Children's Revised Impact Of Event Scale Research Articles

Agency and life satisfaction in Bedouin children in occupied Palestinian territory: a cross-lagged longitudinal study

BackgroundBedouin children living in occupied Palestinian territory are at risk of developing trauma-related pathologies because of chronic exposure to political and military violence. Little is known about psychological wellbeing and life satisfaction in this group of children, or their coping skills and survival skills in adjusting to these conditions. MethodsOur longitudinal study aimed to assess the function of agency in predicting life satisfaction as a moderator for traumatic stress. We reasoned that the more that children show agency over time in activating domains of life satisfaction, the more they can be satisfied with their life and the less they will present signs of trauma. A cross-lagged path model (CLPM) was used to assess 143 children living in Bedouin communities located northeast of Jerusalem (area E1, Al Khan Al-Ahmar). The CLPM, a discrete time structural equation model to analyse panel data in which two or more variables are repeatedly measured at different timepoints, was run in January, 2019 (Time 1) and after 6 months (Time 2). We used the Children's Hope Scale (CHS) as a measure of agency, the Multidimensional Student Life Satisfaction Scale (MSLSS), and the Children's Revised Impact of Event Scale (CRIES). FindingsThe mean age of participants was 12·02 years (SD 2·05); 65 (46%) were male and 78 (55%) were female. Agency scores had a medium total positive standardised effect on life satisfaction (β=0·25 [95% CI 0·149 to 0·449]; p=0·004) and a small direct standardized effect on trauma symptoms (β=0·08 [0·139 to 0·450]; p=0·023). The indirect effect of agency on trauma was –0·04 (95% CI –0·119 to –0·101]; p=0·044). Life satisfaction had a small statistically significant effect on trauma (β=–0·17 [–0·484 to –0·191]; p=0·037). Statistically significant total standardised effects were found between agency, life satisfaction (β=0·25 [0·161 to 0·476]; p=0·010), and trauma symptoms (β=–0·13 [–0·317 to 0·203]; p=0·044) at Time 1. Similarly, agentic competencies were found to be more related to life satisfaction (β=0·14 [0·025 to 0·338]; p=0·047;) than to trauma symptoms (β=–0·10 [–0·543 to 0·036]; p=0·145) at Time 2. The inclusion of the cross-lagged paths increased the fit of the model significantly. InterpretationChildren are acting for their wellbeing, mobilising personal and contextual resources. Such agentic attitudes contribute to easing their lives under occupation and minimising negative effects on their mental health despite the prevailing chronic traumatic conditions. Children implement skills of resilience rather than yield to the negative effects of political and military violence. The more that children perceive themselves as agentic in activating life satisfaction, the more effectively they deploy their survival skills and resilience. FundingNone.

Mental health of unaccompanied refugee minors in Greece living "in limbo".

The closure of the Balkan migration route in 2016, had implications for unaccompanied refugee minors (URMs), given that the vast majority, who perceived Greece as "stopover" for their desired final destination, were forced to remain in the country for an indeterminate period of time. This created for URMs a challenging situation of living "in limbo" uncertain about their future awaiting for a long time the outcome of their asylum application. This cross-sectional study aimed to explore the mental health of URMs, who arrived in Greece in 2016. The sample comprised 90 URMs (76 boys), aged 13-17 years, consisting of 46 Syrians and 44 originating from other countries. Participants completed socio-demographic information and a range of clinical measures, including Children's Revised Impact of Events Scale (CRIES), Depression Self-Rating Scale (DSRS), Children's Post-Traumatic Cognitions Inventory (cPTCI), a measure of trauma exposure and perceived social support. Syrian URMs were significantly more likely than URMs originating from other countries to score within the probable clinical depression range (71.7% versus 47.7% respectively, p=0.020), to display probable posttraumatic stress disorder (PTSD), i.e., score within clinically significant range of posttraumatic stress symptoms and negative post-trauma cognitions (87% versus 65.9%, p=0.018), and meet the comorbidity PTSD/depression criterion (65.2% versus 40.9%, p=0.021). Multiple linear stepwise regression analyses showed that legal status (seeking asylum in Europe through family reunification procedure) significantly predicted higher levels of depressive symptoms (β=0.29, p=0.004), posttraumatic stress symptoms (β=0.21, p=0.034) and negative cognitions (β=0.33, p=0.001). The total number of stressful/traumatic experiences and male gender were found to be significantly related only with posttraumatic symptoms severity score (β=0.29, p=0.003), whereas lower levels of perceived social support were associated with increased levels of depressive symptoms (β=0.24, p=0.018) and negative cognitions and appraisals of the world and the self (β=0.26, p=0.008). These findings highlight the burden of living "in limbo" situation and add weight to the argument for amending restrictive EU asylum policies and accelerating the family reunification procedure under Dublin-III Regulation, as well as the pressing need for improved URMs access to mental health services and psychosocial support.

