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Abuse and Neglect Questionnaire: Revised

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 Bahria Journal of Professional Psychology, July 2022, Vol. 21, No. 2, 01-13
Abuse and Neglect Questionnaire: Revised

*Aasma Yousaf, Aisha Sitwat, PhD and Sara Latif

Centre for Clinical Psychology, University of the Punjab, Lahore, Pakistan
The present study was aimed to revise an indigenous multidimensional Abuse and Neglect
Questionnaire (2018) for the screening of past history of abuse and neglect in adults in
Pakistan. It was a multistage research project that was executed in three stages. Initial stage
was aimed towards item identification from first version of questionnaire that were collated
during factor analysis and re-operationalization of the constructs of abuse and neglect and
description and explanation of its types. Intermediary stage involved evaluation of the
questionnaire by mental health professionals after which experts’ opinions were collated and
final questionnaire was devised. Final stage included pilot study on 10 participants which was
followed by main study during which data was collected from 500 participants (Mage = 30. 82;
SD = 8.8). Demographic Questionnaire and Symptom Checklist Revised (Rahman et al.,
2009) were employed during study. A Principal Component Analysis (PCA) of 51 items with
Varimax rotation yielded 5 factors and the scree plot also showed the emergence of 5 distinct
factors which were extracted and labelled as per thematic analysis i.e. Emotional Abuse,
Sexual Abuse, Physical Abuse, Emotional Neglect, and Physical Neglect. Well established
Psychometric properties of the measure emerged such as the test retest reliability (intra class
correlation coefficient) for all subscales comes out to be .96, .95, .91, .74, and .89
respectively; Internal Consistency Reliability (.94, .93, .81, .78, and .56 respectively) and
average inter item correlation (.45, .50, .35, .32, and .22 respectively). In addition, the
construct and face validity of the respective questionnaire were also established. The
development and validation of this questionnaire has manifold implications as it can be
employed in the future researches, in clinical settings and can be helpful in devising cultural
sensitive indigenous interventions.
Keywords: Abuse and neglect questionnaire, emotional abuse, sexual abuse, physical abuse,
emotional neglect, and physical neglect
Maltreatment with humans and violating their rights has become a social and global
pattern (Kim & Drake, 2019). Despite it is hard to imagine someone deliberately harming a
child or neglecting the child’s essentials, the child abuse and neglect cases are growing day
by day in Pakistan (Mehnaz, 2018). According to the Ministry of Human Rights Government
of Pakistan (2019), in the past few years there has been an upsurge in the cases of child abuse
reported in Media. More than 200 cases of sexual abuse reported in Qasur, Punjab Pakistan
and the Zainab’s Case – a young girl from the same City created uproar in the Media. A
number of National and International Organizations surveys calls for the implementation of
an effective law and a mechanism of deterrence as well as awareness to curb the growing
menace (Federal Ombudsman, 2019).
According to Child Welfare Information Gateway (2018), Child Abuse is defined as
the threat to the welfare of the child through physically, emotionally and sexually exploiting
him. It includes a spacious extent of abuse of children, which tends to include child
punishment, beating, emotional maltreatment, sexual abuse in addition to incest and

*Correspondence concerning this article should be addressed to Aasma Yousaf, Centre for
Clinical Psychology, University of the Punjab, Lahore, Pakistan. E-mail:
[email protected]
 YOUSAF, SITWAT AND LATIF

exploitation (Mehnaz, 2018). Child neglect is defined as physical, or emotional negligence

and probably failure to provide minimal care such as (food, shelter, safety, health, physical &
emotional care) to the child that is threatening for his wellbeing (Child Welfare Information
Gateway, 2018).

Statistics on maltreatment revealed alarming proportions around the globe. A meta-

analysis of 244 researches from various Countries revealed the life time prevalence of
physical abuse to be (22.6%), emotional abuse (36.3%), physical neglect (16.3%), and
emotional neglect (18.4%; Soltenborgh et al., 2015). Moreover, it was revealed that Asian
Countries showed exceptionally lower onset and recurring rate of abuse and neglect as
compared to other Countries (Kim & Drake, 2019).

