The Structured Trauma-Related Experiences and Symptoms Screener (STRESS): Assessing factor structure and clinical utility in a juvenile justice sample

Psychol Trauma. 2023 May;15(Suppl 1):S143-S153. doi: 10.1037/tra0001310. Epub 2022 Jul 7.

Abstract

Objective: High prevalence of traumatic event exposure and posttraumatic stress disorder (PTSD) among justice-involved adolescents has necessitated the use of trauma screening in juvenile justice settings. The present study explored the psychometric properties, factor structure, and construct validity of a trauma screen, the Structured Trauma-Related Experiences and Symptoms Screener (STRESS), in a detained adolescent sample. Prior to the current study, psychometric characteristics of the STRESS were evaluated only in a child welfare sample (Grasso et al., 2015).

Method: The sample consisted of 132 adolescents in secure detention facilities in a southeastern state. Participants were included in the study if they engaged in the mental health screening process at intake and a follow-up assessment process with facility staff psychologists. Data consisted of de-identified, archival records.

Results: The STRESS total symptom and 4 criterion symptom count scores demonstrated high internal consistency. Confirmatory factor analysis revealed that the STRESS had excellent fit with the DSM-5 four-factor PTSD model. Equally strong evidence was found for a higher order PTSD model, thus reinforcing the use of both STRESS PTSD total and criterion symptom count scores with justice-involved adolescents. Additionally, preliminary evidence of convergent and discriminant validity was supported.

Conclusions: Findings support the STRESS as a reliable and valid trauma screen for use with detained adolescents. Results suggest that both STRESS total symptom and criterion symptom count scores have clinical utility for intake-level mental health decisions in juvenile detention settings. Implications for expanding use of the STRESS to inform appropriate interventions for justice-involved adolescents are discussed. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

MeSH terms

  • Adolescent
  • Child
  • Diagnostic and Statistical Manual of Mental Disorders
  • Factor Analysis, Statistical
  • Humans
  • Mental Health
  • Psychometrics
  • Reproducibility of Results
  • Stress Disorders, Post-Traumatic* / diagnosis
  • Stress Disorders, Post-Traumatic* / psychology