The Youth and Childhood Adversity Scale: A step towards developing a new measure of adversity and its severity

Abstract:

Background: Early adversity (EA) can contribute to the onset, manifestation, and course of various mental disorders. Measuring EA is still conceptually and psychometrically challenging due to issues such as content coverage, wording of items, scaling methods, and validation procedures. Method: To this end, we have developed a 13-item measure of EA, the Youth and Childhood Adversity Scale (YCAS). Beyond a dichotomous assessment of whether a set of adverse events have been experienced, this scale assesses an important but currently under-investigated facet of EA: the respective severity of these events. Here, we evaluate the YCAS in a sample of 596 adolescent students (ages 16-19) and a second sample of 451 medical students (ages 18-30+). We psychometrically assessed both factor scores and sum scores of the YCAS.Results: In both samples a one-factorial solution was found for both responses to dichotomous items and severity items. Item loadings had a broad range, with minimum loadings of .1-.2 and maximum loadings of .7-.9. Irrespective of response type, this factor exhibited good reliability (omega total) and was associated with a range of mental health outcome measures, self-esteem, and childhood maltreatment. The sum score reliability (coefficient alpha) was acceptable and most of the associations with the validation measures held.Conclusions: The YCAS allows an efficient, reliable, and valid assessment of EA. The YCAS covers a reasonable breadth of events, while simultaneously being parsimonious. The psychometric soundness of the severity facet suggests that the assessment of adversity severity may be worthwhile, but needs further examination.