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Author links open overlay panelAbigailCasas-MuñozPhDaPersonEnvelopeÁngel EduardoVelasco-RojanoPsyDaNoéGonzález-GarcíaPsyDaCorinaBenjetPsyDbJorge JavierCaraveo-AnduagaPhDbNora AngélicaMartínez-VélezbArturoLoredo-AbdaláMDa
Research using the IPSCAN Child Abuse Screening Tool for Children (ICAST-C), has provided ample evidence of the magnitude of violence against children. Knowledge about its psychometric characteristics and validity is limited. Hence, our objective was to translate and culturally adapt the ICAST-C in adolescents from Mexico City and determine its psychometric properties.
Participants and setting
To determine the psychometric properties of the instrument 723 adolescents between 11 and 18years of age from 9 public secondary schools in Mexico City participated.
The study was carried out in two phases: 1) translation and adaptation of the instrument (in 5 steps) and 2) pilot evaluation of the psychometric properties. Total and factor reliabilities were determined, Pearson correlation was used for temporal stability while construct validity was determined by Confirmatory Factor Analysis (CFA), and final adequacy of the items eliminated by the CFA.
We developed the culturally relevant Mexican Spanish version of the ICAST-C. The CFA confirmed the six-factor structure hypothesis. To improve the original model we eliminated ten items, the final model showed good global fit indices (χ2(1310)=2207.68, p<.01, χ2/df=1.68; CFI =0.95; RMSEA=0.02 [CI95% 0.02–0.03]; SRMR=0.08). Total and factor reliabilities were adequate (Alpha=0.79–0.92, r=0.52–0.75), except for the non-violent discipline factor (Alpha=0.59, r=0.38).
While these data suggest that this version of the ICAST-C is valid and reliable for adolescents in Mexico City public secondary schools, further research should evaluate the psychometric properties in a national sample.
Violence against children is a problem that affects all countries in the world, independent of culture, social class, educational and income levels, or ethnic origin (Pinheiro, 2006). Evaluation of violence against children has raised methodological and ethical challenges. These challenges are related to conceptual and operational differences, which in turn influence the available indicators and evidence on the magnitude and impact of this problem around the world (Runyan et al., 2009). The scarcity of the available data to estimate the prevalence of different types of violence throughout the world (Zolotor et al., 2009), is related to problems of detection and with official records of experiences of violence. Most official reports consider only more severe cases; thus, compromising the registration of subtle cases. This is because many of the criteria to determine the magnitude of the problem normalize violence as punishment or discipline (Álvarez-Gutiérrez & Castillo-Koschnick, 2019; Carrillo-Urrego, 2018). The importance of data quality transcends the public policies and programs that are established to prioritize, guarantee and protect children's rights (World Health Organization, 2020). Based on the above, the International Society for the Prevention of Child Abuse and Neglect (ISPCAN) has taken the initiative to improve the approach, measurement and evaluation of violence towards children, and this was recommended by the General Assembly and Secretary General of the United Nations Organization in the World Report on violence against children (Pinheiro, 2006). To assess, compare and gain a better understanding of children's and adolescents´ exposure to violence internationally, a panel of child abuse experts developed and tested the feasibility of using the ISPCAN Child Abuse Screening Tool for Children Questionnaire (ICAST-C) in children from forty countries (Zolotor et al., 2009).
While research using the ICAST-C, in its different versions, has provided ample evidence of the problem of violence towards children around the world, knowledge about its psychometric characteristics and validity is limited. Zolotor et al. (2009) reported feasibility evidence documented in 14 countries. In addition, Silveira and Grassi-Oliveira (2016) in Brazil, reported the semantic validation process of the Questionnaire into Portuguese. Dhamayanti et al. (2020) in Indonesia tested the factor reliability and the item correlations. In Sri Lanka, Chandraratne et al. (2018) reported evidence of construct validity, demonstrated with principal component analysis; two confirmatory factor analyses were promising — one carried out in the Balkans with adequate fit (Meinck et al., 2020), and the other in Taiwan with acceptable results (Chang et al., 2013) — although some fit indices were below the recommended cutoff points. Finally, in South Africa, Meinck et al. (2018) adapted a brief version for clinical interventions known as ICAST-Trial, which has adequate fit in the confirmatory factor analysis, but with non-optimal adjustment in all indices (CFI 0.925 and TLI 0.908) (Hu & Bentler, 1999).
