Development of a Brief Screen for Symptoms of Posttraumatic Stress Disorder in Young Children: The Young Child PTSD Screen

ABSTRACT: Objective: The ability to reliably detect posttraumatic stress disorder (PTSD) symptoms that require treatment in young children through universal screening efforts is a critical step toward providing appropriate treatment. The developmental differences in this age group compared to older youths pose challenges for accurate detection. A brief age-appropriate screen has not yet been quantitatively validated. This study aimed to address that gap by creating a rapid and brief screen based on empirical data that focused on sensitivity and face validity for children aged 3 to 6 years. Methods: A trauma-exposed group (N = 284) and a non-trauma-exposed group (N = 46), aged 3 to 6 years, were assessed using a semistructured diagnostic interview with their primary caregivers. Results: One hundred twenty combinations of items were evaluated for sensitivity, specificity, positive predictive value, negative predictive value, associations with functional impairment, and frequency of false positives. Many combinations of items performed well on these psychometrics, and the final selection of a 6-item screener was influenced by considerations of face validity so that the screen would best reflect the unique symptoms of PTSD. Conclusion: The screener proposed is a promising tool that will benefit from additional research to examine its psychometric properties as a stand-alone PTSD screen. Future research ought to include test–retest reliability and replication of these findings in other samples and settings. Eventual uses of a brief screen for PTSD in young children include screening during primary care visits and large-scale screening efforts following disasters, where cost and time need to be considered. Address for reprints: Michael Scheeringa, MD, Department of Psychiatry and Behavioral Sciences, Tulane University School of Medicine, 1430 Tulane Avenue, #8448, New Orleans, LA 70112; e-mail: mscheer@tulane.edu. Financial support for this study was provided by National Institute of Mental Health (R01 MH065884). Disclosure: The author declares no conflict of interest. Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (www.jdbp.org). Received May 18, 2018 Accepted October 23, 2018 Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.

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