A GLOBAL-SCALE TO MEASURE THE QUALITY OF THE FAMILY ENVIRONMENT

Background: Simple, reliable measures of the quality of the environmen t in which a child was reared that can be used in clinical research an d practice are lacking. Method: The reliability and validity of a glob al scale to retrospectively appraise the quality of that environment w ere examined. Fifty-three clinicians from 4 centers in Australia and 1 in Hong Kong, People's Republic of China, used the scale to rate 7 ca se vignettes; 4 clinicians rated 20 medical records, and 49 rated 211 subjects after clinical interviews. Results: Interrater reliability (i ntraclass correlation coefficient) was 0.82 (time 1) and 0.84 (time 2) for case vignettes, 0.90 for medical records, and 0.89 for clinical i nterviews. Consistency in time was high (r=0.91). Lower ratings, indic ative of a less adequate environment, were associated with a clinical diagnosis of oppositional defiant or conduct disorder. Conclusions: Ou r simple-to-use scale appears to measure reliably a relevant clinical construct and fills a gap among the instruments available. Ratings may be useful as a cost-effective index to consider in outcome studies, w hen examining response to treatment, or in other clinical research.