Development and Psychometric Evaluation of the Child Neglect Questionnaire.

563836 research-article2014

JIVXXX10.1177/0886260514563836Journal of Interpersonal ViolenceStewart et al.

Article

Development and Psychometric Evaluation of the Child Neglect Questionnaire

Journal of Interpersonal Violence 1–24 © The Author(s) 2014 Reprints and permissions: sagepub.com/journalsPermissions.nav DOI: 10.1177/0886260514563836 jiv.sagepub.com

Chris Stewart, PhD,1 Levent Kirisci, PhD,2 Abigail L. Long, BA,3 and Peter R. Giancola, PhD3

Abstract Neglect poses a significant risk for children throughout their development and is often linked with serious consequences that reach into adulthood. The Child Neglect Questionnaire (CNQ) fills existing gaps by incorporating multiple perspectives from both parents and the child, as well as measuring the complex phenomenon of neglect multidimensionally. Furthermore, this measure addresses the need for an instrument specifically developed for late childhood (ages 10-12), as much of the extant evidence and corresponding measures focus on young children and their mothers. A panel of three psychologists, using Cicchetti’s model of child neglect as a theoretical guide, began by selecting items from an existing database. Results of exploratory and confirmatory factor analyses and item response theory demonstrated the unidimensionality of physical, emotional, educational, and supervision neglect as well as a second-order construct of child neglect. Analyses controlling for risk status due to father’s substance use disorder, socioeconomic status, and child’s ethnicity demonstrated that father’s and mother’s (parental) neglect, particularly in the child’s versions, had sound concurrent and predictive validity. Concurrently, at age 10-12, the child’s 1Texas

A&M University, Commerce, USA of Pittsburgh, PA, USA 3University of Kentucky, Lexington, USA 2University

Corresponding Author: Chris Stewart, School of Social Work, Texas A&M University, 2600 South Neal Street, Commerce, TX 33620, USA. Email: [email protected]

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Journal of Interpersonal Violence

version of both parents’ neglect correlated with their parenting behaviors evaluated by other available measures. Prospectively, from 10-12 years of age to 11-13 years of age, parental neglect predicted child’s drug use frequency with coexisting psychological dysregulation, psychiatric symptoms, antisocial behavior, non-normative sexual behavior, involvement with deviant peers and leisure activities thus demonstrating sound predictive validity. Also, internal consistency and inter-rater reliability were excellent. The CNQ, particularly the child’s version, may thus be useful for detecting children at high risk for parental neglect. Keywords child abuse, neglect, anything related to child abuse

Introduction Neglect poses a significant risk for children throughout their development and is often associated with serious consequences that reach into adulthood (Cicchetti & Valentino, 2006; Dubowitz, 1999; Manly, Oshri, Lynch, Herzog, & Wortel, 2013; Youngblade & Belsky, 1990). Although the exact prevalence rate for neglect can be difficult to determine, the literature has consistently confirmed child neglect as a large category of child maltreatment (Daro & McCurdy, 1993; Horwath, 2005; Manly et al., 2013; Stoltenborgh, Bakermans-Kranenburg, & Van Ijzendoorn, 2013). Despite the high prevalence of child neglect, such research is significantly lagging behind other types of child maltreatment research (Schumacher, Slep, & Heyman, 2001; Stoltenborgh et al., 2013; Zuravin, 1999). Despite fairly universal agreement on the need for increased research, however, the considerable debate as to the most accurate manner to conceptualize and subsequently operationalize child neglect has significantly hindered progress (Dubowitz et al., 2005; Stoltenborgh et al., 2013). By addressing many of these recognized issues, the Child Neglect Questionnaire (CNQ) presents an available alternative to further elucidate neglect etiology and its impact on the psychosocial and physical development of children. The initial step in furthering the understanding of child neglect is to accurately conceptualize the construct (Dubowitz, 2007; Dubowitz et al., 2005). Although several solid conceptualizations exist, there is a lack of universal agreement, perhaps due to the extremely complicated interaction of factors involved with child neglect (Manly et al., 2013; Rosenman & Rodgers, 2004; Scott, 2014; Stoltenborgh et al., 2013).