According to the data collected by Pakistani NGO’s, there has been an increment of
32% in child abuse cases in 2018 as compared to 2017 (Ministry of Human Rights
Government of Pakistan, 2019). In the Punjab province, child abduction and abuse cases has
reached at shocking level (12 children are abused every day). Moreover, latest researches
revealed that in Pakistan, the child sexual abuse cases raised 10% in the year 2017 (Javed,
2017). According to a Report, due to sexual abuse, abortion rate has also been raised from
6.2% in 2008 to 16.2% in 2018 which calls for strict measures to tackle the issues of child
protection (Federal Ombudsman, 2019).

Child abuse varies from culture to culture and has different manifestations in various
regions according to the age, gender, economic background and family structure (Epstein,
2008) and parenting style (Camilla et al., 2019). The exposure of young children to abuse and
neglect impose serious effects on their lives (WHO, 2012). These traumatic experiences in
childhood alter their perception about themselves and the world; in turn influences the
capacity to cope with the stressors effectively (Bano & Akhtar, 2018). Thus, as such children
grow older they experiences challenges in their relationships and in grasping hard facts of
life, gradually developing psychological disorders (Aghalipuor, et al., 2013).

Though Human Rights Ministry Officials raised the issue of abuse and neglect
incidents with the ex Prime Minister Imran Khan to tackle maltreatment cases and to draft a
child protection policy and therefore Prime Minister proposed that death penalty to be fixed
for the perpetrators to discourage the attacks on humanity (Hasan, 2019). Nevertheless, it’s
imperative that other bodies shall also get united to eradicate the associated morbidity. With
reference to Pakistan, there is scarcity of laws and bodies to keep a check on such incidents;
develop assessment tools to screen individuals with abuse in childhood; and rehabilitate such
individuals. Thus, for assessment, identification and diagnostic purposes, a great need was
emerged to develop some instrument to identify abuse and neglect in childhood history of
adults with several mental disorders. Such instrument was required to be free from language
and cultural biases in order to represent the valid test for Pakistani population.

Although several international questionnaires with well-established psychometric

properties are available that assesses abuse and neglect experiences such as Childhood
Trauma Questionnaire (CTQ), Juvenile Victimization Questionnaire (JVQ), Childhood Abuse
and Trauma Scale (CAT), Trauma Symptom Checklist (TSC), ISPCAN Child Abuse
Screening Tool, and the Sexual and Physical Abuse Questionnaire (SPAQ). However, some
of the questionnaires such as CTQ-SF (28 items), TSC (40 items), and ISPCAN Child Abuse
Screening Tool – Child’s Institutional version (43 items) need to be purchased per
administration and demands high cost (Johnson et al., 1999). Some other questionnaires also
have limitations such as CTQ- SF items lacks behavioral base and overlook important
ABUSE AND NEGLECT QUESTIONNAIRE

information regarding onset of abuse/ neglect, disclosure, and perpetrator etc. (Margolin,
2005). Likewise, JVQ criterion validity has not been assessed and specific exposures are
determined by only one item for example physical abuse is determined by a single item
(Jackson et al., 2000).

Though few indigenous questionnaires were also developed but have certain
limitations. Malik and Shah (2007) developed indigenous child abuse scale that was used to
evaluate different levels and types of abuse and neglect among 200 children of age range 8 to
12 years. In this research, only data from children was collected from schools. However,
adult population and children from homes, schools and community was not recruited.
Likewise, Naz and Kauser (2012) developed indigenous Child Abuse Interview (CAI) as part
of research that was conducted on adolescents with somatoform disorder. It comprised of 44
items to assess abuse and neglect among adolescents with somatoform disorder. It consisted
of four sub scales (physical abuse, emotional abuse, sexual abuse & neglect). Types of
neglect i.e. emotional and physical neglect were not explored. Moreover, it was not
standardized on Pakistani population. The psychometric properties of a tool are very
important to establish because these are important part of test construction (Kumar, 2015).
Thus a reliable and valid tool that is standardized on Pakistani population is deemed essential.
Abuse and neglect questionnaires employed in other academic researches also lack well
established psychometric properties and has certain limitations such as not standardized on
Pakistani population (Ghaffar & Malik, 2014; Irfan & Cowburn, 2004).

