Children's PTSD Inventory

Submitted by mholliday on Tue, 10/02/2012 - 13:29

Overview

Acronym: 
CPTSD-I
Author(s): 
Saigh, Phillip, A., Ph.D.
Citation: 

Saigh, P.A. (2004). A structured interview for diagnosing
Posttraumatic Stress Disorder: Children’s PTSD Inventory. San
Antonio, TX: PsychCorp.

Obtain(Email/Website): 
customer_service@harcourt.com ; www.HarcourtAssessment.com
Cost: 
Cost Involved
Copyrighted: 
Yes
Measure Description: 

The CPTSD-I is a structured clinician-administered interview for
youths 6 to 18 years old that assesses PTSD symptoms and
diagnoses, qualifying event, and current functioning. Items are
based on DSM-IV-TR diagnostic criteria for PTSD, and the
inventory form is divided into five sections of questions that
correspond to DSM IV-TR PTSD symptom clusters (Exposure
and Situational Reactivity, Reexperiencing, Avoidance and
Numbing, Increased Arousal, and Significant Distress or
Impairment).
DSM IV-TR symptoms that reflect compound statements are
divided into separate statements, where a Yes on any of the
statements indicates a Yes for that symptom.

Domain(s) Assessed : 
Traumatic Stress
Language(s) : 
English
French
Spanish
Age Range: 
6-18
Measure Type: 
In-depth Assessment
# of Items: 
50
Measure Format: 
Structured Interview
Average Time to Complete (min): 
18
Reporter Type: 
Self
Average Time to Score (min): 
10
Periodicity: 
Unknown
Response Format: 

2-point rating scale: Yes/No

Materials Needed: 
Paper/Pencil
Sample Item(s): 
Domains ScaleSample Items
Trauma HistoryExposure to
traumatic events
Not available
 Situational ReactivityNot available
PTSD symptomsReexperiencingNot available
 Avoidance/NumbingNot available
 Increased ArousalNot available
 Significant Distress
or Impairment
Not available
Information Provided: 
Areas of Concern/Risks
Clinician Friendly Output
Continuous Assessment
Diagnostic Info DSM IV
Dichotomous Assessment
Raw Scores

Training

Administration Training: 
< 4 Hours Training by Experienced Clinician
Manual/Video
Training to Interpret: 
Manual/Video
Training by Experienced Clinician (<4 hours)

Parallel/Alternate Forms

Parallel Form: 
No
Alternate Form: 
No
Different Age Forms: 
No
Altered Version Forms: 
Yes
Describe Alternative Forms: 

The original Children's PTSD Inventory (Saigh, 1987)
was based on DSM-III criteria.

Psychometrics

Clinical Cutoffs: 
Yes
If Yes, Specify Cutoffs: 
Diagnostic cutoffs for each symptom cluster and overall diagnosis based on DSM-IV criteria.
Reliability: 
Type:RatingStatisticsMinMaxAvg
Test-RetestAcceptablekappa0.6610.86
Internal ConsistencyAcceptableChronbach's alpha0.580.950.8
Inter-raterAcceptable Chronbach's alpha0.7910.92
Parallel/Alternate Forms
References for Reliability: 

Statistics reported in the table are from the manual (Saigh, 2004).
TEST-RETEST RELIABILITY
(Examined with Sample 2 described under “Population Used to Develop Measure.”)
2-week interval (kappa/intraclass correlation), n=42
Exposure (1/.93), Situational Reactivity (1/.94), Reexperiencing (.81/.89), Avoidance and
Numbing (.86/.85), Increased Arousal (.78/.81), Significant Distress (.66/.87), Overall
diagnosis (.91/.90).
Of the 42, were 6 diagnosed as PTSD positive both administrations, and 35 diagnosed as
PTSD negative.
INTERNAL CONSISTENCY (Cronbach’s alpha)
(Examined with Sample 1 described under “Population Used to Develop Measure.”)
Situational Reactivity (.58), Reexperiencing (.88), Avoidance and Numbing (.89),
Increased Arousal (.80), Significant Distress (.70), Overall diagnosis (.95).
INTERRATER RELIABILITY
(Examined with Sample 1.)
2 examiners (kappa/intraclass correlation)
Exposure (1/.96), Situational Reactivity (.79/.92), Reexperiencing (.86/.96), Avoidance
and Numbing (.93/.96), Increased Arousal (.96/.96), Significant Distress (.96/.96), Overall
diagnosis (.96/.98).
Both examiners diagnosed 39 participants as PTSD positive, 106 as PTSD negative, and
2 as no diagnosis, with disagreements on only 3 out of 150 cases.

