Agreement Between Prospective and Retrospective Measures of Childhood Maltreatment: A Systematic Review and Meta-analysis

Abstract

Importance: Childhood maltreatment is associated with mental illness. Researchers, clinicians, and public health professionals use prospective or retrospective measures interchangeably to assess childhood maltreatment, assuming that the 2 measures identify the same individuals. However, this assumption has not been comprehensively tested.

Objective: To meta-analyze the agreement between prospective and retrospective measures of childhood maltreatment.

Data sources: MEDLINE, PsycINFO, Embase, and Sociological Abstracts were searched for peer-reviewed, English-language articles from inception through January 1, 2018. Search terms included child* maltreatment, child* abuse, child* neglect, child bull*, child* trauma, child* advers*, and early life stress combined with prospective* and cohort.

Study selection: Studies with prospective measures of childhood maltreatment were first selected. Among the selected studies, those with corresponding retrospective measures of maltreatment were identified. Of 450 studies with prospective measures of childhood maltreatment, 16 had paired retrospective data to compute the Cohen κ coefficient.

Data extraction and synthesis: Multiple investigators independently extracted data according to PRISMA and MOOSE guidelines. Random-effects meta-analyses were used to pool the results and test predictors of heterogeneity.

Main outcomes and measures: The primary outcome was the agreement between prospective and retrospective measures of childhood maltreatment, expressed as a κ coefficient. Moderators of agreement were selected a priori and included the measure used for prospective or retrospective assessment of childhood maltreatment, age at retrospective report, sample size, sex distribution, and study quality.

Results: Sixteen unique studies including 25 471 unique participants (52.4% female [SD, 10.6%]; mean [SD] age, 30.6 [11.6] years) contained data on the agreement between prospective and retrospective measures of childhood maltreatment. The agreement between prospective and retrospective measures of childhood maltreatment was poor, with κ = 0.19 (95% CI, 0.14-0.24; P < .001). Agreement was higher when retrospective measures of childhood maltreatment were based on interviews rather than questionnaires (Q = 4.1521; df = 1; P = .04) and in studies with smaller samples (Q = 4.2251; df = 1; P = .04). Agreement was not affected by the type of prospective measure used, age at retrospective report, sex distribution of the sample, or study quality.

Conclusions and relevance: Prospective and retrospective measures of childhood maltreatment identify different groups of individuals. Therefore, children identified prospectively as having experienced maltreatment may have different risk pathways to mental illness than adults retrospectively reporting childhood maltreatment. Researchers, clinicians, and public health care professionals should recognize these critical measurement differences when conducting research into childhood maltreatment and developing interventions.

Figure 1.. Study Selection for Meta-analysis of the Agreement Between Prospective and Retrospective Measures of Childhood Maltreatment

A complete list of the studies included in the analysis with κ agreement is found in the Table.

Figure 2.. Overlap Between Individuals Identified by Virtue of Prospective or Retrospective Measures of Childhood Maltreatment

In the Venn diagrams, the light circles indicate retrospective recall, whereas the dark circles indicate prospectively identified childhood maltreatment. The light nonoverlapping section (R-P) shows the proportion of individuals who retrospectively reported a history of childhood maltreatment but were not prospectively identified as experiencing maltreatment in childhood. The dark nonoverlapping section (P-R) shows the proportion of individuals who were prospectively identified as experiencing maltreatment in childhood but did not retrospectively report a history of childhood maltreatment. The overlap between the 2 circles (RΩP) shows the proportion of individuals who were prospectively identified as experiencing maltreatment in childhood and retrospectively reported a history of child maltreatment. Seven studies^,,,,,, included childhood maltreatment; 8 studies,^,,,,,,, childhood sexual abuse; 9 studies,^,,,,,,,, childhood physical abuse; 4 studies,^,,, childhood emotional abuse; and 4 studies,^,,, childhood neglect. An individual study by Reuben et al investigated the overlap between groups identified by virtue of prospective or retrospective measures of childhood separation from from parents (due to separation, divorce, death, or removal from home; not included in the meta-analysis).

Figure 3.. Forest Plot Depicting the Results of a Random-Effects Meta-analysis

Results are reported as Cohen κ agreement between prospective and retrospective measures of childhood maltreatment. When studies reported multiple effect sizes for different maltreatment types, the mean of the κs was calculated to compute 1 overall effect size per study (κ = 0.19; 95% CI, 0.14-0.24; P < .001; I² = 93%). Diamond marker indicates overall effect size and its variation; different sizes of markers are a function of the standard error for κs in individual studies in the random-effects model.

Figure 4.. Forest Plot Depicting the Results of a Random-Effects Meta-analysis Stratified by the Type of Retrospective Measure Used

Results are reported as Cohen κ agreement between prospective and retrospective measures of childhood maltreatment. Retrospective measures included interview vs questionnaire (Q = 4.1521; df = 1; P = .04). Diamond marker indicates overall effect size and its variation; different sizes of markers are a function of the standard error for κs in individual studies in the random-effects model.