This initial attempt to develop a Child Abuse Scale needs additional studies to
replicate the psychometric characteristics of the scale, especially the factorial structure and
the cut-off scores with larger and different samples, including a clinical sample. The samples
may be selected from different settings of child abuse, for example, home, schools and
community, differing in the intensity and nature of abuse and neglect. This would add to the
sensitivity of the measure to identify and categorise the instances and the intensity of child
abuse and neglect in the larger context. This initial attempt to develop a Child Abuse Scale
needs additional studies to replicate the psychometric characteristics of the scale, especially
the factorial structure and the cut-off scores with larger and different samples, including a
clinical sample. The samples may be selected from different settings of child abuse, for
example, home, schools and community, differing in the intensity and nature of abuse and
neglect. This would add to the sensitivity of the measure to identify and categorise the
instances and the inten sity of child abuse and neglect in the larger context. This initial
attempt to develop a Child Abuse Scale needs additional studies to replicate the psychometric
characteristics of the scale, especially the factorial structure and the cut-off scores with larger
and different samples, including a clinical sample. The samples may be selected from
different settings of child abuse, for example, home, schools and community, differing in the
intensity and nature of abuse and neglect. This would add to the sensitivity of the measure to
identify and categorise the instances and the intensity of child abuse and neglect in the larger
context

The first version/ original questionnaire developed by Yousaf, et al. (2018) had some
limitations i.e. the factor loadings that were yielded through Explanatory Factor Analysis
with Varimax rotation generated three factors. The factor analysis combined abuse and
neglect items into one factor i.e. physical abuse and physical neglect items were clustered
together; where as emotional abuse and emotional neglect items were merged. However,
literature shows that although both these constructs lead towards psychopathology but abuse
and neglect should be dealt separately (Toth & Manly, 2018). Since, the Abuse and neglect is
 YOUSAF, SITWAT AND LATIF

multi factorial in nature, a multi-dimensional approach was needed for the identifications of
high risk individuals. Thus the present study was designed to develop and validate a multi-
dimensional measure of abuse and neglect screening questionnaire with sound psychometric
properties which can be further employed for clinical purposes i.e. to assess actual abuse and
neglect experiences. It will also serve as the backbone for further researches in the realm of
Mental Health.

Method
This research project was executed in three stages.
Initial Stage
Foremost, the items were identified from first version of questionnaire (Yousaf, et al.,
2018) that were collated during factor analysis. Then the construct of Abuse and Neglect was
re-operationalized in the light of previous and current literature, theoretical model and
theoretical knowledge. The items were pooled with respect to existing literature, Islamic
perspective and in the face of cultural context. The items reflect cognitive, behavioral and
affective elements that are implicit in the Abuse and Neglect construct. An item pool
comprised of 51 items that were generated on the basis of 3 types of Abuse (Emotional
Abuse, Sexual Abuse, Physical Abuse) and 2 types of Neglect (Emotional Neglect &
Physical Neglect).
Intermediary Stage
The formulated questionnaire was sent to seven Senior Clinical Psychologists/ Mental
Health Professionals who hold sound knowledge and expertise of the respective subject. Only
the experts meeting the desired criteria were nominated for evaluating the questionnaire: 1) A
Professional having Ph. D / MS Degree in Clinical Psychology and 2) is practicing Clinical
Psychologist/ Mental Health Professional in the relevant field for at least 5 five years. The
feedback of the experts highlighted the sensitivity of the tool and proved helpful in
reformulating and restating certain ambiguous items. The feedback of all the professionals
was collated and the final questionnaire was devised. The questionnaire was reviewed time
and again and was finalized.
Final Stage
During the final stage, pilot and main study was conducted.
Participants
Non probability purposive sampling strategy was employed to recruit participants. A
total of 500 participants (Mage = 30. 82, SD = 8.8) were recruited as per criteria from Centre
for Clinical Psychology, Sir Ganga Ram Hospital, MAYO Hospital, Punjab Institute of
Mental Health, Services Hospital, Jinnah Hospital and Mian Afzal Trust Hospital.
Measures
Abuse and neglect questionnaire – revised. This revised version of the first
questionnaire (Yousaf, et al., 2018) is comprised of 51 items that is aimed to assess abuse and
neglect experiences. It is a 5-point likert scale that ranges from Never True (1) to Very Often
True (5). It has five subscales i.e. Emotional Abuse, Sexual Abuse, Physical Abuse,
Emotional Neglect, and Physical Neglect with high alpha coefficient reliability for each
subscale was emerged i.e. .94, .93, .81, .78, and .56 respectively.
ABUSE AND NEGLECT QUESTIONNAIRE

