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CTSQ - Child Trauma Screening Questionnaire

The CTSQ is a 10-item self-report screen which can be used to assist in the identification of children at risk of developing PTSD. The questions are designed to assess traumatic stress reactions in children following a potentially traumatic event.

Overview

Acronym: 

CTSQ

Authors: 
Kenardy, J. A., Spence, S. H., & Macleod, A. C.
Citation: 

Kenardy, J. A., Spence, S. H., & Macleod, A. C. (2006). Screening for posttraumatic stress disorder in children after accidental injury. Pediatrics, 118(3), 1002-1009.

Contact Information: 

Professor Justin Kenardy, email j.kenardy@uq.edu.au . The CTSQ is freely available, however it is copyrighted. Please register interest through a form on this website: http://www.som.uq.edu.au/childtrauma/ctsq.aspx and if it is used for research, forward a copy of the results to Justin.

Cost: 
Free
Copyrighted: 
Yes
Domain Assessed: 
Traumatic Stress
Age Range: 
7-16
Measure Type: 
Screening
Measure Format: 
Questionnaire

Administration

Number of Items: 
10
Average Time to Complete (min): 
5-10
Reporter Type: 
Self
Average Time to Score (min): 
1-2
Periodicity: 
This instrument is not subject to practice effects so can be administered as frequently as needed. We recommend testing within the first two weeks of trauma exposure, then a re-screen at 4-6 weeks post-trauma.
Response Format: 

Dichotomous measure: Yes = 1, No = 0

Materials Needed: 
Paper/Pencil
Sample Items: 
DomainsScalesSample Items
Re-experiencing (5 items)
Yes/NoDo you have bad dreams about the event?
Hyper-arousal (5 items)Yes/NoDo you feel grumpy or lose your temper?
Information Provided: 
Dichotomous Assessment

Training

Training to Administer: 
None Needed
Training to Interpret: 
None Needed

Parallel or Alternate Forms

Parallel Forms: 
No
Alternate Forms: 
No
Different Age Forms: 
No
Altered Version Forms: 
Yes
Alternative Forms Description: 

The CTSQ is a child version of the Trauma Screening Questionnaire developed by Brewin et al. (2002), and was adapted by rewording the questions to make them more comprehensible for children.

Psychometrics

Clinical Cutoffs: 
Yes
Clinical Cutoffs Description: 

A score equal or above 5, indicates the child is at high risk of developing PTSD.

Reliability: 
Type:RatingStatisticsMinMaxAvg
Test-Retest
Internal Consistency0.69alpha
References for Reliability: 

Kenardy et al. (2006).

Content Validity Evaluated: 
Yes
References for Content Validity: 

The CTSQ was developed from the TSQ (Brewing et al. 2002), which is an excellent predictor of PTSD in adult populations. This version was re-worded for better comprehension by children. No problems with item comprehension were identified during pilot testing (see Kenardy et al. 2006).

Construct Validity Evaluated: 
Yes
Construct Validity: 
Validity TypeNot knownNot foundNonclincal SamplesClinical SamplesDiverse Samples
Convergent/Concurrentx
Discriminantx
Criterion Validity Evaluated: 
No
Criterion Validity: 
Not KnownNot FoundNonclinical SamplesClinical SamplesDiverse Samples
Predictive Validity:
Postdictive Validity:
References for Criterion Validity: 

ROC Curve analyses found that the CTSQ was significantly better than chance at predicting PTSD symptoms at six months (AUC = .78, p < .001). These analysis also found the CTSQ was more accurate at predicting PTSD in children at six months post-trauma than the Children's Impact of Events Scale (CIES-8) (see Kenardy et al. 2006). Analyses also indicated that inclusion of heart rate with the screen increased the accuracy of identifying children likely to develop PTSD symptoms (Olsson et al. 2008). Other research found the CTSQ identified 14% of their sample to be at risk of PTSD, and of these children, 55% were diagnosed with PTSD using the CAPS-CA criteria (which included 18% also diagnosed with the DSM-IV criteria) (Charuvastra et al, 2010). Concurrent Validity: The CTSQ is significantly positively correlated with the CIES-8 (r = .56, p = .01).

Sensitivity Rate Score: 
At 1 month: 0.85 (0.65-1.04). At 6 months: 0.82 (0.59-1.05)
Specificity Rate Score: 
At 1 month: 0.75 (0.67-0.82). At 6 months: 0.74 (0.66-0.82)

Translations

Languages: 
English
Translation Quality: 
Language:TranslatedBack TranslatedReliableGood PsychometricsSimilar Factor StructureNorms AvailableMeaure Developed for this Group
1. Arabic Yes
2. Croatian Yes

Population Information

Population Used for Measure Development: 

Children aged 7-16 years old, were recruited while admitted to hospital from an accidental physical injury. Children were excluded if they had an intellectual impairment, had sustained a head injury, were in foster care, or if the injury resulted from child abuse.

Populations with which Measure Has Demonstrated Reliability and Validity: 
Medical Trauma
Witness Death
Accidents
Use with Diverse Populations: 
Population Type: 123456

Pros & Cons/References

Pros: 

Brief Easy to administer and score Free and easily available Preliminary psychometrics appear promising More accurate than the commonly used CIES-8 Demonstrated potential feasibility in a Screen and Treat program in a school setting (Charuvastra et al.2010)

Cons: 

The CTSQ needs more psychometric testing in different trauma populations Needs to be evaluated using child report on diagnostic PTSD interviews. The CTSQ was developed as a predictive screener, so there is no data available on the measure's ability to screen concurrently.

References: 

Brewin, C.R., Rose, S., Andrews, B., et al. (2002). Brief screening instrument for post-traumatic stress disorder. The British Journal of Psychiatry, 181(2), 158-162. Charuvastra, A., Goldfarb, E., Petkova, E., & Cloitre, M. (2010). Implementation of a screen and treat program for child posttraumatic stress disorder in a school setting after a school suicide. Journal of traumatic stress, 23(4), 500-503. doi: 10.1002/jts.20546 Kenardy, J. A., Spence, S. H., & Macleod, A. C. (2006). Screening for posttraumatic stress disorder in children after accidental injury. Pediatrics, 118(3), 1002-1009. Olsson, K. A., Kenardy, J. A., De Young, A. C., & Spence, S. H. (2008). Predicting children's post-traumatic stress symptoms following hospitalization for accidental injury: combining the Child Trauma Screening Questionnaire and heart rate. Journal of anxiety disorders, 22(8), 1447-1453. doi: 10.1016/j.janxdis.2008.02.007 Developer of Review:

Developer of Review: 
Justin Kenardy
Last Updated: 
Thursday, September 5, 2013