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Psychometric Properties of Darryl, a Cartoon Based Measure to Assess Community Violence-Related PTSD in Children

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Abstract

Objective

To examine the reliability and validity of Darryl, a cartoon-based measure of PTSD symptoms and a screening tool for identifying children and adolescents with a PTSD diagnosis.

Method

Exposure to community violence, PTSD symptoms and diagnostic status were assessed in a sample of 49 children and adolescents at an urban outpatient psychiatry clinic.

Results

Darryl has good internal consistency for the full scale and adequate reliability for each DSM-IV PTSD symptom cluster. Darryl correlates significantly (r = 0.64, P < 0.001) with the most frequently used measure for assessing PTSD in children (CPTSD-RI). As a screening tool, Darryl has excellent sensitivity and specificity in relationship to the KID-SCID.

Conclusions

In comparison to other child PTSD measures, Darryl has comparable or better psychometric properties and assesses PTSD symptoms in a more developmentally appropriate manner, especially in the domain of community violence. The value of Darryl as a screening tool remains preliminary given the limited number of diagnosed cases of PTSD in the study sample. Full scale efforts at replication are warranted.

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References

  1. Wilson MD, Joffe A: Adolescent medicine. Journal of the American Medical Association 273:1657–1659, 1995.

    Article  PubMed  CAS  Google Scholar 

  2. Horowitz K, Weine S, Jekel J: PTSD symptoms in urban adolescent girls: Compounded community trauma. Journal of the American Academy of Child & Adolescent Psychiatry 34:1353–1361, 1995.

    Article  CAS  Google Scholar 

  3. Lipschitz DS, Winegar RK, Hartnick E, et al.: Posttraumatic stress disorder in hospitalized adolescents: Psychiatric comorbidity and clinical correlates. Journal of the American Academy of Child & Adolescent Psychiatry 38:385–392, 1999.

    Article  CAS  Google Scholar 

  4. Berton MW, Stabb SD: Exposure to violence and post-traumatic stress disorder in urban adolescents. Adolescence 31:489–498, 1996.

    PubMed  CAS  Google Scholar 

  5. Buka SL, Stichick TL, Birdthistle SM, et al.: Youth exposure to violence: Prevalence, risks and consequences. American Journal of Orthopsychiatry 71:298–310, 2001.

    Article  PubMed  CAS  Google Scholar 

  6. Davis L, Siegel LJ: Posttraumatic stress disorder in children and adolescents: A review and analysis. Clinical Child & Family Psychology Review 3:135–154, 2000.

    Article  CAS  Google Scholar 

  7. Ohan JL, Myers K, Collett BR: Ten-year review if rating scales. IV: Scales assessing trauma and its effects. Journal of the American Academy of Child & Adolescent Psychiatry 41:1401–1422, 2002.

    Article  Google Scholar 

  8. American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders. 2nd Ed. Washington, DC: Text Revision (DSM-IV-TR), 2000.

    Book  Google Scholar 

  9. Fairbank JA, Ebert LE, Caddell JM: Posttraumatic Stress Disorder. In: Adams HE, Sutker PB (eds) Comprehensive Handbook of Psychopathology. 3rd Ed. NewYork: Kluwer Academic, 2000.

    Google Scholar 

  10. Spitalny K: Clinical finding regarding PTSD in children and adolescents. In: Silva RR (ed) PTSD in & Adolescents Handbook. New York: WW Norton & Co, 2004.

    Google Scholar 

  11. Kilpatrick DG, Aciero R, Saunders B, et al.: Risk factors for adolescent substance abuse and dependence: Data from a national sample. Journal of Consulting & Clinical Psychology 68:19–30, 2000.

    Article  CAS  Google Scholar 

  12. Miller LS, Wasserman GA, Neugebauer R, et al.: Witnessed community violence and antisocial behavior in high-risk, urban boys. Journal of Consulting & Clinical Psychology 28:2–11, 1999.

    CAS  Google Scholar 

  13. Moses A: Exposure to violence, depression and hostility in a sample of inner city high school youth. Journal of Adolescence 22:21–32, 1999.

    Article  PubMed  CAS  Google Scholar 

  14. Silva RR, Alpert M, Munoz DM, et al.: Stress and vulnerability to PTSD in children and adolescents. American Journal of Psychiatry 157:1229–1235, 2000.

    Article  PubMed  CAS  Google Scholar 

  15. Margolin G, Gordin EB: The effects of family and community violence on children. Annual Review of Psychology 51:445–479, 2000.

    Article  PubMed  CAS  Google Scholar 

  16. Saigh PA: Assessment of PTSD in children and adolescents. In: Silva RR (ed) PTSD in Children & Adolescents Handbook. New York: WW Norton & Co, 2004.

    Google Scholar 

  17. Shaffer D, Fisher P, Lucas CP, et al.: NIMH Diagnostic Interview Schedule for Children Version IV (NIMH DISC-IV): Description, differences from previous versions, and reliability of some common diagnoses. Journal of the American Academy of Child & Adolescent Psychiatry 39:28–38, 2000.

