Screening for maternal experiences of physical abuse during childhood

Because a parental history of abuse during childhood is a documented risk factor for child abuse, pediatricians have been urged to assess parents' childhood discipline experiences. A brief set of questions was developed to detect a maternal history of childhood physical abuse that could be incorporated into a comprehensive psychosocial screening questionnaire. A criterion-based definition was used as the measure for physical abuse. In phase I, four screening questions were developed in a cross-sectional survey of 284 middle-class women attending a family medicine clinic, of whom 32% met the criteria definition for physical abuse. In phase II, the screening questions were tested in 428 mothers seen in Salt Lake City- and Seattle-area pediatric clinics. The four screening questions had a sensitivity of > 90%, a specificity of > 85%, a positive predictive value of > 75%, and a negative predictive value of > or = 90%--as compared with the criteria-based definition in both pediatric settings. These four screening questions compared favorably to a criteria-based definition of physical abuse during childhood and may be useful additions to psychosocial questionnaires.