3.4 Prevalence and Correlates of Anxiety Disorders Among Lebanese Children and Adolescents: Results From the PALS Study

Anxiety disorders (AD) are among the most common mental health conditions in children and adolescents; however, their prevalence and correlates in Lebanese children and adolescents remains an area that is yet to be understood. A nationally representative household sample of 1517 children and adolescents were recruited in Lebanon using probability sampling technique as part of the Pittsburgh ADHD Longitudinal Study (PALS). Of those, 1287 participants aged 8 to 17 years, 11 months and their parents completed the Screen for Child Anxiety Related Emotional Disorders (SCARED), Mood and Feelings Questionnaire (MFQ), Strengths and Difficulties Questionnaire (SDQ), the Peer Relations Questionnaire (PRQ), and the Children's Revised Impact of Event Scale (CRIES). Parents completed a sociodemographic questionnaire and the General Health Questionnaire (GHQ). Among our sample, 290 participants (22.58%) had a probable AD. Their average age was 11.32 years, and 167 were females (57.49%). Among those with a probable AD, 127 (43.71%) screened positive for PTSD, 82 (28.22%) screened positive for suicidal ideation, 62 (21.35%) screened positive for depression, 28 (9.65%) screened positive for conduct disorder, and 25 (8.63%) screened positive for a hyperactivity disorder. In the logistic regression model, compared to children without AD, those with a probable AD were more likely to be females (OR = 1.705; 95% CI, 1.027-1.061), have acceptable (OR = 1.54; 95% CI, 1.029-2.306) or suboptimal school performance (OR = 2.653; 95% CI, 1.214-5.800), be a victim of bullying only (OR = 4.074; 95% CI, 2.508-6.616), be a bully only (OR = 2.173; 95% CI = 1.385-3.408), be both a victim and a bully (OR = 4.471; 95% CI, 2.418-8.269), have a chronic physical illness (OR = 1.730; 95% CI, 1.066-2.809), and higher parental total score on the GHQ (OR = 1.044; 95% CI, 1.027-1.061). Also, compared to those without AD, children and adolescents with probable AD were less likely to be in the middle-income range (OR = 0.505; 95% CI, 0.344-0.741) or higher income range (OR = 0.418; 95% CI, 0.222-0.788). Only 20 (6.97%) of those with probable AD ever sought mental health help. Anxiety disorders among Lebanese children and adolescents are highly prevalent; however, only a minority of this population is seeking mental health help. The burden of AD and its correlates must inform public and private efforts to help mitigate the huge treatment gap.

The mediating role of alexithymia between earthquake exposure and psychopathology among adolescents 8.5 years after the wenchuan earthquake

Alexithymia refers to difficulties in recognizing and describing one's emotions. We studied potential connections of alexithymia with severity of earthquake exposure, panic/somatic symptoms, posttraumatic stress disorder (PTSD) and depression in 5,195 adolescents affected by the Wenchuan earthquake. Participants completed the Toronto Alexithymia Scale (TAS-20), the Children's Revised Impact of Event Scale (CRIES)-13, the abbreviated Kutcher Adolescent Depression Scale (KADS), and the panic/somatic subscale of the Screen for Child Anxiety-Related Emotional Disorders. The rate of alexithymia was 6.7%, and a greater proportion females were alexithymic than males (7.6% vs 5.7%). Alexithymia was more frequent among older subjects and those who were only-children. Alexithymia, severity of earthquake exposure and negative life events were independently associated with post-disaster psychological or somatic symptoms, and alexithymia was a mediator between traumatic experiences and psychopathology. Our data highlight the importance of alexithymia in the development of psychological distress, implying that alexithymia-targeted interventions may help treat or even prevent psychological distress after a disaster.

