screening questions for abuse vs. harsh discipline

["Oddone Virginio" <oddovir@xxxxxxxxx>]

"Screening" is essentially a medical term, indicating a procedure by which
a given population - which is at risk for a specific disease - is examined
by using a simple diagnostic test, in order to discover the "silent",
pre-clinical stages of that disease in those of its members who are
developing it. The test must be easy, innocuous, with a high level of
sensibility and specificity; it is directed to one or a few "markers" of
the disease of proven diagnostic and prognostic significance; the
procedure, the choice of the test and of the most meaningful "disease
markers" are the result of - and tested through - multicenter research;
they have been officially worked out in formal "consensus statements"; the
whole terminology is carefully worked, so to avoid any confusion and
ambiguity. In positive cases, "screening" represents the initial step of
more complex (and costly, also in emotional terms) procedure of diagnosis
confirmation and treatment; strictly linked to screening is the problem of
both "false positive" and "false negative" results.

In the "abuse/harsh discipline screening test" under discussion we have
instead:

- "Mark" is so equivocal (as remarked by some participants in the
discussion) as to be meaningless; 
- "corporal punishment", "harsh discipline" and "potential abuse" are vague
terms that may - and may not - indicate the same thing while giving the
impression of being different (and indeed many discussants admitted
uneasiness);
- "loosing control while spanking" can be either a cause of spanking or its
consequence (in an aroused punishing adult).

It is like stating that every "nodule" - without further specification at
dimension, aspect, location (whether in the breast or in the armpit or
under the scalp), etc. - is a potential marker of breast cancer.

Virginio.



Virginio Oddone MD
V. Avogadro 6
10121 - Torino (Italy)
e-mail: oddovir@ipsnet.it
+ 39.11.5628528



>Hello,
>
>A colleague is starting to analyze data from a screening questionnaire
>and asked me to post this query.
>
>The questionnaire contains 3 items regarding parental discipline:
>
>1) Have you spanked your child more than once in the previous month?
>2) Have you ever felt like you have lost control while spanking your
>child?
>3) Have you ever left a mark from spanking your child?
>
>If a parent endorses any 2 of these 3 items, she is trying to use this as
>an indication of either: "corporal punishment"; or "harsh discipline"; or
>"potential abuse".
>
>What do you think of this?  Would endorsing 2 of the 3 items qualify as
>punishment or harsh discipline or potential abuse?
>
>
>Thank you.
>
>Sandra Bishop
>Yale Child Study Center
>