Development And Evaluation On Reliability And Validity Of Childhood Chronic Stress Assessment Questionnaire

Objective To develop and evaluate the reliability and validity of the Childhood Chronic Stress Questionnaire, which was useful to Chinese children. To provide an effective evaluation and reference tool for the description of the distribution of chronic stress events, as well as the screening of symptoms and status for mental and behavioral disorders in children.Methods According to the ecological system theory of childhood life environment, the Childhood Chronic Stress Questionnaire has been established from the family environment, school environment, peer relationship and adverse childhood experience. The original questionnaire contained 80 items through a large number of literature reading, repeated discussions of the research group and expert consultation. A total of 1850 students were selected to the cross-sectional survey from the third experimental primary school in Beng Bu, so many statistical methods like Independent samples t test, correlation analysis, factor analysis were used to screen the useful items, the reliability and validity of the questionnaire were evaluated by Cronbach’s alpha coefficient, split half reliability and others. Finally, a total of 60 items questionnaire was developed, which was with good reliability and validity. A total of 2276 students from three primary schools in Ma’anshan were selected to the study for the use of questionnaire. Described the distribution of P25, P50, P75, P90 for the scores of questionnaire. Independent sample t test and Chi-square test were applied to evaluate the discrimination validity of the questionnaire between different genders, stages of puberal development and depression symptoms.Results Through the project analysis, a total of 60 items were developed for the questionnaire, including 3 major dimensions, peer bullying(15 items, 2 sub-dimension including peer relationship bullying and physical bullying), childhood abuse and neglect(29 items, 4 sub-dimension including emotional and physical abuse, sexual abuse, emotional neglect and physical neglect), adverse childhood experiences(16 items, 3 sub-dimension including family, school and personal adverse experience). The Cronbach’s α coefficient, split-half reliability coefficient, and test-retest reliability coefficient were 0.946, 0.798, 0.921 respectively. The results of exploratory factor analysis indicated that the cumulative variance contribution rate of the questionnaire was 59.81%. The structural equation model of the questionnaire was fit well, which was constructed by AMOS software for the confirmatory factor analysis. All of the results showed that the questionnaire has good validity, content validity and construct validity, which was consistent with the theoretical design. There was significant difference between genders, early and on-time pubertal timing, depression and non-depression of the scores and P90 value for the Childhood Chronic Stress Assessment Questionnaire(P<0.05). So the questionnaire has a better discrimination validity.Conclusion With a good reliability and validity, the Assessment Questionnaire of Childhood Chronic Stress could reflect the distribution of chronic stress events in children and adolescents more exactly and comprehensive, and could be further extended the application as an effective tool in the assessment of chronic stress in children and adolescents.