Childhood Experience of Care and Abuse Questionnaire (CECA.
Q)
CECA.Q SCORING
www.cecainterview.com
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The CECA.Q is a questionnaire version of the Childhood Experience of Care
and Abuse interview (Bifulco, Brown et al. 1994) . It covers parental loss,
neglect, antipathy (hostile or cold parenting), support, physical and sexual
abuse before age 17 in adolescents or adults. It is validated against the
interview measure(Bifulco, Bernazzani et al. 2005)
Version 2 covers additional psychological abuse and version 3 covers both
psychological abuse and role reversal (parentification/young carer).
References
Bifulco, A., O. Bernazzani, et al. (2005). "The Childhood Experience of Care and Abuse
Questionnaire (CECA.Q) - Validation in a community series." British Journal of Clinical
Psychology 44: 1-20.
Bifulco, A., G. W. Brown, et al. (1994). "Childhood Experience of Care and Abuse (CECA): A
retrospective interview measure." Journal of Child Psychology and Psychiatry 35: 1419-
1435.
Scoring the questionnaire:
1. Parental Loss (section 1:Loss)
Any death of mother or father before age 17 or any continuous separation of one year or
more is taken as a loss risk factor.
If reason for loss is ‘abandonment’ or ‘other’ this incurs higher risk.
2. Parental care, (section 2,3 Neg/Ant)
2A. Mother Antipathy
Mother antipathy scales - reverse items 8 and 11 and then sum 1, 4, 6, 8-11, 16.
Repeat summing procedure for father’s antipathy. See below for cut-off scores
Mother Neglect
Mother neglect scale - reverse items 2,3,5,12,13,14 and then sum 2,3,5,7,12-15.
Repeat summing procedure for father’s neglect. See below for cut-off scores.
2B Mother Psychological Abuse (Version 2 section 2B Psychab)
This section has not yet been validated against interview and so no standard cut-off scores have
yet been devised. However, the items 1-17 should be summed with ‘yes=2’, ‘unsure=1’ and
‘no=0’.
Frequency should be summed as Never=0, Once=1, Rarely=2 and Often=3.
Note that each of the psychological abuse items have a high risk valence, and therefore any one
item marked as present should be taken as indicator of risk
3A. Father Antipathy (Section 3A Neg/ant)
Father antipathy scales - reverse items 8 and 11 and then sum 1, 4, 6, 8-11, 16.
Repeat summing procedure for father’s antipathy. See below for cut-off scores
Father Neglect
Father neglect scale - reverse items 2,3,5,12,13,14 and then sum 2,3,5,7,12-15.
Repeat summing procedure for father’s neglect. See below for cut-off scores.
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Childhood Experience of Care and Abuse Questionnaire (CECA.Q)
3B Father Psychological Abuse (Version 2 Psychab)
This section has not yet been validated against interview and so no standard cut-off scores have
yet been devised. However, the items 1-17 should be summed with ‘yes=2’, ‘unsure=1’ and
‘no=0’.
Frequency should be summed as Never=0, Once=1, Rarely=2 and Often=3.
Note that each of the psychological abuse items have a high risk valence, and therefore any one
item marked as present should be taken as indicator of risk
3C ROLE REVERSAL (Version 3 – Section 3c RR)
This section has not been validated against interview and so no standard cut-off scores
determined. However, a sum of scores will indicate higher role reversal.
4. SUPPORT (supp)
There is no interview-validated scoring for the support section. Presence of at least one support
figure taken to be a positive factor.
5. Physical abuse (section 5 Phyab)
Screen item
When you were a child or teenager were you ever hit repeatedly with an implement (such as a belt or stick) or punched,
kicked or burnt by someone in the household? YES= 1 NO=0
Total score = 0-1
Severity of physical abuse
Mother : Excluding age, sum remaining items:
Did the hitting happen on more than one occasion? Yes = 1, No=0)
How were you hit?:
Belt or stick OR Punched/kicked Score 1 if either present
Were you ever injured e.g. bruises, black eyes, broken limbs? Yes= 1, No=0
Was this person so angry they seemed out of control? Yes = 1, No=0
Total score = 0-4
Father : Excluding age, sum remaining items:
Did the hitting happen on more than one occasion? Yes = 1, No=0)
How were you hit?:
Belt or stick OR Punched/kicked Score 1 if either present
Were you ever injured e.g. bruises, black eyes, broken limbs? Yes= 1, No=0
Was this person so angry they seemed out of control? Yes = 1, No=0
Total score = 0-4
6. Sexual Abuse – (section 6 sexab)
Screen items - for each below rated ‘Yes’ or ‘unsure’ = score 1
When you were a child or teenager did you ever have any unwanted sexual experiences?
YES= 1, UNSURE = 1, NO=0
Did anyone force you or persuade you have sexual intercourse against your wishes before age 17?
YES=1, UNSURE=1, NO=0
Can you think of any upsetting sexual experiences before age 17 with a related adult or someone in
authority e.g.teacher? YES=1,
UNSURE=1, NO=0
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Childhood Experience of Care and Abuse Questionnaire (CECA.Q)
Total score = 0-3
Severity of sexual abuse
Scoring for each abuse: Excluding age, any item scored yes= 1,sum (total=0-7)
Was the other person someone you knew Yes=1 No=0
Was the other person a relative Yes=1 No=0
Did the other person live in your house Yes=1 No=0
Did this person do it on more than once occass Yes=1 No=0
Did it involve touching private parts your body Yes=1, No=0
Did it involve touching private parts of other Yes=1 No=0
Did it involve sexual intercourse Yes=1, No=0
Total score = 0-7
CUT-OFF SCORES
The following cut-off scores were derived from the validation exercise with the CECA
interview. Column A gives best cut-offs for severity as compared with interview ‘marked or
moderate’ level of severity for the type of neglect or abuse. Column B gives best predictor
of major depression in adulthood.
CECA.Q scale A.Cut off B.Cut-off
(optimising (optimising
sensitivity re levels for
CECA interview) disorder
outcomes)
Antipathy mother >=25 >=28
Antipathy father >=25 >=30
Neglect mother >=22 >=25
Neglect father >=24 >=26
Physical abuse >=1 >=3
mother
Physical abuse >=1 >=3
father
Sexual abuse >=1 >=1
screen
Sexual abuse >=1 >=2
severity (1st
abuse)
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