Demographic information questionnaire. It was devised as part of the research

work to yield basic demographics of the participants of the study. It included age, gender,
education, occupation, religion, siblings, birth order, marital status, no. of children, family
system and socioeconomic status. It also included questions related to monthly income at the
time of abuse, total family members at the time of abuse, type of abuse, no of times abused,
age at abuse, relationship with the perpetrator, and influence of abuse on life.
Symptom Checklist Revised (SCL-R). It was adapted in Urdu by Rahman, et al.
(2009) and was employed in the study to assess Depressive Disorders, Anxiety, Somatoform,
Schizophrenia and OCD among the participants. The items were rated on a four point likert
type rating scale Not At All (0) to Very Much (3). Five subscales of SCL-R were
administered on the psychiatric population i.e. Depression (24 items), Anxiety (29 items),
Somatoform (27 items), Schizophrenia (15 items) and Obsessive Compulsive Disorder (15
items). The validity of SCL-R is .40-.60. The reliability range determined by test retest
method is .74- .92.
Procedure
The permission was sought from Department Ethical Committee to execute the
research project. The permission to use the Symptom Checklist Revised was taken from the
respective author and the permission to collect the data was sought from the Director of
Centre for Clinical Psychology and from head of the Psychiatric Departments of major
hospitals of Lahore, Pakistan: Sir Gange Ram Hospital, MAYO Hospital, PIMH, Services
Hospital, Jinnah Hospital and Mian Afzal Trust Hospital.
Pilot study was conducted on 10 participants (4 from Centre for Clinical Psychology
and 6 from Sir Ganga Ram Hospital) to examine if the questions were clearly stated and
understood well by the participants. The participants found questions easy to comprehend.
They only found difficulty in comprehending negative worded questions. They provided
feedback to make these items easy. Thus the researcher rephrased the items stating in clear
and straight forward way. The average time consumed to complete the questionnaire was 45
minutes.
During the main study, a total of 565 participants were approached, however; 540 met
the inclusion/ exclusion criteria. 520 participants gave their consent and voluntarily
participated in the study. Some questionnaires were discarded during the data entry due to
several reasons such as incomplete questionnaires etc. Thereby, a total data of 500
participants responded (Response Rate 88.4%) based on which the final version of the Child
Abuse and Neglect Questionnaire of 51 items, along with Demographic Questionnaire and
Symptom Checklist Revised (SCL-R) were administered. During the verbal administration,
the rationale and objectives of the study were explained to the participants and their consent
was taken. Moreover, they were assured that all the data will be kept confidential and will
only be used for research and educational purposes. All ethical considerations were observed
during the entire research process.
Results
A Principal Component analysis of 51 items was executed out with rotation method
(Varimax with Kaiser Normalization). The method employed for factor retention was Kaiser
or mineigen greater than 1 criterion (K1), which retains factors with eigenvalues greater than
1 (Kaiser, 1960). Furthermore, Cattell’s Scree test was also used to determine the number of
factors to retain. It displayed plot of Eigen values which was used to examine breaks or
discontinuities (Cattell & Jaspers, 1967). Rotations were converged in 7 iterations. The
 YOUSAF, SITWAT AND LATIF

Kaiser-Meyer-Olkins measure verified that the sample is adequate for the analysis KMO= .90
(superb’ according to Field, 2009). Barlett’s test of spherecity χ2 (1275) = 12374.587, p<.001
indicated that the inter item correlation was sufficiently large for PCA. A preliminary
analysis was done to obtain Eigen value for all the component in the data. The Kaiser criteria
of 1 yielded 5 factors. The factor analysis yielded a neat arrangement of 5 factors and
explained 52.38 % of variance.
Table 1
Factor Loading for Fix Factor Analysis with Varimax Rotation of Childhood Abuse and
Neglect Questionnaire.
Item numbers Factors EA SA PA EN PN
1 EN .24
2 EA .53
3 PN .62
4 EA .68
5 PN .34
6 PN .71
7 EA .63
8 EN .22
9 PA .73
10 SA .87
11 PA .82
12 PA .82
13 PA .49
14 PA .85
15 PN .76
16 SA .83
17 PN .51
18 PA .38
19 SA .89
20 SA .89
21 PA .74
22 EA .79
23 EN .55
24 EA .71
25 SA .60
26 EA .78
27 EA .58
28 SA .38
29 SA .61
30 EA .69
31 SA .65
32 EA .77
33 EN .55
34 EN .69
35 EN .57
36 EN .67
37 EN .62
38 EN .56
39 SA .78
ABUSE AND NEGLECT QUESTIONNAIRE