Quality of life and post-traumatic stress symptoms in paediatric patients with tibial fractures during treatment with cast or Ilizarov frame

PurposeTo compare quality of life in children and adolescents with tibial fracture during treatment with either a definitive long-leg cast or Ilizarov frame. MethodsA prospective, longitudinal cohort study was undertaken. Patients aged between 5 and 17 years with tibial fractures treated definitively using a long-leg cast or Ilizarov frame were recruited at first follow-up. Health related quality of life was measured at each clinic appointment during treatment using the Pediatric Quality of Life Inventory (PedsQL) [1]; a validated measure of age-adjusted physical and psychosocial functioning. Psychological trauma symptoms were assessed using the Children's Revised Impact of Events Scale (CRIES) [2]. Results were analysed based on time from injury (less than 30 days, 30 to 120 days). Data regarding injury and treatment was recorded from the clinical records. Statistical analysis was undertaken using a Kruksal–Wallis test with a Tukey–Kramer subgroup analysis. ResultsTwenty-five patients from each group were included in the final analysis. Injuries were more severe in the frame patients based on the AO/OTA classification and number of open fractures. No statistically significant differences were detected in any of the outcome scores between treatment groups at either time point. A significant improvement was found in the child reported physical and total domains in both treatment groups based on time from application (<30 days vs. >30 days, frame: p < 0.0001, cast: p = 0.003). There were no differences in the child reported psychosocial domain scores at any time point or between treatment groups. Parent reported scores only showed a significant physical improvement in the frame group (p < 0.0001). CRIES scores for psychological trauma in the intrusion and avoidance domain improved significantly in the cast group between time points (p < 0.05), Multivariate analysis identified polytrauma, mechanism of injury and time from injury but not treatment modality (cast or frame) as significant predictors of quality of life scores (PedsQL) and severity of post-traumatic symptoms (CRIES). ConclusionWe found no difference in health-related quality of life during treatment between our patients treated for tibial fractures using a cast or an Ilizarov frame.

Mental health problems from direct vs indirect exposure to violent events among children born and growing up in a conflict zone of southern Thailand.

This study aims to examine and compare the effects of direct and indirect exposure to armed conflicts on the mental health of primary school students in the three southernmost provinces of Thailand. A school-based survey was conducted. Detailed exposure of traumatic events both directly and indirectly were measured by a self-completed questionnaire. Behavioral-emotional problems were measured by the Strength and Difficulty Questionnaire and screening for post-traumatic stress disorder (PTSD) was done using the Children's Revised Impact of Events Scale (CRIES). Multivariate analysis adjusted for gender and other covariates was used to determine the effect of direct and indirect exposure of armed conflict on mental health problems. Out of 941 students included in the study, almost half had direct exposure to an armed conflict event. Overall, 42.1% of students had at least one behavioral-emotional problem (47.6% and 38.5% in the direct- and indirect-exposed groups, respectively) and 30.5% was found to have PTSD (37.3% and 25.9% in the direct- and indirect-exposed groups, respectively). Students who had direct exposure to an armed conflict event had a two times higher odds of mental health problems than their peers. Other modifiable factors of mental health problems were receiving news from two sources including other adults and media, and exposure to other non-conflict-related traumatic life events. Children living in armed conflict areas of southern Thailand, although without any direct exposure to traumatic events, also suffered from mental health problems. Research on appropriate interventions for these children should be further conducted.

