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C-SARS - Checklist of Sexual Abuse and Related Stressors

The C-SARS was developed to measure stress associated with sexual victimization during childhood or adolescence. It assesses for the occurrence of 70 stressful events related to sexual abuse.

Events include not only those events associated with the actual abuse but perpetrator behaviors that set the stage for the event (e.g., inducements, manipulations, threats), events that occur as a consequence of the abuse (e.g., disruptions in family relationships, disbelief of children’s disclosures), and events that occur as a consequence of public disclosure of abuse (e.g., intrusive encounters with social service, police, and legal professionals).

The measure yields a total scale as well as scores for three event categories and their subscales:
1. Abuse Events (Negative Coercion, Inducements, Violations of Trust, Stigmatizing Messages)
2. Related Events (Family/Conflict/Dysfunction, Loss of Social Contacts, Non-Supportive Responses to Disclosure)
3. Public Disclosure Events (Spaccarelli, 1995)

Overview

Acronym: 

C-SARS

Authors: 
Spaccarelli, Steve, Ph.D.
Citation: 

Spaccarelli, S. (1995). Measuring abuse stress and negative cognitive appraisals in child sexual abuse: Validity data on two new scales. Journal of Abnormal Child Psychology, 23(6), 703-727.

Contact Information: 
Domain Assessed: 
Trauma Exposure/Reminders
Subcategories of Domains Assessed: 
Trauma Exposures
Age Range: 
11-18
Measure Type: 
In-depth Assessment

Administration

Number of Items: 
70
Average Time to Complete (min): 
15
Average Time to Score (min): 
5
Periodicity: 
Not reported
Response Format: 

Yes/No

Note: Time to complete and score are estimated, given the length of the measure. Age range is estimated, given the age of children in the published study (Spaccarelli, 1995).

Materials Needed: 
Paper/Pencil
Sample Items: 
DomainsScaleSample Items
Abuse StressorsNegative CoercionTell you something bad will happen if you didn't do a sexual behavior he/she wanted.
Inducements: Bribes and RewardsGive you extra attention.
Inducements: MisrepresentationTell you that sexual behaviors were a grown-up thing to do.
Inducements: SeductionTell you that sexual behaviors were a fun thing to do.
Violations of TrustBreak a promise not to hurt you in the sex behaviors.
Victim denigrationTell you that the sexual behaviors were bad or naughty.
Information Provided: 
Areas of Concern/Risks
Continuous Assessment
Raw Scores

Parallel or Alternate Forms

Parallel Forms: 
No
Alternate Forms: 
No
Different Age Forms: 
No
Altered Version Forms: 
No

Psychometrics

Clinical Cutoffs: 
No
Reliability: 
Type:RatingStatisticsMinMaxAvg
Internal ConsistencyQuestionnableCronbach's alpha0.450.930.72
References for Reliability: 

The internal consistency for the total scale was high, as was the Total Abuse Category. The Total Related Events Category alpha was acceptable, but the Total Disclosure Events was questionable. In the table alpha is coded as acceptable because the internal consistency of the total was high.
In addition, examination of the public disclosure events suggests that while items are conceptually related, they might be related as a cluster or index rather than as a scale where items are expected to “hang” together.

Spaccarelli (1995):
INTERNAL CONSISTENCY
Total Events Score (.93)

Total Abuse Events (.93)
Subscales: Negative Coercion (.89), Inducements (.89), Trust Violations (.74),
Denigration/Secrecy (.57)

Total Related Events (.73)
Subscales: Family Conflict (.66), Nonsupportive Disclosure (.70), Loss of Social Contact
(.56)

Total Disclosure Events (.66)
Subscales: Investigation Difficulty (.45), Dislocation/Placement (.65), Legal System
Difficulty (.67)

References for Content Validity:
From Spaccarelli (1995):
Items development was guided by a review of the literature regarding events that make
sexual abuse stressful. Events were grouped into three subtypes:

1. Abuse-Specific Events (e.g., Coerciveness and Victim Denigration)

2. Abuse-Related Events (e.g., Family Conflict, Nonsupportive Responses to Abuse)

3. Public Disclosure Related Events (e.g., Repeated Interviews and Adjudication)

References for Content Validity: 

