignificant item-test
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correlation (p . .05). Despite this general good outcome, 16 items have correlations lower than .40 with the total test in both versions. Item Analysis Of the 159 items included, 125 of them discriminated (p , .05) between child-abusing individuals and the control group (31 at p , .01; 82 at p , .0001). Of the 82 items with greater discriminating power (p , .0001), 55 belong to Milner’s Abuse Scale, 20 are part of the Experimental Abuse Scale, 1 item is from the Negligence Scale, 2 from the Lie Scale, 3 from the Random Response Scale and 1 is a filler item. The most discriminating items were those related to loneliness, locus of control, unhappiness, problems with the actual family, problems with the family of origin, child with problems, anxiety, self-esteem, and irritability. Six items of the Abuse Scale did not significantly discriminate between the study and the control groups (p . .05). These items are: children being always neat; children having play clothes and good clothes; the respondent having a physical handicap, having several close friends in the neighborhood, or being deeply in love. Two other items of the Abuse Scale showed significant differences between both groups, but the error probability was greater than the 55 previous ones (.01 , p , .05). They reflect the value that the population interviewed places on order and cleanliness. Finally, 18 items were significant in terms of their discriminating ability, though it was expected that they would not be. These correspond to items related to the validity scales of the instrument (9 from the lie scale and 9 from the random response scale). The hypothesis is that the sample studied tended to overlook the adverbs indicating frequency of the behavior in the statements, that makes the difference between “normal” people and abusers. Predictive Validity In the Chilean sample, the weighted-scores Abuse Scale yielded an observed range from 21 to 457 points (the theoretical range is 0 to 486 points). Figure 1 shows the score distribution of both groups. As can be seen in Figure 1, the control group has a range of values below that of the study group. However, 19% of the respondents of that group obtained scores between 215 (the cut-off point suggested by Milner for samples drawn from the general population) and 339 points. Given that this range involves an abuse risk on Milner’s Scale, a problem of false positives occurring in the control group is clearly perceived. With the 166 cut-off point, which is the one that would correspond to the sample drawn in Chile, the Abuse Scale correctly classified 83% of the participants (96% of the abuse group and 70% of the control group). In misclassification, 15% were false positives and 2% were false negatives in the whole sample. The discriminating ability is quite high for abusing parents but it loses validity in Chile for the control group. This is due to the fact that some items in the Abuse Scale are related to cultural characteristics of the Chilean population, specially those which belongs to the low socioeconomic strata, rather than to abuse correlates. Consequently, many respondents in the control group scored very high on this scale. Additionally, the weighting which Milner assigns to the items in the US does not match the discriminatory power of the items in Chile. It is to be pointed out that, in Milner’s view, the chief problem of the discriminating capacity displayed by the instrument is due to the number of false negatives it yields, that is, abusers that are classified as nonabusers. The problem in Chile is quite the opposite: some nonabusers are classified as abusers. Using a 215 cut-off point, the discriminating power of the Abuse Scale improves slightly (87%), almost retaining the discriminating power in the abuse group (94%) and increasing it in the control group (81%). Of people misclassified in the abuse and control samples taken as a whole, 3%
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Figure 1. Milner’s Abuse Scale Distribution with weighted items, by group.
corresponds to false negatives and 10% to false positives. The false positives evidently decrease somewhat when the cut-off point is increased. By using a simple score for the scale, the range obtained was 4 to 71 points in the total sample (the theoretical range is 0 to 76 points). A discriminant analysis was carried out with 76 items, and the cut-off score obtained, that is the centroids mean was 39 points. Figure 2 shows the unweighted score distribution for each group in the sample. Milner’s simple scored Abuse Scale correctly classified 90% of respondents (91% in the abuse group and 88% in the control group). Of people misclassified, 4% were false negatives and 6% false positives. As it can be appreciated, the discriminating capacity improves somewhat with unweighted items. Though it slightly loses discriminating power in the abuse group, it improves considerably in the control group. This result reinforces the idea that the weighted items are not applicable in Chile. The different results in the discrimination rates, depending on the cut-off point and the weighting used, are shown in Table 2. The correlation between the weighted scale score and the simple one is very high (r 5 .99, N 5 134, p 5 .00), although the simple scale seems to be better for the Chilean population. Construct Validity To evaluate the dimensionality of the items, Milner carried out a factor analysis of the 77 items of the Abuse Scale (Milner, Gold, & Wimberley, 1986), finding that 6 factors were the most significant. These were: distress, unhappiness, rigidity, problems from others, problems with child and self, and problems with family.