Currently, the available information on violence against children in Mexico is fragmented and limited, precluding an accurate and complete assessment and surveillance of the problem. A first step for such assessment is having a culturally validated and reliable screening tool. Such a tool, and the information derived from it, is essential to design more effective public policies to protect children (Álvarez-Gutiérrez & Castillo-Koschnick, 2019). Therefore, the objective of this study was to translate and culturally adapt the ICAST-C screening tool for violence against children in Mexico City and to determine its psychometric properties.
We conducted an observational, longitudinal study in two phases as follows (Fig. 1): 1) Translation and adaptation of the instrument and 2) Pilot evaluation of the psychometric properties of the translated and adapted instrument. The Spanish adaptation versions can be reviewed in Appendix A (supplementary material).
Phase 1. Translation and adaptation of the instrument
We first obtained permission from ISPCAN to translate and adapt the original English version of ICAST-C V 3.0 to Mexican Spanish and to evaluate the reliability and validity of this
The frequency distribution of the responses showed that there were options endorsed with very low or null frequency. Therefore, we recoded the responses into three options: 0 (It has never happened to me), 1 (Yes, it happened to me, but before), 2 (It happened to me in the past year). When examining the frequency per option, the asymmetry coefficient, the kurtosis, and the normality tests of the recoded items, they were not normally distributed, neither individually nor as a whole (Mardia
We provide novel evidence for the reliability and validity of a multidimensional Mexican-Spanish self-report scale for measuring experiences of violence in adolescents. A particular strength is that we translated and adapted the ICAST-C instrument, which has been used and evaluated in other languages and countries, thus permitting comparisons between countries and cultural contexts.
The confirmatory factor analysis of this Mexican Spanish version is the first one to corroborate the six
Submission declaration and verification
The work described has not been previously published. It is not under consideration for publication elsewhere. Its publication is approved by all authors and tacitly or explicitly by the responsible authorities where the work was carried out. If accepted, it will not be published elsewhere in the same form, in English or in any other language, including electronically without the written consent of the copyright holder.
This work was supported for the conduct of the research by the National Pediatrics Institute (Instituto Nacional de Pediatría, México) through the Fiscal Resource Fund of the E022 Program.
ACM and NGG conceptualized the present study. ACM, NGG, CB, JJCA and ALA participated in the translation and adaptation process. ACM and NGG managed the data collection. ACM, NGG and AEVR had the responsibility for conceptualizing and writing the paper. AEVR led and conducted the analyses with the support of ACM, NGG, NMV, JJCA and CB. All contributed in the interpretation of the findings and structure of the paper. All authors reviewed and approved the final version.
Declaration of competing interest
We thank the social service interns María Teresa Arias González, Víctor Alam Gaona Badillo, Óscar Pérez Toscano, and CIELO staff for their support during the applications of the instrument. Our thanks also go to Dr. Franziska Meinck, who kindly shared the ICAS-T version applied in South Africa and some of her experience and guidance with the adaptation process.
We thank CONACYT (CV166938) and the Doctorate program in Medical, Dental and Health Sciences, recognized by the CONACYT National Quality
- A.J. Zolotor et al.ISPCAN Child Abuse Screening Tool Children's version (ICAST-C): Instrument development and multi-national pilot testing
Child Abuse & Neglect
- D. Runyan et al.Introduction to the development of the ISPCAN child abuse screening tools
Child Abuse & Neglect
- F. Meinck et al.Measuring violence against children: The adequacy of the International Society for the Prevention of Child Abuse and Neglect (ISPCAN) child abuse screening tool - Child version in 9 Balkan countries
Child Abuse & Neglect
- F. Meinck et al.Adaptation and psychometric properties of the ISPCAN Child Abuse Screening Tool for use in trials (ICAST-Trial) among South African adolescents and their primary caregivers
Child Abuse & Neglect
- H.Y. Chang et al.Psychometric testing of the Chinese version of ISPCAN Child Abuse Screening Tools Children's Home Version (ICAST-CH-C)
Children and Youth Services Review.
