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  • Instructions for the CATS

    (Child and Adolescent Trauma Screening)

     

     

    What is the basis for the CATS and what does the CATS measure?

    The CATS questionnaire is a short freely accessible screening instrument directly based on the DSM-5 criteria for Posttraumatic Stress Disorder (PTSD). It is a measure of potentially traumatic events and of posttraumatic stress symptoms.

     

    Which versions are available?

    The CATS has been translated in several languages. Currently there are English, German, Norwegian and Spanish translations available. There are 3 different versions of the CATS:

     

    • CATS Self-report (7-17 Years)
    • CATS Caregiver-report (7-17 Years)
    • CATS Caregiver-report (3-6 Years)

     

    What is important to remember when using the CATS?

    The CATS is a screening instrument for posttraumatic stress symptoms (PTSS) in children and adolescents. First, the respondents need to check on page 1 whether they have experienced at least one potential traumatic event (PTE) (A-criterion). For those without any reported PTE the assessment is finished. Those respondents with at least one endorsed PTE indicate their (child's) most distressing event and rate their (child's) stress symptoms (criteria B, C, D and E) on page 2. Additional items describe any restrictions of functioning in different domains.

    The validation of the CATS showed good psychometric properties and has proven good to excellent internal consistency of the symptom scales with α ranging between .88 - .94 for the different versions.

    Publication: https://www.ncbi.nlm.nih.gov/pubmed/28049104

    The CATS questionnaire does not replace a thorough clinical assessment! It is constructed as a screening instrument with emphasize on sensitivity. Children and adolescents with positive results on the CATS should be diagnosed using a semi-structured clinical interview.

     

    How to score and interpret the CATS?

    The 4-point symptom response scales indicate the reported frequency/severity of each symptom. There are differences in calculating the scores for children from age 7 and adolescents vs. preschool children.

     

    There are two possibilities of scoring the CATS:

    1. Using the DSM-5 algorithm:

    You can either use the stop light sheet or the scoring sheet presented below, which will guide you through the process.

    When using the stoplight sheet or the scoring sheet do not forget that the CATS is constructed as a screening instrument and children and adolescents with positive results on the CATS should be diagnosed using a semi-structured clinical interview.

    2. Using the total symptom score:

    The determination of preliminary cutoff scores was done based on an estimation derived from the validation of a previous DSM-IV based questionnaire (see below).   

    Ages 7-17: A total symptom score is calculated by summing up the raw scores of items 1-20 (possible range = 0-60). We recommend to use a cut-off ≥ 21 as indication of a clinically relevant level of symptoms.

    Ages 3-6: The total symptom score is calculated by summing up the items 1-16 (possible range = 0-48). We recommend to use a cut-off ≥ 16 as indication of a clinically relevant level of symptoms in preschool children.

     

     

     

     

    A Dutch Version of the CATS is currently created and validated by Lieke Kooij and the group of Ramon Lindauer.

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