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Figure 2. Milner’s Abuse Scale Distribution with unweighted items, by group.
In this study, an exploratory factor analysis was performed with the 76 unweighted items of the Abuse Scale. The factors were extracted using the method of principal components and an oblique rotation (Oblimin, SPSS-PC) was performed because the factors were expected to be correlated. Different analysis were performed drawing from 5 to 8 factors. The best solution was also obtained with 6 factors, accounting for 53.8% of the variance. Factor 1 was designated Loneliness and Sadness: Almost all of the items belong to the dimension “Distress” as specified by Milner, and it explains 35.7% of the variance. Factor 2 was denominated Rigidity: All the items of this factor grouped well in Milner’s “Rigidity” dimension. This factor explains 4.9% of the variance. Factor 3 was denominated Unhappiness and Problems with family: All of the items belong to Milner’s “Unhappiness” and “Problems with Family” subscales. It accounts for 4.2% of the variance. Factor 4 was denominated Problems with child: Some of the items belong to Milner’s “Rigidity” subscale, referred specially with rigidity with children, and others to the subscale “Problems with child and self.” It explains 3.6% of the variance. Factor 5 was denominated Irritability, Impulsiveness, and
Table 2. Chilean Sample: Discrimination Rate of Milner’s Abuse Scale, According to Scoring and Cut-off Points Group Abuse Scale
Total
Study
Control
Weighted Scale (166 Cut-Off Point) Weighted Scale (215 Cut-Off Point) Scale With Simple Scoring
82.8 87.3 89.6
95.5 94.0 91.0
70.1 80.6 88.1
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Anxiety: Although the items with the greatest communalities belong to Milner’s “Distress” subscale, several items in this Milner’s subscale concentrated in Factor 1. This factor explains 2.8% of the variance. Factor 6 was denominated Unhappiness Due to External Locus of Control and Problems with Others. The items of this factor appear in “Distress” and “Problems with Others” Milner’s subscales, and it explains 2.7% of the variance. Validity Scales The Lie Scale. The lie scale is made up of 18 items. A score of “1” is assigned when respondents answer to the item in a manner which would make them appear socially acceptable. The score “0” is granted to the responses more frequently given by people and which do not reflect social desirability. In studies carried out in the US, the mean of heterogeneous groups with respect to demographic characteristics (N 5 836) was 3.5 points (SD 5 3.1) and P95 5 was 7 points for respondents having 12 or more years of education and 8 for those with less than 12 years (Milner, 1986). The studies carried out in Spain and Argentina showed higher indexes on this scale. In Spain the mean was 9.5 points (N 5 829), with a normal distribution (DePau´l et al., 1991), and in Argentina the P95 (N 5 80) was 13 points (Bringiotti & Barbich, 1992). In this study the mean was 6.7 points (SD 5 3.2). The P95 was 12 points (N 5 134). Its distribution is normal. When compared to the samples from the studies conducted in the US, this distribution shows higher scores, and when comparing it with those from Spain and Argentina, it shows lower ones. The difference with the values obtained in the US is too large, so it makes a further revision of this scale necessary. Due to the results already obtained in Spain and Argentina, Milner has suggested not to use this scale with the Latin population (Milner, 1994). The research findings in Chile support this proposal. For the Chilean population the greatest problem is the grasp of the items, tending to omit frequency adverbs, which must necessarily be considered in this scale. The Random Scale. The random scale has 18 items. A score of “1” is assigned when people give an answer infrequently chosen and “0” when a frequent answer is given. The items of this scale showed low correlation in the US with the Abuse Scale (Milner, 1986). In the studies conducted by Milner in the US this scale had an average mean (N 5 735) of 2.2 points (SD 5 1.4) and the P95 is 6. In the Chilean study the mean was 4.0 points (SD 5 1.7), with a positive skewed distribution. The P95 was 7 points (N 5 134). The revision of this scale is also necessary, due to the correlation that some items