Validation of the post-traumatic stress disorder subscale of the child behaviour checklist (PTSD-CBCL): screening for post-traumatic stress disorder or attention deficit/hyperactivity disorder?

Soc Psychiatry Psychiatr Epidemiol. 2023 Jul 24. doi: 10.1007/s00127-023-02535-8. Online ahead of print.

Abstract

Purpose: Almost 20% of children and adolescents who attend in mental health centres are witnesses of domestic violence (WDVs). It would therefore be clinically useful to have an appropriate screening instrument for this population, such as the PTSD-CBCL. Our aim here was thus to assess the psychometric properties of relevant tools by determining their internal consistency, sensitivity/specificity, and positive/negative predictive values in our centre's population.

Methods: We recruited 194 parents of children aged 4-16 at the Child and Adolescent Mental Health Service of the Hospital Sant Joan de Déu and Els Pins primary school. This sample was divided into: (1) a WDV group (n = 104); (2) an ADHD diagnosis group (n = 28); and (3) a general population (GP) primary school group (n = 62).

Results: The PTSD-CBCL total reliability score was high (Cronbach's alpha = 0.87). We found significant mean difference for WDV vs. GP (MD = 8.57; p < 0.001) with significantly higher mean scores in WDV than in GP. We also found significant differences for ADHD vs. GP (MD = 6.91; p < 0.001) with higher mean scores in ADHD than in GP. We observed good discriminatory power indices in the following group comparisons: WDV vs. GP, ADHD vs. GP, WDV vs. ADHD + GP, and GP vs. WDV + ADHD. Nevertheless, the PTSD-CBCL did not discriminate WDV vs. ADHD.

Conclusions: Thus, we conclude that the PTSD-CBCL instrument has good discriminatory power in general and clinical populations, and could be implemented in the context of prevention and early intervention after trauma.

Keywords: Psychometric properties; Trauma; Validation; Witness of domestic violence.