title: International development and psychometric properties of the Child and Adolescent Trauma Screen (CATS).
abstract: 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.
  
  
  
  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).
  
  
  
  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.
  
  
  
  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).
  
  
  
  The external validation of the CATS with a DSM-5 based semi-structured clinical interview and corresponding determination of cut-points is pending.
  
  
  
  The CATS has satisfactory psychometric properties. Clinicians may consider the CATS as a screening tool and for symptom monitoring.
authors.affiliation: University of Ulm, Clinic for Child and Adolescent Psychiatry/Psychotherapy, Germany. Electronic address: cedric.sachser@uniklinik-ulm.de.
authors.forename: Cedric
authors.initials: C
authors.lastname: Sachser
authors.affiliation: Harborview Center for Sexual Assault and Traumatic Stress, Seattle, United States. Electronic address: lucyb@u.washington.edu.
authors.forename: Lucy
authors.initials: L
authors.lastname: Berliner
authors.affiliation: Norwegian Center for Violence and Traumatic Stress Studies, Oslo, Norway; Mental & Physical health, Norwegian Institute of Public Health. Electronic address: tonje.holt@nkvts.no.
authors.forename: Tonje
authors.initials: T
authors.lastname: Holt
authors.affiliation: Norwegian Center for Violence and Traumatic Stress Studies, Oslo, Norway; University of Oslo, Department of Psychology, United States. Electronic address: tine.jensen@psykologi.uio.no.
authors.forename: Tine K
authors.initials: TK
authors.lastname: Jensen
authors.affiliation: Harborview Center for Sexual Assault and Traumatic Stress, Seattle, United States. Electronic address: jungbn@uw.edu.
authors.forename: Nathaniel
authors.initials: N
authors.lastname: Jungbluth
authors.affiliation: Center on Child Abuse and Neglect, University of Oklahoma Health Sciences Center, USA. Electronic address: Elizabeth-Risch@ouhsc.edu.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Risch
authors.affiliation: Catholic University of Eichstätt-Ingolstadt, Department of Psychology, Eichstätt, Germany. Electronic address: rita.rosner@ku.de.
authors.forename: Rita
authors.initials: R
authors.lastname: Rosner
authors.affiliation: University of Ulm, Clinic for Child and Adolescent Psychiatry/Psychotherapy, Germany. Electronic address: lutz.goldbeck@uniklinik-ulm.de.
authors.forename: Lutz
authors.initials: L
authors.lastname: Goldbeck
mesh_terms: D000293:Adolescent; D001007:Anxiety / Q000175:diagnosis; D002648:Child; D002675:Child, Preschool; D003863:Depression / Q000175:diagnosis; D005260:Female; D005858:Germany; D006801:Humans; D007802:Language; D008297:Male; D009664:Norway; D011594:Psychometrics; D015203:Reproducibility of Results; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis*; D011795:Surveys and Questionnaires
keywords: Children and adolescents; PTSD; Questionnaire; Screening; Traumatic events