Child Trauma Measures for Research and Practice

Poster session presented at the annual meeting of the EMDR International Association, Montreal, September 2004.

Address correspondence to: Ricky Greenwald, Psy.D., Child Trauma Institute, P.O. Box 544, Greenfield, MA 01302, USA.

Electronic mail is preferred, and may be sent via Internet to rg@www.ticti.org.

Introduction

This is a practical guide to objectively scored measures of child/adolescent post-traumatic stress symptoms. It is geared to the field-based researcher and the practicing clinician, who must balance scientific value with the limitations inherent in clinical practice settings. This is not a comprehensive review, but rather a selective sampling of those instruments most likely to be useful in the above contexts. The full text of this poster is available at www.ticti.org.

Several issues must be considered in selecting instruments for assessing child trauma.

Source of Information

Generally, children are better at identifying their own internal states but worse at describing their own behavior. Parents (and others) are worse at identifying children’s internal states, but better at reporting on observed behavior (Loeber, Green, & Lahey, 1990). Multiple sources of information are essential.

Identified Trauma or Not

The usefulness of scales specific to an identified trauma is limited to assessment of response to that event. If you want to know about the child’s entire post-traumatic burden, you’ll have to ask more general questions, not just questions tied to a specific referenced event.

PTSD vs. All PTS Symptoms

Children and adolescents have a much broader range of clinically significant responses to trauma exposure, beyond those represented by the PTSD diagnostic criteria (Giaconia et al, 1995; Kendall-Tackett, Williams, & Finkelhor, 1993). Also, children may have PTSD-like responses (possibly excepting hyper-arousal) to non-criterion-A experiences, such as major loss, family breakup, or accumulated minor trauma (see Greenwald, in press).

Psychometric Properties

Reported validity should be specific to your population, including age, gender, reading level, cultural background, language, and traumatic stressor. Since a perfect match is unlikely, use your judgment, extend related findings, and compensate with additional assessment strategies (Newman, 2002).

Convenience

If you have money for interviewers and participant compensation, you can get a lot done. Otherwise, you’re generally better off sticking to the “one page” rule for any measure.

Behavior Change

Trauma is often assumed to be the source of problem behaviors (Greenwald, 2002). These behaviors should be tracked directly, in addition to reported PTS symptoms. Sometimes existing data can be used, such as school attendance, grades, discipline referrals, or arrests. When you can relate changes in constructs (such as PTS symptoms) to changes in outcome (such as better grades), you are in a position to discuss theory as well as efficacy.

Health Status

In large-scale studies, statistically significant health-related effects have been noted, for example, a decline in visits to the school nurse following successful trauma treatment (Chemtob, Nakashima, Hamada, & Carlson, 2002).

Related Constructs: Anxiety, Depression, Empathy, Dissociation, Anger

Anxiety and depression are commonly measured in trauma studies, but show a much weaker effect than scales of post-traumatic symptoms. Trauma studies must include PTS scales to ensure sensitivity. Additional scales can be useful for redundancy and/or to further assess a construct of special interest, such as anger in children with conduct problems. Anxiety and depression measures are generally well known and will not be further addressed here.

It’s been hard to find a good empathy measure. However, it may be possible to operationalize empathy, for example, by tracking the type and frequency of aggressive behaviors.

The obvious pick for measuring dissociation is the Adolescent Dissociative Experiences Scale (Armstrong, Putnam, Carlson, Libero, & Smith, 1997), which is available from the Sidran Institute (www.sidran.org). This screener is a widely respected 30 item checklist with good psychometrics and reasonable ease of completion and scoring.

None of the anger measures are perfect, but there are some that may be suitable for specific populations/needs. For example, the Anger Response Inventory (ARI; Tangney 1998) is a very well-designed, thorough, situation-specific measure with child and adolescent forms, which takes about 25 minutes to complete and would thus be most appropriate for resource-rich research projects. The State-Trait Anger Expression Inventory (STAXI; Spielberger, 1996) has some difficult language but is reasonably useful with adolescents as long as someone is available to help with a word here and there.

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Exposure to Trauma:

Lifetime Incidence of Traumatic Events, Student/Parent Forms (LITE-S/P)

What it measures: History of exposure to the child/adolescent’s adverse life events; past and current distress level for each of the endorsed events.