Content Validity Evaluated: 
Yes
References for Content Validity: 

(From Saigh, 2004)
Items were developed to be consistent with the DSM-IV/DSM-IV-TR diagnostic criteria for
PTSD and to be short, jargon free, and easy to understand. Items were piloted with ten 8-
year-old children with no history of trauma exposure.
Children were asked to paraphrase items. Based on their responses, some items were
modified to improve clarity.
The measure was then tested with a sample of 50 South African female adolescent rape
victims; and items were added, deleted, and modified based on feedback from this study.
The measure was also reviewed by two urban school psychologists, two board-certified

child psychiatrists, two elementary schoolteachers, and a social worker, and was modified based
on their feedback.
“One of the co-chairs and two members of the DSM-IV PTSD Work Group independently
rated CPTSD-I items for correspondence with DSM-IV PTSD criteria." Ratings indicated
good correspondence.

Construct Validity Evaluated: 
Yes
Construct Validity: 
Validity TypeNot knownNot foundNonclincal SamplesClinical SamplesDiverse Samples
Convergent/ConcurrentYesYes
DiscriminantYesYes
Sensitive to ChangeYes
Intervention EffectsYes
Longitudinal/Maturation Effects
Sensitive to Theoretically Distinct GroupsYesYes
Factorial Validity
References for Construct Validity: 

From Saigh (2004):
The CPTSD-I has been found to correlate with total and subscale scores of the
Revised Children’s Manifest Anxiety Scale, the Children’s Depression Inventory,
the Junior Eysenck Personality Inventory Neuroticism scale, and the Child
Behavior Checklist total and internalizing scales. In addition there are strong
correlations between the number of symptoms endorsed on the CPTSDI-I and
the DICA-R and SCID PTSD (r = >.77). Discriminant validity is suggested by
the lack of significant correlation with the CBCL externalizing scale, suggesting
that the CPTSD-I is tapping a different construct.
In a diverse sample of 55 children aged 8-17 who had been physically abused or
sexually maltreated, Linning and Kearney (2004) examined differences between
maltreated youth with a PTSD diagnosis and those without a PTSD diagnosis.
They used the CPTSD-I to determine diagnostic status and reported significant
group differences with regard to symptoms of Reexperiencing,
Avoidance/Numbing, Hyperarousal, Distress, and Total Symptoms. Children
with PTSD were more likely to be girls, to have more extensive family alcohol
and drug use, and longer experiences of maltreatment. They also had more
comorbid diagnoses (as assessed using the Anxiety Disorder Interview Schedule
for Children-Child Version) and higher scores on the When Bad Things Happen
Scale.
Jaycox, Ebener, Damesek, & Becker (2004) examined PTSD diagnosis and its
relation to treatment retention in a diverse sample of 212 adolescents in longterm
residential drug treatment. Trauma exposure included physical
abuse/assault, sexual abuse, life-threatening illness, accident, natural disaster,
and fire/explosion. Similar to what is reported in the manual, they found
correlations between the CPTSD-I and CBCL internalizing but not externalizing
behavior problems. PTSD diagnosis (as assessed by the CPTSD-I) was also
associated with past-year life stressors and total trauma exposure.
Adolescents with PTSD had significantly higher internalizing problems
trauma history but no PTSD were more likely to drop out of treatment.
An unpublished master’s thesis (Hetz, 1994), found the CPTSDI-I to be sensitive
to treatment effects in a sample of South African adolescents aged 13-17
randomly assigned to a 6-week cognitive behavioral group PTSD treatment or a
comparison group. The treatment group showed significant declines on total
PTSD, Reexperiencing, Arousal, and Avoidance and Numbing, whereas the
comparison group did not.

Criterion Validity: 
Not KnownNot FoundNonclinical SamplesClinical SamplesDiverse Samples
Predictive Validity:YesYesYes
Postdictive Validity:
References for Criterion Validity: 

Criteria-related validity, sensitivity, and specificity have been examined with
multiple instruments. Data presented below are from the manual (Saigh,
2004). Data reported above are based on agreement with the SCID PTSD
Module.
Diagnostic Interview for Children and Adolescents (DISC)
Sensitivity (.92), Specificity (.93), Positive Predictive Power (.63), Negative
Predictive Power (.99), Diagnostic Efficiency (.93)
Structured Clinical Interview for the DSM PTSD Module (SCID)
Sensitivity (.87), Specificity (.95), Positive Predictive Power (.72), Negative
Predictive Power (.98), Diagnostic Efficiency (.94)
Clinician-derived diagnoses
Sensitivity (.84), Specificity (.98), Positive Predictive Power (.93), Negative
Predictive Power (.95), Diagnostic Efficiency (.95)
 

Sensitivity Rate Score: 
0.87
Specificity Rate Score: 
0.95
Positive Predictive Power: 
0.72
Negative Predictive Power: 
0.98
Overall Psychometric Limitations: 

1. Psychometrics of measure have been established with samples involving youth of varied
ethnic/racial backgrounds.
2. Although the measure is designed for children aged 6-18, age analyses have not been
reported. Samples typically appear to have included older children (e.g., from manual age:
M=13.48, SD=2.86; M=12.53, SD=3.03).
Given that younger children may express symptoms not included in DSM-IV PTSD criteria
(e.g., regression, separation anxiety), more research is needed to determine the applicability
of the measure with younger children aged 6 and 7.

