Child Stress Disorders Checklist

Submitted by mholliday on Fri, 08/03/2012 - 15:18

Overview

Acronym: 
CSDC
Author(s): 
Glenn Saxe, M.D.
Citation: 

Saxe, G.N. (2001). Child Stress Disorders Checklist (CSDC) (v.4.0-11/01). National Child Traumatic Stress Network and Department of Child and Adolescent Psychiatry, Boston University School of Medicine.

Saxe, G., Chawla, N., Stoddard, F., Kassam-Adams, N., Courtney, D., Cunningham, K., Lopez, C., Sheridan, R., King, D., & Kind, L. (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.

Obtain(Email/Website): 
Cost: 
Free
Copyrighted: 
Yes
Measure Description: 

The Child Stress Disorders Checklist (CSDC) is an observer report measure designed for use as a screening instrument for traumatic stress symptoms in children. It measures symptoms of Acute Stress Disorder (ASD) and Posttraumatic Stress Disorder (PSTD).
The CDSC assesses for the trauma and DSM-IV A2 criteria for PTSD and ASD. It yields a total score as well as scores for Reexperiencing, Increased Arousal, Avoidance, Numbing and Dissociation, and Impairment in Functioning.

The measure can be completed by multiple types of observers who may have contact with a child including caregivers, nurses, teachers, and social service workers.

Domain(s) Assessed : 
Trauma Exposure/Reminders
Externalizing Symptoms
Language(s) : 
English
Age Range: 
2-18
Measure Type: 
Screening
# of Items: 
36
Measure Format: 
Questionnaire
Average Time to Complete (min): 
10
Reporter Type: 
Other
Average Time to Score (min): 
5
Periodicity: 
1 month (scale instructions are now or within the past month)
Response Format: 

0=not true, 1=somewhat or sometimes true, 2=very true or often true

Materials Needed: 
Paper/Pencil
Sample Item(s): 
DomainsScaleSample Items
TotalReexperiencingChild reports uncomfortable memories of the event.
 Increased ArousalChild startles easily. For example, he or she jumps when hears sudden or loud noises.
 AvoidanceChild avoids doing things that remind him or her of the event.
 Numbing and DissociationChild seems "spaced out" or in a daze.
 Impairment in FunctioningChild has difficulty getting along with friends, schoolmates, or teachers.
Information Provided: 
Areas of Concern/Risks

Training

Training to Interpret: 
Prior Experience Psych Testing/Interpretation

Parallel/Alternate Forms

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

The measure was formerly called the Child Stress Reaction Checklist (Saxe, 1997).

There is also a Child Stress Disorders Checklist Screening Form (CSDC-SF), Saxe & Bosquet (2004), which consists of the first 5 items from this questionnaire and is available at http://www.nctsnet.org/nctsn_assets/acp/hospital/CSDC-Screening%20Form2.pdf.

The CSDC-SF is also reviewed in this database.

Psychometrics

Clinical Cutoffs: 
No
Reliability: 
Type:RatingStatisticsMinMaxAvg
Test-Retest-# days: 2Acceptabler0.630.890.78
Internal ConsistencyAcceptableCronbach's alpha0.830.860.85
Inter-raterQuestionnableIntraclass correlation0.240.450.34
Parallel/Alternate Forms
References for Reliability: 

Data reported in the above table are summarized from Saxe et al. (2003).

TEST-RETEST RELIABILITY
Burn sample: 2 days
Total Score (.84), Arousal (.74), Numbing and Dissociation (.70), Avoidance (.85),
Functioning (.63), and Reexperiencing (.89)

INTERNAL CONSISTENCY
Whole sample: alpha=.84
Burn sample: alpha=.83
MVA sample: alpha=.86

INTERRATER RELIABIILTY
Burn sample: between parent and primary nurse (intraclass correlations)
Total score (.44), Arousal (.36), Numbing and Dissociation (.24), Avoidance (.28),
Functioning (.27), Reexperiencing (.45)

Reliability data were also reported by Saxe (1997) in three samples of children: 1) children
with burns (n=43), 2) children experiencing a motor vehicle accident (n=41), and 3)
children experiencing child abuse (n=45).

TEST-RETEST RELIABILITY 2-day interval, Total Score (r=0.84), subscale correlation range: 0.63-0.89

INTERNAL CONSISTENCY
Full sample: Cronbach’s alpha=.091
Burn sample: 0.83
MVA sample: 0.92
Child abuse sample: 0.93

INTERRATER RELIABILITY
Burn sample: parent and primary nurse as reporters
Total Score (r=0.43)
All subscales significant (range=0.30-0.51) with exception of Avoidance subscale

References for Content Validity: 

The measure is based on DSM-IV ASD and PTSD symptomatology. No other information was provided regarding content validity.

