Symptoms of trauma exposure

Scale: Child Post Traumatic Stress Disorder Symptom Scale (CPSS)

What it measures:

  • Posttraumatic Stress Disorder (PTSD) diagnostic criteria and symptom severity; Trauma exposure.

Intended age range: 8- to 18-year-olds.

Brief Description: The CPSS consists of 26 items that include 2 event items, 17 symptom items, and 7 functional impairment items. Youth are first asked to write down: (1) their most distressing event; and (2) the length of time that has lapsed since that event occurred. Youth then respond to symptom items on a 4-point scale: “Not at all or only at one time”, “Once a week or less/once in a while”, “2-4 times a week/half the time”, or “5 or more times a week/almost always.” Sample symptom items include: “Having bad dreams or nightmares,” “Trying to avoid activities, people or places that remind you of the traumatic event,” and “Having trouble falling or staying asleep.” Youth then indicate (“Yes” or “No”) whether the symptoms they experienced have gotten in the way of any of 7 areas of life (i.e., led to functional impairment). Sample items/domains include “Relationships with friends,” “Fun and hobby activities,” and “Schoolwork.”

Rationale: There are few sound child measures of trauma exposure, and the CPSS appears to provide a comprehensive, reliable, and valid assessment of trauma exposure and, for those interested, specific characteristic aspects of PTSD (e.g., re-experiencing the event, avoidance, and hyperarousal). Several recent studies provide strong psychometric evidence for males and females and diverse racial and ethnic groups.

Cautions: A clinical professional or researcher with relevant training should be involved in the use of this measure. This type of support will be essential for interpreting responses and scores on the measure appropriately as well as for ensuring follow-up with individual youth when appropriate. Moreover, an important consideration is the sensitive nature of the questions (e.g., asking youth about an upsetting event). As noted, programs using this measure should be prepared to respond appropriately to content that may be shared (e.g., follow-up and possible referral for mental health treatment). It is also strongly recommended that programs administer the CPSS with a staff member present in view of the sensitive nature of the questions (e.g., do not mail out for independent completion). In cases where brevity is a top priority, users may prefer to use the symptom scale alone. Several studies support adequate to excellent reliability of this scale; however, evidence regarding its predictive validity (i.e., how well it predicts other key outcomes) is less clear.

Special administration information: The full scale requires about 10 to 15 minutes for completion.

How to score: Each item is scored a 4-point scale (0 = Not at all or only at one time; 1= Once a week or less/once in awhile; 2 = 2-4 times a week/half the time; 3 = 5 or more times a week/almost always) and yields a total symptom-severity score (ranging from 0 to 51) and a total severity-of-impairment score (ranging from 0 to 7). Measure developers recommend viewing a score of 11 or higher as suggestive of the presence of PTSD; however, there is ongoing debate regarding the most appropriate cut score, with recommendations ranging from 11 to 20.

How to interpret findings: Higher scores are associated with greater trauma exposure and functional impairment.

Access and permissions: The measure is available for non-commercial use with no charge and can be accessed online here. Translations are available in Spanish, Korean, Russian, Armenian, Chinese, German, Hebrew, Norwegian, Polish, and Swedish.

Alternatives: Those interested in a briefer measure of trauma exposure may want to consider the 4-item Post-Traumatic Stress (PTS) subscale of the SCARED-Brief Assessment of Anxiety and PTS. Preliminary evidence suggests promising psychometric properties of this scale, and it does not require specialized clinical training for administration or interpretation. However, the measure does not yet have an adequate base of research support to be fully confident in its reliability and validity.


Citation: Foa, E. B., Johnson, K. M., Feeny, N. C., Treadwell, K. R. H. (2001). The Child PTSD Symptom Scale: A preliminary examination of its psychometric properties. Journal of Clinical Child Psychology, 30, 376–384. http://dx.doi.org/10.1207/S15374424JCCP3003_9

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