showed with the Abuse Scale and to the fact that an important number of its items discriminated between the study and control groups. The Internal Inconsistency Scale. This scale was developed as a complementary one to the random response scale, in order to reduce false-positive classifications. Inconsistency was operationally defined as contradictory responses in two items with a similar content, and similar responses to items with an opposite content. This scale has 20 item-pairs. A score of “1” is assigned when respondents answer inconsistently and “0” when they answer consistently. The cut-off score suggested by Milner (1986) for this scale is 6 points. In studies carried out in the US (N 5 735), Milner (1986) found an average mean of 2.8 points (SD 5 2.1). In the Chilean pilot study (N 5 56) half of the items of the original version showed a high degree of inconsistency (in more than 30% of the sample; Ramı´rez et al., 1994). In this research practically the same item-pairs were responded inconsistently by a considerable percentage of the sample, even though some modification in the wording was introduced to some of the items. Malfunctioning was due, in most cases, to the fact that one of the items did not discriminate and its pair did.
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The rest of the cases were related to the meaning of the sentences, which seemed to mean different things to the participants. DISCUSSION Using a simple score, the Abuse Scale discriminated between abusing and nonabusing individuals. It correctly classified 90% of the respondents. The factor analysis was similar to that obtained by Milner (1986). The items which had the greatest discriminating power in Chile between people abusing their children and those who do not were those related to feelings of depression, loneliness, anxiety, and problems with family. The items in Milner’s Abuse Scale which were not discriminatory are associated mainly with conducts related to neatness and appearance of children and home, which would reveal the presence of some cultural elements in Milner’s Abuse Scale. This fact doesn’t mean that people in Chile is cleaner than people in the US; it means, maybe, that neatness and appearance are more socially desirable in Chile, especially in low-income families. As the three validity scales proved not to be very efficient in Chile, changes to them should be tested in future research. Regarding the lie scale, it seems necessary to change the wording of some items and to add others, so that they distinctly discriminate between those who tell the truth and those who do not. As to the random scale, it is necessary to replace some items with others that didn’t discriminate and which were answered in the same sense by many people. Finally, new pairs of items must be added in the inconsistency scale, to replace some of them. Some limitations of the study are worth mentioning. The main limitation is related to the sample design, which contemplated extreme populations: cases of severe physical child abuse and cases of reportedly nonabusive parents with a positive attitude towards their children. The design was developed precisely in this manner so as to test the degree of discrimination of the items. However, the items should also be able to discriminate between physical abusers and the general population, taking into account its cultural heritage. Moreover, the sample was almost exclusively made up by women, which could have biased some of the items. Finally, in order to fully verify the properties of the Inventory for the Chilean population, it is necessary to use a larger-sized and a more representative sample. A new research project is being developed, taking into account the limitations mentioned above. This new validation study will include new items to replace those with low discriminant properties in the present study. The final goal is to develop a version of the CAP appropriate for the Chilean population, so as to delineate with a greater degree of precision the more relevant personality traits which are at the base of the conduct and risk of physical child abuse. Acknowledgment—The authors wish to thank Joel Milner, author of the Child Abuse Potential Inventory, for all the assistance given to this research; his interest, support, and information were a very significant contribution to the study.