Translation Quality

Language(s) Other Than English: 
Language:TranslatedBack TranslatedReliableGood PsychometricsSimilar Factor StructureNorms AvailableMeasure Developed for this Group
1. SpanishYesYesYesYesYesNoNo
2. French (Canadian)YesYesYesYesYesNoNo

Population Information

Population Used For Measure Development: 

(From Saigh, 2004)
Psychometrics were examined with two samples of children.
SAMPLE 1: The first sample included 109 trauma exposed and 41 unexposed children,
aged 7.08 to 18.74 (M=13.48, SD=2.86); 56% male and 44% female.
The ethnic composition was 60.7% Hispanic, 19.3% African American, 13.3% Caucasian,
6% Asian, and .7% Other.
SES level, based on Hollingshead: Class I (highest: 5.6%), Class II 20.4%, Class III
(33.1%), Class IV (26.1%), and Class V (14.8%).
For trauma-exposed children, exposure to the trauma occurred within 6 months of
assessment, with predominant trauma types including physical assaults (28.4%), motor
vehicle/bicycle accidents (22%), hand injuries (12.8%), stabbings/shootings (9.2%), and
sexual assaults (9.2%).
SAMPLE 2: The second sample included 31 participants from the first sample and 11 from
a private clinic. The sample included 22 stress-exposed and 20 nonexposed children
aged, 6.28-17.89; 54.8% male, 45.2% female.
The ethnic composition was 48.7% Hispanic, 29.3% Caucasian, 17.1% African American,
and 4.9% Asian.
SES level, based on Hollingshead: Class I (highest: 0%), Class II (20.6%), Class III
(14.7%), Class IV (41.2%), and Class V (23.5%).
 

Measure has demonstrated evidence of reliability and validity in which populations?: 
Physical Abuse
Sexual Abuse
Medical Trauma
Witness Death
Natural Disaster
Domestic Violence
Community Violence
Kidnapping/Hostage
War/Combat
Accidents
Assault
Other
Use with Diverse Populations: 
Population Type: Measure Used with Members of this GroupMembers of this Group Studied in Peer-Reviewed JournalsReliableGood PsychometricsNorms AvailableMeasure Developed for this Group
1. Lower socio-economic statusYesYesYesYesNoUnk
2. Rural populationsYesYesYesYesNoNo

Pros & Cons/References

Pros: 

1. The measure yields both a total symptom count and diagnosis based on DSM-IV/DSMIV-
TR PTSD. There are few measures that do this.
2. The content validity of the measure is well studied and ensures that items do reflect
DSM IV/DSM-IV-TR PTSD criteria.
3. The wording is simple and easy to understand.
4. The test is easy to administer and score, with specific details provided on the test form.
5. This is a well-researched PTSD measure for children, with psychometric properties
reviewed and published in peer-reviewed journal articles.
6. A randomized clinical trial demonstrated that this measure detected changes in PTSD
symptoms that were due to treatment (Hetz, 1994).
7. The measure has been used with children exposed to many different types of trauma
(see “Use with Trauma Populations”).
8. There are Spanish and French (Canadian) versions available from the publisher.
 

Cons: 

1. Similar to other diagnostic measures (e.g., DISC, SCID), for individual items there is no
coding of intensity, which may limit the measure’s statistical power and ability to detect
potential change. Individuals may decrease in the intensity of a specific symptom while
still meeting criteria for that symptom. The author reports that “the possibility of using a
Likert-type format for intensity was considered, tested, and ultimately rejected because
younger children have a difficult time with the alternative format and this was associated
with much lower reliability. It also dramatically increased the length of test administrations.”
2. Although the measure is designed for children aged 6-18, age analyses have not been reported. Samples typically appear to have included older children (e.g., from manual age:
M=13.48, SD=2.86; M=12.53, SD=3.03). Given that younger children may express
symptoms not included in DSM-IV PTSD criteria (e.g. regression, separation anxiety),
more research is needed to determine the applicability of the measure with younger
children aged 6 and 7.
3. Although there is a Spanish and a French (Canadian) version, no published research
was found examining the psychometrics of these versions.

