The Comprehensive Adversity Measure (CAM): A measure of early adversity and its severity

Abstract

Background

Early adversity scales often display insufficient content coverage and typically assess the presence of adversity, but not its severity.

Objective

To address some of these limitations, we developed the 13-item Youth and Childhood Adversity Scale. We subsequently revised and expanded the scale regarding content coverage and item wording, resulting in a 22-item version, which we here describe.

Methods

We conducted one cross-sectional (N = 1498; 43.9 % females; 24.42 years, SD = 3.72, range: 18–30 years) and one longitudinal study (N = 1084; 39.6 % females; 32 years, SD = 10.49, range: 18–75 years). To reflect the nature of the revised measure more accurately, it was named the Comprehensive Adversity Measure (CAM).

Results

Exploratory factor analysis suggested a one-factor model for both the presence/absence and the severity facet, which both displayed good model fit in subsequent confirmatory factor analyses. Factor models demonstrated at least scalar measurement invariance across gender and country (US/UK). Correlations with psychological distress, depression, anxiety, substance use, posttraumatic stress symptoms, obsessive-compulsive symptoms, suicide attempts, rumination, social comparison, self-esteem, and quality of life provided evidence in support of construct validity – concurrently and prospectively.

Conclusions

The CAM offers a psychometrically-sound, content-wise comprehensive, and free to use assessment of early adversity.