EMDR Group Treatment of Children Refugees—A Field Study

Given the significant growth in the migration flow of refugees who are fleeing from persecution, terrorism, and war-torn countries to Europe, there is an urgent need for effective interventions for the treatment of this highly traumatized population. EMDR Integrative Group Treatment Protocol (EMDR-IGTP) was provided to 14 child refugees (7 females) in 2016 at a Turkey orphanage near the Syrian border which was housing adult and child Syrian refugees. Treatment was provided in three groups, one each for children aged 3–7 years, pre-adolescents aged 9–12, and adolescents aged 13–18 with three sessions provided to each group. Pre-treatment assessment with multiple measures was compromised by difficulties with translator availability and refugee mobility, resulting in high attrition. When the post-treatment assessment was conducted 45 days later, many refugees had already left the orphanage. The sparse character of the data matrix produced analyzable data for 8 children (mean age 11 ± 3; 4 females) on the Children's Revised Impact of Event Scale (CRIES). Statistical analysis showed a significant decrease in CRIES scores, reflecting a decrease in severity of posttraumatic symptoms.

The Prevalence of PTSD Symptoms and Depressive Symptoms and Related Predictors in Children and Adolescents 3 Years After the Ya'an Earthquake.

The objectives of this study were to investigate the prevalence of post-traumatic stress disorder (PTSD) symptoms and depressive symptoms in teenage survivors three years after the Ya'an earthquake to assess the differences between left-behind (LBC) and non-left-behind (non-LBC) children, and to explore predictors for PTSD symptoms and depressive symptoms. The participants were assessed using children's revised impact of event scale (CRIES) and short mood and feelings questionnaire (SMFQ), after which t tests, Chi square tests, and a multivariate logistic regression were conducted to examine the differences in the LBC and identify the associated predictors. It was found that the PTSD and depressive symptom prevalences were 13.10% and 20.75%, with the LBC having a significantly higher prevalence than the non-LBC. The PTSD and depression symptoms tended to be highly comorbid (r = .52, p < .001). Being female, being aged less than 15, having siblings, being an LBC, and having higher exposure were found to be associated with PTSD and depressive symptoms.

Children's Reactions to Flood Disaster in Kashmir.

Background:The flood disaster of 9th–10th September 2014 wreaked havoc in the Jammu and Kashmir region of India. Incessant rains and deluge claimed 283 lives and damaged 2.53 lakh houses. This article presents the findings of the psychosocial care team from the National Institute of Mental Health and Neuro Sciences, Bengaluru, India, during the early phase of disaster.Materials and Methods:The team assessed posttraumatic stress symptoms of 64 child survivors from six villages of two districts struck by floods using Children's Revised Impact of Event Scale (CRIES)-8 and qualitative narrations.Results:Children showed high levels of intrusion and avoidance in the aftermath of floods. Both boys and girls showed moderate to severe level of psychological impact on the domains of CRIES-8. The narrations by the children centred on the theme of “water” and “enjoyment in seeing lots of water;” followed by “fearing of the parent's life,” later on “fear of their own life,” and subsequently to avoidance to go near the river and nightmares like “floating in the water.”Conclusion:Disasters immensely impact children because of their particular stage of psychological and social development. This highlights the need for psychosocial interventions to minimize the impact of disasters on children at the earliest using simple psychosocial care techniques by employing available community-based manpower.

Prevalence and Predictors of Somatic Symptoms among Child and Adolescents with Probable Posttraumatic Stress Disorder: A Cross-Sectional Study Conducted in 21 Primary and Secondary Schools after an Earthquake.

PurposeTo explore the prevalence rates and predictors of somatic symptoms among child and adolescent survivors with probable posttraumatic stress disorder (PTSD) after an earthquake.MethodsA total of 3053 students from 21 primary and secondary schools in Baoxing County were administered the Patient Health Questionnaire-13 (PHQ-13), a short version of PHQ-15 without the two items about sexuality and menstruation, the Children's Revised Impact of Event Scale (CRIES), and the self-made Earthquake-Related Experience Questionnaire 3 months after the Lushan earthquake.ResultsAmong child and adolescent survivors, the prevalence rates of all somatic symptoms were higher in the probable PTSD group compared with the controls. The most frequent somatic symptoms were trouble sleeping (83.2%), feeling tired or having low energy (74.4%), stomach pain (63.2%), dizziness (58.1%), and headache (57.7%) in the probable PTSD group. Older age, having lost family members, having witnessed someone get seriously injured, and having witnessed someone get buried were predictors for somatic symptoms among child and adolescent survivors with probable PTSD.ConclusionsSomatic symptoms among child and adolescent earthquake survivors with probable PTSD in schools were common, and predictors of these somatic symptoms were identified. These findings may help those providing psychological health programs to find the child and adolescent students with probable PTSD who are at high risk of somatic symptoms in schools after an earthquake in China.

