CHILD STRESS DISORDERS CHECKLIST (CSDC)

Abstract

The Child Stress Disorders Checklist (CSDC) is a specialized psychometric instrument designed for the assessment of post-traumatic symptoms and stress reactions in children following exposure to a frightening or harmful event. Utilizing an observer report format, the CSDC is typically completed by a parent, caregiver, or professional who possesses intimate knowledge of the child’s recent behavior. The checklist systematically collects both qualitative data concerning the nature of the traumatic event and quantitative data related to immediate and sustained post-traumatic responses. The resulting scores are calculated across multiple dimensions, aligning with established clinical models of trauma response, including clusters for reexperiencing, avoidance, and arousal symptoms.

Keywords

Child Stress Disorders Checklist, CSDC, Post-traumatic Stress Disorder, Acute Stress, Childhood Trauma, Observer Report, Dissociation, Psychological Assessment, Trauma assessment

Authors

Glenn N. Saxe, M.D.

Purpose

The primary objective of the Child Stress Disorders Checklist (CSDC) is to provide a structured and quantifiable measure of a child’s behavioral and emotional sequelae following a potentially traumatic event. The scale is specifically calibrated to identify symptoms characteristic of both immediate, acute stress reactions and longer-term manifestations of post-traumatic stress that have persisted within the past month.

The CSDC performs a dual function essential for clinical and research applications. First, it systematically records crucial descriptive information about the trauma exposure, including the nature of the event and the child’s age at the time of exposure. Second, it generates specific scores for symptom clusters, enabling clinicians and researchers to accurately gauge the severity and dimensional profile of the child’s perceived stress level, thereby facilitating clinical formulation, diagnosis, and focused intervention planning.

Construct

The CSDC rigorously measures the psychological construct of post-traumatic stress symptoms in pediatric populations. This construct is defined by a spectrum of affective, behavioral, and cognitive disturbances that emerge subsequent to trauma exposure. The instrument operationalizes this construct across two distinct temporal phases: immediate post-event responses and sustained, chronic symptoms.

The chronic symptoms assessed by the CSDC are organized into five distinct psychological dimensions, which directly reflect key aspects of trauma pathology frequently associated with the diagnostic criteria for Post-traumatic Stress Disorder (PTSD) and Acute Stress Disorder. Critically, higher scores obtained on the CSDC are interpreted as correlating directly with a greater level of perceived psychological distress and an increased symptom burden related to the original traumatic experience.

Validity

The source material does not explicitly detail specific empirical psychometric validity coefficients, such as convergent, discriminant, or criterion validity data. However, the inherent structure of the instrument suggests robust content validity. This is evidenced by the organization of the items into dimensions that align directly with recognized clinical classifications of post-traumatic symptomology observed in children.

The scale’s methodology, which mandates the segregation of immediate acute reactions from sustained chronic symptoms, significantly enhances its utility for accurately assessing the temporal progression of stress disorders in children. Users should seek out peer-reviewed validation studies published by the author or associated researchers to confirm the extent to which CSDC scores precisely reflect formal clinical diagnoses or functional impairment levels.

Reliability

Specific empirical reliability coefficients, such as Cronbach’s alpha for internal consistency or test-retest reliability data, are not provided within the initial source content. Reliability, when applied to the CSDC, pertains chiefly to the consistency with which observers rate the child’s symptoms, either across different points in time or across different observers (inter-rater reliability).

Given the CSDC’s widespread application in both clinical and research environments, it is presumed to demonstrate acceptable levels of reliability, particularly within its empirically defined symptom dimensions. Nonetheless, users are strongly advised to consult primary research articles authored by Dr. Saxe or collaborating researchers to access the empirical reliability coefficients necessary for rigorous scientific application.

Factor Analysis

The CSDC employs a multi-dimensional factor structure to systematically categorize the 30 primary items focused on chronic post-traumatic symptoms. While the specific statistical procedures (e.g., Exploratory or Confirmatory Factor Analysis) used to derive these dimensions are not detailed here, the instrument clearly outlines five principal symptom clusters utilized in the assessment.

The scoring methodology permits a detailed profile analysis of the child’s stress response by calculating total scores for each dimension. The first five items of the checklist address immediate post-event responses, generating an Immediate Response Score. The subsequent 30 main items contribute to the Total Post Traumatic Symptom Score. The five established dimensions and their corresponding item numbers are:

• Reexperiencing: Items 1, 3, 12, 19, 22, 23, 25
• Avoidance: Items 5, 14, 21, 28, 30
• Numbing and Dissociation: Items 4, 7, 9, 16, 18, 20, 26, 27
• Increased Arousal: Items 2, 6, 8, 13, 17, 29
• Impairment in Functioning: Items 10, 11, 15, 24

Instrument

Test Type: Psychological Inventory/Symptom Checklist

Format: Observer Report (Completed by a Caregiver, Parent, or Professional)

Language Available: English (based on available source materials)

Population Group: Children and Youth exposed to traumatic events

Age Group: Not explicitly specified, but the scale is designed for use with children capable of exhibiting and experiencing trauma symptoms.

Population Details: The scale is used for assessing post-traumatic symptoms following a wide range of critical events, including but not limited to, accidents, physical or sexual assault, fires, storms, or serious illness.

Test Methodology: The CSDC utilizes a 3-point Likert scale for symptom scoring: 0 (Not True), 1 (Somewhat or Sometimes True), and 2 (Very True or Often True). The instrument begins with a non-scored section dedicated to documenting the traumatic event details, followed by scored sections for immediate responses (5 items) and chronic symptoms (30 items). Scores are summated to provide both a total symptom burden score and specific dimensional profiles.

