Development of an Age-Appropriate Household Dysfunction Measure and its Concurrent Validity With Multiple Outcomes Among Middle School Adolescents in Southeast Texas

Existing adverse childhood experience (ACE) measures include a limited number of household dysfunction (HD) items and the use of adult-oriented language that is not always appropriate for middle schoolers. We developed an age-appropriate 10-item HD measure informed by previously validated ACE measures and tested its concurrent validity with dating violence (DV) perpetration, lifetime substance use, and mental health outcomes among middle schoolers in Southeast Texas. This cross-sectional study used the baseline data from a DV prevention intervention program for sixth graders (<i>N</i> = 126), Me & You Tech. Baseline data were collected from March 2023 to April 2023. To test the concurrent validity of the newly developed HD measure, we conducted a series of multivariable regression models regarding the association between HD and the six key outcomes while controlling for covariates. The most common type of HD exposure was parental separation/divorce (33.3%). We found significant associations between HD and physical (AOR = 1.45; 95% CI [1.00, 2.10]) and psychological DV perpetration (AOR = 1.75; 95% CI [1.20, 2.56]). For each additional reported HD exposure, there were 61% higher odds for adolescents to engage in lifetime alcohol use (AOR = 1.61; 95% CI [1.11, 2.34]). Finally, we found significant associations between HD and depression (β = 1.34; 95% CI [0.57, 2.12]) and HD and anxiety (β = 1.28; 95% CI [0.52, 2.03]). Our findings suggest the HD measure is pragmatic and has strong evidence of concurrent validity. This measure may be a helpful tool in assessing HD among middle school-aged adolescents, both in school and clinic settings.