Assessing post-traumatic responses among South African adolescents : a comparison of different methods

Abstract

The present study compares the use of standardised diagnostic clinical interviews, self-report scales, and unstructured interviews, to determine if these different methods of assessment elicit the same or similar information with regards to trauma exposure, post-traumatic stress disorder, and depression in adolescents. A sample of Grade ll learners was drawn from two schools in the Northern Suburbs of Cape T own. The total sample comprised of 58 learners between the ages of 16 and 18 years. Each participant was administered a demographic questionnaire, a clinical diagnostic interview, two self-report scales, and an unstructured interview. The diagnostic interview used was the Schedule for Affective Disorders and Schizophrenia for School-Aged Children - Present and Lifetime version (K-SADS-PL), and the self- report scales used were the Child and Adolescent Trauma Survey (CATS) and the Children's Depression Inventory (CD1). The demographic questionnaire and qualitative interview were devised for the study. The McNemar Chi-Square statistic was used to determine differences between the interview and self-report methods of assessment, and a content analysis of the qualitative interview was conducted. Additionally, a Receiver Operating Characteristic analysis was used to establish a CATS score, indicating a high risk of PTSD, that was more sensitive to the sample. The results indicate that even though clinical interviews and self-report scales appear to produce different information, if appropriate cut-off points are used, self-report scales can be used as a screening device to reduce the number of clinical interviews required, thus contributing to a more efficient use of resources. They also indicate that unstructured qualitative interviews can elicit useful information about post- traumatic responses that is not captured by the DSM IV criteria.