Pınar ZENGİN AKKUŞ, Esra SERDAROĞLU, Ayça KÖMÜRLÜOĞLU, Muhammet ASENA, Evin İLTER BAHADUR, Gökçenur ÖZDEMİR, Sevilay KARAHAN, Elif Nur ÖZMERT

Screening traumatic life events in preschool aged children: cultural adaptation of Child and Adolescent Trauma Screen (CATS) Caregiver-report 3-6 years version

Background. Given the high prevalence of potentially traumatic events (PTEs), pediatric providers are in a novel position in early identification and referral of the children with PTEs. Yet paucity of culturally adapted instruments to screen PTEs and related symptoms in preschool-aged children limits pediatric providers. This multicenter study aimed to screen the traumatic life events of preschool-aged children admitted to pediatric outpatient clinics at four different cities of Turkey and to determine the socio-demographic risk factors associated with PTEs. Moreover, it was also intended to develop the cultural adaptation of the Child and Adolescent Trauma Screen (CATS) Caregiver-report 3-6 Years version to Turkish and to analyze its reliability. Methods. Participants of this multicenter study were collected from four different hospitals in three different regions (Central Anatolia, Black Sea, and Southeastern Anatolia regions) of Turkey. All parents of children at the age of 3-6 years who were admitted to the hospital for a clinical visit (sick-child or well-child visits) were invited to the study. In total, 188 preschool-aged children were included in the study. Socio-demographic characteristics of the child and the family were questioned and parents were asked to fill out the Turkish version of the CATS Caregiver-report. Results. Internal consistency (Cronbach’s alpha) of the Turkish version of the CATS Caregiver-report 3-6 Years was found as 0.86. This study revealed that half of the participating children had experienced at least one PTE and more than one fourth experienced more than one event. Strikingly, no association between sociodemographic risk factors and PTE exposure was identified suggesting that PTE exposure is indeed widespread in our study population. Conclusion. The findings of this study manifest the importance of routine screening of PTEs and related symptoms in children.

PDF

___

1. Kessler RC, McLaughlin KA, Green JG, et al. Childhood adversities and adult psychopathology in the WHO World Mental Health Surveys. Br J Psychiatry 2010; 197: 378-385.

2. National Scientific Council on the Developing Child. Excessive stress disrupts the development of brain architecture. J Child Serv 2014; 9: 143-153.

3. Shonkoff JP, Boyce WT, McEwen BS. Neuroscience, molecular biology, and the childhood roots of health disparities: building a new framework for health promotion and disease prevention. JAMA 2009; 301: 2252-2259.

4. Anda RF, Felitti VJ, Bremner JD, et al. The enduring effects of abuse and related adverse experiences in childhood. A convergence of evidence from neurobiology and epidemiology. Eur Arch Psychiatry Clin Neurosci 2006; 256: 174-186.

5. Center for Substance Abuse T. SAMHSA/CSAT Treatment Improvement Protocols. TraumaInformed Care in Behavioral Health Services. Rockville, MD: Substance Abuse and Mental Health Services Administration (US), 2014.

6. Cohen JA, Kelleher KJ, Mannarino AP. Identifying, treating, and referring traumatized children: the role of pediatric providers. Arch Pediatr Adolesc Med 2008; 162: 447-452.

7. Garner AS, Shonkoff JP. Committee on Psychosocial Aspects of Child and Family Health; Committee on Early Childhood, Adoption, and Dependent Care; Section on Developmental and Behavioral Pediatrics. Early childhood adversity, toxic stress, and the role of the pediatrician: translating developmental science into lifelong health. Pediatrics 2012; 129: e224-e231.

8. Eklund K, Rossen E, Koriakin T, Chafouleas SM, Resnick C. A systematic review of trauma screening measures for children and adolescents. Sch Psychol Q 2018; 33: 30-43.

9. Strand VC, Sarmiento TL, Pasquale LE. Assessment and screening tools for trauma in children and adolescents: a review. Trauma Violence Abuse 2005; 6: 55-78.

10. Hollingshead AB, Redlich FC. Social class and mental illness: a community study. 1958. Am J Public Health 2007; 97: 1756-1757.

11. Sachser C, Berliner L, Holt T, et al. International development and psychometric properties of the Child and Adolescent Trauma Screen (CATS). J Affect Disord 2017; 210: 189-195.

12. Ulmer Onlineklinik. Available at: https://ulmeronlineklinik.de/course/view.php?id=1701. (Accessed 30/03/2020).

13. Glackin E, Forbes D, Heberle A, Carter A, Gray SAO. Caregiver self-reports and reporting of their preschoolers’ trauma exposure: discordance across assessment methods. Traumatology (Tallahass Fla) 2019; 25: 172-180.

14. Stover CS, Berkowitz S. Assessing violence exposure and trauma symptoms in young children: a critical review of measures. J Trauma Stress 2005; 18: 707- 717.

15. Grasso DJ, Ford JD, Briggs-Gowan MJ. Early life trauma exposure and stress sensitivity in young children. Pediatr Psychol 2013; 38: 94-103.

16. Roberts YH, Ferguson M, Crusto CA. Exposure to traumatic events and health-related quality of life in preschool-aged children. Qual Life Res 2013; 22: 2159-2168.

17. Briggs-Gowan MJ, Ford JD, Fraleigh L, McCarthy K, Carter AS. Prevalence of exposure to potentially traumatic events in a healthy birth cohort of very young children in the northeastern United States. J Trauma Stress 2010; 23: 725-733.

18. Bush HH, Eisenhower A. Exposure to interpersonal violence and socioemotional adjustment in economically disadvantaged preschoolers. J Genet Psychol 2014; 175: 214-232.

19. Tolin DF, Foa EB. Sex differences in trauma and posttraumatic stress disorder: a quantitative review of 25 years of research. Psychol Bull 2008; 132: 959- 992.

20. Burke NJ, Hellman JL, Scott BG, Weems CF, Carrion VG. The impact of adverse childhood experiences on an urban pediatric population. Child Abuse Negl 2011; 35: 408-413.

21. Marie-Mitchell A, O’Connor TG. Adverse childhood experiences: translating knowledge into identification of children at risk for poor outcomes. Acad Pediatr 2013; 13: 14-19.

22. von Sneidern E, Cabrera KP, Galeano N, Plaza M, Barrios M. Association between adverse childhood experiences (ACEs) and developmental delay of preschool children in a rural area of Colombia. J Child Adolesc Trauma 2017; 10: 225-232