The Revision Of Child Psychological Maltreatment Scale And The Epidemiological Investigation Of Child Psychological Maltreatment

Objective:(1) To revise the Child Psychological Maltreatment Scale(CPMS) and test the validity and reliability of it, and to provide a standardized measurement tool for understanding the child psychological maltreatment in the context of Chinese culture; (2) To understand the positive rate and the common types of child psychological maltreatment and its impact on children's mental health in the context of Chinese culture by applying the three-stage sampling method in an epidemiological investigation of the status quo of child psychological maltreatment in Hunan Province, and to analyze the affecting factors of child psychological maltreatment.Methods:(1) Our self-developed Child Psychological Maltreatment Scale of 2005 was revised through our literature review and expert discussions, and a preliminary test questionnaire was developed for the Child Psychological Maltreatment Scale based on a small sample investigation. (2) Six regions in Hunan, namely, Changsha, Yiyang, Loudi, Huaihua, Chenzhou, and Yongzhou, were selected as the investigation sites as per the economic situation, neonatal mortality and regional characteristics of this province in 2005, and a total of 7,644 school children of grades 3 to 9 were sampled by applying a three-stage (city/countryside-school-class) sampling method. Each subject completes general data questionnaire, Child Psychological Maltreatment Scale, Childhood Experience Questionnaire, Piers-Harris Child Self-Concept Scale, Achenbach Child Behavior Rating Scale, Child Depression Self-Rating Scale, and Screen for Child Anxiety-Related Emotional Disorders. FoxPro 9.0 databases were created, and statistical analyses were performed with the SPSS 17.0 statistics package.(3) A revised child psychological maltreatment scale of 23 items was developed after an item-by-item factor analysis of the original items. The reliability of the scale was tested in terms of test-retest reliability and homogeneity reliability, and the validity of the scale was tested in terms of content validity, construct validity, and criterion validity.Results:(1) The revised Child Psychological Maltreatment Scale consists of 23 items covering five dimensions:terrorizing, ignoring, belittling, intermeddling, and corrupting. The test-retest reliability of dimensions and the scale was 0.712-0.863,The Cronbach's Alpha was 0.539-0.840; The correlations between the psychological maltreatment subscale and its five dimensions were 0.395-0.851; the correlations among the five dimensions were 0.110-0.596; the exploratory factor analysis revealed that each item has moderate to strong loading on its corresponding factors, and the five extracted factors explained 47.159% of the total variance; the adjusted goodness-of-fit index, the relative goodness-of-fit index, and the non-standard goodness-of-fit index of the confirmatory factor analysis were all 0.93-0.96, with the root mean square error of approximation less than 0.1; and the correlation between CPM and the Psychological maltreatment sub-scale of CEQ was 0.639 and was significant.(2) 32.9%of the children were maltreated, and 20.9% of the children were non-maltreated. Terrorizing was the most common type of psychological maltreatment, and belittling was the least common. (3) The psychological-maltreatment-positive rate showed statistically significant differences (P＜0.05) in its distribution among different variables, such as gender, home location, age, mother's gestational health and emotion, childbirth condition, single-child or non-single-child, earlier childhood health, and parenting attitude. (4) The multiple linear regression indicated that the frequency of psychological maltreatment in children with male gender,poor earlier childhood health,urban home location and inconsistent parenting attitudes will increase; With the increasing of childrens's age and decreasing of their mothers'education, the frequency of psychological maltreatment will increase.The logistic regression showed that the risk factors for children being terrorized included age, inconsistent parenting attitudes, and poor earlier childhood health, and the corresponding protective factors were rural home location and male gender; the risk factors for children being ignored were high income level of family and age; the protective factors for children being belittled were female gender and age; the protective factors for parental intermeddling were age, non-single-child and female gender; the protective factors for children being corrupted were female gender, age and high educational level of mothers. (5) The maltreated children's self-concept was significantly lower than that of the non-maltreated children (P< 0.05), and the former score significantly higher than the latter on internalizing and externalizing problems, anxiety and depression (P＜0.05). (6) All types of psychological maltreatment were significant predictors of multiple psychological functions of children. Terrorizing, ignoring, and belittling were negative predictors of children's self-concept; terrorizing, belittling, intermeddling and corrupting were positive predictors of internalizing and externalizing problems; and terrorizing, ignoring, belittling, intermeddling, and corrupting were all positive predictors of anxiety and depression.Conclusion:(1) The child psychological maltreatment scale has good reliability and validity, can well meet the requirements of psychological measurement and is fit for dissemination into practical applications. (2) The child psychological maltreatment is common in the context of Chinese culture, and 32.9% of the children are maltreated, with terrorizing being its most common type. The psychological maltreatment negatively affects children's self-concept, behaviors, and emotions, and it deserves due attention from the families and the whole society. (3) The occurrence of child psychological maltreatment is associated with such factors as the children's gender, age, earlier childhood health, single-child or non-single-child,home location, family income level, maternal educational level and their parents'parenting attitudes, which shall be the major concerns in the future prevention and intervention of child psychological maltreatment.