Childhood experience of care and abuse (CECA) measure

The CECA is a detailed semi-structured interview about childhood experiences. This is structured in terms of the number of household arrangements in childhood with different parental figures questioned about in detail. Initial questions concern loss or separation from parent up to the age of 17. In this way the number of different family arrangements within which an individual was brought up is determined. The questions concerning care, antipathy of parents, discord and violence between parents are repeated for each of these family arrangements. All physical and psychological abuse from household members is covered, as well as all sexual abuse from any perpetrator. Longer versions of the CECA include assessments of role reversal (young carers) and family context involving financial hardship, parent's psychiatric disorder etc.

What makes the instrument different from other measures of childhood is the breadth of coverage and the use of contextual judgements for assessing severity. Thus for example, ratings of severity of sexual abuse are not based purely on the degree of sexual contact as in some other instruments, but also on a range of other contextual information such as relationship to the perpetrator, frequency of abuse, early age of abuse, imposed secretiveness and so on. This method has proved successful in succinctly capturing the full contextual severity of the experience.

The reliability of the instrument is high, with correlations between independent raters on 20 interviews all above 0.78.The validity of the instrument is also high in terms of good inter-respondent agreement. This was assessed with over 80 pairs of sisters reporting independently on childhood experience.

Results with the CECA consistently show odds-ratios of neglect or abuse experience of 3 to 5 with adult disorder. Highest associations occur for sexual abuse or psychological abuse, although all severe instances of antipathy, neglect, role reversal, physical abuse are consistently related. In adolescents the odds-ratios are even higher from 3 to 7 in relation to a range of different disorders, including substance abuse and conduct disorder. The results are confirmed in both males and females and at different lifestages including older age. CECA indices and depression are mediated by adult vulnerability such as insecure attachment style.

The CECA.Q is a self-report measure of childhood with high reliability and predictive of disorder. It assesses parental loss, antipathy, neglect, physical and sexual abuse.


Key references

Bifulco, A., Brown, G. W., & Harris, T. O. (1994). Childhood Experience of Care and Abuse (CECA): A retrospective interview measure. Journal of Child Psychology and Psychiatry, 35, 1419-1435.

Bifulco, A., & Moran, P. (1998). Wednesday's Child: Research into women's experience of neglect and abuse in childhood and adult depression. London, New York: Routledge


For further information on CECA measure visit Childhood Experience of Care and Abuse CECA website -


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