Validation of the Ukrainian Caregiver-Report Version of the Child and Adolescent Trauma Screen (CATS) in Children and Adolescents in Ukraine

Objective: Emerging research indicates that the ongoing conflict in Ukraine has led to an increased prevalence of war-related posttraumatic stress disorder (PTSD) in children and adolescents. The current study sought to test the psychometric properties of a Ukrainian-translated measure of PTSD for children and adolescents; the Child and Adolescent Trauma Screen (CATS; Sachser et al., 2017). Method: Participants were an opportunistic sample of N = 2,004 parents living in Ukraine who provided data on themselves and one target child in their household as part of The Mental Health of Parents and Children in Ukraine Study. The latent structure of the parent-reported CATS was tested using confirmatory factor analysis, composite reliability estimates were estimated, and criterion validity was assessed. Results: The latent structure of the parent-reported CATS was best reflected by a three-factor model and a four-factor model in the preschool and child and adolescent samples, respectively. Estimates of internal reliability were high for both samples. Criterion validity was supported through associations with external measures of internalizing, externalizing, and attention problems. Parent-report child milestone development delays and prior psychological or pharmacological support were associated with higher average scores on the CATS symptom scales. The prevalence of probable PTSD for the preschool sample was 15.4% (n= 77) and the prevalence of probable PTSD for the child and adolescent sample was 14.4% (n= 217). Discussion: This study supports the psychometric properties of the Ukrainian parent-reported CATS which can be used routinely in clinical practice for the caregiver-rated assessment of PTSD. Clinical Impact Statement This study demonstrates that the Ukrainian parent-reported Child and Adolescent Trauma Screen (CATS) is a valid and reliable measure of posttraumatic stress disorder for children and adolescents. This is the first-ever study to test and provide support for the psychometric properties of the CATS in children and adolescents living in an active war zone. The availability of this empirically validated measure should facilitate the identification and treatment of at-risk Ukrainian children and adolescents. This measure can be used in a variety of settings in Ukraine such as in- and outpatient services, private practice, and by pediatricians, as well as in neighborhood countries that host Ukrainian refugees to ensure that these children and adolescents receive the support they need.