- N.K. Chandraratne et al.Cultural adaptation, translation and validation of the ISPCAN Child Abuse Screening Tool - Retrospective Version (ICAST-R) for young adults in Sri Lanka
Child Abuse & Neglect
- M. Álvarez-Gutiérrez et al.
Panorama estadístico de la violencia contra niñas niños y adolescentes en México
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Developmental science in the 21st century: Emerging questions, theoretical models, research designs and empirical findings
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Authentic assessment: Using assessment to help students learn
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Castigos en la crianza de los hijos e hijas: Un estado de la cuestión
Revista Latinoamericana de Ciencias Sociales, Niñez y Juventud
Identificación de los conceptos culturalmente relevantes que niños mexicanos asocian con maltrato infantil, pre-propuesta para una herramienta de tamizaje. Tesis de Maestría
Students' personal traits, violence exposure, family factors, school dynamics and the perpetration of violence in Taiwanese elementary schools
Health Education Research
Pautas éticas internacionales para la investigación relacionada con la salud con seres humanos
Validity and reliability update of the Indonesian version of International Society for Prevention of Child Abuse and Neglect - Child Abuse Screening Tool (ICAST-C)
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Communications in Statistics: Theory and Methods
International test commission guidelines for test adaptation: A criterion checklist
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Ethical considerations for the collection, analysis & publication of child maltreatment data
Research articleDiagnostic profiles in adolescence and emerging adulthood: Transition patterns and risk factors
Revista de Psiquiatría y Salud Mental, 2022
Complex diagnostic profiles (i.e., clusters of comorbid disorders) may be present in adolescence with long-lasting effects later in life. Little is known about their developmental transitions to adulthood as well as potential risk factors. This study aimed to identify the diagnostic profiles in adolescence and emerging adulthood, patterns of transitions and risk factors.
A sample of 1062 Mexican adolescents (43.22% men, M=14.19 years at baseline, SD=1.68) was assessed for psychiatric disorders at adolescence and emerging adulthood. Latent class analysis was used to identify diagnostic profiles. Profile transition was studied using multi-state modeling between the life periods. Logistic regression was utilized to study risk factor influence on profile development in adulthood.
Three diagnostic profiles (i.e., minimal disorder/no-psychopathology; and two clinical profiles: internalizing and externalizing) were identified in both periods. Anxiety disorders were the most frequent psychiatric presentation in adolescence, while depression was the most prevalent disorder in adulthood. More than 15% of participants showed a clinical profile regardless life period. Comorbidity was present in 57% of participants with a clinical psychiatric profile. Finally, common (suicidal behavior) and specific risk factors (sex, parents’ education and income) predicted transitions to profiles from adolescence to emerging adulthood.
Psychiatric disorders are frequently observed adopting a complex diagnostic profile in both adolescence and emerging adulthood. Comorbidity seems to be common in both life periods. Developmental issues and comorbidity should be considered for health service provision and treatment choice.
El malestar psiquiátrico puede incluir presentaciones diagnósticas complejas (perfiles diagnósticos) en la adolescencia. Dichas presentaciones tienen influencia duradera en la adultez. Si bien poco se sabe de cómo evolucionan estos perfiles hacia la adultez. Este estudio pretendía identificar los perfiles diagnósticos en la adolescencia y la juventud, sus patrones de transición y factores de riesgo.
