title: Testing the validity and reliability of the shame questionnaire among sexually abused girls in Zambia.
abstract: OBJECTIVE
  The aim of the current study is to test the validity and reliability of the Shame Questionnaire among traumatized girls in Lusaka, Zambia.
  
  
  METHODS
  The Shame Questionnaire was validated through both classical test and item response theory methods. Internal reliability, criterion validity and construct validity were examined among a sample of 325 female children living in Zambia. Sub-analyses were conducted to examine differences in construct validity among girls who reported sexual abuse and girls who did not.
  
  
  RESULTS
  All girls in the sample were sexually abused, but only 61.5% endorsed or reported that sexual abuse had occurred. Internal consistency was very good among the sample with alpha = .87. Criterion validity was demonstrated through a significant difference of mean Shame Questionnaire scores between girls who experienced 0-1 trauma events and more than one traumatic event, with higher mean Shame Questionnaire scores among girls who had more than one traumatic event (p = .004 for 0-1 compared to 2 and 3 events and p = .016 for 0-1 compared to 4+ events). Girls who reported a history of witnessing or experiencing physical abuse had a significantly higher mean Shame Questionnaire score than girls who did not report a history of witnessing or experiencing physical abuse (p<.0001). There was no significant difference in mean Shame Questionnaire score between girls who reported a sexual abuse history and girls who did not. Exploratory factor analysis indicated a two-factor model of the Shame Questionnaire, with an experience of shame dimension and an active outcomes of shame dimension. Item response theory analysis indicated adequate overall item fit. Results also indicate potential differences in construct validity between girls who did and did not endorse sexual abuse.
  
  
  CONCLUSIONS
  This study suggests the general utility of the Shame Questionnaire among Zambian girls and demonstrates the need for more psychometric studies in low and middle income countries.
authors: Social Intervention Group, Global Health Research Center of Central Asia, School of Social Work, Columbia University, New York, New York, United States of America.
authors: Lynn T M
authors: LT
authors: Michalopoulos
authors: Center for Refugee and Disaster Response, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States of America.
authors: Laura K
authors: LK
authors: Murray
authors: Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States of America.
authors: Jeremy C
authors: JC
authors: Kane
authors: Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States of America.
authors: Stephanie
authors: S
authors: Skavenski van Wyk
authors: Ministry of Community Development, Mother Child Health (MCDMCH), Lusaka, Zambia.
authors: Elwyn
authors: E
authors: Chomba
authors: Center for Traumatic Stress in Children & Adolescents, Allegheny General Hospital, Drexel University College of Medicine, Pittsburgh, Pennsylvania, United States of America.
authors: Judith
authors: J
authors: Cohen
authors: School of Medicine, University of Zambia, Lusaka, Zambia.
authors: Mwiya
authors: M
authors: Imasiku
authors: Center for Global Health & Development, Boston University School of Public Health, Boston, Massachusetts, United States of America.
authors: Katherine
authors: K
authors: Semrau
authors: School of Social Work, University of Maryland, Baltimore, Maryland, United States of America.
authors: Jay
authors: J
authors: Unick
authors: Center for Refugee and Disaster Response, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States of America.
authors: Paul A
authors: PA
authors: Bolton
mesh_terms: D000293:Adolescent; D002648:Child; D002650:Child Abuse, Sexual / Q000523:psychology*; D005260:Female; D006801:Humans; D012752:Shame; D011795:Surveys and Questionnaires