A new measure for distress sexual abuse examinations: Examination distressduring child the genital scale

Objective: The primary aim was to develop a simple scale to quantify indice s of emotional distress during the rectal-genital (anogenital) phase of a c hild sexual abuse examination. Method: A scale successfully developed to measure reactions of children to painful procedures, in particular bone marrow aspirations, was used as a mo del (Elliot, Jay, si Woody, 1987). This new scale was developed to have a s implified raring format, more relevant operational definitions and possibly a different set of behavioral categories. This new scale was developed usi ng 300 children being examined for possible child sexual abuse. Intraclass correlation coefficients identified reliable items to use. Factor analysis and Cronbach alpha were employed to understand the internal structure of th e scale. Paired t-tests, Pearson correlations and hierarchical regression w ere used to explore validity. Results: A simple 7-item scale was developed along with two subscales repre senting agitated and verbally mediated distress. Ratings of distress were s ignificantly greater during the anogenital phase than the general physical part of the examination. Increased distress was associated with positive ph ysical findings. Ratings by the children that they disliked the physician l ooking at their bodies provided discriminant validity by correlating with i ncreased scores for emotional distress during the anogenital segment of the examination. Conclusion: The Genital Examination Distress Scale (GEDS) has been develope d fur measuring the emotional distress of children during the anogenital co mponent of child sexual abuse examinations. The GEDS has been provided for prudent use. Descriptive data offer a comparative standard for other progra ms and research. (C) 1998 Elsevier Science Ltd.