Transcript MNBS-CR - University of New Hampshire

Development and Psychometric Properties
of the Child Self-Report Multidimensional
Neglectful Behavior Scale (MNBS-CR)
Glenda Kaufman Kantor, Ph.D.
Funded by N.I.C.H.D. Grant # RO1MD39144-01
Grant No. 2002-JW-BX-0002 (OJJDP)
Prior Child Report Measures
of Neglect
• Few child measures
• Young children rarely source of data in
instruments measuring neglect
• Some measure just one or two
components of neglect
• Varying definitions
Measurement Issues
•
•
•
•
•
Omission
Chronicity
Causal factors separate from acts
Acts vs. Injury
Cultural Boundaries
Challenges in Measurement
•
•
•
•
•
•
•
•
•
•
Children’s terminology
Language development, grammar
Cultural aspects of language
Reliability
Age of child
Distractibility
Cognitive ability
Response Sets
Recall Bias
Desire to please
Central Aims of the Study
• Develop a standardized instrument to
measure neglect based on Child SelfReport
• Describe the relationship of neglect to
child behavior problems & family
characteristics
Assessment of Child Neglect in
Community and Clinical Samples:
Development of the Multidimensional
Neglectful Behavior Scale for Child SelfReport
Glenda Kaufman Kantor &
Murray Straus, Family Research
Lab; Carolyn Mebert, UNH,
Wendy Brown, FRL, Crystal
Macallum & Todd Flannery,
Westat
Methods
Clinical Sample
• Spurwink Child Abuse Program
• Maine DHS
• NH DCYF
Eligibility
• Inclusionary Criteria- 6-15 yrs old
• Lived in foster care < 6 months (age 6-9)
• Lived in foster care < 1 year (age 10-15)
• Exclusionary Criteria• Visually impaired
• Hearing impaired
• No spoken language ability
• Non-English speaking
• Formal diagnosis of mental retardation
• Deemed “not interviewable” by clinician
Sample Characteristics
• Clinical Sample
•
•
•
•
•
•
N = 224
49% 6-9 years of age
50% 10-15 yrs. of age
50% female
50% male
8% non-white
• Community Sample
•
•
•
•
•
•
N = 84
71% 6-9 years of age
29% 10-15 yrs. of age
57% female
43% male
27% non-white
Child & Parent Characteristics
• Children
– 1/3 in clinical sample had some emotional or or
severe behavioral problem- depression, anxiety,
ADHD, conduct disorder
• Parents
–
–
–
–
10% Developmental Disability
1/3 Substance Abuse Problem
1/3 Depression
>60% Domestic Violence
Maltreatment Types in Clinical Sample
Number & % in
Group
(Total N = 224)
Overall Types
Neglect
Physical abuse
Sexual abuse
Emotional/Psychological abuse
138 (61.6%)
60 (26.8%)
138 (61.6%)
67 (29.9%)
“Pure” Categories (Participants with
only one designated abuse type)
Neglect
Physical abuse
Sexual abuse
Emotional/Psychological abuse
118 (52.7%)
Multiple Abuse Types
106 (47.3%)
42 (18.8%)
3 (1.3%)
73 (32.6%)
0 (0%)
Measures
Child Report
Clinician
Caretaker
Child Self Report Neglect Scale
• Measures cognitive, emotional,
supervision, and physical neglect
• Includes subscales on: Child
Endangerment: exposure to parental
conflict & violence, abandonment, and
parental alcohol abuse;
• Includes subscale on child’s general
feelings or appraisals of each domain
ACASI
• Audio enhanced version of the Computer
Assisted Self-Administered Interview
• Uses an audio system and touch screen to
interview child
• Tutorial
• Scale version adapted by Age and Gender of
the Child and Gender of the Primary
Caretaker
• Interactive program
• Older children can take Independently
• Computer game break
Emotional Neglect Sample Item
Which girl is most like you?
This girl’s father doesn’t
make her feel better when
she is sad or scared
This girl’s father makes her
feel better when she is sad or
scared
Emotional Neglect Sample Item Cont.
Is this…
A little Sort of
A lot Really a lot
like you like you like you like you
Cognitive Neglect Sample Item
Which girl is most like you?
This girl’s mother talks to
her about what she is
learning in school
This girl’s mother does not
talk to her about what she is
learning in school
Supervision Neglect Sample Item
(age 6-9)
Which boy is most like you?
This boy’s mother knows
where he’s playing
outdoors
This boy’s mother doesn’t
know where he’s playing
outdoors
Supervision Neglect Sample Item
(age 10-15)
Which boy is most like you?
This boy’s father does not find
out where he is going after
school
This boy’s father finds out
where he is going after
school
Hasn’t left alone for a couple of days
without grown-ups
Physical Neglect Sample Item
Which boy is most like you?
This boy’s mother makes sure
he takes a bath
This boy’s mother does not
make sure he takes a bath
Sees grown-ups in the house
hitting each other
Hears grown-ups
in the house fighting
Child Witnessing Item:
Parent Lets Other People
in the House Hurt Child
Depression Sample Item
Which girl is most like you?
Some girls are unhappy
a lot of the time
Other girls are pretty
happy a lot of the time
Depression Sample Item Cont.
