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J Child Adolesc Psychopharmacol. 2016 Feb;26(1):10-8. doi: 10.1089/cap.2015.0098. Epub 2016 Jan 8.

Confirmation of the Factor Structure and Measurement Invariance of the Children's Scale of Hostility and Aggression: Reactive/Proactive in Clinic-Referred Children With and Without Autism Spectrum Disorder.

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1 Department of Psychology, The Ohio State University , Columbus, Ohio.
2 Department of Pediatrics and Developmental Neuroscience, National Institute of Mental Health , Bethesda, Maryland.
3 Department of Medical Social Sciences, Northwestern University , Chicago, Illinois.
4 Department of Health Psychology, University of Missouri , Columbia, Missouri.
5 Department of Child Psychiatry, University of Utah , Salt Lake City, Utah.
6 Waisman Center, University of Wisconsin , Madison, Wisconsin.
7 Children's Medical Center of Dayton , Dayton, Ohio.
8 Department of Psychiatry, University of Illinois at Chicago , Illinois.
9 Department of Psychology, Nationwide Children's Hospital , Columbus, Ohio.



The measurement of aggression in its different forms (e.g., physical and verbal) and functions (e.g., impulsive and instrumental) is given little attention in subjects with developmental disabilities (DD). In this study, we confirm the factor structure of the Children's Scale for Hostility and Aggression: Reactive/Proactive (C-SHARP) and demonstrate measurement invariance (consistent performance across clinical groups) between clinic-referred groups with and without autism spectrum disorder (ASD). We also provide evidence of the construct validity of the C-SHARP.


Caregivers provided C-SHARP, Child Behavior Checklist (CBCL), and Proactive/Reactive Rating Scale (PRRS) ratings for 644 children, adolescents, and young adults 2-21 years of age. Five types of measurement invariance were evaluated within a confirmatory factor analytic framework. Associations among the C-SHARP, CBCL, and PRRS were explored.


The factor structure of the C-SHARP had a good fit to the data from both groups, and strict measurement invariance between ASD and non-ASD groups was demonstrated (i.e., equivalent structure, factor loadings, item intercepts and residuals, and latent variance/covariance between groups). The C-SHARP Problem Scale was more strongly associated with CBCL Externalizing than with CBCL Internalizing, supporting its construct validity. Subjects classified with the PRRS as both Reactive and Proactive had significantly higher C-SHARP Proactive Scores than those classified as Reactive only, who were rated significantly higher than those classified by the PRRS as Neither Reactive nor Proactive. A similar pattern was observed for the C-SHARP Reactive Score.


This study provided evidence of the validity of the C-SHARP through confirmation of its factor structure and its relationship with more established scales. The demonstration of measurement invariance demonstrates that differences in C-SHARP factor scores were the result of differences in the construct rather than to error or unmeasured/nuisance variables. These data suggest that the C-SHARP is useful for quantifying subtypes of aggressive behavior in children, adolescents, and young adults with DD.

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