Mil sesenta y dos adolescentes mexicanos (43,22% chicos, M=14,19 años en línea base, DT=1,68) fueron evaluados respecto a trastornos psiquiátricos en la adolescencia y la juventud. Se identificaron perfiles diagnósticos mediante modelos de clase latente. Se usaron modelos multiestado para estudiar transiciones entre periodos vitales y regresión logística para analizar la influencia de factores de riesgo en las transiciones entre perfiles.
Se identificaron 3 perfiles diagnósticos (i.e. no-psicopatología y 2 clínicos: internalizante y externalizante) para ambos periodos vitales. Los trastornos más prevalentes fueron internalizantes en ambos periodos. Más del 15% de participantes mostró un perfil diagnóstico clínico. La comorbilidad psiquiátrica se dio en el 57% de los casos con perfil clínico. Finalmente, la transición a perfiles clínicos en la juventud se explicó mediante factores de riesgo comunes (conducta suicida) y específicos del perfil (sexo, educación parental y nivel de ingresos).
El malestar psiquiátrico puede presentar formas complejas, tanto en la adolescencia como en la juventud. La comorbilidad suele ser algo común en ambos periodos vitales. Por ello, estos aspectos deben ser considerados a la hora de indicar el tratamiento y planificar la atención clínica.
Research articleShock filter as the classifier for image inpainting problem using the Cahn-Hilliard equation
Computers & Mathematics with Applications, Volume 123, 2022, pp. 105-114
We consider a problem of digital image inpainting using the modified Cahn-Hilliard equation, where the standard double well potential is replaced by the shock filter. Using fixed point arguments and Aubin-Lions lemma we prove the existence and uniqueness of the solution. In addition, we introduce a numerical method based on the convexity splitting idea to approximate the solutions of the considered problem. We apply this method to several binary images and demonstrate that this approach naturally extends image features and preserves their edges.
Research articleChild health nurses' experiences of using the Safe Environment for Every Kid (SEEK) model or current standard practice in the Swedish child health services to address psychosocial risk factors in families with young children – A mixed-methods study
Child Abuse & Neglect, Volume 132, 2022, Article 105820
Child maltreatment (CM) is often hidden, and the youngest children are often those most exposed. CM can be prevented through programs that address risk factors, but few primary prevention strategies have been evaluated.
To examine the experiences of nurses using the Safe Environment for Every Kid (SEEK) model compared to nurses using current standard practice in the Swedish child health services (CHS) to address psychosocial risk factors in the family environment.
Nurses at 27 child health centers in the CHS in the county of Dalarna, Sweden participated in the study. A survey was answered by 55 nurses and 18 nurses participated in focus-group interviews.
A convergent mixed methods research design with focus-group interviews and survey data was used. Qualitative Content Analysis was used to analyze the interview data and Mann Whitney U test was used to analyze the survey data.
The qualitative analysis identified four categories – “Framing the prerequisites for successful practice”; “Managing the mission of the CHS”; “Meeting the family as a professional”; and “Working with psychosocial risk factors can be emotional” – under the overarching theme “Universal application of a structured method adds value to experience-based knowledge when addressing psychosocial risk factors”. Survey data showed that SEEK nurses rated to a greater degree that they possessed adequate knowledge, competence and sense of security to address psychosocial risk factors in their work.
This study indicates that using SEEK can strengthen the nurses in identifying and responding to families in need of psychosocial support.
Research articleThe impact of childhood maltreatment on women's reproductive health, with a focus on symptoms of polycystic ovary syndrome
Child Abuse & Neglect, Volume 133, 2022, Article 105831
Childhood maltreatment leads to lifelong health risks, particularly in women. Although reproductive health has been linked to such maltreatment, limited literature exists on its association with polycystic ovary syndrome (PCOS).
In a sample of psychiatrically healthy women, we evaluated the impact of child maltreatment (subtypes of abuse and neglect) on women's reproductive health outcomes, specifically PCOS.
The 237 psychiatrically healthy women, aged between 18 and 79years, were control participants in a case-control study (SHARED ROOTS), conducted in Cape Town, South Africa, between May 2014 and June 2017.
