The Child Trauma Screen: A Follow‐Up Validation

Abstract

Although the prevalence of exposure to potentially traumatic events and associated outcomes among children is well documented, widespread trauma screening remains limited. This study provides additional data supporting the psychometrics of the Child Trauma Screen (CTS), a free, brief, empirically derived measure that was intended as a trauma screen for use across child-serving systems. Participants were an ethnically diverse sample of 187 children aged 6-18 years recruited from an urban children's community mental health clinic. At intake, children and their caregivers completed the CTS and other standardized measures of posttraumatic stress disorder, externalizing behavior, anxiety, and depression. Results indicated that the CTS had strong properties on both child and caregiver reports, including internal consistency (Cronbach's α = .78 for both), convergent validity (r = .83 and r = .86), divergent validity (mean across measures and reporters, r = .31; range r = .01-.70), and criterion validity (sensitivity = 0.83 and 0.76; specificity = 0.95 and 0.79, correct classification 89.3% and 81.4%). Suggested cut points and recommendations for using the CTS as a trauma screen are provided. This study provides further empirical support for the use of the CTS as a brief trauma screening measure and provides recommendations for further research.

Interplay between long‐term vulnerability and new risk: Young adolescent and maternal mental health immediately before and during the COVID‐19 pandemic

“…Child post‐traumatic stress disorder (PTSD) symptoms were assessed using mother and child report on the Child Trauma Scale symptoms scale (Lang & Connell, 2017), which includes six items assessing DSM PTSD symptoms over the prior 30 days. The analysis used a total score and a cut point of ≥6 for both child and parent reports (Lang & Connell, 2018).…”

Validating the Child Trauma Screen Among a Cross-Sectional Sample of Youth and Caregivers in Pediatric Primary Care

“…However, this sample is representative of the urban community in which the primary care practice was located and prior research on the CTS has included more diverse and representative samples by race/ethnicity. 21,22 Given somewhat higher rates of trauma exposure and adversity among ethnic minority populations 27 and the location of the study clinic in a large urban area, the rates of trauma exposure and reactions found in the current study may be higher than the general population. Finally, we did not collect data about the utility of trauma screening and to what extent screening helped or hindered the primary care visit and/or referral to or receipt of behavioral health services, which could be a focus of future research.…”

“…An RI-5 total score of 35 or greater (indicating likely PTSD diagnosis) was used as the criterion variable 24 ; 3.5% of caregiver reports and 10.3% of youth reports met this criterion. At a score of 6 or greater, established in 2 prior validation studies based on clinical samples, 21,22 caregiver sensitivity was 1.00 and specificity was 0.85, with 85% of youth correctly classified. For youth, a score of 6 or greater resulted in sensitivity of 0.88, specificity of 0.72, and correct classification of 85% of cases.…”

“…The Reaction subscale has demonstrated good reliability (youth Cronbach’s α = .78; caregiver Cronbach’s α = .82), strong convergent and divergent validity, and excellent sensitivity and specificity using a cutoff score of 6 or greater for youth or caregiver report. 21,22 Children and caregivers each completed the CTS separately.…”

“…The CTS is a 10-item measure of trauma exposure and PTSD symptoms that was empirically developed and previously supported by 2 studies of independent clinical samples of children. 21,22 The present cross-sectional study was developed to answer the following research questions: (1) does the CTS identify children within a pediatric primary care population and setting who are suffering from PTSD symptoms, compared with a longer validated measure of PTSD symptoms; and (2) what are the rates of trauma exposure and PTSD symptoms among children in a pediatric primary care setting in a large urban practice?…”