Validation of the Korean Version of the Children's Revised Impact of Event Scale.

ObjectiveThis study examined the psychometric properties of the Korean version of the Children's Revised Impact of Event Scale (CRIES) and its validity as a screening instrument for the post-traumatic stress disorder (PTSD).MethodsThe study population consisted of two samples. The clinical sample consisted of 60 child and adolescent patients from the Department of Neuropsychiatry, Ilsan Paik Hospital, Inje University College of Medicine. The normal sample consisted of 291 students from four schools (primary, middle, and high schools). We administered four self-report questionnaires (the CRIES, Child Reports of Post-traumatic Symptoms [CROPS], State-Trait Anxiety Inventory for Children [STAI-C], and Children's Depression Inventory [CDI]) to 351 children and adolescents after obtaining informed consent from all participants and their parents.ResultsThe CRIES showed good reliability (Cronbach's α for the full scale and subscales ranged from 0.85 to 0.93). The total CRIES score was positively correlated with CROPS, STAI-C, and CDI. Confirmatory factor analysis indicated that a three-factor structure for the CRIES (intrusion, avoidance, and hyper-arousal) had a significantly better fit than a two-factor model (intrusion/hyper-arousal and avoidance). Receiver operating characteristic curve analysis indicated that a cutoff of 26 offered the optimum predictive point. That is, this cutoff maximized the balance between sensitivity (0.88) and specificity (0.85). Using this cutoff, the positive predictive value was 0.86, and the negative predictive value was 0.99.Conclusion These findings imply that the CRIES is a highly accurate diagnostic test in clinical settings.

Characteristics of the Children's Revised Impact of Event Scale in a clinically referred Dutch sample.

Early identification of posttraumatic stress disorder (PTSD) in children is important to offer them appropriate and timely treatment. The Children's Revised Impact of Event Scale (CRIES) is a brief self-report measure designed to screen children for PTSD. Research regarding the diagnostic validity of the CRIES is still insufficient, has been restricted to specific populations, and sample sizes have often been small. This study evaluated the reliability and validity of the 8-item (CRIES-8) and 13-item (CRIES-13) versions of the CRIES in a large clinically referred sample. The measure was completed by 395 Dutch children (7-18 years) who had experienced a wide variety of traumatic events. PTSD was assessed using the Anxiety Disorders Interview Schedule for DSM-IV: Child and Parent version. A cutoff score of 17 on the CRIES-8 and 30 on the CRIES-13 emerged as the best balance between sensitivity and specificity, and correctly classified 78%-81% of all children. The CRIES-13 outperformed the CRIES-8, in that the overall efficiency of the CRIES-13 was slightly superior (.81 and .78, respectively). The CRIES appears to be a reliable and valid measure, which gives clinicians a brief and user-friendly instrument to identify children who may have PTSD and offer them appropriate and timely treatment.