Time Estimate: Administration – 5 minutes; Scoring – 1 minute

Languages: English, German, Spanish, Persian, Swedish

Cost: $16 for packet including Student and Parent forms, with permission to copy.

Description: The 16 items cover a broad range of potential trauma and loss events and ask for an estimate of emotional impact at both the time of occurrence and the present. Available in student and parent forms (LITE-S, LITE-P)

Comments: There is no currently available measure of a child/adolescent’s exposure to possibly traumatic events which is simple, brief, and well validated. Several structured interviews have been developed, as well as a couple of rather cumbersome but thorough paper & pencil instruments. This is the only one-pager I know of. Note that although the language is simple and clear, the format can be a bit confusing for some people. The parent and student forms of the LITE sometimes show modest discrepancies (Greenwald & Rubin, 1999), possibly reflecting parent-child differences in forgetting, willingness to disclose, or access to information. The measures were designed for screening, but for research purposes various scoring systems have been tried. None has been firmly established, but one simple strategy is to sum the number of items that have been endorsed.

Psychometric Maturity: ———————–|———————————————————-

Under Basic Mature

Construction Properties

Intact

Psychometric Properties: Similar measures of trauma history for adults have been found to have adequate reliability; however, items are occasionally reported on only the initial test or on the retest, but not both (Goodman, Corcoran, Turner, Yuan, & Green, 1998; Knight, Rierdan, Meschede, & Lasardo, 1997). Regarding this type of instrumentation, validation of reported incidents has not yet been studied. The LITE-S and the LITE-P together formed the basis of a clinician rating which correlated with current post-traumatic symptoms CROPS r=.60; PROPS r= .56 (Greenwald & Rubin, 1999; note that the rating of current distress was not included in that version of the LITE). Correlations in other studies: LITE-S/CROPS r=.48-.57; LITE-S/TSCC r=.53-.56 (see Greenwald, Rubin, Russell, & O’Connor, 2002).

Sample Items:

  • been in a car accident (yes/no)
    • if yes: how many times
    • how old you were
    • how much it upset you then (none, some, lots)
    • how much it bothers you now (none, some, lots)
  • someone in the family died
  • parents (or grownups) broke things or hurt each other
  • been made to do sex things
  • been robbed (or house robbed)

Contact:

Author: Ricky Greenwald, Psy.D.

Purchase: Child Trauma Institute

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Single Incident:

Impact of Events Scale – 8 Child Items (IES-8)

What it measures: Intrusion and avoidance symptoms related to an identified event.

Time Estimate: Administration – 5 minutes; Scoring – 2 minutes

Languages: Many

Cost: None

Description: This is an 8-item self-report of the child’s intrusion and avoidance responses to a specific identified event.

Comments: The Impact of Events Scale (IES; Horowitz, Wilner, & Alvarez, 1979) is widely used with adults following a critical incident, and 8 of the items have survived norming with children and adolescents (Dyregrov & Yule, 1995; Smith, Perrin, Dyregrov, & Yule, 2003). The IES-8 items only address avoidance and intrusion; five hyperarousal items have been developed more recently, with inconclusive value (Smith et al, 2003). Either way, the focus is on classic PTSD symptoms, and many PTS responses are not detected by this measure. Also, the IES will not detect PTS responses that are not directly related to the referenced event.

Psychometric Maturity: ———————————————————————|————

Under Basic Mature

Construction Properties

Intact

Psychometric Properties: Smith and colleagues (2003) reported the following in their sample of 2,976 war-exposed children, ages 9-14, in Bosnia:

  • internal consistency (alpha)
    • total symptom scale (8 items) alpha = .75
    • subscale alphas = .70 (intrus), .73 (avoid)

Other types of validity have also been established, with other versions of the instrument.

Sample Items:

  • I thought about it when I didn’t mean to. (not at all, rarely, sometimes, often)
  • Pictures about it popped into my mind.
  • I tried to remove it from memory.
  • I tried not to talk about it.

Contact: Atle Dyregrov, Ph.D.

atle.dyregrov@psych.uib.no

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Single Incident:

Acute Stress Checklist for Children (ASC-Kids)

What it measures: Acute stress symptoms within a month of an identified event.

