Validity of criteria-based content analysis (CBCA) at trial in free-narrative interviews.

OBJECTIVE

The reliability of child witness testimony in sexual abuse cases is often controversial, and few tools are available. Criteria-Based Content Analysis (CBCA) is a widely used instrument for evaluating psychological credibility in cases of suspected child sexual abuse. Only few studies have evaluated CBCA scores in children suspected of being sexually abused. We designed this study to investigate the reliability of CBCA in discriminating allegations of child sexual abuse during court hearings, by comparing CBCA results with the court's final, unappealable sentence. We then investigated whether CBCA scores correlated with age, and whether some criteria were better than others in distinguishing cases of confirmed and unconfirmed abuse.

METHODS

From a pool of 487 child sexual abuse cases, confirmed and unconfirmed cases were selected using various criteria including child IQ≥70, agreement between the final trial outcome and the opinion of 3 experts, presence of at least 1 independent validating informative component in cases of confirmed abuse, and absence of suggestive questions during the child's testimonies. This screening yielded a study sample of 60 confirmed and 49 unconfirmed cases. The 14 item version of CBCA was applied to child witness testimony by 2 expert raters.

RESULTS

Of the 14 criteria tested, 12 achieved satisfactory inter-rater agreement (Maxwell's Random Error). Analyses of covariance, with case group (confirmed vs. unconfirmed) and gender as independent variables and age as a covariate, showed no main effect of gender. Analyses of the interaction showed that the simple effects of abuse were significant in both sex. Nine CBCA criteria were satisfied more often among confirmed than unconfirmed cases; seven criteria increased with age.

CONCLUSION

CBCA scores distinguish between confirmed and unconfirmed cases. The criteria that distinguish best between the 2 groups are Quantity of Details, Interactions, and Subjective Experience. CBCA scores correlate positively with age, and independently from abuse; all the criteria test except 2 (Unusual Details and Misunderstood Details) increase with age. The agreement rate could be increased by merging criteria Unusual and Superfluous details that achieve a low inter-rater agreement when investigated separately.

PRACTICE IMPLICATION

Given its ability to distinguish between confirmed and unconfirmed cases of suspected child abuse, the CBCA could be a useful tool for expert opinion. Because our strict selection criteria make it difficult to generalize our results, further studies should investigate whether the CBCA is equally useful in the cases we excluded from our study (for example mental retardation).