The Utility of the Children's Revised Impact of Event Scale in Screening for Concurrent PTSD Following Admission to Intensive Care

Although there is some information available regarding the utility of the Children's Revised Impact of Event Scale (CRIES) in screening for posttraumatic stress disorder (PTSD), data are scarce and limited to studies sampling children predominantly injured in road traffic accidents. This study investigated the utility of 2 versions, the CRIES-8 and CRIES-13, in identifying those children meeting criteria for PTSD following admission to a pediatric intensive care unit (PICU). The Children's PTSD Inventory (CPTSDI), a diagnostic interview, and the CRIES-13 were administered to 55 children, aged 6-16 years, 6 months following admission to the PICU. Of the 55, 14 (25%) met criteria on the CPTSDI. Cutoff scores of 14.5 on the CRIES-8 and 22.5 on the CRIES-13 maximized sensitivity and specificity and correctly classified 78%-86% of children. Both cutoff scores were lower than those reported in other samples. The CRIES-13 appeared to offer greater utility than the CRIES-8, also in contrast to previous findings. Methodological or sampling differences may account for the discrepancy with prior studies. The proposed cutoffs are recommended specifically for use with PICU patients and replication and further validation of the CRIES with other samples is warranted.

Structure of the Children's Revised Impact of Event Scale (CRIES) with Children and Adolescents Exposed to Debris Flood

AimPTSD symptoms were pervasive among children and adolescents after experiencing or exposure to traumatic events. Screening and diagnosis of PTSD symptoms is crucial in trauma-related research and practice. The 13-item Children's Revised Impact of Event Scale (CRIES) has been demonstrated to be a valid and reliable tool to achieve this goal. This study was designed to examine the psychometric properties of the 13-item CRIES in a sample of Chinese debris flood victims.MethodsA total of 268 participants (145 girls, 123 boys) aged 8–18 years were recruited from an integral part of a service oriented project, supported by the Institute of Psychology, Chinese Academy of Sciences following the debris flood. The participants were given the 13-item CRIES 3 months after the debris flood.ResultsThe results of confirmatory factor analysis indicated that a two-factor structure (intrusion+arousal vs avoidance) emerged as the model best fit in total sample, boys and girls subsamples, respectively. The scale was also demonstrated to have good internal consistency (Cronbach's alpha = 0.83).ConclusionThe study confirmed the good psychometric properties of the CRIES and its' applicability to Chinese children and adolescents. Moreover, these findings imply that the CRIES factor structure is stable across age, gender, and different types of trauma.

Validation of the Chinese version of the Children's Revised Impact of Event Scale (CRIES) among Chinese adolescents in the aftermath of the Sichuan Earthquake in 2008

ObjectiveThis study examined the psychometric properties of the 13-item Chinese version of the revised Impact of Event Scale for Children (CRIES) among 3160 high school students in Chengdu, China, 1 month after the Sichuan Earthquake in 2008. MethodsParticipants self-administered a structured questionnaire in classroom settings. Posttraumatic stress symptoms (using the Chinese version of the CRIES) and other psychological variables, including depression, anxiety, thoughts of physical threat, and earthquake-related experiences, were measured. Confirmatory factor analysis and Spearman correlation analyses were conducted to confirm the factor structure and examine the validity of the CRIES. ResultsAs in previous Western studies, confirmatory factor analysis results indicated that the 3-factor structure of the CRIES (intrusion, avoidance, and hyperarousal) provided a significantly better fit than the single-factor model and the 2-factor model. The CRIES showed good reliability (Cronbach αs for the full scale and subscales ranged from .74 to .85). The CRIES total score was positively correlated with depression, anxiety, automatic thought of physical threat, earthquake-related worries, and postearthquake suicidal ideation. ConclusionsThe CRIES has shown to be reliable and valid in assessing Chinese adolescents' symptoms of potential posttraumatic stress disorder. Our findings also support the 3-factor measurement model of posttraumatic stress symptoms, which is comparable with their Western studies. Further validation studies on other forms of traumatic experience among Chinese adolescents are warranted.

