Invited CommentaryThe case for prospective longitudinal studies in child maltreatment research: commentary on Dube, Williamson, Thompson, Felitti, and Anda (2004)
Section snippets
Reliability
The article by Dube et al. (2004) focuses on the evaluation of reliability, or test-retest reliability of responses in recall of childhood trauma and household dysfunction. In the case of the Dube et al. analysis, an examination of test-retest reliability (stability) was provided by an unusual situation where a small subset (n = 658) of a much larger group of individuals (n = 17,337) was inadvertently sent the same questionnaire twice, the second time approximately 20 months later. The mean age
Validity
Is what people tell researchers in retrospective self-reports of their childhoods accurate? The article by Dube et al. (2004) does not inform the reader about the validity of the reports (that is, whether the respondent’s report accurately reflects the occurrence of the event). More than 30 years ago, Radke-Yarrow, Campbell, and Burton (1970) pointed out the importance of the construction of information, noting that information one remembers from childhood may be heavily dependent on
Reporting and recall bias
Dube et al. (2004) are correct in noting that simple or random errors in reporting of childhood adversity will tend to bias associations between childhood adversity and health outcomes toward the null. However, a major problem in making inferences about the association between retrospectively assessed childhood adversity and later health outcomes is not random measurement error, but recall bias (Raphael, 1987). The net effect of recall bias is to lead artifactually to an inflation of measures
Sampling bias
Retrospective studies such as that used in the paper by Dube and co-workers also introduce potential biases in the respondent sample. The design in the Dube et al. (2004) study might be characterized as involving only relatively healthy and well-functioning abuse survivors by virtue of their enrollment in an HMO, making the sample unlikely to be representative of the larger victimized population. It is possible that omitting individuals with poor outcomes might bias results toward weaker
Ambiguity in the meaning of relationships
In several places in the article, Dube and co-workers write that child abuse “leads” to certain outcomes. This wording is suggestive of a causal relationship between child abuse and certain consequences, whereas the data upon which the statement is made cannot address the temporal sequence of the events. Because of the heavy reliance on retrospective self-reports in the context of cross-sectional designs, there is little possibility of examining causal relationships, and there remains
Direct comparisons of retrospective and prospective findings
Three papers have directly compared data from retrospective reports with findings from prospective longitudinal data and have found significant differences in the consequences of child abuse for pain (Raphael, Widom, & Lange, 2001) and for drug abuse (Widom, Weiler, & Cottler, 1999) and of other childhood adversity with pain in adulthood (McBeth, Macfarlane, Benjamin, Morris, & Silman, 1999). In the first two studies, the pattern of results differed dramatically if one analyzed the data using
Conclusion
The issues of the accuracy and meaning of retrospective recollections of early childhood victimization remain controversial in the field, and heavy reliance on retrospective reports introduces considerable ambiguity into study findings. The field of child maltreatment research needs to understand the meaning of retrospective reports of early childhood experiences and their implications for current functioning. Nevertheless, researchers must be careful not to conclude that retrospective
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