Child abuse rating system for archival information in severe mental illness

Kee Hong Choi, L. Felice Reddy, Will Spaulding

Research output: Contribution to journalArticlepeer-review

5 Scopus citations


Background: Assessing and addressing child abuse histories are one of the grand challenges in psychiatric rehabilitation. Archival information, e.g., comprehensive psychosocial evaluations, objective testing, court documents, and medical chart information can provide useful and objective historical accounts. It is essential to develop a reliable and valid child abuse rating system for archival information. Purpose and methods: This study aimed to examine the reliability and predictive validity of a highly structured and specific child abuse rating system used to code archival information for 150 psychiatric inpatients with severe mental illness (SMI). Results: The child abuse rating system produced reliable ratings across raters and subtypes of child abuse were highly inter-related. More than half (56.5%) of the sample with SMI was identified to have one or more types of child abuse history; specifically, child sexual abuse (CSA, 36%), child physical abuse (CPA, 27.3%), emotional maltreatment (EM, 36%), failure to provide (FTP, 10.7%), and lack of supervision (LOS, 32%). Female participants (50%) with SMI had higher rates of CSA than male participants (20.8%). Subtypes of child abuse history were related to poorer premorbid functioning, but the relationships varied across different types of child abuse. In addition, CSA and EM were related to greater suspiciousness/hostility. Conclusion: The child abuse rating system for archival data fills an important gap in existing methodology and, in conjunction with a self-report measure, is expected to improve the assessment and understanding of the prevalence of child abuse among adults with SMI. Potential limitations and recommendations for future research are discussed.

Original languageEnglish (US)
Pages (from-to)1271-1279
Number of pages9
JournalSocial Psychiatry and Psychiatric Epidemiology
Issue number8
StatePublished - Aug 2012


  • Child abuse
  • Psychiatric rehabilitation
  • Severe mental illness
  • Trauma-informed assessment

ASJC Scopus subject areas

  • Epidemiology
  • Health(social science)
  • Social Psychology
  • Psychiatry and Mental health


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