Is this…
A little Sort of
A lot Really a lot
like you like you like you like you
Results
Reliability and Validity
• Full Scale Alpha Older Children =.94
• Full Scale Alpha Young Children .76
• Emotional Subscale- highest alphas for
both young and older children
Total MNBS-CR Scores by Child
Neglect Sample: Age 6-9
Neglect Total
10
8.31
8
6
4
3.96
2
0
Community Sample
N = 60
Clinical Sample
N = 110
p < .01
Total MNBS-CR Scores by Child
Neglect Sample: Age 10-15
Neglect Total
11.40
12
10
8
6
5.10
4
2
0
Community Sample
N = 24
Clinical Sample
N = 114
% Neglect Reported by Child and
Community & Clinical Samples
6-9 years
Subscale
Clinical
Cmty.
n = 66
n = 63
% Emotional
38
26
% Cognitive
47
36
% Supervision
40
26
% Physical
50
32
% Abandonment
6
2
% Violence Exp.
37
28
% Alcohol Exp.
9
0
10-15 years
Clinical
Cmty.
n = 78
n = 24
43
29
35
29
46
39
34
25
5
4
25
18
9
0
Neglect Profile
6-9 yr. old children
10-15 yr. old children
Severe Neglect :
• Abandonment
• Alcohol-related Parental
Neglect
• Physical Neglect--Not
enough food in the
house
• Inadequate Supervision
Minor Neglect
Severe Neglect
• Failure to Protect--lets
other people in the
house hurt him
• Abandonment
• Alcohol-related parental
neglect
• Physical Neglect
Minor Neglect--separate
factor
Effects of Parental Characteristics
on Child Reports of Neglect
• Series of Analyses
– Severity weighted score MNBS-CR =
dependent variable
– Clinical Record Data on:
• Parent Mental Illness (No effects found)
• Domestic Violence
• Parent Substance Abuse*
% Child Behavioral Problems by
MNBS-CR Median Split Scores
70%
62%
60%
50%
40%
30%
36%
37%
31%
20%
10%
0%
6-9 year olds
10-15 year olds
N = 102
N = 98
Below Median
Above Median
DV, Victimization and
Child Depression
• Among young children, self-reported
depression is not associated with their reports
of exposure to conflict/violence.
– But Exposure to conflict/violence is significantly
correlated with their self-reports of emotional
neglect
• Among older children, self-reports of
exposure to conflict/violence are associated
with significantly more self-reported
depression.
DV, Victimization and Child Behavior
Problems: Summary of Analysis Results
6-9 Year Olds
• No significant effects
of DV, Sex of
Caretaker, or self
reports of severe
Neglect on CBCL
scores
10-15 Year Olds
• No significant effects
of DV or sex of
caretaker on CBCL
scores
• Severe Neglect is a
significant predictor
of CBCL scores:
• Beta=.336, t=2.101,
p=.04
PPVT Standard Scores by Presenting
Maltreatment Type
PPVT Standard Score
Age 6-9 (n=109)
Age 10-15 (n=107)
Yes
94.24**
96.81
No
100.54
99.50
Yes
92.81
96.41
No
98.43
98.20
Yes
98.75*
97.78
No
93.26
97.53
Yes
95.46
98.85
No
97.53
96.96
Neglect Concerns
Physical Abuse Concerns
Sexual Abuse Concerns
Psych. Abuse Concerns
* p < .05, ** p < .01
Relation between MNBS-CR Scores
& Parent/Child Characteristics: 6-9
• Higher neglect total & appraisal scores were
related to more child self-reported depression
• Child Reports of supervisory neglect
significantly correlated with Clinical Reports
of Parental drug abuse
• Child reports of emotional neglect
significantly correlated with their reports of
conflict/violence exposure
• Higher appraisal scores were associated with
lower Parent IQ scores
Sibling Concordance
• Tested 83 pairs of siblings
– 61 pairs in clinical sample
– 22 pairs in community
• Results of Analysis
– If one sibling reported neglect, other sibs
had 78% chance of also reporting neglect
– Children in Clinical sample reported greater
similarity in neglect than those in community
– Gender significant predictor of concordance
(girls more concordant than boys)
Relation between MNBS-CR Scores &
Parent/Child Characteristics: 10-15 (1)
• Higher neglect total & appraisal scores were related to
more child self-reported depression & more severe
child behavioral problems
• Greater perceptions of neglect were associated with
more child-reported social, thought, & attention
problems and aggressive behavior
• Higher alcohol exposure scores were related to more
child-reported delinquency, thought problems, &
aggressive behaviors
• Greater perceptions of neglect were associated with
lower parent IQ and more parental substance abuse
Conclusions
• Children, particularly older children report
patterns of severe neglect that are consistent
with typical CPS cases
• Neglect multidimensional phenomenon
• Parental Substance major component of
Child Neglect
• No significant effects of Domestic Violence or
Parental Mental Illness
• But parental failure to protect the child from
being hurt, or to keep the child safe, are
associated with a severe dimension of
neglect
Conclusions
• MNBS-CR is promising measure
– Strong Discriminant Validity
– Substantial Evidence of Construct Validity
– High Reliability for Older Children
– Moderate Reliability for Younger Children
– Important tool for screening, assessment,
target interventions
– Multiple measures best
Next Steps
•
•
•
•
•
Test modified items
Social Desirability Scale
Follow-up Study
Develop cutting points
Immediate Score Reports