(PS3-93) Trauma Measures Are Not Interchangeable: Item Content Analysis of Scales Used to Screen or Assess Trauma and PTSD

Abstract Text:

Objectives: Traumatic events are common: it is estimated that more than 60% of adults experienced an adverse event in their childhood (Hustedde, 2021). However, only some of these lead to long term psychiatric sequelae. Unfortunately, identification of these instances is poor, for a variety of reasons, often including that families do not volunteer the information, and providers often do not ask during routine evaluation. The diagnostic criteria also have changed across nosological revisions. Therefore, it would be valuable to have measures that would improve early identification and measure treatment response. We hypothesized average content overlap would be poor, and scales that contained the highest number of PTSD-related questions would score highest.

Methods: Following the work of Fried (2017), analyses compared 9 PTSD scales for pediatrics, mixing youth and parent report and interviews. These scales were selected based on a recent review (La Greca & Danzig, 2020) to cover a broad age range in order to compare symptoms due to changes from a child to an adolescent. Each scale is freely available to the public at no cost to the professional or family These measures were evaluated based on the ICD-11 criteria for PTSD, the length of the scale, and the primary target audience.

Results: Each question was mapped into distinct symptom categories, totaling 46 symptoms and associated features. Using the software R, a Jaccard Index quantified the overlap among each scale. It was found that there was a moderate mean overlap of 0.42, with a maximum overlap of 0.85 and a minimum of 0.17. It was found that 13% of symptoms appear in all the scales.

Conclusion: Consistent with prior work in mood disorders and anxiety, there was only moderate overlap in item content, and variable coverage of current diagnostic criteria. Overall, the UCLA-PTSD RI assessed the most symptoms, with 25 specific to the scale, and was found to have the greatest clinical significance, targeting both children and adolescents. The K-SADS assessed the fewest symptoms, with only six specific to the scale, while also requiring the most time for the provider to administer, reducing the clinical utility. Results enable providers to identify the assessment that offers the most accurate information and offer the optimal coverage of symptoms. Limitations include the use of cost-free scales and the limited prior research on pediatric PTSD symptom scales.