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The sensitivity and specificity of the Modified Conflict Tactics Scale for detecting clinically significant elder abuse

Published online by Cambridge University Press:  01 August 2009

Claudia Cooper ,
Kate Maxmin ,
Amber Selwood ,
Martin Blanchard  and
Gill Livingston
Claudia Cooper*
Affiliation:
Department of Mental Health Sciences, University College London, London, U.K.
Kate Maxmin
Affiliation:
Department of Mental Health Sciences, University College London, London, U.K.
Amber Selwood
Affiliation:
Department of Mental Health Sciences, University College London, London, U.K.
Martin Blanchard
Affiliation:
Department of Mental Health Sciences, University College London, London, U.K.
Gill Livingston
Affiliation:
Department of Mental Health Sciences, University College London, London, U.K.
*
Correspondence should be addressed to: Claudia Cooper, Dept of Mental Health Sciences, University College London, Holborn Union Building, Archway Campus, Highgate Hill, London, N19 5LW, U.K. Phone: +44 (0) 207 2885931. Email: [email protected].
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Abstract

Background: A third of family carers of people with dementia describe acting abusively in research studies, but far fewer cases of abuse are currently detected in clinical situations. This discrepancy may be explained by inadequate detection by health professionals, or disagreement regarding what constitutes elder abuse. This study was undertaken to determine the sensitivity and specificity of the revised Modified Conflict Tactics Scale (MCTS) for detecting clinically significant abuse.

Methods: We interviewed 220 family carers of people consecutively referred to psychiatric services with dementia in Essex and London (U.K.), using the MCTS to measure abuse. We defined abuse cases using (1) the MCTS conventional scoring system; (2) the Pillemer criteria; and (3) clinical judgment of an expert panel.

Results: Our panel judged that 15 (6.8%) of carers reported potentially clinical concerning abusive behavior; but 47 (21%) were cases according to the Pillemer criteria and 74 (34%) using the MCTS conventional scoring system. We developed a weighted MCTS scoring system, with high sensitivity and specificity for detecting clinically concerning abuse.

Conclusions: The MCTS could be used routinely in clinical practice with carers of people with dementia to detect clinically concerning cases of abuse, many of which are currently being missed.

Keywords

elder abusedementiacarerpsychometric
Type
Research Article
Information
International Psychogeriatrics , Volume 21 , Issue 4 , August 2009 , pp. 774 - 778
Copyright
Copyright © International Psychogeriatric Association 2009

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