Posttraumatic Stress Disorder in Children and Adolescents

A validation study of the Adolescent Dissociative Experiences Scale

OBJECTIVE

The purpose of this study was to further the validation process of the Adolescent Dissociative Experiences Scale (A-DES). In this study, a 6-item Likert response format with descriptors was used when responding to the A-DES rather than the 11-item response format used in the original A-DES.

METHOD

The internal reliability and construct validity of the A-DES were examined by analyzing the relationships between A-DES scores, sexual abuse, and behavior. The sample consisted of 65 females ranging in age from 11 to 18 who were categorized into two groups. Thirty-four adolescents who were not in therapy and who denied a history of traumatic experiences formed the nonclinical group. Thirty-one sexually abused adolescents who were currently receiving therapy formed the clinical group. The adolescent participants completed the A-DES, their parent or guardian completed a measure of behavior (the Child Behavior Checklist-CBCL), and the therapists of the clinical adolescents completed a Trauma History Form.

RESULTS

The A-DES discriminated between the nonclinical and clinical sexually abused adolescents. However, in post hoc analyses, the A-DES did not discriminate between PTSD adolescents and those with other psychiatric diagnoses. Significant moderate correlations were found between the A-DES and the CBCL Total behavior problem scale and Internalizing and Externalizing scales.

CONCLUSIONS

The A-DES items are internally consistent, and the A-DES shows promise for screening adolescents for pathological dissociation.

Posttraumatic stress disorder in children. The influence of developmental factors

Despite the prevalence of childhood trauma, there are currently no developmentally oriented cognitive theories of posttraumatic stress disorder (PTSD). This paper outlines the definitional issues of PTSD in children, reviews the incidence of PTSD in children, and compares PTSD profiles in children and adults. We propose that a cognitive theory of childhood PTSD needs to accommodate developmental factors, including knowledge, language development, memory, emotion regulation, and social cognition, in addition to contextual factors such as family interactions. Implications of these developmental factors for assessment and treatment of traumatized children are discussed.