# Development of a rating scale for maladaptive symptoms by maltreatment: Perspectives of attachment and dissociation

## TL;DR

This study created a new rating scale to identify maladaptive symptoms in children who have experienced abuse, helping to distinguish them from neurodevelopmental disorders.

## Contribution

The novel contribution is the development and validation of a 20-item rating scale (RS-MSM) for identifying abuse-related maladaptive symptoms in children.

## Key findings

- A two-factor, 20-item rating scale (RS-MSM) was developed for abuse-related maladaptive symptoms.
- The scale demonstrated high reliability and convergent validity in confirmatory analysis.
- Optimal cutoff values were identified for effective screening of maltreated children.

## Abstract

Child abuse has been increasing in Japan. Abused children’s behavior may often be confused with neurodevelopmental disorders; therefore, specialized tools to identify these cases and specific care for maltreatment are crucial. This study aimed to develop an objective early screening scale for abuse-related maladaptive symptoms. To do this, two surveys were conducted. Survey 1 included 60 children attending public elementary schools, who had been admitted to orphanages due to abuse (maltreated group), and 154 children attending public elementary schools with no reported maltreatment (control group). In this survey, 40 existing scale items related to attachment behavior and dissociative symptoms were evaluated. Childcare staff and homeroom teachers evaluated children’s behaviors. Receiver operating characteristic (ROC) curves were drawn to determine optimal cut-off values. In Survey 2, 39 children in the maltreatment group and 186 children in the control group were subjected to confirmatory factor analysis to examine the new scale’s reliability and validity. Based on the results of an exploratory factor analysis, a two-factor, 20-item rating scale for maladaptive symptoms due to maltreatment (RS-MSM) was developed. The receiver operating characteristic curve indicated that cutoff values set in Survey 1 were appropriate for screening the general population and children in the clinical range. The results confirmed a two-factor structure with high reliability and convergent validity in the Survey 2 sample. Therefore, the developed RS-MSM scale is valid and will allow for easy screening of maltreated children at school.