REFERENCES Alvarez, P. (1992). Maltrato infantil y contexto social: Una perspectiva siste´mica (Child abuse and social context: A systemic perspective). Revista Salud y Cambio, 3, 23–28. Anderson, S. C., & Lauderdale, M. L. (1982). Characteristics of abusive parents: A look at self-esteem. Child Abuse & Neglect, 6, 285–293. Bringiotti, M. I., & Barbich, A. (1992). Adaptacio´n y validacio´n del Child Abuse Potential Inventory-CAP. Versio´n preliminar para la Argentina (Adaptation and validation of the Child Abuse Potential Inventory-CAP. A preliminary version for Argentina). Unpublished manuscript. Subsecretarı´a de Investigaciones, Facultad de Psicologı´a, Buenos Aires, Argentina. Connelly, C. D., & Straus, M. A. (1992). Mother’s age and risk for physical abuse. Child Abuse & Neglect, 16, 709 –718. DePau´l, J., Arruabarrena, I., & Milner, J. S. (1991). Validacio´n de una versio´n espan˜ola del Child Abuse Potential Inventory
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para su uso en Espan˜a (Validation of a Spanish version of the Child Abuse Potential Inventory for its use in Spain). Child Abuse & Neglect, 15, 495–504. Ellis, R. H., & Milner, J. S. (1981). Child abuse and locus of control. Psychological Reports, 48, 507–510. Garbarino, J., & Crouter, A. (1978). Defining the community context for parent-child relations: The correlates of child maltreatment. Child Development, 49, 604 – 616. Justice, B., & Calvert, A. (1990). Family environment factors associated with child abuse. Psychological Reports, 66, 458 – 461. Milner, J. S. (1986). The Child Abuse Potential Inventory: Manual (2nd ed.). Webster, NC: Psytec Inc. Milner, J. S. (1989). Applications and limitations of the Child Abuse Potential Inventory. Early Child Development and Care, 42, 85–97. Milner, J. S. (1990). An interpretative manual for the Child Abuse Potential Inventory. Webster, NC: Psytec Inc. Milner, J. S. (1993). Social information processing and physical child abuse. Clinical Psychology Review, 13, 275–294. Milner, J. S. (1994). Assessing physical child abuse risk: The Child Abuse Potential Inventory. Clinical Psychology Review, 14, 547–583. Milner, J. S., & Ayoub, C. (1980). Evaluation of “at risk” parents using the Child Abuse Potential Inventory. Journal of Clinical Psychology, 36, 945–948. Milner, J. S., Gold, R. G., & Wimberley, R. C. (1986). Prediction and explanation of child abuse: Cross-validation of the Child Abuse Potential Inventory. Journal of Consulting and Clinical Psychology, 54, 865– 866. Milner, J. S., Robertson, K. R., & Rogers, D. L. (1990). Childhood history of abuse and adult child abuse potential. Journal of Family Violence, 5, 15–34. Pruitt, D. L., & Erickson, M. T. (1985). The Child Abuse Potential Inventory: A study of concurrent validity. Journal of Clinical Psychology, 41, 104 –111. Ramı´rez, V., Haz, A. M., & Browne, B. (1994). Adaptacio´n de un instrumento para detectar riesgo de maltrato fı´sico infantil: resultados de una aplicacio´n piloto (Adaptation of an instrument to detect risk of physical child abuse: Findings of a pilot application). Psykhe, 3, 87–96. Robertson, K. R., & Milner, J. S. (1983). Construct validity of the Child Abuse Potential Inventory. Journal of Clinical Psychology, 39, 426 – 429. Starr, R. H. (1988). Physical abuse of children. In V. Van Hasselt, R. Morrison, A. S. Bellack, & M. Hersen (Eds.), Handbook of family violence (pp. 119 –150). New York: Plenum. Straus, M. A., & Kantor, G. (1986). Stress and physical child abuse. Child Abuse & Neglect, 4, 75– 88.
