Practice Post by Kirsten L. Anderson, University of Dayton
Children and adolescents with untreated PTSD are at a greater risk of developing substance use disorder, experiencing suicidality, and exhibiting poorer overall mental health over the lifetime (Chapman & Ford, 2008; Jaycox, Ebener, Damesek, & Becker, 2004). Despite the importance of accurately diagnosing PTSD in this population, clinicians do not currently have a brief, psychometrically validated assessment tool for PTSD that corresponds to current DSM-5 criteria for the disorder. This article describes two newly validated versions of the Child PTSD Symptom Scale (CPSS) that can be administered quickly to reliably screen for probable PTSD diagnosis. The Child PTSD Symptom Scale for DSM-5 Self Report (CPSS-5-SR) and the Child PTSD Symptoms Scale for DSM-5 Interview (CPSS-5-I) are invaluable tools for clinicians who work with children and adolescents, particularly clinicians with large caseloads or in settings where in-depth diagnostic interviews may not be feasible.
Article Title: Psychometrics of the Child PTSD Symptom Scale for DSM-5 for Trauma-Exposed Children and Adolescents
Article Authors: Edna B. Foa, Anu Asnaani, Yinyin Zang, Sandra Capaldi, & Rebecca Yeh
Why is this article relevant to practice? Early diagnosis of PTSD is imperative to preventing long-term negative outcomes associated with unresolved trauma. Unfortunately, currently available validated scales for assessing PTSD in children and adolescents often take too long to administer and do not correspond to the current DSM-5 criteria. This article delineates the psychometric properties of the revised Child PTSD Symptom Scale for DSM-5 (CPSS-5) and suggests validated screening items for clinicians to use when considering a diagnosis of PTSD.
What are the key takeaways from the article?
- 64 children and adolescents who had experienced a Criteria A traumatic event were recruited for this study. Participants completed a revised self-report version of the Child PTSD Symptom Scale (CPSS-5-SR), the Children’s Depression Inventory (CDI; Kovacs, 1982), and the Multidimensional Anxiety Scale for Children (MASC; March, Parker, Sullivan, Stallings, & Conners, 1997). In addition, the researchers administered an interview version of the revised CPSS-5 (CPSS-5-I).
- The CPSS-5-SR and the CPSS-5-I demonstrated strong psychometric properties (internal consistency, test-retest reliability (Table 1, p. 42) and discriminant validity (Table 2, p. 43) as well as high convergence to one another (convergent validity, diagnostic agreement, and severity of symptoms).
- The CPSS-5-SR and CPSS-5-I are the first reliable, valid tools to assess for PTSD in children and adolescents based on current DSM-5 criteria.
- ROC analyses suggested a cutoff score of 31 or greater (out of a possible score of 80) on the CPSS-5-SR as a probable indicator for PTSD in children. In addition, six of seven items from the CPSS-5-I measuring impairment were identified as reliable screening items for PTSD in children and adolescents.
- Both CPSS-5 versions could be used as efficient, yet reliable, screening tools in settings where conducting longer diagnostic interviews may not be feasible. The CPSS-5-I takes about 30 minutes and the 6-item CPSS-5-SR provides a quick screen.
What do the authors say are the limitations of the article?
- Because PTSD is a relatively rare diagnosis and there are systematic barriers preventing children and adolescents from receiving mental health services, the sample size of this study was fairly small.
- The CPSS-5-SR necessitates strong reading comprehension skills, making it difficult for younger children to accurately complete the assessment. Children under 8 were not included in the study.
Link to the article: https://www.tandfonline.com/doi/full/10.1080/15374416.2017.1350962
Full Article Reference: Foa, E. B., Asnaani, A., Zang, Y., Capaldi, S., & Yeh, R. (2018). Psychometrics of the Child PTSD Symptom Scale for DSM-5 for trauma-exposed children and adolescents. Journal of Clinical Child & Adolescent Psychology, 47(1), 38-46. doi: 10.1080/15374416.2017.1350962
CPSS-5 Interview Version: https://www.div12.org/wp-content/uploads/2014/11/CPSS-I-5.pdf
CPSS-5 Self-Report Version (includes trauma screen): http://www.afcbt.org/materials/Downloads/CPSS-V%2003-15-17.pdf
Clinicians interested in the Spanish version of the CPSS-5-SR should contact Rafael Kichic, PhD at email@example.com