Els van Meijel

85 Parental posttraumatic stress | Chapter 5 Children’s posttraumatic stress At T1, the children completed the Dutch version of the Child Revised Impact of Event Scale (CRIES; Children and War Foundation, 1998; Olff, 2005; Verlinden et al., 2014). This self-report measure is based on the definition of PTSD according to DSM-IV-TR criteria and gives a good indication of the presence of PTSD (APA, 2000; Verlinden et al., 2014). It consists of 13 questions in the subscales re-experiencing, avoidance and hyperarousal, with answers on a 4-point scale. An example of an item is: “Do you have waves of strong feelings about it?” We asked the children to focus on their accident when answering the questions. Items are rated according to the frequency of their occurrence during the past week ( Not at all =0, Rarely =1, Sometimes =3 and Often =5). The Dutch CRIES is an effective and valid tool for screening of PTSD and shows moderate to good reliability: Cronbach’s alpha for the total score is 0.89 and for the subscales of re-experiencing, avoidance and hyperarousal 0.82, 0.77 and 0.74, respectively (Verlinden et al., 2014). The total score can range from 0 to 65. The cut-off score for a positive test is 30. The outcome correlates highly with the PTSD diagnosis according to the Anxiety Disorders Interview Schedule for DSM-IV, Child and Parent Version (ADIS C/P) (Verlinden et al., 2014). For the current sample Cronbach’s alpha was 0.87 (van Meijel et al., 2015). In the current study we used a dichotomous variable: yes or no PTSS. PTSS is considered if symptoms are at a clinically significant level (a score of 30 or more) (Verlinden et al., 2014). At T2, we used two self-report measures: the CRIES for children under 18 and the IES-R (see ‘Parental posttraumatic stress symptoms’ above) for children 18 years and older. Figure 5.1 Summary of data collection