40 PN .47
41 EA .60
42 EN .53
43 EA .61
44 EA .63
45 EA .59
46 SA .34
47 SA .85
48 EA .50
49 EA .53
50 EN .62
51 PN .30
Note. EA= Emotional Abuse, EN= Emotional Neglect, PA= Physical Abuse, PN= Physical
Neglect, SA= Sexual Abuse.
Table 1 depicts five factors along with their factor loadings. These factors were
thematically analyzed and entitled as per content of the items in each factor. The thematic
analysis suggested factor one as ‘Emotional Abuse’. This scale comprises of 19 items i.e. 2,
4, 7, 8, 17, 22, 24, 26, 27, 30, 32, 34, 38, 41, 43, 44, 45, 48 and 49. Second factor is identified
as ‘Sexual Abuse’. It comprises 11 items i.e. 10, 16, 19, 20, 25, 28, 29, 31, 39, 46 and 47.
Factor three is comprised of items that relates to ‘Physical Abuse’. 8 items come under this
factor i.e. 23, 33, 35, 36, 37, 42, 50 and 51. Factor four ‘Emotional Neglect’ comprises of 8
items i.e. 1, 9, 11, 12, 13, 14, 18 and 21. Factor five was named as ‘Physical Neglect’. Five
items that are item# 3, 5, 6, 15 and 40 come under this component
All the factors utilize a four point intensity scale for measurement and depicted
adequate content, construct and face validity as Clinical Psychologists and experts opinions
also evaluated it to be above average.
Table 2
Factor, Items in the Original Item Pool, Items after Factor Analysis and Total No. of Items
Factors Item No’s in the Original Total No. Item No’s after Total No.
Item Pool of items Factor Analysis of items
EA 2, 4, 7, 22, 24, 26, 27, 30, 15 2, 4, 7, 8, 17, 22, 24, 26, 19
32, 41, 43, 44, 45, 48 and 49 27, 30 32, 34, 38, 41, 43,
44, 45, 48 and 49
SA 10, 16, 19, 20, 25, 28, 29, 11 10, 16, 19, 20, 25, 28, 29, 11
31, 39, 46, 47 31, 39, 46, 47
PA 9, 11, 12, 13, 14, 18, 21 7 1, 9, 11, 12, 13, 14, 18, 21 8
EN 1, 8, 23, 33, 34, 35, 36, 37, 11 23, 33, 35, 36, 37, 42, 50, 8
38, 42, 50 51
PN 3, 5, 6, 15, 17, 40, 51 7 3, 5, 6, 15, 40 5
Note. EA= Emotional Abuse, EN= Emotional Neglect, PA= Physical Abuse, PN= Physical
Neglect, SA= Sexual Abuse.

Table 2 shows factor and corresponding items numbers in the original pool. It also
displays item numbers and number of items after Varimax rotation (Principal Component
 YOUSAF, SITWAT AND LATIF

Analysis). Only 6 items i.e. item no # 8, 17, 34, 38, 1 and 51 were misclassified. These items
belong to some other factor but after factor analysis (Varimax Rotation) they were classified
with the factor that constitute all the items that probe some other type of abuse/ neglect.