Time Estimate: Administration – 10 minutes; Scoring – 5 minutes

Languages: English, Spanish

Cost: None

Description: This is a 29-item (2 page) self-report measure of Acute Stress Disorder for children ages 8-17. It includes questions on how the event was experienced at the time, current symptoms, and current resources, social support, and coping.

Comments: The items should be read aloud to children under 10. Further study is underway.

Psychometric Maturity: ————————————|———————————————

Under Basic Mature

Construction Properties

Intact

Psychometric Properties: Kassam-Adams, Baxt, and Shrivastava (2003) report the following in their first sample of 144 recently-injured children and teens:

  • internal consistency (alpha)
    • total ASD scale (25 items) alpha = .86
    • subscale alphas = .63 (diss.), .73 (reex.), .74 (avoid.), .77 (arous.)
  • test-retest reliability (N=80)
    • total ASD scale (25 items) r = .73
    • test-retest reliability for subscales = .66 (diss.), .73 (reex.), .59 (avoid.), .68 (arous.)
  • convergent validity
    • correlation with the CATS symptom scale [a measure of posttraumatic stress symptoms] administered at the same time (r = .77)
    • correlation with concurrent parent report of child ASD symptoms (r = .38)
  • predictive validity (N = 81)
    • ASC-Kids total scale was correlated (r = .63) with CATS symptom scale (PTSD severity) at 3 months post-injury.

Sample Items:

  • I wanted to make it stop, but I couldn’t.
  • I felt in a daze  like I didn’t know what was going on.
  • Pictures or sounds from what happened keep popping into my mind.
  • It’s hard for me to fall asleep or stay asleep.
  • If I get sad or upset, I have a way to help myself feel better.

Contact: Nancy Kassam-Adams, Ph.D.

nlkaphd@mail.med.upenn.edu

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PTSD:

Child PTSD Symptom Scale (CPSS)

What it measures: PTSD symptoms and diagnosis.

Time Estimate: Administration – 10 minutes; Scoring – 5 minutes

Languages: English

Cost: None

Description: This self-report form is keyed to the DSM criteria for PTSD. It includes 2 event items, 17 symptom items, and 7 items on whether the symptoms interfere with various types of functioning.

Comments: The wording is a bit complex, many kids will need help completing this.

Psychometric Maturity: ————————————|———————————————

Under Basic Mature

Construction Properties

Intact

Psychometric Properties: Foa, Johnson, Feeny, and Treadwell (2001) reported the following in their first sample of 75 children and teens two years after an earthquake:

  • internal consistency (alpha)
    • total symptom scale (17 items) alpha = .89
    • subscale alphas = .80 (re-exp), .91 (avoid), .90 (arous)
  • test-retest reliability at 1-2 weeks (n=65)
    • total symptom scale (17 items) r = .84
    • subscales r = .85 (re-exp), .63 (avoid), .76 (arous)
    • functional impairment scale (7 items) r= .70
  • convergent validity
    • correlation with the CPTSD-RI [a measure of posttraumatic stress symptoms/PTSD] administered at the same time (r = .80)
    • correlation with concurrent parent report of child ASD symptoms (r = .38)

Sample Items:

  • Feeling upset when you think about it or hear about the event (for example, feeling scared, angry, sad, guilty, etc)
    • Not at all or only at one time
    • Once a week or less/ once in a while
    • 2 to 4 times a week/ half the time
    • 5 or more times a week/almost always
  • Trying to avoid activities, people, or places that remind you of the traumatic event
  • Being overly careful (for example, checking to see who is around you and what is around you)
  • Areas of functioning, have the above problems gotten in the way of…
    • Doing your prayers (yes/no)
    • Relationships with your family

Contact: Edna Foa, Ph.D.

foa@mail.med.upenn.edu

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PTSD:

PTSD Checklist – child/parent forms (PCL-C/PR)

What it measures: PTSD symptoms and diagnosis

Time Estimate: Administration – 5 minutes; Scoring – 5 minutes

Languages: English

Cost: None

Description: This is a 17-item checklist that can be completed by the child or parent, covering the PTSD symptoms.

Comments: This instrument does not assess event or functioning, so if you want a real PTSD diagnosis you’ll have to establish these in some other way. Some of the items are a bit wordy, so younger kids will need help.

