Childhood Maltreatment Interview Schedule Short Form

John Briere, Ph.D.

Please note: Use of this scale is limited to professional researchers. It is not intended as, nor should it be used as, a self-test under any circumstances.

Cut and paste, as needed, into word processor. Adapted from the full CMIS, published as an appendix in J. Briere (1992), Child Abuse Trauma: Theory and Treatment of the Lasting Effects. Newbury Park, CA: Sage Publications.

This instrument is freely available to all researchers. No permission is required, although Briere, 1992 should be cited.

Like most traumatic event reviews, there are no studies known to the author regarding the overall reliability or validity of CMIS-SF. This is partly due to the fact that, other than the Psychological Abuse subscale (the sum of all scores within item number 7), all items simply ask about potential maltreatment experiences, are not summed to form scales, and can be used by various researchers in different ways according to their interests. There are, however, data on the Psychological Abuse subscale (e.g., Briere & Runtz, 1998, 1990) suggesting reasonably good alpha reliability. Further, the successful use of the CMIS-SF in various studies suggests predictive and construct validity.

Briere, J., & Runtz, M. (1990). Differential adult symptomatology associated with three types of child abuse histories. Child Abuse & Neglect: The International Journal, 14, 357-364.

Briere, J., & Runtz, M. (1988). Multivariate correlates of childhood psychological and physical maltreatment among university women. Child Abuse & Neglect: The International Journal, 12, 331-341.

CMIS-SF

Age _____

 Sex:    Male ___ Female ___

 Race:    Caucasian/White ___  Black ___  Asian ___  Hispanic ___  

Other ___

Are you currently receiving psychotherapy or psychiatric treatment?

Yes ___ No ___

The following survey asks about things that may have happened to
you in the past. Please answer all of the questions that you can,
as honestly as possible.

1) Before age 17, did any parent, step-parent, or foster-parent
ever have problems with drugs or alcohol that lead to medical
problems, divorce or separation, being fired from work, or being
arrested for intoxication in public or while driving?

Yes__  No__   If yes, who? __________________________

About how old were you when it started?   ___ years old

About how old were you when it stopped?   ___ years old

[Check here if it hasn't stopped yet __]

2) Before age 17, did you ever see one of your parents hit or beat
up your other parent?

Yes ___ No ___

If yes, how many time can you recall this happening?

____ times

Did your father ever hit your mother?  Yes ___  No ___

Did your mother ever hit your father?  Yes ___  No ___

Did one or more of these times result in someone
needing medical care or the police being
called? 

Yes ___ No ___

3) On average, before age 8, how much did you feel that your
father/step-father/foster-father loved and cared about you? 

Not at all            Very much

        1     2      3      4

4) On average, before age 8, how much did you feel that your
mother/step-mother/foster-mother loved and cared about you? 

Not at all            Very much

        1     2      3      4

5) On average, from age 8 through age 16, how much did you feel
that your father/step-father/foster-father loved and cared about
you? 

Not at all            Very much

        1     2      3      4

6) On average, from age 8 through age 16, how much did you feel
that your mother/step-mother/foster-mother loved and cared about
you? 

Not at all            Very much

        1     2      3      4

7) When you were 16 or younger, how often did the following happen
to you in the average year? Answer for your parents or stepparents
or fosterparents or other adult in charge of you as a child:

              once     twice     3-5     6-10     11-20     over 20
                    a          a      times    times     times      times
never     year       year     a year   a year    a year    a year

   0          1            2             3         4           5            6

A) Yell at you                       0    1    2    3    4    5    6 

B) Insult you                        0    1    2    3    4    5    6

C) Criticize you                     0    1    2    3    4    5    6

D) Try to make                     0    1    2    3    4    5    6
you feel guilty

E) Ridicule or                        0    1    2    3    4    5    6
humiliate you 

F) Embarrass you                  0    1    2    3    4    5    6
in front of others

G) Make you feel                   0    1    2    3    4    5    6
like you were
a bad person

8) Before age 17, did a parent, step-parent, foster-parent, or
other adult in charge of you as a child ever do something to you on
purpose (for example, hit or punch or cut you, or push you down)
that made you bleed or gave you bruises or scratches, or that broke
bones or teeth? 

Yes__   No__    If yes, who did this? ______________________

How often before age 17? ____ times

How old were you the first time? ___ years

How old were you the last time (before age 17)? ___ years

Were you ever hurt you so badly that you had to see a
doctor or go to the hospital? 

Yes__ No__

9. Before you were age 17, did anyone ever kiss you in a sexual way,
or touch your body in a sexual way, or make you touch their
sexual parts? 

Yes__  No__

Did this ever happen with a family member?

Yes__  No__  If yes, with who? ___________________________

At what ages? ___________)

Did this ever happen with someone 5 or more years
older than you were? 

Yes__  No__  

If yes, with who (check all that apply):

___ A friend     (at what ages? __________)

___ A stranger  (at what ages? __________)

___ A family member   (who? __________________)

(At what ages? _________)

___ A teacher, doctor, or other professional  

(who? __________________)

(At what ages? ___________)

___ A babysitter or nanny   (At what ages? ___________)

___ Someone else not mentioned above

(who? _______________________________)

(at what ages? _______________)

Did anyone ever use physical force on any of these
occasions? 

Yes__ No__      If yes, who? _____________

Overall, about how many times were you kissed or touched in a
sexual way or made to touch someone else's sexual parts by someone
five or more years older before age 17? 

____ times

Overall, how many people (five or more years older than you)
did this?

___ people 

10) Before you were age 17, did anyone ever have oral, anal, or
vaginal intercourse with you, or insert a finger or object in your
anus or vagina? 

Yes__  No__

Did this ever happen with a family member?

Yes__  No__   If yes, with who? _____________________________

At what ages? ___________)

Did this ever happen with someone 5 or more years
older than you were? 

Yes__  No__

If yes, with who (check all that apply):

___ A friend   (at what ages? __________)

___ A stranger   (at what ages? __________)

___ A family member   (who? __________________)

(At what ages? ___________)

___ A teacher, doctor, or other professional  (who? __________________)

(At what ages? ___________)

___ A babysitter or nanny   (At what ages? ___________)

___ Someone else not mentioned above

(who? _______________________________)

(at what ages? _______________)

Did anyone ever use physical force on any of these
occasions? 

Yes__ No__ If yes, who? _____________

About how many times did anyone five or more years older have
oral, anal, or vaginal intercourse with you before
age 17, or insert a finger or object in your anus or
vagina?

___ times

Overall, how many people (five or more years older than you)
did this?

___ people

11) To the best of your knowledge, before age 17, were you ever

Sexually abused? Yes__ No__ 

Physically abused? Yes__ No__