Familial risk and protective factors in alcohol intoxicated adolescents: psychometric evaluation of the family domain of the Communities That Care Youth Survey (CTC) and a new short version of the Childhood Trauma Questionnaire (CTQ)

Alcohol intoxicated adolescents (AIA) in emergency department are an important target group for prevention and valid information on their familial risk and protective factors (RPF) is crucial for implementing customized family-based counseling in hospitals. We therefore, examined the psychometric characteristics of scales which assess familial RPF.

We used seven family scales from the Communities That Care Youth Survey Instrument (CTC-F7); four assess risk factors: family conflicts, poor family management, parental attitudes favorable towards drug use/antisocial behavior; three assess protective factors: family attachment, opportunities and rewards for prosocial involvement. To assess physical and emotional abuse and emotional neglect, we created a new scale composed of six items from the Childhood Trauma Questionnaire (CTQ-6). We tested these eight scales on 342 AIA aged 13-17. Based on the classical test theory we calculated descriptive item and scale statistics and internal consistency. We assessed construct validity by confirmatory factor analysis with Maximum Likelihood (ML) estimation in a sample with imputed missing values (EM-Algorithm). To check robustness, we repeated the analyses with complete cases, with multiple imputed data, and with methods suitable for categorical data. We used SPSS 21, AMOS 21 and R (randomForrest and lavaan package).

Three of seven CTC-F scales showed poor psychometric properties in the descriptive analysis. A ML-confirmatory model with five latent factors fitted the remaining CTC-F scales best (CTC-F5). The latent structure of the CTQ-6 is characterized by three first-order factors (physical abuse, emotional abuse, emotional neglect) and one second-order factor. The global goodness-of-fit indices for the CTC-F5 and the CTQ-6 demonstrated acceptable fit (for both models: TLI and CFI>0.97, RMSEA<0.05). The confirmatory evaluation based on complete cases (n=266), on multiple imputed data, and with alternative estimation methods produces global and local model-fit indices that are comparable to those from the main analysis. The final subscales CTC-F5 and CTQ-6 show acceptable to good internal consistency (α>0.7).

The final CTC-F5 and the newly developed CTQ-6 demonstrate acceptable to good psychometric properties for the AIA sample. The CTC-F5 and the CTQ-6 facilitate a psychometrically sound assessment of familial RPF for this vulnerable and important target group for prevention.