The CECA is a detailed semi-structured interview about childhood experiences.
This is structured in terms of the number of household arrangements
in childhood with different parental figures questioned about in detail.
Initial questions concern loss or separation from parent up to the
age of 17. In this way the number of different family arrangements
within which an individual was brought up is determined. The questions
concerning care, antipathy of parents, discord and violence between
parents are repeated for each of these family arrangements. All physical
and psychological abuse from household members is covered, as well
as all sexual abuse from any perpetrator. Longer versions of the CECA
include assessments of role reversal (young carers) and family context
involving financial hardship, parent's psychiatric disorder etc.
What
makes the instrument different from other measures of childhood is
the breadth of coverage and the use of contextual judgements for assessing
severity. Thus for example, ratings of severity of sexual abuse are
not based purely on the degree of sexual contact as in some other
instruments, but also on a range of other contextual information such
as relationship to the perpetrator, frequency of abuse, early age
of abuse, imposed secretiveness and so on. This method has proved
successful in succinctly capturing the full contextual severity of
the experience.
The reliability
of the instrument is high, with correlations between independent raters
on 20 interviews all above 0.78.The validity of the instrument is
also high in terms of good inter-respondent agreement. This was assessed
with over 80 pairs of sisters reporting independently on childhood
experience.
Results
with the CECA consistently show odds-ratios of neglect or abuse experience
of 3 to 5 with adult disorder. Highest associations occur for sexual
abuse or psychological abuse, although all severe instances of antipathy,
neglect, role reversal, physical abuse are consistently related. In
adolescents the odds-ratios are even higher from 3 to 7 in relation
to a range of different disorders, including substance abuse and conduct
disorder. The results are confirmed in both males and females and
at different lifestages including older age. CECA indices and depression
are mediated by adult vulnerability such as insecure attachment style.
The CECA.Q
is a self-report measure of childhood with high reliability and predictive
of disorder. It assesses parental loss, antipathy, neglect, physical
and sexual abuse.
Key
references
Bifulco, A., Brown, G. W., & Harris, T. O. (1994). Childhood
Experience of Care and Abuse (CECA): A retrospective interview
measure. Journal of Child Psychology and Psychiatry,
35, 1419-1435.
Bifulco,
A., & Moran, P. (1998). Wednesday's Child: Research into
women's experience of neglect and abuse in childhood and adult
depression. London, New York: Routledge
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For further
information on CECA measure visit Childhood Experience of Care and Abuse CECA website - www.cecainterview.com.