Psychometric Maturity: ————————————|———————————————

Under Basic Mature

Construction Properties

Intact

Psychometric Properties: Daviss et al (2000) and Ford et al (1999) reported the following in their samples of 48 injured children ages 7-17, and 165 children in an outpatient psychiatric clinic, ages 6-17, respectively.

  • internal consistency (alpha)
    • total scale (17 items) alpha = .92/.89
    • subscale alphas = .88/.84 (re-exp), .80/.77 (avoid), .79/.80 (arous)
  • test-retest reliability at 1 week (n=21)
    • total scale (17 items) r = .92
    • convergent validity
  • correlation with the CAPS-CA [a structured interview of posttraumatic stress symptoms/PTSD] administered at the same time (r = .47)

Sample Items:

  • Feeling very upset when something reminded her/him of a stressful experience from the past?
    • Not at all
    • A little bit
    • Moderately
    • Quite a bit
    • Extremely
  • Avoiding activities or situations because they reminded him/her of a stressful experience from the past?
  • Feeling as if her/his future will somehow be cut short?
  • Being “super-alert” or watchful or on guard?

Contact: Julian D. Ford, Ph.D.

ford@PSYCHIATRY.UCHC.EDU

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PTSD:

Chidren’s PTSD Inventory (C-PTSD-I)

What it measures: PTSD symptoms and PTSD

Time Estimate: Administration – 5-20 minutes (depending on symptom endorsement; Scoring – 1-10 minutes

Languages: English, Spanish, Canadian French

Cost: Manual: $66; Pack of 25 test protocols: $43

Description: This is a structured child/adolescent interview of PTSD symptoms and diagnosis, including qualifying event, symptoms, and current functioning.

Comments: The structured interview is considered the gold standard of PTSD diagnosis, but is too costly to be practical in many treatment and research contexts. This is the quickest of the structured PTSD interviews for kids, without sacrificing anything in validity.

Psychometric Maturity: ——————————————————-|————————–

Under Basic Mature

Construction Properties

Intact

Psychometric Properties: Saigh (2004) reported the following in samples of 150 stress-exposed children ages 7-18, 6 months after the stressor, and 42 children ages 6-17, some stress-exposed and some not, respectively.

  • Sample 1 internal consistency (alpha)
    • overall diagnosis alpha = .95
    • subscale alphas = .58 (react), .88 (re-exp), .89 (avoid), ..80 (arous), .70 (distress)
  • Sample 1 inter-rater reliability
    • Cohen’s kappa = .96 (overall diagnosis)
    • Intraclass correlation coefficient = .91 (overall diagnosis)
  • Sample 2 test-retest reliability at 2 weeks (n=42)
    • overall diagnosis kappa = .91
  • convergent validity
    • high correlations with several structured PTSD interviews
    • convergent and discriminant validity with several other measures

Sample Items:

  • Has a very scary thing happened to you?
  • Did you feel that you could not do anything to stop this from happening?
  • If you see or think about people, places, or things that remind you about what happened, do your hands feel sweaty?
  • Since this happened, have you changed your mind about your chances of having a long life?
  • Have your grades in school gotten worse since this happened?

Contact:

Author: Phillip A. Saigh, Ph.D. PASaigh@aol.com

Purchase: PsychCorp www.PsychCorp.com

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PTS and Sub-Scales:

Trauma Symptom Checklist for Children (TSCC)

What it measures: PTS symptoms and symptom clusters.

Time Estimate: Administration – 15-20 minutes; Scoring – 5-10 minutes

Languages: English, Spanish, French-Canadian

Cost: Manual: $42; pack of 25 tests: $48; scoring forms and programs also available.

Description: This is a 54-item self-report checklist covering a wide range of PTS symptoms. It features the following sub-scales:anxiety, depression, anger, PTS, dissociation, and sexual concerns.

Comments: The TSCC is probably the most widely used measure of children’s PTS symptoms. For many purposes, the TSCC sub-scales can be used in the place of additional measures. It is a bit lengthy, and also takes a few minutes to score. It also fails to address some important aspects of child trauma symptomatology, such as somatic complaints and pessimistic future. The items are clear and well-written. The sexual concern items sometimes raise eyebrows. An alternate form is available which omits the 10 items relating to sexual concerns.