Author Comments : 

The author provided comments and feedback, which were integrated.

References: 

The reference for the manual is:
Saigh, P.A. (2004). A structured interview for diagnosing Posttraumatic Stress Disorder:
Children’s PTSD Inventory. San Antonio, TX: PsychCorp.
A PsychInfo literature search (6/05) of "Children's PTSD Inventory” or “CPTSDI-I" anywhere
revealed that the measure has been referenced in 16 peer-reviewed journal articles. These
articles are listed below.
1. Cook-Cottone, C. (2004). Childhood posttraumatic stress disorder: Diagnosis, treatment,
and school reintegration. School Psychology Review, 33(1), 127-139.
2. International Society for the Study of Dissociation, Task Force on Children and
Adolescents, Northbrook, IL (US). (2004). Guidelines for the evaluation and treatment of
dissociative symptoms in children and adolescents. Journal of Trauma & Dissociation, 5(3),
119-150.
3. Jaycox, L.H., Ebener, P., Damesek, L., & Becker, K. (2004). Trauma exposure and
retention in adolescent substance abuse treatment. Journal of Traumatic Stress, 17(2), 113-
121.
4. Linning, L.M., & Kearney, C.A. (2004). Post-traumatic stress disorder in maltreated
youth: A study of diagnostic comorbidity and child factors. Journal of Interpersonal Violence,
19(10), 1087-1101.
5. Lonigan, C.J., Phillips, B. M., & Richey, J.A. (2003). Posttraumatic stress disorder in
children: Diagnosis, assessment, and associated features. Child & Adolescent Psychiatric
Clinics of North America, 12(2), 171-194.
6. Lubit, R., Hartwell, N., van Gorp, W.G., & Eth, S. (2002). Forensic evaluation of trauma
syndromes in children. Child & Adolescent Psychiatric Clinics of North America, 11(4), 823-
858.
7. Ohan, J.L., Myers, K., & Collett, B.R. (2002). Ten-year review of rating scales. IV: Scales
assessing trauma and its effects. Journal of the American Academy of Child & Adolescent
Psychiatry, 41(12), 1401-1422.
8. Ruggiero, K.J., Morris, T.L., & Scotti, J.R. (2001). Treatment for children with
posttraumatic stress disorder: Current status and future directions. Clinical Psychology:
Science & Practice, 8(2), 210-227.
9. Saigh, P.A. (1989). A comparative analysis of the affective and behavioral
symptomology of traumatized and nontraumatized children. Journal of School Psychology,
27(3), 247-255.
10. Saigh, P.A. (1988). The validity of the DSM-III posttraumatic stress disorder
classification as applied to adolescents. Professional School Psychology, 3(4), 283-290.
11. Saigh, P.A., Yasik, A. E., Oberfield, R.A., Green, B.L., Halamandaris, P.V., &
Rubenstein, H. et al. (2000). The children's PTSD inventory: Development and reliability.
Journal of Traumatic Stress, 13(3), 369-380.
12. Saigh, P.A., Yasik, A. E., Oberfield, R.A., Halamandaris, P.V., & McHugh, M. (2002).
An analysis of the internalizing and externalizing behaviors of traumatized urban youth with
and without PTSD. Journal of Abnormal Psychology, 111(3), 462-470.
13. Saxe, G., Chawla, N., Stoddard, F., KassamAdams, N., Courtney, D., Cunningham, K.,
et al. (2003). Child stress disorders checklist: A measure of ASD and PTSD in children.
Journal of the American Academy of Child & Adolescent Psychiatry, 42(8), 972-978.
14. Strand, V.C., Sarmiento, T.L., & Pasquale, L.E. (2005). Assessment and screening
tools for trauma in children and adolescents: A review. Trauma, Violence, & Abuse, 6(1), 55-
78.
15. Ward, C.L., Flisher, A.J., Zissis, C., Muller, M., & Lombard, C.J. (2004). Measuring
adolescents' exposure to violence and related PTSD symptoms: Reliability of an adaptation
of the Harvard Trauma Questionnaire. Journal of Child & Adolescent Mental Health, 16(1),
31-37.
16. Yasik, A.E., Saigh, P.A., Oberfield, R.A., Green, B., Halamandaris, P., & McHugh, M.
(2001). The validity of the Children's PTSD Inventory. Journal of Traumatic Stress, 14(1), 81-
94.

Developer of Review: 
Chandra Ghosh Ippen, Ph.D., Amie Alley, Ph.D.
Editor of Review: 
Chanrda Ghosh Ippen, Ph.D., Madhur Kulkarni, M.S.
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