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

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.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.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.Adolescence is a critical developmental period that may also 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]. PTSD is one syndrome that may result from exposure to extreme trauma and is characterized by persistent reexperiencing, avoidance/numbing, and hyperarousal symptoms, present for more than one month and associated with significant distress and/or functional impairment [3].Although 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 a