items), psychological aggression (8 items), physical assault (12 items), sexual coercion (7 items), and consequence (physical injury) (6 items). The 39 items are rated on an 8-point frequency scale (never, once, twice, 3 to 5 times, 6 to 10 times, 11 to 20 times, and more than 20 times, not in the past year but it did happen before). Interpersonal problem-resolution behaviors range from benign (e.g., “When you had a dispute has spouse discussed the issue calmly?”) to dangerous (e.g., “Has your spouse threatened you with a knife or gun?”). Each question is asked in terms of both respondent’s and partner’s behavior. Reliability ranges from 0.79 to 0.95, and initial evidence of construct validity has been obtained (reliability and validity of the scale are well established, and early factor analysis revealed constructs representing (1) verbal reasoning, (2) psychological abuse/aggression, (3) physical aggression, and (4) life-threatening violence. The CTS allows different types (physical and sexual) and intensities of violence to be documented and collects data on specific behavioral aspects of violent events. It can be used in both clinical and epidemiological settings. Weaknesses of the CTS include a potential overfocus on physical and sexual violence incident identification in that the CTS does not assess financial exploitation or neglect.
Using a modified version of the CTS (in addition to other queries) Pillemer and Finkelhor (1988) directly studied over 2,000 randomly selected older adults in the Boston metropolitan area. A two-stage interview was used in which a 30-minute screening interview (conducted either via telephone or in person) was followed by a more thorough interview to assess the context and specific aspects of abuse. The decision to use telephone or in person interviews was made on the basis of respondent availability, ability, and preference to use the telephone (telephone was the default method). An oversample of older adults living with others (a major abuse risk factor) was studied to increase likelihood of interviewing abuse victims. Proxy interviews were also conducted in instances where older adults were incapable of being interviewed. Modified CTS questions were used to assess physical abuse. Modified Older Americans Resources and Services questions were used to assess neglect. Precise wording of assessment questions was not provided in the report.
The strengths of this modified elder mistreatment assessment methodology included combining the CTS with a prescreen to limit assessment time. In addition, multiple assessment formats were used, including telephone, in-person, and proxy interviews. Weaknesses were few. Most notably, event-based interviews cannot study neglect and abuse of demented individuals, and of course caregivers or proxies must be assessed in these instances, but this weakness is not inherent in this assessment method, per se.
Several other measures have been used to study elder abuse, ranging