Discussion
It is imperative that indigenously screening tools needs to be developed to have a
clear picture of manifestation of abuse and neglect in a particular culture. Therefore, the
present study was designed to develop and validate a Multidimensional Indigenous Child
Abuse and Neglect Screening Questionnaire Revised. The initial researches on scale
development are carried out mostly on psychiatric populations (for example Bernstein et al.,
2003; Finkelhor et al., 2005; Fakunmoju & Bammeke, 2013; Fergusson, et al., 2013;
Dinwiddie et al., 2000; Beitchman, et al., 1992; Naz, 2011; Yousaf & Sitwat, 2010).
Therefore, in the present research also psychiatric population was targeted for the
development and validation of this questionnaire.
Two sets of factor analyses were executed employing Principal Component Analysis
with Varimax rotation for Child Abuse and Neglect. Five factors extracted through fix factor
analysis in the current study affirmed Child Abuse and Neglect Screening Questionnaire-
Revised. It is consistent with the previous researches such as Bernstein et al. (2003) also
developed and validated Childhood Trauma Questionnaire (the CTQ-SF) to screen the
participants with past history of maltreatment. This 70 items based screening questionnaire
was devised for both clinical and general population. Factor analysis of 70 items of CTQ-SF
also yielded five domains i.e. physical abuse, physical neglect, emotional abuse, emotional
neglect and sexual abuse (Bernstein, et al., 2003). In the preset study Emotional abuse factor
comprises 15 items that are sufficient to probe occurrence of verbal attacks such as
criticizing, insulting, rejecting and teasing. All the 15 items also after Factor Analysis were
categorized in the factor Emotional Abuse which reflects that the content of the items was
adequate. All the items under its heading relates to harming one’s emotional stability that
results in the significant change in his/ her emotional responsiveness and behavior. Factor one
‘Emotional Abuse’ was also assessed in other researches and the results are consistent with
the findings of the current research (Bernstein & Fink, 1997).
Second factor is identified as ‘Sexual Abuse’ as all the 11 items of the questionnaire
come under its heading that relates to sexually exploitative behavior such as forcing any child
to engage in sexual behavior, fondling the child’s genitals, compelling for oral and anal sex,
incest and rape. After factor analysis also the same 11 items were loaded on the same factor
i.e. Sexual Abuse. This factor was also measured by other researchers. Child Abuse
Screening Tool was devised by an International body working for the Prevention of Child
Abuse and Neglect. This respective tool was based on 43 items and factor analysis generated
three subscales i.e. physical abuse, emotional abuse and sexual abuse (Zolotor et al., 2009).
The content of the items of sexual abuse subscale in this study is consistent with the items of
the other researches. Fergusson, et al. (2013) also assessed sexual abuse during childhood and
after 30 years its impact on adulthood on 900 participants. Results revealed that child sexual
abuse is accompanied by higher rates of post traumatic symptoms, lowers self-esteem and
negatively influences life. It leads to Depression, Anxiety disorder, Suicidal ideation,
suicidal attempt, and substance dependence.
Factor three is comprised of 8 items that relates to ‘Physical Abuse’ that probe any
occurrence of non-accidental and deliberate risk or harm directed towards the child such as
minor injuries that may range from mild (bruises, laceration, wounds, abrasions) to severe
ABUSE AND NEGLECT QUESTIONNAIRE

(injuries, aches, or broken bones). Factor analysis revealed that the content of the items under
this factor was adequate. All the items of this factor were loaded under their respective factor.
This factor was also measured by other researchers. Ghaffar and Malik (2014) developed
Child Abuse Scale Adolescent form. The following questionnaire measures child
maltreatment (physical, emotional and sexual abuse in adolescents).
Factor four ‘Emotional Neglect’ relates to items regarding failure to fulfill emotional
needs of a child. It includes failure to provide love, encouragement, affiliation, support. It
includes persistent ignoring and socially isolating someone. This factor comprises of 8 items.
However, after factor analysis its one item was loaded under the second factor of Physical
Abuse and three other factors were loaded under Emotional Abuse. Thus, these four items
can be rephrased in the future research. This factor was also measured by other researchers.
Fakunmoju and Bammeke (2013) presented psychometric properties of the Perception of
Child Maltreatment Scale (PCMS) that was comprised of 34 items. This scale was intended
to measure child labor and maltreatment during childhood (physical or emotional in nature).
Another Child Abuse Scale developed by Malik and Shah (2007) for child population also
has four empirically determined subscales i.e. physical abuse, physical neglect, emotional
abuse and emotional neglect.
Factor five includes items relating to neglecting child needs and failure to provide
food, shelter, safety, health and minimal physical care to the child. Therefore, this factor was
named as ‘Physical Neglect’. Factor Analysis suggest that item no 17 and 51 of Physical
Neglect scale need to be revised as they were loaded under some other factor. The content of
the remaining items was adequate. This factor was also assessed by many other researches
(Naz, & Kauser, 2012; Yousaf, et al., 2018).
Test retest Reliability (intra class correlation coefficient) was established by
administering the same questionnaire on 50 participants over a period of 2 weeks to evaluate
it for stability over time. The participant’s scores on five subscales of Abuse and Neglect
Screening questionnaire for the first time administration and for re-administration were then
evaluated to seek correlation coefficient. By keeping Two Way Mixed Model and Absolute
Agreement type, the intra class correlation coefficient for all subscales (i.e. Emotional Abuse,
Sexual Abuse, Physical Abuse, Emotional Neglect, and Physical Neglect) comes out to be
.96, .95, .91, .74, and .89 respectively. It indicates high test retest reliability of all subscales.
Internal consistency Reliability was used to estimate the extent to which multiple test
items of the same scale that probe the similar construct generate the same results. Internal
consistency Reliability was estimated by computing Chronbach’s Alpha and Average Inter
Item Correlation.
Chronbach’s Alpha reliability analysis of each subscale was also carried out by
computing Cronbach’s alpha. For each subscale Emotional Abuse, Sexual Abuse, Physical
Abuse, Emotional Neglect, and Physical Neglect high alpha coefficient reliability emerged
i.e. .94, .93, .81, .78, and .56 respectively.
Average Inter Item Correlation was computed for all subscales by selecting all the
items of each subscale of Abuse and Neglect Screening Questionnaire that probe the same
construct and by computing its correlation coefficient. Afterwards the average of all of the
correlation coefficients was computed to yield the average inter-item correlation for all
subscales which was observed to be .45, .50, .35, .32, and .22 for Emotional Abuse, Sexual
Abuse, Physical Abuse, Emotional Neglect, and Physical Neglect respectively.
 YOUSAF, SITWAT AND LATIF