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The primary issues are to not only untangle the impact of environmental factors such as poverty or differences of ethnicity but also conceptualizing when parenting behaviors fall below “normal” expectations (Manly et al., 2013; Rosenman & Rodgers, 2004; Scott, 2014). These conceptual difficulties, among others, have led one prominent neglect researcher to suggest that a universal definition may not be possible (Dubowitz, 2007). Similarly, these issues directly complicate the operationalization of child neglect (Manly et al., 2013; Stoltenborgh et al., 2013). Historically, the measurement of neglect has often involved the use of existing state Child Protective Service (CPS) agency data (Dubowitz et al., 2005; Stoltenborgh et al., 2013). By utilizing pre-existing data from CPS services, research definitions of child neglect must necessarily match, a priori, these categories, creating numerous possible definitions, often heavily dependent upon the perspective of the particular CPS worker collecting the data, which may be culturally influenced or biased (Manly et al., 2013; Rosenman & Rodgers, 2004; Scott, 2014). Furthermore, the use of such a priori data may not allow for a comprehensive conceptualization as CPS systems tend to conceptualize child neglect unidimensionally, either from the perspective of the child or the deficient caregiver but not both (Manly, 2005; Slack, Holl, Altenbernd, McDaniel, & Stevens, 2003; Stoltenborgh et al., 2013). In an effort to reduce the impact of these issues and increase child neglect conceptualization reliability, there have been attempts to codify CPS data. Systems such as the Maltreatment Classification System (MCS; Barnett, Manly, & Cicchetti, 1993) transform pre-existing reported incidences of child neglect, often from CPS records, into valid categories of neglect that can produce greater rigor in research and more meaningful generalizations of results (Barnett et al., 1993). Although these systems do succeed in greatly increasing the reliability of such data, the reliance upon secondary data continues to present problems. Differing systemic a priori categorizations of neglect, the untested reliability of caseworkers, and the consistent lack of differing perspectives or cultural bias create significant problems for researching such a complex phenomenon as child neglect. Additional attempts have been made to rectify these issues and more accurately assess current child neglect or the potential for such maltreatment by inclusion of the child’s environment. These measures identify particular environmental risks, such as the condition of the living space, that might be targeted for intervention and thus reduce the risk of maltreatment in general. Alternatively, in the case of the Checklist for Living Environments to Assess Neglect (CLEAN), child neglect is targeted specifically (Watson-Perczel, Lutzker, Greene, & McGimpsey, 1988). Others have utilized constellations


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of family risk factors, such as parental monitoring, associated with general child maltreatment. The Washington State Risk Assessment Matrix (WARM) and Child Endangerment Risk Assessment Protocol (CERAP) exemplify this approach (Illinois Department of Children and Family Services, 1996; Palmer, 1988). One measure was specifically designed to address neglectful situations, the Ontario Child Neglect Index (CNI) and is completed by child service workers, without benefit of either child or caregiver participation (Trocme, 1996). While all of these models allow child service workers to focus on particular factors that have demonstrated potential for maltreatment, they may not specifically address incidents of neglect or neglectful caregiver behavior or may miss past incidences of maltreatment. In addition, systems that categorize incidences of child neglect from CPS records, such as the MCS or instruments that assess risk solely from the child’s environment, without either the child or caregiver’s direct report, are problematic because they may not accurately conceptualize the multiple dimensions of child neglect or incorporate the perspective of those directly involved (McGee, Wolfe, Yuen, Wilson, & Carnochan, 1995; Stoltenborgh et al., 2013). Even when the child’s perspective is considered, there is the issue of accurate recall, particularly if significant time has passed or is focusing on a single episode. The Childhood Trauma Questionnaire (CTQ) is one measure that has received significant attention in the neglect literature (Bernstein et al., 1994; Stoltenborgh et al., 2013). The CTQ identifies those adult individuals who experienced maltreatment as children. Although the child’s perspective is the focus of the CTQ, it does not specifically target neglect. While some dimensions may be addressed by a single scale, the literature suggests that a multidimensional approach may be more accurate in operationalizing child neglect (Belsky, 1993; Cicchetti & Lynch, 1995; Cowen, 1999; Manly et al., 2013; Rosenman & Rodgers, 2004; Scott, 2014; Stoltenborgh et al., 2013). While measures targeting some aspects of neglect singularly from the child’s perspective, such as the CTQ, may be preferable to those that only indirectly assess neglect or do not directly measure the child’s response, all contain a missing critical element that may be significant in either a discrete neglectful incident or contributing to recurring neglect: caregiver perspective or caregiver behavior. Given the issues utilizing either existing CPS data or only the child’s perspective, it is not surprising to find that some work uses parental behavior to identify occurrences of neglect or neglectful behavior. The Child Abuse and Neglect Interview Schedule (CANIS), the Child Well-Being Scale (CWBS), the Child Abuse Potential Inventory (CAPI), and the Conflict Tactics Scale (CTS) all operate through this mechanism (Ammerman, Van Hasselt, &


