Cedric Sachser1, Lucy Berliner2, Tonje Holt3, Tine K Jensen4, Nathaniel Jungbluth5, Elizabeth Risch6, Rita Rosner7, Lutz Goldbeck8. 1. University of Ulm, Clinic for Child and Adolescent Psychiatry/Psychotherapy, Germany. Electronic address: cedric.sachser@uniklinik-ulm.de. 2. Harborview Center for Sexual Assault and Traumatic Stress, Seattle, United States. Electronic address: lucyb@u.washington.edu. 3. Norwegian Center for Violence and Traumatic Stress Studies, Oslo, Norway; Mental & Physical health, Norwegian Institute of Public Health. Electronic address: tonje.holt@nkvts.no. 4. Norwegian Center for Violence and Traumatic Stress Studies, Oslo, Norway; University of Oslo, Department of Psychology, United States. Electronic address: tine.jensen@psykologi.uio.no. 5. Harborview Center for Sexual Assault and Traumatic Stress, Seattle, United States. Electronic address: jungbn@uw.edu. 6. Center on Child Abuse and Neglect, University of Oklahoma Health Sciences Center, USA. Electronic address: Elizabeth-Risch@ouhsc.edu. 7. Catholic University of Eichstätt-Ingolstadt, Department of Psychology, Eichstätt, Germany. Electronic address: rita.rosner@ku.de. 8. University of Ulm, Clinic for Child and Adolescent Psychiatry/Psychotherapy, Germany. Electronic address: lutz.goldbeck@uniklinik-ulm.de.
Abstract
BACKGROUND: Systematic screening is a powerful means by which children and adolescents with posttraumatic stress symptoms (PTSS) can be detected. Reliable and valid measures based on current diagnostic criteria are needed. AIM: To investigate the internal consistency and construct validity of the Child and Adolescent Trauma Screen (CATS) in three samples of trauma-exposed children in the US (self-reports: n=249; caregiver reports: n=267; pre-school n=190), in Germany (self-reports: n=117; caregiver reports: n=95) and in Norway (self-reports: n=109; caregiver reports: n=62). METHOD: Internal consistency was calculated using Cronbach's α. Convergent-discriminant validity was investigated using bivariate correlation coefficients with measures of depression, anxiety and externalizing symptoms. CFA was used to investigate the DSM-5 factor structure. RESULTS: In all three language samples the 20 item symptom score of the self-report and the caregiver report proved good to excellent reliability with α ranging between .88 and .94. The convergent-discriminant validity pattern showed medium to strong correlations with measures of depression (r =.62-.82) and anxiety (r =.40-.77) and low to medium correlations with externalizing symptoms (r =-.15-.43) within informants in all language versions. Using CFA the underlying DSM-5 factor structure with four symptom clusters (re-experiencing, avoidance, negative alterations in mood and cognitions, hyperarousal) was supported (n =475 for self-report; n =424 for caregiver reports). LIMITATIONS: The external validation of the CATS with a DSM-5 based semi-structured clinical interview and corresponding determination of cut-points is pending. CONCLUSION: The CATS has satisfactory psychometric properties. Clinicians may consider the CATS as a screening tool and for symptom monitoring.
BACKGROUND: Systematic screening is a powerful means by which children and adolescents with posttraumatic stress symptoms (PTSS) can be detected. Reliable and valid measures based on current diagnostic criteria are needed. AIM: To investigate the internal consistency and construct validity of the Child and Adolescent Trauma Screen (CATS) in three samples of trauma-exposed children in the US (self-reports: n=249; caregiver reports: n=267; pre-school n=190), in Germany (self-reports: n=117; caregiver reports: n=95) and in Norway (self-reports: n=109; caregiver reports: n=62). METHOD: Internal consistency was calculated using Cronbach's α. Convergent-discriminant validity was investigated using bivariate correlation coefficients with measures of depression, anxiety and externalizing symptoms. CFA was used to investigate the DSM-5 factor structure. RESULTS: In all three language samples the 20 item symptom score of the self-report and the caregiver report proved good to excellent reliability with α ranging between .88 and .94. The convergent-discriminant validity pattern showed medium to strong correlations with measures of depression (r =.62-.82) and anxiety (r =.40-.77) and low to medium correlations with externalizing symptoms (r =-.15-.43) within informants in all language versions. Using CFA the underlying DSM-5 factor structure with four symptom clusters (re-experiencing, avoidance, negative alterations in mood and cognitions, hyperarousal) was supported (n =475 for self-report; n =424 for caregiver reports). LIMITATIONS: The external validation of the CATS with a DSM-5 based semi-structured clinical interview and corresponding determination of cut-points is pending. CONCLUSION: The CATS has satisfactory psychometric properties. Clinicians may consider the CATS as a screening tool and for symptom monitoring.
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