Keywords
child sexual abuse
disclosure
assessment instruments
mentalization
How to Cite
Abstract
Objectives: This study compared rates of childhood sexual abuse (CSA) disclosure across three commonly used assessment instruments in a clinical adolescent sample: the Child Attachment Interview (CAI), the Computerized Diagnostic Interview Schedule for Children (C-DISC), and the Childhood Trauma Questionnaire (CTQ).
Methods: Participants (N = 421) completed one or more of the instruments. CSA disclosure rates were calculated for each, and McNemar’s tests were used to compare rates of disclosure between each pair of tools.
Results: The CAI yielded the highest overall percentage of CSA disclosures (18.8%), followed by the C‑DISC (13.1%), and the CTQ (12.9%). However, McNemar’s test revealed that while the CAI elicited significantly more disclosures than the C‑DISC, it did not differ significantly from the CTQ. The CAI and CTQ each identified unique cases not captured by the other, while the C‑DISC consistently elicited the fewest disclosures.
Implications: Findings suggest that different instruments may facilitate disclosure for different subgroups of adolescents. The CAI’s narrative relational format may support disclosure for some youth, while the CTQ’s private self‑report format may do so for others. The C-DISC’s structured symptom-based format may limit reflective processing. These results underscore the need for multi-method assessment strategies to more fully capture CSA experiences.
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