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Hersen, 1988; Magura & Moses, 1986; Milner, 1986; Straus, Hamby, Finkelhor, Moore, & Runyan, 1998). Although these measures utilize parenting behaviors often correlated with general abuse, and some offer neglect subscales, none of these target child neglect specifically, perhaps demonstrating the difficulty of the complexity of child neglect (Edwards, Shipman, & Brown, 2005; Manly, 2005; Scott, 2014; Stoltenborgh et al., 2013). An instrument, however, that does specifically measure neglect is the Mother-Child Neglect Scale (MCNS; Lounds, Borkowski, & Whitman, 2004). Unfortunately, this assessment tool only measures the mother’s behavior, exemplifying a single-perspective approach by not incorporating the perspective of the child. Advocating for either the child’s perspective or the parental behavior perspective will have strengths and deficits, for example, the parents may reduce incidences or related social desirability issues. Furthermore, there have been fairly significant differences in the prevalence of neglect coming from selfreport versus official CPS sources that may indicate possible measurement bias (Stoltenborgh et al., 2013). To reduce this possible issue and still take advantage of the benefits of self-report, it may be advantageous to create a measure that combines both parental and child perspectives in operationalizing child neglect. Neglectful situations may more accurately be operationalized by simultaneously considering the behavior of the caregiver with the perspective of the child. Furthermore, it would be helpful to understand the perspective of both mother and father, if available. Many of the available measures, such as the MCNS target only the mother (Lounds et al., 2004). Little is currently known concerning paternal or other male influence in neglectful situations and one method to improve knowledge is to include this perspective whenever possible in a sound and comprehensive metric (Dunn et al., 2002). Increased reliability and validity are also possible with this combined perspective as it is possible to measure not only the report of each individual on their own behavior but also the behavior of other individuals in the family scenario. Of further importance is the lack of many existing measures to incorporate the multiple dimensions of child neglect. Extant evidence suggests that child neglect is comprised of multiple dimensions, such as physical, educational, emotional, and supervisory, that should be included along with severity in accurate operationalization (Belsky, 1993; Cicchetti & Lynch, 1995; Cowen, 1999; Manly et al., 2013; Scott, 2014). These factors are critical with the application of a developmental perspective, as suggested by the literature (Belsky, 1993; Cicchetti & Lynch, 1995; Cowen, 1999; Dubowitz, 1999; Manly et al., 2013; Scott, 2014). It is likely that differing neglect dimensions will be important for different developmental stages (i.e., physical neglect in


