Validation of the Child and Adolescent Trauma Screen-2 (CATS-2) in a Turkish clinical sample: psychometric properties across ICD-11 and DSM-5 frameworks Validación del Cuestionario de Tamizaje de Trauma para Niños y Adolescentes 2 (CATS-2) en una muestra clínica turca: propiedades psicométricas según los marcos diagnósticos de la CIE-11 y el DSM-5
European Journal of Psychotraumatology, cilt.17, sa.1, 2026 (SSCI, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 17 Sayı: 1
- Basım Tarihi: 2026
- Doi Numarası: 10.1080/20008066.2026.2694190
- Dergi Adı: European Journal of Psychotraumatology
- Derginin Tarandığı İndeksler: Social Sciences Citation Index (SSCI), Scopus, EMBASE, MEDLINE, Psycinfo, Directory of Open Access Journals, Academic Search Ultimate (EBSCO), Health Research Premium Collection (ProQuest), Psychology & Behavioral Sciences Collection (EBSCO)
- Anahtar Kelimeler: CATS-2, complex PTSD, cross-cultural validation, ICD-11, Posttraumatic stress disorder, psychometric properties
- Yıldız Teknik Üniversitesi Adresli: Evet
Özet
Background: Early identification of posttraumatic symptoms in children and adolescents is essential for timely intervention. The Child and Adolescent Trauma Screen-2 (CATS-2) is a brief, freely accessible instrument that simultaneously assesses DSM-5 PTSD, ICD-11 PTSD, and ICD-11 complex PTSD (CPTSD) symptoms across child and caregiver report forms. Cross-cultural validation of the CATS-2 in underrepresented settings remains limited. This study examined the psychometric properties of the Turkish CATS-2 in a clinical sample. Method: Participants were 196 children and adolescents referred to a child and adolescent psychiatry outpatient clinic. ICD-11 PTSD and CPTSD diagnoses were established through clinician-administered assessments. Internal consistency, test-retest reliability, convergent and discriminant validity, child-caregiver agreement, confirmatory factor analysis (CFA), known-groups validity, and diagnostic accuracy were examined. Results: The CATS-2C showed good to excellent internal consistency (α=.81–.94) and test-retest reliability (ICC =.86–.90). CFA supported a two-factor correlated model of ICD-11 PTSD and disturbances in self-organization (DSO), and the DSM-5 four-factor model, for both forms. The CATS-2C showed strong convergent validity (r =.79–.89) and negligible associations with externalizing symptoms (r =.08–.12, ns). Known-groups validity was excellent for the CATS-2C (η² =.48–.58) but limited for the CATS-2P (η² =.076–.119). Diagnostic accuracy was good to excellent for the CATS-2C (AUC =.868–.947) and poor to acceptable for the CATS-2P (AUC =.606–.735), all subscales significant. Optimal CATS-2C cut-offs against clinician ICD-11 diagnoses were ≥7 for ICD-11 PTSD (sensitivity = 84%, specificity = 78%), ≥17 for ICD-11 CPTSD (93%, 85%), and ≥30 for DSM-5 PTSD (85%, 89%). Child-caregiver agreement was poor (ICC =.259–.344). Conclusions: The Turkish CATS-2C demonstrated sound psychometric properties, supporting its use as a reliable screening tool in child and adolescent mental health settings. The CATS-2P showed acceptable structural validity and internal consistency but more limited diagnostic discrimination, underscoring the importance of directly assessing symptoms from the child. These findings contribute preliminary evidence regarding ICD-11 PTSD and CPTSD constructs in an underrepresented, middle-income clinical setting. Trial registration:ClinicalTrials.gov identifier: NCT06975852.