Keywords

Trauma assessment, Child mental health, PTSD screening, Behavioral checklist, Symptom inventory, Glenn N. Saxe, Boston University School of Medicine, Psychological distress

Authors

Author ORCID Identifier: Not provided in source content.

Affiliation Email addresses: [email protected]

Correspondence Address: National Child Traumatic Stress Network & Department of Child and Adolescent Psychiatry, Boston University School of Medicine.

Permissions & Fee and Test Year

Information regarding specific copyright permissions, usage fees, and the exact initial publication year of the CSDC is not available in the provided source material. Users interested in implementing this scale for clinical or research purposes must contact the author, Glenn N. Saxe, M.D., or the National Child Traumatic Stress Network (NCTSN) directly to obtain official usage guidelines and licensing information.

The source documentation related to the CSDC and stress assessment in out-of-school programs includes two important PDF resources:

• The original PDF version of the CSDC instrument can be downloaded here: http://www.nctsnet.org/nctsn_assets/acp/hospital/CSDC.pdf
• A discussion paper on assessing stress relevant to the CSDC is available here: http://www.afterschoolpgh.org/assets/AssessingStress1.pdf

Reference’s

Saxe, G. N. (n.d.). Child Stress Disorders Checklist (CSDC). National Child Traumatic Stress Network & Department of Child and Adolescent Psychiatry, Boston University School of Medicine. (As distributed in associated materials regarding stress assessment).

Items of the CHILD STRESS DISORDERS CHECKLIST (CSDC)

IMPORTANT: The following scale items must be preserved in their original language and must not be changed in any way.

Child’s Name (or ID #): _________________ Age: _______ Sex: M F

Person Completing Questionnaire: ______________________ Date___________

Relationship to Child: ________________________________

Has your child experienced or witnessed an event that caused‚ or threatened to cause‚ serious harm to him or herself or to someone else? Please check any and all events (and age(s) of your child at the time of the event or events) below-

1) Car Accident ____ Age(s) ____ 5) Physical Illness ____ Age(s) ____

2) Other Accident ____ Age(s) ____ 6) Physical Assault ____ Age(s) ____

3) Fire ____ Age(s) ____ 7) Sexual Assault ____ Age(s) ____

4) Storm ____ Age(s) ____ 8) Any Other Event ____ Age(s) ____

Please provide any details about this (or these) events in the box below. For example- Where did the event occur? Who was with your child? Who hurt your childHow often did this happenHow long did it lastHow badly was your child hurt? Did he or she require medical care?

Directions: Below is a list of feelings or behaviors that children sometimes have immediately after a frightening event (or after he or she regained consciousness from such an event). For each item that describes your child immediately after the event‚ please circle 2 if the item is VERY TRUE of your child. Circle 1 if the item is SOMEWHAT TRUE of your child. If the item is NOT TRUE of your child‚ circle 0.

Please answer all items as well as you can even if some do not seem to apply to your child. For children who have experienced more than one event‚ choose the event that was most distressing to him or her.

0 = Not True (as far as you know) 1 = Somewhat True 2 = Very True

1. Child felt terrified (extreme anxiety or fear).
2. Child felt horrified (extreme feelings of revulsion‚ disgust‚ or shame).
3. Child felt helpless.
4. Child’s behavior became agitated. For example‚ his or her behavior became hyperactive‚ impulsive‚ or difficult to control.
5. Child’s behavior became disorganized. For example‚ his or her behavior became very different than is usual‚ his or her behavior did not make sense.

Directions: Below is a list of behaviors that describe children. For each item that describes your child NOW or WITHIN THE PAST MONTH‚ please circle 2 if the item is VERY TRUE or OFTEN TRUE of your child. Circle 1 if the item is SOMEWHAT or SOMETIMES TRUE of your child. If the item is NOT TRUE of your child‚ circle 0.

Please answer all items as well as you can even if some do not seem to apply to your child. The term “event” refers to the most stressful experience that you have described above.

0 = Not True (as far as you know)‚ 1 = Somewhat or Sometimes True‚ 2 = Very True or Often True

1. Child reports uncomfortable memories of the event.
2. Child startles easily. For example‚ he or she jumps when hears sudden or loud noises.
3. Child gets very upset if reminded of the event.
4. Child seems numb or distant from his or her feelings.
5. Child avoids doing things that remind him or her of the event.
6. Child seems irritable or angry.
7. Child has difficulty remembering details about the event.
8. Child has difficulty falling asleep or staying asleep.
9. Child seems detached or distant from other people.
10. Child has difficulty getting along with friends‚ schoolmates or teachers.
11. Child does things that he or she outgrew. For example‚ thumb sucking‚ bedwetting‚ nail biting‚ or requests to sleep with parents.
12. Child reports feeling as if the event were happening again.
13. Child is restless and doesn’t sit still.
14. Child avoids places that remind him or her of the event.
15. Child has difficulty getting along with family members.
16. Child appears confused about things that he or she should know.
17. Child seems “on edge” or nervous.
18. Child seems “spaced out” or in a daze.
19. Child acts as if the event were happening again.
20. Child has trouble keeping track of time. He or she may become confused about the time of day‚ the day of the week‚ or when something really happened.
21. Child avoids talking about the event.
22. Child reports bad dreams.
23. Child reports more physical complaints when reminded of the event. For example‚ headaches‚ stomach aches‚ nausea‚ difficulty breathing.
24. Child has difficulty performing activities such as schoolwork or chores.
25. Child plays about the event (child expresses what happened to him or her with toys‚ games‚ drawings‚ or other fantasy-play).
26. Child appears slowed down. It takes him or her a long time to respond to things.
27. Child reports that his or her environment seems different than it used to. For example‚ he or she may report that things look or sound different.
28. Child avoids people who remind him or her of the event.
29. Child has trouble concentrating
30. Child reports that he or she does not want to think about the event.