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the early stages and emotional neglect in the later stages), because the same action may not constitute neglect in all stages (Cicchetti & Barnett, 1991). In this manner, the age of the child is critical, and a metric developed for young children will not be applicable for an older adolescent. As most neglect research focuses on young children and their relationship with their mothers, there is a current lack of appropriate assessment tools for older adolescent children that specifically target neglectful behavior. Furthermore, those with special developmental or educational needs will also need special consideration (Nandyal et al., 2013). The CNQ was developed to address the abovementioned gaps of current existing metrics and specifically to address the need for a psychometrically sound measure of child neglect in late childhood. The CNQ defines child neglect from an ecological approach, as a product of parent–child interaction (Belsky, 1993; Cicchetti & Barnett, 1991; Manly et al., 2013; Scott, 2014). This interaction is characterized by the caregiver’s failure to provide adequate care that may result in damage to the child (Dunn et al., 2002). Defined in this manner, the CNQ operationalizes neglect not as a unidimensional construct but by including both the child’s and all available primary caregiver’s experiences. Furthermore, the need for a multidimensional measure, as delineated by the literature, is accomplished through the use of child neglect as a second-order latent construct that utilizes four subscales, including physical, emotional, educational, and supervisory/monitoring forms of neglect (Cicchetti & Barnett, 1991; Cicchetti & Lynch, 1995). As a dearth of information is available concerning neglect in older children, the CNQ was specifically created to measure neglect with older children, ages 10-12. Moreover, the measure includes a 4-point Likert scale to capture severity, which is also advocated by the neglect literature (Dubowitz, 1999; Manly et al., 2013; Scott, 2014; Zuravin, 1999). The CNQ offers a reliable and valid manner for capturing the impact of multiple factors in neglectful events and has been developed utilizing the collected knowledge of the neglect literature to fill a current need in older children (Belsky, 1993; Cicchetti & Lynch, 1995; Zuravin, 1999).

Method Sample The sample was comprised of 172 families that included male and female 10- to 12-year-old children and both biological parents, regardless of marital status. The children were distributed into two risk groups on the basis of their father’s substance use disorder (SUD) status, namely, the high-risk (HR)


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group (n = 76) for fathers with an SUD diagnosis and the low-risk (LR) group (n = 96) for fathers without an SUD diagnosis. No significant differences existed between the groups regarding age and educational level and the proportion of females and males. However, socioeconomic status (SES), defined according to Hollingshead (1975) criteria, was lower in the LR group (MHR = 41.26, SDHR = 13.42 vs. MLR = 49.34, SDLR = 11.97, t = −4.15, p < .001). In addition, child’s ethnic composition (African American and European American) was significantly different as the proportion of African Americans was higher in the HR group compared with the LR group (%HR = 24 vs. %LR = 10) and the proportion of European Americans was higher in the LR group compared with the HR group (%HR = 76 vs. %LR = 90, chi-square = 5.47, p < .05). Because father’s SUD, SES, and child’s ethnicity differed between groups, these variables were controlled for in all statistical analyses. At follow-up, approximately 1 year later, the children in the study were between the ages of 11 and 13. The participation rate was 70%. The main reason for non-participation was an inability to contact the subjects. The number of subjects who refused to participate at follow-up was 13 (5%). Parental SES and child’s age, education, gender, and ethnicity did not differentiate between retained and attrited subjects.

Procedures The study was first approved by the University institutional review board and received a Certificate of Confidentiality from the National Institute of Drug Abuse (NIDA). To maximize the likelihood of recruiting SUD fathers, recruitment sites included drug and alcohol treatment facilities and other research studies. Families were also recruited randomly from the community using a marketing-research firm. The study protocol was completely explained and consents to participate were completed for all members of the family before any information was collected. Inclusion criteria required the study families to include a father with or without a Diagnostic and Statistical Manual of Mental Disorders (3rd ed., rev.; DSM-III-R; American Psychiatric Association [APA], 1987) diagnosis of SUD with a 10- to 12-year-old biological son or daughter and the biological mother of the children all agreeing to participate in the study protocol. To secure the validity of the data, families were excluded from the study if any member had an IQ, measured by Wechsler Intelligence Scale for ChildrenRevised/Wechsler Adult Intelligence Scale-Revised (WISC-R/WAIS-R), lower than 75; a chronic disability; chronic neurological disease; neurological injury requiring hospitalization; schizophrenia; life threatening disease; or could not comprehend English.