Psychometric Maturity: ———————————————————————————|

Under Basic Mature

Construction Properties

Intact

Psychometric Properties: Various studies using the TSCC (and TSCC-A) indicate that it is reliable (alphas in the mid to high 80s for all scales but Sexual Concerns, which tends to be in the high 60s and low 70s) and has convergent and predictive validity in samples of traumatized and nontraumatized children and adolescents. (For more detail, see full summary at http://www.johnbriere.com/tscc.htm.) Norming sample of about 3,000, ages 8-17.

Sample Items:

  • Bad dreams or nightmares
    • never
    • sometimes
    • lots of times
    • almost all of the time
  • Feeling lonely
  • Crying
  • Wanting to hurt other people
  • Feeling like I did something wrong

Contact:

Author: John Briere, Ph.D.

Purchase: Psychological Assessment Resources, Inc. www.parinc.com

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PTS and Sub-Scales:

Trauma Symptom Checklist for Young Children (TSC-YC)

What it measures: PTS symptoms and symptom clusters

Time Estimate: Administration – 20 minutes; Scoring – 10 minutes

Languages: English, Spanish

Cost: None – yet! Will be published soon by PAR.

Description: This is a care-taker checklist covering a wide range of PTS symptoms for children ages 3-12. It includes 90 items and features the following sub-scales:anxiety, depression, anger, PTS (and further PTSD subscales), dissociation, and sexual concerns.

Comments: This is a new instrument which will be particularly valuable for children who are too young to respond for themselves. It has many of the same features as the TSCC. It is on the long side, but the sub-scales are informative and may be used in place of additional measures focused on those constructs.

Psychometric Maturity: ————————————|———————————————

Under Basic Mature

Construction Properties

Intact

Psychometric Properties: In a multi-site sample of 219 traumatized children (Briere et al, 2001), the TSCYC clinical scales had good reliability (alpha values for the clinical scales ranged from .81 for Sexual Concerns to .93 for PTSD-Total, with an average value of .87) and were predictive of exposure to childhood sexual abuse, physical abuse, and witnessing domestic violence. (For more detail, see full summary at http://www.johnbriere.com/tscyc.htm.)

Sample Items:

  • Telling a lie
    • not at all
    • sometimes
    • often
    • very often
  • Not doing something he or she was supposed to do
  • Playing games about something bad that actually happened to him or her in the past
  • Becoming frightened or disturbed when something sexual was mentioned or seen

Contact:

Author: John Briere, Ph.D.

Purchase: Psychological Assessment Resources, Inc. www.parinc.com

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PTS Symptoms for Adolescents:

Los Angeles Symptom Checklist (LASC)

What it measures: PTS symptoms and PTSD diagnosis.

Time Estimate: Administration – 10 minutes; Scoring – 2 minutes

Languages: English, Spanish (?)

Cost: None

Description: This is a 43-item self-report checklist of PTS and other stress-related symptoms, for teens.

Comments: Simple language, short phrases, especially suited to urban teens. There are no event or functioning items but it does include 17 PTSD symptom items, which can be scored separately.

Psychometric Maturity: ———————————————————————|————

Under Basic Mature

Construction Properties

Intact

Psychometric Properties: King, King, Leskin and Foy (1995) modified the original instrument for use with teens, most notably in detecting exposure to violence among urban teens, and exposure to trauma among juvenile delinquents (Foy, Wood, King, King, & Resnick, 1997). The modified LASC has been normed with several thousand adolescents in community and clinical samples, and has been used in a number of trauma studies.

Sample Items:

  • abusive drinking
    • not a problem
    • a slight problem
    • a moderate problem
    • a serious problem
    • an extreme problem
  • pervasive disgust
  • girlfriend problems
  • excessive eating
  • excessive jumpiness

Contact:

David W. Foy, Ph.D. David.Foy@pepperdine.edu

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Child/Adolescent PTS Symptoms:

Child Report of Post-traumatic Symptoms (CROPS)

What it measures: PTS symptoms

Time Estimate: Administration – 5 minutes; Scoring – 1 minute

Languages: German, Spanish, Bosnian, Persian, Dutch, Italian, Finnish

Cost: $16 for packet including Student and Parent forms, with permission to copy.