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

Significant correlations between CSDC scores and scores on the Child Behavior Checklist PTSD Scale, Child Dissociation List, and the Child PTSD Reaction Index provide evidence of validity:

CBCL-PTSD: Parent Report (r=.39, p<.05)
CDC: Parent Report (r=.49, p<.01), Nurse Report (r=.33, p<.05)
CPTSD-RI: Parent Report (r=.49, p<.01), Nurse Report (r=.35, p<.05)
Three-month CSDC Reexperiencing, Numbing, and Dissociation scores were significantly lower than were scores during acute hospitalization, suggesting the measure is sensitive to change.

2. Bosquet, Saxe, & Kassam-Adams (2004) also examined the validity of the CSDC. Similar to Saxe et al. (2003), they reported significant correlations
between the Total Parent Score and the CPTSD-RI (r=.29, p<.01), CBCL-PTSD (r=.56, p<.001), and CDC (r=.47, p<.001).

Discriminant validity was shown by lower correlations with CBCL Thought Problems (r=.31, p<.01) and CBCL-Delinquency scales (r=.21, p=N.S.).

Nurse reports on the CSDC were correlated with scores on the CBCL-PTSD (r=.43, p<.001) and CDC (r=.37, p<.01). As expected, they were not correlated with CBCL Thought Problems or CBCL Delinquency scores.

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

No data on Sensitivity or Specificity.
Saxe et al. (2003) reported that Parent CSDC scores were also related to CDC and CBCL-PTSD scores 3 months later (r=.59, p<.05 and r=.47, p<.05,
respectively), but they were not significantly related to CPTSD-RI scores (r=.38, p=N.S.).

Bosquet et al. (2004) found that Parent CSDC scores predicted CPTSD-RI, CBCL-PTSD, CDC scores 3 months later.

They also predicted Parent and Child reports on the Diagnostic Interview for Children and Adolescents (DICA) 3 months later, and Child DICA reports 6
months later.

Nurse reports also significantly predicted Parent DICA reports 3 months later (r=.41, p<.01)

Population Information

Population Used For Measure Development: 

Scale development was conducted with three subsamples (Saxe, 1997; Saxe et al., 2003):

1. Burn victims (n=43): Children averaged 11.67 years of age (SD=3.20); 35% female, 65% male; 67% White, 21% Black, 4% Hispanic, 4% Native American.

2. Children experiencing traffic accidents (n=41): Children were aged 5-17 (M=10, SD=3.55); 30% female, 70% male; 42% White, 46% Black, 2% Hispanic, 10% Asian American.

3. Clinic sample of children with abuse histories (n=45).

Measure has demonstrated evidence of reliability and validity in which populations?: 
Medical Trauma
Accidents
Other

Pros & Cons/References

Pros: 

1. The measure is unique in assessing both Acute Stress Disorder and Posttraumatic Stress Disorder Symptomatology using the observer report.

2. The measure is based on DSM-IV criteria for Acute Stress Disorder and Posttraumatic Stress Disorder.

3. Additional benefits include assessment of exposure and reaction to the traumatic event, impairment in functioning, and symptoms of dissociation, in addition to PTSD symptomatology.

4. The measure is free and easily available.

Cons: 

1. Psychometrics have been examined only by the first author.

2. The measure has yet to be examined in terms of ability to detect change due to treatment and relationship to diagnostic classifications (sensitivity and specificity).

3. Although the measure is designed for children aged 2-18 and was used with this age range in the psychometric study, examination of the actual items suggests that it may not be an appropriate screen for younger children, given that a number of items would not apply to them.

4. The wording on some of the items is somewhat technical, most likely because items were derived from the DSM-IV.

THIS IS NOT A CON, JUST INFORMATION: For many of the items, the wording refers to “the event,” suggesting that the measure was not designed for a chronic or multiply traumatized population. It was designed to screen for ASD and PTSD symptoms following an event.

References: 

A PsychInfo search of the words “Child Stress Disorder Checklist” and “CSDC” anywhere (6/05) revealed that the measure has been referenced in 3 peer-reviewed journal articles.
Two are review articles.

Cardeña, E., & Weiner, L. A. (2004). Evaluation of dissociation throughout the lifespan. Psychotherapy: Theory, Research, Practice, Training. Educational Publishing Foundation, 41(4), 496-508.

Saxe, G., Chawla, N., Stoddard, F., Kassam-Adams, 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.

Vostanis, P. (2004). The impact, psychological sequelae and management of trauma affecting children. Current Opinion in Psychiatry, 17(4), 269-273.

Developer of Review: 
Trauma Center Staff
Editor of Review: 
Chandra Ghosh Ippen, Ph.D.
Last Updated: 
Fri, 02/14/2014
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