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After pre-screening to ensure the families met the inclusion criteria and completed the consent procedure to undergo a diagnostic interview using the Structure Criteria Interview Diagnosis for Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV; APA, 1994) (SCID), an interview was conducted with the father to determine whether he met criteria for a lifetime DSM-IV SUD diagnosis (Spitzer, Gibbon, Janet, & Janet 1996). The families of those fathers meeting the diagnostic criteria for an SUD were placed in the HR group as there is increased risk for neglect within families struggling with substance use issues (Chaffin, Kelleher, & Hollenberg, 1996; Dunn et al., 2002). The families of fathers who did not present with an SUD or any other psychiatric disorder were included in the LR group. The interview and the initial diagnostic formulation were conducted by a trained interviewer and then verified by a diagnostic team composed of all research associates involved in the assessment of the family directed by a clinical psychologist. The final diagnosis of SUD was obtained using the Best Estimate Method (Leckman, Sholomskas, Tompson, Belanger, & Weissman, 1982) by which all information available that may contribute to a diagnosis is taken into consideration. For the follow-up measures, the families who agreed, at baseline, to participate in the follow-up assessment were contacted and invited to participate at the study office. Families who resided out of the city of Pittsburgh or could not meet at the study office were interviewed over the telephone, mailed the battery of self-report questionnaires included in the research protocol, and returned the completed measures by mail. The mother and child were paid $100 each and the father was paid $80 by check to compensate for their participation in the study.

Instrumentation The CNQ was developed under the auspices of the National Institute of Dental and Craniofacial Research/National Institute of Drug Abuse (NICDR/NIDA)funded Child Neglect Study. A panel composed of three psychologists defined the constructs of physical, emotional, educational, and supervision neglect based on the model of child neglect proposed by Cicchetti and Lynch (1995). The panelists selected items from instruments included in the research protocol of the Center for Education and Drug Abuse Research (CEDAR) by matching them to the criteria of physical, emotional, educational, and supervision dimensions of the child neglect construct (Cicchetti & Lynch, 1995). Additional items not found in the CEDAR database were added to the CNQ. As shown in Table 1, the CNQ draft included 46 items distributed into physical (17 items), emotional (15 items), educational (8 items), and supervision (7 items) neglect scales. The administration time is 20 min, and requires


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Stewart et al. Table 1. Child Neglect Questionnaire. Physical neglect 1. Given your child clean clothes to wear 2. Given your child enough food to eat 3. Given your child shampoo for his/her hair 4. Given your child toothpaste 5. Taken your child to a dentist for regular checkups 6. Made sure your child got enough sleep 7. Left your child alone without any adult around 8. Allowed your child to eat fast food or junk food whenever he/she wanted 9. Made sure the house was clean 10. Made sure your child had warm clothes in winter 11. Made sure your child had a warm room to sleep in 12. Taken your child to see a doctor when he/she was sick 13. Taken your child to see a dentist when he/she had a problem 14. Got your child medicine when he/she was sick 15. Given your child soap for a bath or shower 16. Taken your child to a doctor for regular physical checkups Emotional neglect 17. Done things with your child that were fun and interesting 18. Paid attention to your child when he/she was upset or crying 19. Watched TV with your child 20. Asked your child about his/her daily activities 21. Listened to your child when he/she wanted to talk 22. Tried to understand your child’s opinions or feelings 23. Hugged your child 24. Kissed your child 25. Told your child that I loved him/her 26. Told your child I liked the things he/she did 27. Let your child know when he/she did something well 28. Made your child feel that he/she is important 29. Encouraged your child to take care of his/her physical appearance 30. Said nice things about the way your child looked 31. Said nice things about things your child did Supervision neglect 32. Known if your child did something wrong 33. Known what your child did outside the home 34. Cared if your child got into trouble at school 35. Cared if your child did bad things 36. Made rules about what your child was allowed to do 37. Known who your child’s friends were 38. Asked where your child went with friends Educational neglect 39. Taken your child to a zoo, library, or museum 40. Bought your child school supplies 41. Made sure your child did his/her homework 42. Helped your child with our schoolwork when he/she needed help 43. Talked to your child about events in the news 44. Shown interest in your child’s grades at school 45. Made sure your child went to school 46. Attended PTA meetings at your child’s school


