International Psychogeriatrics

Research Article

The sensitivity and specificity of the Modified Conflict Tactics Scale for detecting clinically significant elder abuse

Claudia Coopera1 c1, Kate Maxmina1, Amber Selwooda1, Martin Blancharda1 and Gill Livingstona1

a1 Department of Mental Health Sciences, University College London, London, U.K.

ABSTRACT

Background: A third of family carers of people with dementia describe acting abusively in research studies, but far fewer cases of abuse are currently detected in clinical situations. This discrepancy may be explained by inadequate detection by health professionals, or disagreement regarding what constitutes elder abuse. This study was undertaken to determine the sensitivity and specificity of the revised Modified Conflict Tactics Scale (MCTS) for detecting clinically significant abuse.

Methods: We interviewed 220 family carers of people consecutively referred to psychiatric services with dementia in Essex and London (U.K.), using the MCTS to measure abuse. We defined abuse cases using (1) the MCTS conventional scoring system; (2) the Pillemer criteria; and (3) clinical judgment of an expert panel.

Results: Our panel judged that 15 (6.8%) of carers reported potentially clinical concerning abusive behavior; but 47 (21%) were cases according to the Pillemer criteria and 74 (34%) using the MCTS conventional scoring system. We developed a weighted MCTS scoring system, with high sensitivity and specificity for detecting clinically concerning abuse.

Conclusions: The MCTS could be used routinely in clinical practice with carers of people with dementia to detect clinically concerning cases of abuse, many of which are currently being missed.

(Received December 10 2008)

(Revised February 25 2009)

(Revised March 03 2009)

(Accepted March 05 2009)

(Online publication June 04 2009)

Correspondence:

c1 Correspondence should be addressed to: Claudia Cooper, Dept of Mental Health Sciences, University College London, Holborn Union Building, Archway Campus, Highgate Hill, London, N19 5LW, U.K. Phone: +44 (0) 207 2885931. Email: ccooper@doctors.org.uk.

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