Comparative study on the symptoms of PTSD and depression of the children exposed to the Wenchuan earthquake 2 and 3 years after it

Objective To examine the mental health status and its changes among children exposed to the Wenchuan earthquake 2 and 3 years after it has passed, and evaluate the possible influencing factors of mental health. Methods The General questionnaire, the self-reported Children's revised impact of event scale(CRIES) and the Depression self-rating scale for children(DSRSC)were administered to the same children from the earthquake affected areas 2, 3 years after the earthquake. Results Both of the CRIES scores and DSRSC scores had decreased over the 2, 3 years periods after the earthquake(z=-8.772, P=0.00; z=-2.870, P=0.00). The risk factors associated with PTSD 3 years after the earthquake were: gender(OR=1.069, P=0.00), the severity of their family's injury(OR=1.141, P=0.02), the length of living in transferred safe places(OR=1.416, P=0.03), and whether or not witnessed collapse(OR=1.014, P=0.01). The risk factors associated with depression 3 years after the earthquake were: gender(OR=1.367, P=0.00), age(OR=1.035, P=0.04), and despair(OR=2.490, P=0.01). Conclusion Both of the symptoms of PTSD and depression among the children from earthquake affected areas have decreased over the 2, 3 years periods after the earthquake.The mental health status of the children from the earthquake affected areas are influenced by their gender, age, the length of living in transferred safe places, the severity of their family's injury, whether or not witnessed collapse and despair.These factors should be taken into considerations when the long-term post-traumatic psychological interventions are planned. Key words: Earthquake; Children; Post-traumatic stress disorder; Depression; Comparative study

Risk indicators for post-traumatic stress disorder in adolescents exposed to the 5.12 Wenchuan earthquake in China

In Chinese adolescents exposed to the Wenchuan earthquake, we used the Children's Revised Impact of Event Scale (CRIES) as the screening tool, and Post-traumatic Cognitions Inventory (PTCI) and the Social Support Rating Scale (SSRS) were used to assess the cognitive status and their social supports, to evaluate the prevalence and the predictors variables of post-traumatic stress disorder (PTSD) after the Wenchuan earthquake in China, which occurred on 12 May 2008. Subjects with a CRIES score greater than 30 were interviewed and assessed using the DSM-IV criteria for PTSD diagnosis by a trained psychiatrist with the Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children Lifetime version (Kiddie-SADS-L). We found the overall prevalence of PTSD was 2.5% in 3208 adolescents from the surrounding areas of the epicentre 6 months after the earthquake. Risk factors for post-traumatic stress symptoms are as follows: being female, being buried/injured during the earthquake, having parents who were severely injured, having classmate(s) who died, having a house destroyed, and witnessing someone buried/wounded/dying during the earthquake. Individuals with better social support had significantly lower scores on the CRIES. There were significant differences in cognitive style between individuals at low risk for PTSD (CRIES < 30) and those at high risk for PTSD (CRIES ≥ 30). Post-traumatic cognition emerged as an important factor that was associated with PTSD reactions in children. Social support can lessen the impact of a natural disaster by affecting post-traumatic cognition.

The Children's Revised Impact of Event Scale (CRIES): Validity as a Screening Instrument for PTSD

The Children's Revised Impact of Event Scale (CRIES) is a brief child-friendly measure designed to screen children at risk for Posttraumatic Stress Disorder (PTSD). It has good face and construct validity, a stable factor structure, correlates well with other indices of distress, and has been used to screen very large samples of at-risk-children following a wide range of traumatic events. However, few studies have examined the scale's validity against a structured diagnostic interview based on the DSM-IV criteria for PTSD. In the present study, the CRIES and the PTSD section of the Anxiety Disorders Interview Schedule-Child and Parent Version (ADIS-CP) were administered to a sample of children and adolescents (n=63) recruited from hospital accident and emergency rooms and the validity of the CRIES as a screening tool evaluated. Cutoff scores were chosen from this sample with a low base-rate of PTSD (11.1%) to maximize sensitivity and minimize the likelihood that children with a diagnosis of PTSD would fail to be identified. Cutoff scores were then cross-validated in a sample of 52 clinically referred children who had a high base-rate of PTSD (67.3%). A cutoff score of 30 on the CRIES-13 and a cutoff score of 17 on the CRIES-8 maximized sensitivity and specificity, minimized the rate of false negatives, and correctly classified 75–83% of the children in the two samples. The CRIES-8 (which lacks any arousal items) worked as efficiently as the CRIES-13 (which includes arousal items) in correctly classifying children with and without PTSD. Results are discussed in light of the current literature and of the need for further development of effective screens for children at-risk of developing PTSD.