Description: This is a 24-item self-report for children and adolescents, covering a broad range of PTS symptoms.

Comments: One of the interesting consequences of utilizing the full spectrum of post-traumatic stress symptoms (as opposed to only the PTSD symptoms) is that this instrument has been equally sensitive to boys and girls in picking up trauma-related distress. This can be used as a stand-alone but was designed as a companion to the PROPS; although there is some overlap, each instrument takes advantage of the respective strengths of the respondent.

Psychometric Maturity: —————————————————————————-|—–

Under Basic Mature

Construction Properties

Intact

Psychometric Properties: Greenwald and Rubin (1999) and Greenwald, Rubin, Jurkovic et al (2002) have presented multiple studies indicating good internal consistency, test-retest reliability, criterion validity, convergent and discriminant validity, and sensitivity to change. Children were ages 7-17 in a variety of countries and settings including community samples, incarcerated youth, war refugees, and clinical populations.

Sample Items:

  • I daydream. (none, some, lots)
  • I try to forget about bad things that have happened.
  • I have bad dreams or nightmares.
  • I feel all alone.
  • I don’t feel like doing much.

Contact:

Author: Ricky Greenwald, Psy.D.

Purchase: Child Trauma Institute

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Child/Adolescent PTS Symptoms:

Parent Report of Post-traumatic Symptoms (PROPS)

What it measures: PTS symptoms

Time Estimate: Administration – 5 minutes; Scoring – 1 minute

Languages: German, Spanish, Bosnian, Persian, Dutch, Italian, Finnish

Cost: $16 for packet including Student and Parent forms, with permission to copy.

Description: This is a 32-item parent report covering a broad range of PTS symptoms.

Comments: One of the interesting consequences of utilizing the full spectrum of post-traumatic stress symptoms (as opposed to only the PTSD symptoms) is that this instrument has been equally sensitive to boys and girls in picking up trauma-related distress. This can be used as a stand-alone but was designed as a companion to the CROPS; although there is some overlap, each instrument takes advantage of the respective strengths of the respondent.

Psychometric Maturity: ————————————|———————————————

Under Basic Mature

Construction Properties

Intact

Psychometric Properties: Greenwald and Rubin (1999) and Greenwald, Rubin, Jurkovic et al (2002) have presented multiple studies indicating good internal consistency, test-retest reliability, criterion validity, convergent and discriminant validity, and sensitivity to change. Children were ages 7-17 in a variety of countries and settings including community samples, war refugees, and clinical populations. For more details, see www.ticti.org.

Sample Items:

  • Difficulty concentrating (not true, sometimes true, often true)
  • Anxious
  • Fights
  • Nervous
  • Stomach aches

Contact:

Author: Ricky Greenwald, Psy.D.

Purchase: Child Trauma Institute

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Behavior Change:

Problem Rating Scale (PRS)

What it measures: Problem behaviors and other observable symptoms

Time Estimate: Administration – 5 minutes; Scoring – 0 minutes

Languages: Any

Cost: None

Description: This structured interview is an individualized parent rating of the severity of the child’s primary presenting problems.

Comments: The PRS is administered in an interview by having the parent describe the main concerns and rate them on a 0-10 scale of severity. This is face valid, fairly quick, and fits easily within a standard clinical interview or assessment protocol. The same rater should be used on each occasion.

Psychometric Maturity: ————————————|———————————————

Under Basic Mature

Construction Properties

Intact

Psychometric Properties: The PRS (Greenwald, 1996) is a reverse variant of the goal attainment scale, which has been found to be a valid and reliable assessment format (Emmerson & Neely, 1988). It has been used in several trauma treatment studies and appears to be sensitive to change in post-traumatic status.

Sample Items:

  • low grades (0 is no problem, 10 is the worst the problem could be – in the past week)
  • argues a lot
  • doesn’t care anymore
  • quick temper

Contact: Author: Ricky Greenwald, Psy.D.

Purchase: Child Trauma Institute

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References

Armstrong, J. G., Putnam, F. W., Carlson, E. B., Libero, D. Z., & Smith, S. R. (1997). Development and validation of a measure of adolescent dissociation: the Adolescent Dissociative Experiences Scale. Journal of Nervous and Mental Disease, 185, 491-497.

