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.
Overview
CPTSD-I
Saigh, P.A. (2004). A structured interview for diagnosing Posttraumatic Stress Disorder: Children’s PTSD Inventory. San Antonio, TX: PsychCorp.
Administration
2-point rating scale: Yes/No
| Domains | Scale | Sample Items |
|---|---|---|
| Trauma History | Exposure to traumatic events | Not available |
| Situational Reactivity | Not available | |
| PTSD symptoms | Reexperiencing | Not available |
| Avoidance/Numbing | Not available | |
| Increased Arousal | Not available | |
| Significant Distress or Impairment | Not available | |
| Significant Distress | Not available |
Training
Parallel or Alternate Forms
The original Children's PTSD Inventory (Saigh, 1987) was based on DSM-III criteria.
Psychometrics
Diagnostic cutoffs for each symptom cluster and overall diagnosis based on DSM-IV criteria.
| Type: | Rating | Statistics | Min | Max | Avg |
|---|---|---|---|---|---|
| Test-Retest | Acceptable | kappa | 0.66 | 1 | 0.86 |
| Internal Consistency | Acceptable | Chronbach's alpha | 0.58 | 0.95 | 0.8 |
| Inter-rater | Acceptable | Chronbach's alpha | 0.79 | 1 | 0.92 |
| Parallel/Alternate Forms |
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.
(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.
| Validity Type | Not known | Not found | Nonclincal Samples | Clinical Samples | Diverse Samples |
|---|---|---|---|---|---|
| Convergent/Concurrent | Yes | Yes | |||
| Discriminant | Yes | Yes | |||
| Sensitive to Change | Yes | ||||
| Intervention Effects | Yes | ||||
| Longitudinal/Maturation Effects | |||||
| Sensitive to Theoretically Distinct Groups | Yes | Yes | |||
| Factorial 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.
| Not Known | Not Found | Nonclinical Samples | Clinical Samples | Diverse Samples | |
|---|---|---|---|---|---|
| Predictive Validity: | Yes | Yes | Yes | ||
| Postdictive Validity: |
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.
Translations
| Language: | Translated | Back Translated | Reliable | Good Psychometrics | Similar Factor Structure | Norms Available | Measure Developed for this Group |
|---|---|---|---|---|---|---|---|
| 1. Spanish | Yes | Yes | Yes | Yes | Yes | No | No |
| 2. French (Canadian) | Yes | Yes | Yes | Yes | Yes | No | No |
Population Information
(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%).
| Population Type: | Measure Used with Members of this Group | Members of this Group Studied in Peer-Reviewed Journals | Reliable | Good Psychometrics | Norms Available | Measure Developed for this Group |
|---|---|---|---|---|---|---|
| 1. Lower socio-economic status | Yes | Yes | Yes | Yes | No | Unk |
| 2. Rural populations | Yes | Yes | Yes | Yes | No | No |
Pros & Cons/References
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.
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.
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.
The author provided comments and feedback, which were integrated.