From Spaccarelli (1995):
Items development was guided by a review of the literature regarding events that make
sexual abuse stressful. Events were grouped into three subtypes:

1. Abuse-Specific Events (e.g., Coerciveness and Victim Denigration)

2. Abuse-Related Events (e.g., Family Conflict, Nonsupportive Responses to Abuse)

3. Public Disclosure Related Events (e.g., Repeated Interviews and Adjudication)

Construct Validity: 
Validity TypeNot knownNot foundNonclincal SamplesClinical SamplesDiverse Samples
Convergent/ConcurrentYes
DiscriminantYes
References for Construct Validity: 

From Spaccarelli (1995):
Intercorrelations for the three event categories ranged from .33-.48, suggesting that categories are related but not measuring the same construct.

C-SARS Total scores were significantly correlated with therapists’ overall ratings of Abuse Stress (r=.36, p<.05), and the number of Types of Sexual Abuse reported on the Sexual Exposure Questionnaire (r=.40, p<.05).

The number of Stressful Events was significantly correlated to Total Negative Appraisals (NASAS: r=.44, p<.01). Stressful Events scores were not significantly correlated with children’s or parents’ reports of depression, anxiety, or PTSD symptoms, but they were related to parents’ ratings of Aggressive Behaviors (r=.38, p<.05), Sexual Concerns (r=.30, p<.05), and Total Symptoms (r=.30, p<.05).

Criterion Validity: 
Not KnownNot FoundNonclinical SamplesClinical SamplesDiverse Samples
Predictive Validity:
Postdictive Validity:
References for Criterion Validity: 

From Spaccarelli (1995):
Intercorrelations for the three event categories ranged from .33-.48, suggesting that categories are related but not measuring the same construct.

C-SARS Total scores were significantly correlated with therapists’ overall ratings of Abuse Stress (r=.36, p<.05), and the number of Types of Sexual Abuse reported on the Sexual Exposure Questionnaire (r=.40, p<.05).

The number of Stressful Events was significantly correlated to Total Negative Appraisals (NASAS: r=.44, p<.01). Stressful Events scores were not significantly correlated with children’s or parents’ reports of depression, anxiety, or PTSD symptoms, but they were related to parents’ ratings of Aggressive Behaviors (r=.38, p<.05), Sexual Concerns (r=.30, p<.05), and Total Symptoms (r=.30, p<.05).

Overall Psychometric Limitations: 

Only 1 study has examined the psychometrics of the measure. Test-retest reliability has not yet been examined.

Translations

Languages: 
English
Translation Quality: 
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Population Information

Population Used for Measure Development: 

Psychometrics were examined with 48 girls referred to treatment for sexual victimization. Girls were aged 11-18 (median=14); 79% Caucasian, 15% Hispanic, and 4% Black. Families were primarily of middle- or lower socio-economic status (Spaccarelli, 1995).

Use with Diverse Populations: 
Population Type: 123456

Pros & Cons/References

Pros: 

1. The measure is unique in that it assesses multiple types of stressors related to sexual abuse, including items related to the abuse and secondary adversities.

2. The items tap potentially important stressors for sexually abused children, and information provided is clinically important.

3. The measure is free.

4. The items are clearly written.

Cons: 

1. There is little psychometric research on this measure. More work is needed in this area.

2. The measure does not appear to be used by others in the field, although it has been available since at least 1995.

3. The measure is long.

References: 

A literature search (8/05) of “Checklist of Sexual Abuse and Related Stressors" or "CSARS” revealed that the measure has been referenced in 1 peer-reviewed journal articles.

Spaccarelli, S. (1995). Measuring abuse stress and negative cognitive appraisals in child sexual abuse: Validity data on two new scales. Journal of Abnormal Child Psychology, 23(6), 703-727.

Developer of Review: 
The Children's Trauma Consortium of Westchester Editor of Review: Chandra Ghosh Ippen, Ph.D. Last Updated: 8/5/2005 PDF Available: yes (Representative sampling of publications, presentations, psychometric references) (based on author provided information
Editor of Review: 
Chandra Ghosh Ippen, Ph.D.
Last Updated: 
Monday, March 3, 2014