The child and adolescent trauma screen self- and caregiver-report: Factor structure, measurement invariance, and concurrent validity in a clinical sample of children and adolescents.

Abstract

Objective: The child and adolescent trauma screen (CATS) is a widely used tool for assessing posttraumatic stress symptoms in youth; yet very few studies have examined its factor structure, including its measurement invariance and validity, across relevant groups. This information is critical to ensure evidence-based use of the measure while minimizing the risk of inaccurate interpretation.

Method: Utilizing a sample of 259 youth, aged 8-16 years (M = 11.7, SD = 2.4; 63% female), and their caregivers, the factor structure of the CATS was examined, and the optimal factor structure was tested for measurement invariance and construct validity across relevant groups.

Results: A three-factor structure based on International Classification of Diseases 11th Revision criteria for posttraumatic stress disorder that includes "reexperiencing," "avoidance," and "perceived sense of threat" factors based on six items from the total scale was identified as optimal for both CATS self- and caregiver-report (self: χ² = 7.514, root-mean-square error of approximation = .032, comparative fit index = .995, Tucker-Lewis index = .988, standardized root-mean-square residual = .024; caregiver: χ² = 9.663, root-mean-square error of approximation = .049, comparative fit index = .989, Tucker-Lewis index = .971, standardized root-mean-square residual = .032). In addition, measurement invariance was found for this three-factor structure for CATS self-report across youth age, sex, and race. In addition, concurrent validity was found for the CATS self-report total score, as evidenced by significant positive associations with self-reported depression symptoms.

Conclusions: These findings support the use of the total score based on the six-item three-symptom version of the CATS that is based on International Classification of Diseases 11th Revision criteria for posttraumatic stress disorder. Further, these results provide some of the first replicable support for this three-factor structure of the CATS and suggest its use as a highly efficient, short-form screener that may be administered easily across clinical settings. (PsycInfo Database Record (c) 2025 APA, all rights reserved).