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In search for a screening instrument for PTSS and PTSD in children, previous studies explored the Child Behavior Checklist (CBCL Achenbach & Rescorla, 2000) as a useful measure. However, few empirically validated tools exist that are designed explicitly to screen for PTSD in young children. To prevent potential long-lasting adverse effects of exposure to PTEs into later childhood, adolescence and adulthood, early recognition of the sequelae of PTEs in young children is critical for timely referral for further assessment and trauma-focused interventions (Cohen & Scheeringa, 2009 Conradi et al., 2011). Further, previous work on PTEs in early childhood documented increasing odds for poor physical health (Flaherty et al., 2006 Kerker et al., 2015), future academic difficulties (Jimenez et al., 2016 McKelvey et al., 2018), and attachment insecurities (van Duin et al., 2018). For instance, ongoing temper tantrums may disrupt play activities with other children in daycare and thus may hinder the development of first peer relationships. PTSD can have a debilitating impact on a young child’s functioning in different domains of daily life, including the relationship to their parents, siblings, and peers (American Psychiatry Association (APA), 2013). Between 11.9% and 30.5% of trauma-exposed young children develop posttraumatic stress disorder (PTSD) (Woolgar et al., 2021). Studies demonstrate high levels of internalizing and externalizing behaviors as well as posttraumatic stress symptoms (PTSS) of re-experiencing, avoidance, and hyperarousal in young children following trauma exposure (De Young & Landolt, 2018). Young children (0–6 years old) are at particularly high risk of exposure to potentially traumatic events (PTEs) such as abuse, neglect, violence, and accidents, with many young children experiencing more than one PTE (Lieberman, Van Horn, & Harris, 2011). For purposes of discriminant validation of the CBCL-PTSD-6, young children without a history of trauma should be compared to young children with trauma history. Considering the length and the performance of the three investigated subscales, the CBCL-PTSD-6 appears to be a promising and clinically useful CBCL-PTSD subscale as a screener for PTSD and functional impairment due to the easiest and most practicable application.
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Further, all three CBCL-PTSD subscales showed high sensitivity for PTSD and functional impairment. Area under the curves for all three investigated CBCL-PTSD subscales were good to excellent for PTSD and functional impairment.
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The psychometric properties of the existing CBCL-PTSD subscale as well as the alternative subscales based on expert rating ( CBCL-PTSD-17) and based on variable importance ( CBCL-PTSD-6) were evaluated by means of receiver operating characteristic curves, sensitivity, specificity, positive predictive values, and negative predictive values. The sample comprised 116 trauma-exposed young children ( M age = 3.42 years, SD age = 1.21 years, female = 49.1%). Further, the CBCL-PTSD subscales were examined regarding their usefulness in screening for posttraumatic stress-related functional impairment. Therefore, the aim of this study was to create and examine the validity of alternative CBCL-PTSD subscales and compare them to the existing CBCL-PTSD subscale based on the DSM-5 PTSD diagnostic criteria for children 6 years and younger. The Child Behavior Checklist (CBCL 1.5–5 years) posttraumatic stress disorder (PTSD) subscale by Dehon & Scheeringa ( 2006) as a screener for PTSD in trauma-exposed young children has yielded inconsistent results so far.