Screening for post-traumatic stress symptoms in looked after children

DOIhttps://doi.org/10.1108/JCS-10-2014-0045
Pages365-375
Publication Date21 December 2015
AuthorLottie Morris,Paul Salkovskis,Joanna Adams,Andrew Lister,Richard Meiser-Stedman
SubjectHealth & social care,Vulnerable groups,Children's services
Screening for post-traumatic stress
symptoms in looked after children
Lottie Morris, Paul Salkovskis, Joanna Adams, Andrew Lister and Richard Meiser-Stedman
Lottie Morris is Clinical
Psychologist at Manx Cancer
Help, Isle of Man, UK.
Paul Salkovskis is based at
Department of Applied Science
and Clinical Psychology,
University of Bath, Bath, UK.
Joanna Adams is Clinical
Psychologist and Clinical Tutor
at Department of Clinical
Psychology, University of Bath,
Bath, UK.
Andrew Lister is Consultant
Clinical Psychologist at Bristol
City Council, Bristol, UK.
Richard Meiser-Stedman
is Clinical Psychologist at
the University of
East Anglia, Norwich.
Abstract
Purpose Many children who are looked after by the state have experienced adverse and traumatic life
circumstances prior to being removed from their biological parents. Previous research has highlighted that
many of them experience barriers to accessing psychological therapies. The purpose of this paper is to
investigate the feasibility of assessing post-traumatic stress disorder (PTSD)-like symptoms using a screening
tool, and through this to determine the prevalence of PTSD-like symptoms in looked after children presenting
with emotional and/or behavioural problems.
Design/methodology/approach The Child Revised Impact of Events Scale (CRIES-8) was identified as a
suitable screening tool for PTSD-like symptoms. This measure was piloted for three months, and the
prevalence of PTSD-like symptoms amongst respondents (
n
¼27) was recorded.
Findings Prevalence of PTSD-like symptoms was found to be high 75 per cent amongst respondents. The
psychometric properties of the CRIES-8 were similar to those found in a previous study assessing PTSD
following a single-incident trauma. Health care professionals reported finding the CRIES-8 to be a clinically
useful measure.
Originality/value Prevalence of PTSD-like symptoms may be high amongst looked after children, and the
CRIES-8 appears to have good psychometric properties when used with this population. It is likely that this
highly treatable condition is under-detected: thus, recommendations are made for clinical practice and
further research.
Keywords Children, Screening, PTSD, Foster care, Trauma, Looked-after
Paper type Research paper
Introduction
Post-traumatic Stress Disorder (PTSD)
DSM-V defines trauma as an event or events involving a perceived threat to life or physical
integrity, and intense fear, helplessness or horror (American Psychiatric Association, 2013).
The key symptoms of PTSD for this diagnosis are re-experiencing symptoms (e.g. flashbacks,
nightmares); avoidance of reminders of the trauma; hyper-arousal; and emotional numbing.
It has long been recognised that trauma can have a significant and complex impact on children
and young peoples (referred to as children from this stage forward) social, emotional and
behavioural development (Eth and Pynoos, 1985).
PTSD in looked after children
By definition, many children requiring care from the state (termed Looked After Children in
England) have experienced circumstances which most people would agree are likely to be
experienced as traumatic. Indeed, it is likely that some children will have had experiences where
they believed that they or those they love were going to die or be seriously injured. It is less clear
Received 20 October 2014
Revised 20 March 2015
27 April 2015
Accepted 27 April 2015
This research was completed as
part of the corresponding authors
Doctorate in Clinical Psychology.
It received no external funding.
DOI 10.1108/JCS-10-2014-0045 VOL. 10 NO. 4 2015, pp. 365-375, © Emerald Group Publishing Limited, ISSN 1746-6660
j
JOURNAL OF CHILDREN'S SERVICES
j
PAG E 36 5

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