Assessing post-traumatic stress disorder in South African adolescents: using the child and adolescent trauma survey (CATS) as a screening tool

S Suliman,D Kaminer,Dj Stein,S Seedat

doi:10.1186/1744-859x-4-2

Abstract

BackgroundSeveral studies have demonstrated that South African children and adolescents are exposed to high levels of violent trauma with a significant proportion developing PTSD, however, limited resources make it difficult to accurately identify traumatized children.MethodsA clinical interview (K-SADS-PL, selected modules) and self-report scale (CATS) were compared to determine if these different methods of assessment elicit similar information with regards to trauma exposure and post-traumatic stress disorder (PTSD) in adolescents. Youth (n = 58) from 2 schools in Cape Town, South Africa participated.Results91% of youth reported having been exposed to a traumatic event on self-report (CATS) and 38% reported symptoms severe enough to be classified as PTSD. On interview (K-SADS-PL), 86% reported exposure to a traumatic event and 19% were found to have PTSD. While there were significant differences in the rates of trauma exposure and PTSD on the K-SADS and CATS, a cut-off value of 15 on the CATS maximized both the number of true positives and true negatives with PTSD. The CATS also differentiated well between adolescents meeting DSM-IV PTSD symptom criteria from adolescents not meeting criteria.ConclusionsOur results indicate that trauma exposure and PTSD are prevalent in South African youth and if appropriate cut-offs are used, self-report scales may be useful screening tools for PTSD.

Highlights

Adolescence is a critical developmental period that may be characterized as a period of great risk to healthy development [1]
Community violence is highly prevalent in South Africa, a lack of awareness that children and adolescents may be adversely affected both in the short- and long- term [4], has contributed to a dearth of systematic data on youth exposed to violence and post-traumatic stress disorder (PTSD)
Peltzer's study on rural children in South Africa found that 67% had directly or vicariously experienced a traumatic event while 8% fulfilled criteria for PTSD [9]

Summary

Introduction

Adolescence is a critical developmental period that may be characterized as a period of great risk to healthy development [1]. Adolescents are often subjected to a multitude of traumatic events in their daily lives Those who are victimised and/or traumatised often lag behind those who are not, in terms of their behavioural and physical growth [2]. Politically inspired violence has been in decline, criminal and domestic violence continues to prevail in local communities [7,8]. This has seen large numbers of children and adolescents being exposed to, and directly involved in, acts of violence [4]. Several studies have demonstrated that South African children and adolescents are exposed to high levels of violent trauma with a significant proportion developing PTSD, limited resources make it difficult to accurately identify traumatized children

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