Assessment of functional impairment related to post-traumatic stress in children and adolescents: a systematic review
Résumé fourni par la source
Background: Post-traumatic stress disorder (PTSD) often impairs children’s and adolescents’functioning across different life domains. Significant functional impairment is a diagnosticcriterion for PTSD in both the DSM-5 and the ICD-11, but the methods in terms of domainscovered and scoring rules to assess functional impairments are quite inconsistent.Objective: This systematic review evaluates instruments specifically designed to assess post-traumatic stress symptoms (PTSS), PTSS modules within diagnostic interviews, and genericfunctional impairment measures used to capture PTSS-related functional impairment inchildren and adolescents.Method: A systematic search was conducted across six databases for studies publishedbetween January 2010 and November 2025. Eligible papers included the development orpsychometric evaluation of PTSS-specific measures, PTSS modules in diagnostic interview,and generic functional impairment measures validated in samples exposed to trauma oradverse childhood experiences. Data were extracted and categorized based on assessedcontent domains, scoring methods, and psychometric properties, with results stratified byage group (6 years and younger versus 7 years and older).Results: From 3519 records, 30 papers met the inclusion criteria. Thirteen PTSS-specificinstruments, one diagnostic interview module, and one generic functional impairmentmeasure were identified. Together, these instruments assessed 11 different life domains,although considerable variation existed in the domains covered across tools. Scoringmethods also varied, with approximately half using dichotomous response formats and theremainder using multi-categorical scales. Psychometric properties of the functionalimpairment scales were reported in only 20.7% of publications.Conclusion: Current tools for assessing PTSS-related functional impairment in youth lackstandardization. There is a critical need for well-validated instruments that comprehensivelycapture the presence and severity of PTSS-related functional impairment.
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