RE´SUME´ Objectif: Cette e´tude a voulu valider au Chili l’instrument Child Abuse Potential Inventory (Milner, 1986). Me´thode: On a retenu un e´chantillon de 134 participants (64 femmes et 3 hommes) dans la re´gion me´tropolitaine de Santiago et la ville de Iquique et on les a divise´s en deux groupes: ceux qui avaient agresse´s leur enfants et ceux qui n’e´taient pas des agresseurs. On a mene´ une analyse de fiabilite´, une analyse pour mesurer la vlidite´ de la construction de l’instrument et de sa capacite´ a` pre´dire et une analyse de chaque composante de l’instrument. Re´sultats: On a attribue´ aux composantes de l’e´chelle Milner les valeurs propose´es par Milner, puis on leur a aussi assigne´ une valeur simple. Les re´sultats e´taient plus consistents lorsqu’on se servait de la deuxie`me modalite´. L’instrument a classe´ correctement 90% des participants (91% dans le groupe des abuse´s et 88% dans le groupe controˇle). Parmi les 76 composantes de l’e´chelle, 55 e´taient tre`s capables de discriminer, six e´taient sans ve´ritable importance et 15 de´montraient des diffe´rences qui n’e´taient pas suffisamment conside´rables pour apporter des distinctions utiles entre les participants. Pour e´valuer la dimension de chaque composante, on a mene´ une analyse factorielle. C’est en ayant recours a` six facteurs qu’on a obtenu les meilleurs re´sultats, represe´ntant une variance de 53,8%. Conclusions: L’e´chelle de Milner a su discriminer entre les participants abuseurs et ceux qui ne l’e´taient pas et a de´montre´ une analyse factorielle semblable a` l’originale. Certaines des composantes refle`tent des comportements culturels propres au Chili plutoˇt que de de´noter un risque d’agression, comme par exemple, la proprete´ des enfants, surtout dans les familles pauvres, laquelle est une caracte´ristique conside´re´e fort de´sirable dans ce milieu.
RESUMEN Objetivo: El objetivo de este trabajo es una validacio´n preliminar en Chile del Inventario del Potencial de Abuso Infantil (Milner, 1986). Me´todo: Se utilizo´ una muestra de 134 participantes del a´rea Metropolitana de Santiago y la ciudad de Iquique en Chile, dividida en dos grupos: personas identificadas como abusadores fı´sicos de sus propios hijos y personas identificadas como no-abusadores. Como resultado del procedimiento para el muestreo, el grupo de estudio estaba compuesto de 64 mujeres
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y tres hombres. En el grupo control se duplico´ e´sta distribucio´n. Se realizo´ un ana´lisis de confiabilidad, un analisis predictivo y de construccio´n, y un ana´lisis de items, de la Escala de Abuso propuesta por Milner. Resultados: Los items de la Escala de Abuso se tabularon ambos con los puntajes ponderados propuestos por Milner y con scores simples. Los resultados fueron ma´s consistentes con los scores simples. Clasificaron correctamente el 90% de los participantes (91% en el grupo abusado y 88% en el grupo control). De los 76 items de la Escala de Abuso, 55 eran altamente discriminatorios, seis de ellos no eran significativos y 15 de ellos tenı´an diferencias que no eran lo suficientemente grande para discriminar bien a las personas. Para evaluar la dimensionalidad de los items, se llevo´ a cabo un ana´lisis factorial. La mejor solucio´n (rotacio´n Oblimin) se obtuvo con seis factores que dan cuenta de 53.8% de la varianza. Conclusio´n: La Escala de Abuso de Milner discrimino´ entre personas abusivas y no-abusivas, y presento´ un ana´lisis factorial similar al original. Algunos items reflejaban conductas relacionadas con la cultura de Chile en lugar del potencial de abuso: estaban relacionadas con la limpieza y la pulcritud socialmente deseables en los nin˜os y en sus casas, especialmente en familias de bajos ingresos.
This article is being published without benefit of the authors’ review of the corrected proof as this was not available at press time.