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subjects to self-report incidences from the past 6 months. The scoring system ranges from always = 1 to never = 4. There are three versions of father’s neglect and three versions of mother’s neglect based on the informant, namely, the child, self, and spouse. These versions were formatted for optical scanner use and administered to the 10- to 12-year-old children of fathers with and without SUD who participated in the Child Neglect Study. The scores of the instruments described below measuring parenting behavior were used to determine the concurrent validity of the CNQ and were administered to the sample when the children were 10 to 12 years of age. Child Report on Parental Behavior (CRPB). This instrument (Schuldermann & Schuldermann, 1970) assesses parenting practices in fathers and mothers separately reported by the child. It includes scales measuring child acceptance, child centeredness, enforcement of discipline, as well as control vial guilt and instilling anxiety. The present investigation used the scores of the child acceptance (internal consistency = .92/father and .86/mother) and centeredness (internal consistency = .82/father and .76/mother) scales. Family Assessment Measure (FAM). The FAM (Skinner, Steinhauer, & SantaBarbara, 1983) measures the quality of interpersonal relationships between family members. It includes the following scales: task accomplishment, role performance, communication, affective expression, affective involvement, control, and values and norms. Our investigation used scores from the paternal and maternal communication (internal consistency = .72/father and .68/ mother), values/norms (internal consistency = .71/father and .68/mother), and affective expression (internal consistency = .71/father and .61/mother) scales reported by the child. The FAM has good psychometric properties reported by Blackson Tarter, Martin, & Moss. (1994). Areas of Change Questionnaire (ACQ). This measure (Jacob & Seilhamer, 1983) evaluates child’s satisfaction/dissatisfaction with her or his father’s and mother’s parenting behavior. It includes 32 items rated from −3 (much less) to +3 (much more). Examples of the content of the items are as follows: “pay attention to me,” “leave me to myself,” “let me make my own decisions,” and “show respect for me.” The ACQ has good discriminative validity and concurrent validity reported by Jacob and Seilhamer (1983). The internal consistency of father’s and mother’s scales is .90 and .92 respectively (Jacob & Seilhamer, 1983). Child’s Relationship With Caretaker (CRC). This metric (Loeber, 1989) assesses the child’s feelings and thoughts about his or her mother’s (internal consistency = .69) and father’s (internal consistency = .77) parenting behavior.


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Examples of items are as follows: “Thought mother/father really bugged me a lot,” “felt that father/mother loved you,” and “felt that your father/mother was too strict or hard on you.” The response choices ranged from 0 (almost never) to 2 (often). The following instruments were used to determine the predictive validity of the CNQ and were administered to the sample when the children were 11 to 13 years of age: Dysregulation Inventory (DI). This inventory (Mezzich, Tarter, Giancola, & Kirisci, 2001) includes 92 items that measure behavioral (aggressivity, hyperactivity, impulsivity), affective (arousability, irritability, lability of mood), and cognitive (inability to set goals and strategies, monitor behavior, learn from experience and errors) dysregulation. The DI is completed by the mother, child, and teacher all reporting on the child’s psychological dysregulation. The ratings range from 0 (never true) to 3 (always true). The instrument has excellent psychometric properties (Mezzich et al., 2001). The total score of the child’s self-report version was included in the study. The internal consistency was .97. Alcohol and Drug Use History Questionnaire. An expanded version of the Alcohol History Questionnaire (Skinner, 1982) was developed to determine the onset, frequency, route of administration, social and geographical context, consequences, and reasons for increasing, decreasing, or stopping alcohol and drug consumption. The lifetime daily frequency of parental drug use was used in this study. Drug Use Screening Inventory (DUSI). The DUSI (Tarter, 1996) includes 149 items distributed in 10 domains, namely, substance use consequences (15 items), behavioral problems (20 items), health status (10 items), psychiatric symptoms (20 items), social competence (14 items), family system (14 items), school performance (20 items), work adjustment (10 items), peer relationships (14 items), and leisure and recreation (12 items). The answers are rated 1 (yes) or 2 (no). This instrument has good psychometric properties (Kirisci, Mezzich, & Tarter, 1995). In the present investigation, the following domains were included: peer relationships (internal consistency = .73), leisure activity (internal consistency = .62), physical status (internal consistency = .48), and school adjustment (internal consistency = .70). Conventional activities of friends. This inventory (Loeber, 1989) measures prosocial activities of the child’s friends. The instrument includes eight items ranging from 1 (none of them) to 5 (all of them). It comprises social activities


