Reliability and validity of a measure of sexual and physical abuse histories among women with serious mental illness.

OBJECTIVE: The purpose of this paper is to describe a standardized questionnaire of histories of abuse among women with serious and persistent mental illness, and to assess its test-retest reliability and its validity. METHODS: Seventy women enrolled in an outpatient clinic were asked about childhood histories of physical and sexual abuse in a structured clinical interviews at two times. RESULTS: Test-retest reliability yielded a Kappa of .63 for the measure of physical abuse, and .82 for the measure of sexual abuse. Validity, assessed as consistency with an independent clinical assessment, showed 75% agreement for reports of physical abuse, and 93% agreement for reports of sexual abuse. CONCLUSIONS: Childhood histories of physical and sexual abuse can be reliably and validly assessed in women with severe and persistent mental illness using a standardized instrument.

Childhood abuse and neglect among women outpatients with chronic mental illness.

OBJECTIVE: The purposes of the study were to determine the prevalence of childhood sexual abuse, physical abuse, and neglect among women outpatients with severe and persistent mental illness; to examine patterns of co-occurrence of the various types of abuse; and to explore the relationships between childhood abuse and adult psychiatric symptomatology. METHODS: Childhood histories of abuse and data on clinical characteristics of 78 women enrolled in a New York State outpatient clinic were elicited in face-to-face interviews using a structured questionnaire. RESULTS: Sixty-five percent of the women reported histories of some type of abuse or neglect during childhood. Forty-five percent of the sample had been sexually abused, 51 percent had been physically abused, and 22 percent had experienced neglect. Seventy-four percent of the sexually abused women, 70 percent of the physically abused women, and 94 percent of the women who experienced neglect reported at least one additional form of abuse or neglect. Respondents who had been abused in childhood had higher levels of depressive and psychotic symptoms and higher rates of sexual victimization in adulthood than those who had not been abused. Women who experienced neglect as children had higher rates of homelessness in adulthood. CONCLUSIONS: Chronic mentally ill women seem to experience higher rates of abuse and more types of abuse than the general population. Clinicians should try to determine whether chronic mentally ill women have histories of abuse and to develop interventions to meet their special needs.