Published online September 1, 2006
PEDIATRICS Vol. 118 No. 3 September 2006, pp. 1002-1009 (doi:10.1542/peds.2006-0406)
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ARTICLE

Screening for Posttraumatic Stress Disorder in Children After Accidental Injury

Justin A. Kenardy, BSc, PhD, MAPSa,b, Susan H. Spence, BSc, MBA, PhDa and Alexandra C. Macleod, BPsyScb

a School of Psychology
b Centre of National Research on Disability and Rehabilitation Medicine, University of Queensland, Queensland, Australia

OBJECTIVE. Children who have experienced an accidental injury are at increased risk of developing posttraumatic stress disorder. It is, therefore, essential that strategies are developed to aid in the early identification of children at risk of developing posttraumatic stress disorder symptomatology after an accident. The aim of this study was to examine the ability of the Child Trauma Screening Questionnaire to predict children at risk of developing distressing posttraumatic stress disorder symptoms 1 and 6 months after a traumatic accident.

METHODS. Participants were 135 children (84 boys and 51 girls; with their parents) who were admitted to the hospital after a variety of accidents, including car- and bike-related accidents, falls, burns, dog attacks, and sporting injuries. The children completed the Child Trauma Screening Questionnaire and the Children's Impact of Events Scale within 2 weeks of the accident, and the Anxiety Disorders Interview Schedule for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Child Version, was conducted with the parents to assess full and subsyndromal posttraumatic stress disorder in their child 1 and 6 months after the accident.

RESULTS. Analyses of the results revealed that the Child Trauma Screening Questionnaire correctly identified 82% of children who demonstrated distressing posttraumatic stress disorder symptoms (9% of sample) 6 months after the accident. The Child Trauma Screening Questionnaire was also able to correctly screen out 74% of children who did not demonstrate such symptoms. Furthermore, the Child Trauma Screening Questionnaire outperformed the Children's Impact of Events Scale.

CONCLUSIONS. The Child Trauma Screening Questionnaire is a quick, cost-effective and valid self-report screening instrument that could be incorporated in a hospital setting to aid in the prevention of childhood posttraumatic stress disorder after accidental trauma.

Key Words: injury • screening tools • accidents • posttraumatic stress disorder • mental health

Abbreviations: PTSD—posttraumatic stress disorder • RTA—road traffic accident • IES—Impact of Events Scale • CTSQ—Child Trauma Screening Questionnaire • PPV—positive predictive value • NPV—negative predictive value • CIES—Children's Impact of Events Scale • TSQ—Trauma Screening Questionnaire • ADIS-C/P—Anxiety Disorders Interview Schedule for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Child Version, Parent Interview Schedule • ISS—injury severity score • ROC—receiver operating characteristic • AUC—area under the curve

Accepted Apr 10, 2006.




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The Child Trauma Screening Questionnaire predicts PTSD onset 6 months after traumatic accident better than the Children's Impact of Events Scale
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