Briere, J. (1996). Trauma Symptom Checklist for Children (TSCC) professional manual. Odessa, FL: Psychological Assessment Resources.

Briere, J., Johnson, K., Bissada, A., Damon, L., Crouch, J., Gil, E., Hanson, R., & Ernst, V. (2001). The Trauma Symptom Checklist for Young Children (TSCYC): Reliability and association with abuse exposure in a multi-site study. Child Abuse & Neglect, 25, 1001-1014.

Chemtob, C. M., Nakashima, J., Hamada, R., & Carlson, J. G. (2002). Brief treatment for elementary school children with disaster-related posttraumatic stress disorder: A field study. Journal of Clinical Psychology, 58, 99-112.

Daviss, W. B., Mooney, D., Racusin, R., Ford, J. D., Fleischer, A., & McHugo, G. (2000). Predicting post-traumatic stress after hospitalization for pediatric injury. Journal of the American Academy of Child and Adolescent Psychiatry, 39, 576-583.

Dyregrov, A. & Yule, W. (1995, November). Screening measures: The development of the UNICEF screening battery. Presented at the annual meeting of the International Society for Traumatic Stress Studies, Boston, MA.

Emmerson, G. J. & Neely, M. A. (1988). Two adaptable, valid, and reliable data-collection measures: Goal attainment scaling and the semantic differential. The Counseling Psychologist, 16, 261-271.

Foa, E. B., Johnson, K. M., Feeny, N. C., & Treadwell, K. R. H. (2001). The Child PTSD Symptom Scale: A preliminary examination of its psychometric properties. Journal of Clinical Child Psychology, 30, 376-384.

Ford, J. D., Racusin, R., Ellis, C., Daviss, W. B., Reiser, J., Fleischer, A., & Thomas, J. (2000). Child maltreatment, other trauma exposure, and posttraumatic symptomatology among children with Oppositional Defiant and Attention Deficit Hyperactivity disorders. Child Maltreatment, 5, 205-217.

Foy, D. W., Wood, J. L., King, D. W., King, L. A., & Resnick, H. S. (1997). Los Angeles Symptom Checklist: Psychometric evidence with an adolescent sample. Assessment, 4, 377-384.

Giaconia, R. M., Reinherz, H. Z., Silverman, A. B., Pakiz, B., Frost, A. K., & Cohen, E. (1995). Traumas and posttraumatic stress disorder in a community population of older adolescents.Journal of the American Academy of Child and Adolescent Psychiatry, 34, 1369-1380.

Goodman, L., Corcoran, C., Turner, K., Yuan, N., & Green, B. L. (1998). Assessing traumatic event exposure: General issues and preliminary findings for the Stressful Life Events screening questionnaire. Journal of Traumatic Stress, 11, 521-542.

Greenwald, R. (1996). Psychometric review of the Problem Rating Scale. In B. H. Stamm (Ed.), Measurement of stress, trauma, and adaptation, pp. 242-243. Lutherville, MD: Sidran.

Greenwald, R. (2002). The role of trauma in conduct disorder. Journal of Aggression, Maltreatment, and Trauma, 6, 5-23.

Greenwald, R. (in press). Child trauma handbook: A guide for helping trauma-exposed children and adolescents. Binghamton, NY: Haworth.

Greenwald, R. & Rubin, A. (1999). Brief assessment of children’s post-traumatic symptoms: Development and preliminary validation of parent and child scales. Research on Social Work Practice, 9, 61-75.

Greenwald, R., Rubin, A., Jurkovic, G. J., Wiedemann, J., Russell, A. M., O’Connor, M. B., Sarac, T., Morrell, T. R., & Weishaar, D. (2002, November). Psychometrics of the CROPS & PROPS in multiple cultures/translations. Poster session presented at the annual meeting of the International Society for Traumatic Stress Studies, Baltimore.

Greenwald, R., Rubin, A., Russell, A. M., & O’Connor, M. B. (2002, November). Brief assessment of children’s and adolescents’ trauma/loss exposure. Poster session presented at the annual meeting of the International Society for Traumatic Stress Studies, Baltimore.

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