Screening for the Impact of Trauma in Children and Adolescents Presented by: Kristina Nelson, Ph.D., NCC

Assessments Adverse Childhood Experiences ([ACE] ) Clinician-Administered PTSD Scale for DSM-5 ([CAPS-CA-5] Pynoos, 2015) Dimensions of Stressful Events Rating Scale ([DOSE] Fletcher, 1996) Impact of Event Scale-Revised ([IES-R] Weiss & Marmar, 1996) The Children’s Impact of Event Scale ([CRIES -13] Horowitz, Wilner, & Alvarez, 1979) Traumatic Events Screening Inventory for Children ([TESI-C] Ippen, 2002) Trauma Symptom Checklist for Children ([TSCC] Briere, 1996)  Trauma Symptom Checklist for young Children ([TSCYC] Briere, 2005)

Considerations Length of time to administer/take assessment Length of time since the event Number of times the event has occurred Additional traumatic experiences that accompany the one being assessed for Environmental factors that additionally contribute to experiences of trauma

IES-R and CRIES-13 Impact of Event Scale-Revised ([IES-R] Weiss & Marmar, 1996) Adapted for specific events 22 Likert-scaled questions Measures stress responses related to (a) avoidance, (b) intrusion, and (c) hyperarousal, which are aligned with the diagnosis for PTSD. Scores: (a) 24 or higher is indicative that PTSD is a clinical concern, (b) 33 and above indicate the best cutoff for a probable diagnosis of PTSD, and (c) 37 or higher is high enough to suppress the immune system’s functioning (even ten years past the event). Only used as a guideline, not a diagnosis The Children’s Impact of Event Scale ([CRIES -13] Horowitz, Wilner, & Alvarez, 1979) Designed for use with children 8 years of age and older. Limitations: measures distress experienced over the past seven days related to a traumatic event

Symptomology Psychological challenges Intrusion: Depression, anxiety, suicidality, PTSD, etc. Behavioral, Academic, Physical, and Social problems Bed wetting Sexual promiscuity OCD Poor academic performance Distrust of self and others Difficulty with relationships Aggression Isolation Somaticizing distress (e.g., back, abdomen) Intrusion: Trouble Sleeping (e.g., falling asleep, staying asleep) Trouble concentrating Anger and Irritability Avoidance: people, places, etc. Try not to think about it Hyperarousal: Mistaken for ADHD Jumpy Easily startled (Bal et al., 2009; Berliner & Elliott, 2002; Paolucci et al., 2001; Tyler, 2002; Wurtele, 2009)

References Bal, S., Crombez, G., De Bourdeaudhuij, I., & Van Oost, P. (2009). Symptomatology in adolescents following initial disclosure of sexual abuse: the roles of crisis support, appraisals and coping. Child Abuse & Neglect, 33(10), 717-727. Berliner, L., & Elliott, D. M. (2002). Sexual abuse of children. In J. E. B. Myers, L. Berliner, J. Briere, C. T. Hendrix, C. Jenny, & T. A. Reid (Eds.), The APSAC handbook on child maltreatment (2nd ed., pp. 55–78). Thousand Oaks, CA: Sage. Giannopoulou, I., Smith, P., Ecker, C., Strouthos, M., Dikaiakou, A., & Yule, W. (2006). Factor structure of the Children’s Revised Impact of Event Scale (CRIES) with children exposed to earthquake. Personality and Individual Differences, 40(5), 1027-1037. Paolucci, E. O., Genuis, M. L., & Violato, C. (2001). A meta-analysis of the published research on the effects of child sexual abuse. The Journal of Psychology, 135, 17–36. Smith, P., Perrin, S., Dyregrov, A., & Yule, W. (2003). Principal components analysis of the impact of event scale with children in war. Personality and Individual Differences, 34(2), 315-322. Tyler, K. A. (2002). Social and emotional outcomes of childhood sexual abuse: A review of recent research. Aggression & Violent Behavior, 7(6), 567. Weiss, D. S., & Marmar, C. R.. (1996). The Impact of Event Scale-Revised. In J. Wilson, & T. M. Keane (Eds.), Assessing psychological trauma and PTSD (pp. 399-411). New York: Guilford. Wurtele, S. K. 2009. Preventing sexual abuse of children in the twenty-first century: Preparing for challenges and opportunities. Journal of Child Sexual Abuse 18,1-18.