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related to school, clubs, community, family, and so on. Friends’ pro-social activities were indexed by the total sum of the item scores. Student Health Questionnaire. This questionnaire (Marin, Coyle, Gomez, Carvajal, & Kirby, 2000) evaluates the child’s sexual behavior such as having a boyfriend/girlfriend, knowledge about sexual topics, self-efficacy to avoid sexual behaviors, norms about various sexual behaviors, perceptions of peer behaviors, opportunity to have sex, pressures to have sex, pre-coital sexual behaviors, attempts to pressure someone else to have sex, and reasons to have and not have sex. Sexual behaviors pertaining to friends having sex (internal consistency = .72), ever having had sex (internal consistency = .66), and having sex in the past 12 months (internal consistency = .78) were selected for the present study. Child Behavior Checklist–Mother version. This checklist (Achenbach, 1994) evaluates 113 behaviors reported by the mother on the child measuring internalizing (e.g., withdrawal, somatic complaints, anxious/depression) and externalizing (e.g., delinquent behavior, aggression) psychopathology experienced in the past 6 months. The rating scale ranges from 0 (not true) to 2 (very true or often). This instrument has excellent psychometric properties (Achenbach, 1994). Lifetime history of offenses. This measure (Andrew, 1974) assesses violent and non-violent child behaviors. Antisocial behavior was indexed by the total number of violent and non-violent behaviors. Its internal consistency is .72.

Statistical Analyses Mplus (Muthén & Muthén, 2001) was used to run exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) to test undimensionality of the CNQ which is a necessary requirement to run item response theory (IRT) analyses. PARSCALE (Muraki & Bock, 1997) was used to run IRT to assess psychometric qualities of the items and to derive latent trait score of the CNQ physical, educational, emotional, and supervision neglect scales for each parent as informed by child, self, and spouse. Next, three second-order latent constructs of child neglect were developed for each parent using EFA and CFA including the first-order latent constructs of physical, emotional, educational, and supervision neglect. The three-order index of child neglect was computed in each parent by multiplying the CFA factor regression coefficients of the physical, educational, emotional, and supervision neglect latent traits by their IRT latent scores and then summing them. All statistical analyses testing the validity of


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both parental versions of child neglect were controlled for father’s SUD, SES, and child’s ethnicity. An analysis of covariance (ANCOVA) was performed to compare the HR group versus the LR group regarding paternal and maternal child neglect to determine the discriminative validity of the CNQ. Concurrent validity was assessed conducting correlational analysis between the father’s and mother’s CNI (age 10-12) and their scores of the CRPB, FAM, ACQ, and CRC, which measure several dimensions of parenting behavior (age 10-12). The predictive validity of the parental CNI was documented using correlational analysis between this index, evaluated at age 10 to 12, and child’s substance use frequency and related adverse outcomes such as psychological dysregulation, antisocial behavior, risky sexual behavior, psychopathology, physical health, school performance, social competence, deviant leisure activities, and affiliation with deviant peers measured at age 11 to 13. The internal consistency and inter-rater reliability of the CNQ were conducted using Cronbach’s alpha and intra-class correlation coefficients (ICCCs), respectively.

