International development and psychometric properties of the Child and Adolescent Trauma Screen (CATS)

J Affect Disord. 2017 Mar 1;210:189-195. doi: 10.1016/j.jad.2016.12.040. Epub 2016 Dec 27.


Background: Systematic screening is a powerful means by which children and adolescents with posttraumatic stress symptoms (PTSS) can be detected. Reliable and valid measures based on current diagnostic criteria are needed.

Aim: To investigate the internal consistency and construct validity of the Child and Adolescent Trauma Screen (CATS) in three samples of trauma-exposed children in the US (self-reports: n=249; caregiver reports: n=267; pre-school n=190), in Germany (self-reports: n=117; caregiver reports: n=95) and in Norway (self-reports: n=109; caregiver reports: n=62).

Method: Internal consistency was calculated using Cronbach's α. Convergent-discriminant validity was investigated using bivariate correlation coefficients with measures of depression, anxiety and externalizing symptoms. CFA was used to investigate the DSM-5 factor structure.

Results: In all three language samples the 20 item symptom score of the self-report and the caregiver report proved good to excellent reliability with α ranging between .88 and .94. The convergent-discriminant validity pattern showed medium to strong correlations with measures of depression (r =.62-.82) and anxiety (r =.40-.77) and low to medium correlations with externalizing symptoms (r =-.15-.43) within informants in all language versions. Using CFA the underlying DSM-5 factor structure with four symptom clusters (re-experiencing, avoidance, negative alterations in mood and cognitions, hyperarousal) was supported (n =475 for self-report; n =424 for caregiver reports).

Limitations: The external validation of the CATS with a DSM-5 based semi-structured clinical interview and corresponding determination of cut-points is pending.

Conclusion: The CATS has satisfactory psychometric properties. Clinicians may consider the CATS as a screening tool and for symptom monitoring.

Keywords: Children and adolescents; PTSD; Questionnaire; Screening; Traumatic events.

Publication types

  • Validation Study

MeSH terms

  • Adolescent
  • Anxiety / diagnosis
  • Child
  • Child, Preschool
  • Depression / diagnosis
  • Female
  • Germany
  • Humans
  • Language
  • Male
  • Norway
  • Psychometrics*
  • Reproducibility of Results
  • Stress Disorders, Post-Traumatic / diagnosis*
  • Surveys and Questionnaires*