Construct Validity ensures if the child abuse and neglect screening questionnaire and
its subscales truly measures the intended construct rather than extraneous factor. Therefore to
establish construct validity of the questionnaire, the researcher contacted the panel of the
experts and the Professionals of the relevant field and were familiar with the construct.
Construct Validity was thus established through carefully defining the conceptual framework.
The formulated questionnaire was given to ten Senior Mental Health Professionals who hold
sound knowledge and expertise of the respective subject. The experts evaluated the items and
suggested what that specific item reflects and intends to measure. The feedback of the experts
highlighted the sensitivity of the tool and that its content extensively measures Child Abuse
and Neglect. Thus, for the current study the consensus given by the Senior Mental Health
Professionals was utilized as an indicator of construct validity.
Face validity was established on the basis of expert opinion and evaluation of the
Child Abuse and Neglect Questionnaire from Seven Senior Mental Health Professionals.
They were asked to rate the appropriateness and whether the items of the subscales appears to
assess the intended construct under study. They were requested to rate the questions under
each domain and give recommendations/ suggestions/ or indicate amendments if required in
case of low rating of an item. None of the item was deleted after the process of evaluation,
thus confirming the face validity of the questionnaire. Only certain words and sentence
structure of certain items were amended as per suggestions of the experts.
Conclusion
The current study was aimed at devising and validating an indigenous
multidimensional screening measure of child abuse and neglect and to a great extent the
effort was a success. A large sample size of psychiatric population was ensured (N=500).
Moreover from developing and revising measure on the basis of expert opinion to robust data
collection, advanced analyses and establishing psychometric properties, the measure serves as
a reliable and valid screening instrument to be employed for clinical and academic/ research
purposes.
Limitations and Suggestions
Every research work has some constraints in it which in turn serves as the backbone
for further improvement in forthcoming researches. In the current study, for establishing test
retest reliability, the measure was though re-administered on 85 participants but 50
participants were able to complete it. Some left the questionnaire incomplete and some
questionnaires were discarded due to non-serious responses of the participants. Thus, it may
could have yield more reliable results if re-administration could be ensured on large sample.
Besides, for further study the steps to follow include determining the parallel forms
reliability, split half reliability, criterian related validity, formative validity, convergent and
divergent validity of the questionnaire with different measures and populations.
Future Implications
This study will serve as the building block for further researches in the area of
abuse and neglect in the realm of mental health. Reliability and validity studies in the future
will facilitate in identifying the structure of the child abuse and neglect construct. Moreover,
future researches will be undertaken to identify the relationship between the history of abuse
and neglect and mental health. This questionnaire can also be employed in clinical setting for
probing the history of abuse and neglect in childhood and indigenous interventions can
further be devised.
ABUSE AND NEGLECT QUESTIONNAIRE

References
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