Probable PCOS was based on a history of symptoms of ovulatory dysfunction and hyperandrogenism or a diagnosis of PCOS. We conducted hierarchical logistic regression models to assess which child maltreatment subtypes (emotional, physical and sexual abuse and emotional and physical neglect) were significantly associated with PCOS, controlling for sociodemographic and clinical factors.
Probable PCOS was present in 29 (12.2%) women. Emotional abuse (31.6%) was the most frequent type of child maltreatment and was significantly associated with PCOS (OR=5.11, CI 1.87; 13.98), including when other maltreatment types were accounted for (OR=3.90, CI 1.27; 12.02). Physical abuse was associated with PCOS (OR=4.21, CI 1.43; 12.38), but was not significant when other maltreatment types were factored in.
Child maltreatment is independently associated with PCOS in women without psychiatric disorders. In the context of all maltreatment subtypes, emotional abuse remained associated with PCOS, suggesting its unique effect on this endocrinopathy.
Research articleMoving school-based CSA prevention education online: Advantages and challenges of the “new normal”
Child Abuse & Neglect, Volume 132, 2022, Article 105807
One of the many outcomes of the COVID-19 pandemic was a shift in the delivery of elementary (primary) education. Schools transitioned swiftly to e-learning and prioritized education that was already or could be easily adapted to virtual formats. Given the paucity of online content available, it is not likely that child sexual abuse (CSA) prevention education was prioritized.
Given that CSA prevention education has demonstrated success in increasing knowledge, protective behaviors, and disclosures, and the potential long-term need for e-learning options, there is a demand for an exploration of how CSA prevention can be implemented using e-learning strategies. In the current discussion, we explore how school-based CSA prevention education could be implemented in a “new normal” context of e-learning. We first present the existing e-learning content for CSA prevention education. We then describe how best practices for prevention education can be applied to e-learning. Finally, we present considerations for the use of e-learning specifically for CSA prevention education.
In short, implementing CSA prevention programs through e-learning offers many affordances for program accessibility and reach, flexibility in implementation and opportunities for greater exposure to content, and a wide range of ways to demonstrate effective skills and engage children in cycles of practice and feedback. E-learning, may also, however, limit important conversations between children and trained instructors that lead to disclosures.
The extant literature leaves us unsure as to whether implementing CSA prevention programs through e-learning will result in better or worse outcomes for children. However, given the increasing demand for e-learning options, and the promise of some new e-learning programs, further research on the effectiveness of e-learning CSA prevention programs is warranted.
Research articleAntisocial and borderline personality traits and childhood trauma in male prisoners: Mediating effects of difficulties in emotional regulation
Child Abuse & Neglect, Volume 132, 2022, Article 105822
To investigate the prevalence of probable antisocial personality disorder (ASPD) and borderline personality disorder (BPD) among prisoners, and further examine the mediating effect of difficulties in emotional regulation (ER) between childhood trauma and symptoms of ASPD and BPD.
A total of 1491 male participants (35.4±9.69years) were recruited from a prison in Guangdong, China. The symptoms of ASPD and BPD, childhood trauma, difficulties in ER, and suicidal behaviors were measured by self-administered structured questionnaires. Logistic regressions were performed to investigate the associations of ASPD and BPD with suicidal behaviors. Path analysis was used to examine the mediating effects of difficulties in ER between childhood trauma and symptoms of ASPD and BPD.
Approximately, 21.2% and 11.2% of the participants were screened as ASPD and BPD, respectively. Probable ASPD and BPD were associated with higher risk of suicidal behaviors. Childhood trauma and difficulties in ER were significantly associated with suicidal behaviors in prisoners with probable ASPD and BPD. Path analyses showed that partial mediating effects of difficulties in ER were significant in the dimensions of clarity and strategies on ASPD, and in the dimensions of clarity, impulse, and strategies on BPD.
ASPD and BPD are two of the common personality disorders in prisoners. Difficulties in ER are key to understanding the relationships between childhood trauma and personality disorders.
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