Impact of asking sensitive questions about violence to children and adolescents.

PURPOSE: A major gap in our understanding of the ethics of asking sensitive health questions to children is the impact these questions have on their well-being.
METHODS: A survey which included sensitive questions about victimization, perpetration, and exposure to violence was fielded nationally among 1588 youth between 10 and 15 years old. At the end of the survey, youth were asked whether any questions about violence upset them.
RESULTS: One in four youth (23%) indicated that they were upset by the survey questions about violence. Ten themes emerged from the youth's open-ended responses to what specifically upset them, including being upset by specific types of questions (e.g., sex, drugs), being distressed by the thought that young people were engaging in these behaviors, and finding the tone of the survey to be accusatory. Upset youth were three times more likely to be younger than non-upset youth. Victims of direct violence (e.g., physical assault) and indirect violence (e.g., witnessing violence) were no more likely to report being upset than were non-victims.
CONCLUSIONS: Surveys querying sensitive topics must include younger youth to provide accurate prevalence estimates and to avoid floor effects. Great care should be taken to understand the impact that these questions have on youth and to ensure appropriate referral to support services if needed.