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Open Access Highly Accessed Primary research

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

S Suliman1, D Kaminer2, S Seedat1* and DJ Stein1

Author Affiliations

1 MRC Unit on Anxiety and Stress Disorders, Department of Psychiatry, University of Stellenbosch, Tygerberg, 7505, Cape Town, South Africa

2 Department of Psychology, University of Cape Town, Private Bag Rondebosch, 7700, Cape Town, South Africa

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Annals of General Psychiatry 2005, 4:2  doi:10.1186/1744-859X-4-2

Published: 31 January 2005

Abstract

Background

Several 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.

Methods

A 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.

Results

91% 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.

Conclusions

Our 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.

Keywords:
trauma; post-traumatic; stress; assessment; instruments