Results Construct Validity As can be seen in Table 2, the descriptive statistics of the factor loadings of the maternal and paternal neglect scales reported by child, self, and spouse, resulting from the EFA and CFA, revealed that the physical, emotional, educational, and supervision scales measure unidimensional traits of child neglect. As shown in Table 3, the CFA data fit parameters confirmed further that there is a good fit between model and data. Also, as displayed in Table 4, the discriminative capacity of the items was good as indicated by the scores of the IRT item discrimination and threshold parameter above .60. A second-order construct of child neglect in both parents was developed using EFA and CFA including the first-order constructs of physical, emotional, educational, and supervision neglect to determine a second-order parental child neglect construct. The results summarized in Table 5 show that, in effect, the CNQ indeed has a second-order factor structure.

Discriminative Validity The results of the ANCOVA contrasting the HR group and the LR group demonstrated that only the maternal neglect index informed by the child was higher in the HR group than the LR group (MHR = .15, SDHR = .09, MLR = .12,


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Table 2. Descriptive Statistics of the Exploratory and Confirmatory Factor Analyses Factor Loadings of the Child Neglect Latent Traits. Mother’s Neglect Latent Traits

Informants

Father’s Neglect Latent Traits

Child

Self

Exploratory factor analysis Educational M 0.62 0.61 SD 0.10 0.10 Range 0.53-0.73 0.49-0.74 Emotional M 0.78 0.73 SD 0.10 0.14 Range 0.57-0.94 0.49-0.93 Physical M 0.89 0.64 SD 0.10 0.14 Range 0.70-0.98 0.44-0.76 Supervision 0.67 0.67 M SD 0.10 0.24 Range 0.46-0.76 0.32-0.88 Confirmatory factor analysis Educational M 0.61 0.57 SD 0.10 0.10 Range 0.55-0.74 0.46-0.67 Emotional M 0.75 0.52 SD 0.10 0.14 Range 0.57-0.94 0.29-0.74 Physical M 0.84 0.64 SD 0.14 0.14 Range 0.62-0.99 0.44-0.76 Supervision M 0.59 0.45 SD 0.17 0.17 Range 0.26-0.83 0.24-0.59

Father

Child

Self

Mother

0.71 0.17 0.49-0.92

0.74 0.14 0.51-0.88

0.72 0.10 0.61-0.84

0.69 0.17 0.48-0.92

0.80 0.14 0.41-0.95

0.82 0.10 0.58-0.98

0.75 0.14 0.48-0.90

0.76 0.14 0.46-0.97

0.90 0.10 0.65-0.96

0.91 0.04 0.79-0.96

0.85 0.14 0.60-0.98

0.88 0.05 0.83-0.92

0.84 0.14 0.66-0.98

0.82 0.10 0.69-0.96

0.70 0.10 0.60-0.84

0.68 0.14 0.60-0.87

0.68 0.20 0.35-0.95

0.73 0.14 0.52-0.88

0.70 0.06 0.63-0.82

0.71 0.17 0.46-0.91

0.79 0.17 0.42-0.97

0.79 0.14 0.54-0.98

0.71 0.14 0.44 0.93

0.73 0.14 0.48-0.99

0.80 0.20 0.37-0.98

0.89 0.05 0.79-0.97

0.77 0.20 0.40-0.98

0.88 0.04 0.83-0.92

0.72 0.17 0.42-0.89

0.79 0.10 0.64-0.89

0.74 0.10 0.59-0.85

0.72 0.20 0.53-0.97


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Stewart et al.

Table 3. Confirmatory Factor Analysis Data Fit Parameters of the Child Neglect Latent Traits. Mother’s Neglect Traits Informants

Educational χ2 df p RMSEA Emotional χ2 df p RMSEA Physical χ2 df p RMSEA Supervision χ2 df p RMSEA

Father’s Neglect Traits

Child

Self

Father

Child

Self

Mother

4.93 8 .77

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