    Article  CAS  Google Scholar 

  18. Reich W: Diagnostic Interview for Children and Adolescents (DICA). Journal of the American Academy of Child & Adolescent Psychiatry 39:59–66, 2000.

    Article  CAS  Google Scholar 

  19. Ambrosini PJ: Historical development and present status of the Schedule for Affective Disorders and Schizophrenia for School-Age Children (K-SADS). Journal of the American Academy of Child & Adolescent Psychiatry 39:49–58, 2000.

    Article  CAS  Google Scholar 

  20. Matzner F, Silva R, Chowdhury M, et al.: Preliminary test-retest reliability of the KID-SCID, in 1997 Annual Meeting New Research Program and Abstracts. Washington, DC: American Psychiatric Association, 1997.

    Google Scholar 

  21. Frederick CJ: Selected foci in the spectrum of posttraumatic stress disorders. In: Laube J, Murphy S (eds) Perspectives on Disaster Recovery. East Norwalk, CT: Appleton-Century-Crofts, 1985.

    Google Scholar 

  22. Jones RT, Randall J: Psychosocial correlates of fire disaster among children and adolescents. Journal of Traumatic Stress 7:117–121, 1994.

    Article  PubMed  CAS  Google Scholar 

  23. Pynoos RS, Goenjian A, Tashjian M, et al.: Post-traumatic stress reactions in children after the 1988 Armenian earthquake. British Journal of Psychiatry 163:239–247, 1993.

    PubMed  CAS  Google Scholar 

  24. Steinberg AM, Brymer MJ, Decker KB, et al.: The University of California at Los Angeles Post-traumatic Stress Disorder Reaction Index. Current Psychiatry Reports 6:96–100, 2004.

    PubMed  Google Scholar 

  25. Foa EB, Johnson KM, Fenny NC, et al.: The Child PTSD Symptom Scale: A preliminary examination of its psychometric properties. Journal of Clinical Child Psychology 30:376–384, 2001.

    Article  PubMed  CAS  Google Scholar 

  26. Neugebauer R, Wasserman GA, Fisher PW, et al.: Darryl, a cartoon-based measure of cardinal posttraumatic stress symptoms in school-age children. American Journal of Public Health 89:758–761, 1999.

    Article  PubMed  CAS  Google Scholar 

  27. Ernst M, Godfrey KA, Silva RR, et al.: A new pictorial instrument for child and adolescent psychiatry: A pilot study. Psychiatry Research 51:87–104, 1994.

    Article  PubMed  CAS  Google Scholar 

  28. Valla JP: In instrument d’evaluation de la sante mentale des enfants du primaire (six/douze ans). In: Chanoit PF, DeVerbizier D (eds) Evaluation des Sooins en Sante Mentale. Paris, France: Eres, 1989.

    Google Scholar 

  29. Ritchers JE, Martinez P, Valla JP: Levonn: A Cartoon-Based Structured Interview for Assessing Young Children’s Distress Symptoms. Rockville, MD: NIMH, 1990.

    Google Scholar 

  30. Ritchers JE, Martinez P: The NIMH Community Violence Project, I: children as victims of and witnesses to violence. Psychiatry 56:7–21, 1993.

    Google Scholar 

  31. Shrout PE, Link BG, Dohrenwend BP, et al.: Characterizing life events as risk factors for depression: the role of fateful loss events. Journal of Abnormal Psychology 98(4):460–467, 1989.

    Article  PubMed  CAS  Google Scholar 

  32. Pynoos RS, Frederick C, Nader K, et al.: Life threat and posttraumatic stress in school-age children. Archives of General Psychiatry 44:1057–1063, 1987.

    PubMed  CAS  Google Scholar 

  33. McNally RJ: Assessment of posttraumatic stress disorder in children and adolescents. Journal of School Psychology 34:147–161, 1996.

    Article  Google Scholar 

  34. Nader KO: Assessing traumatic experiences in children. In: Wilson JP, Keane TM (eds) Assessing Psychological Trauma and PTSD. New York: Guilford Press, 1997.

    Google Scholar 

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Acknowledgments

The authors gratefully acknowledge Juliana Blome and Angie Oberhelman for assistance with data collection.

This research was supported in part by grants from NIDA (R01DA07612-03), NIMH (P30MH34878), and the Lowenstein Foundation to the Lowenstein Center for the Study and Prevention of Disruptive Disorders, Gail A. Wasserman, PhD, PI.

Author information

Authors and Affiliations

  1. Department of Psychology, Drexel University, 245 N. 15th St., Mail Stop 515, Philadelphia, PA, 19102, USA

    Pamela A. Geller Ph.D. & A. Kyle Possemato M.S.

  2. Epidemiology of Developmental Brain Disorders Department, New York State Psychiatric Institute, New York, NY, USA

    Richard Neugebauer Ph.D.

  3. Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, NY, USA

    Richard Neugebauer Ph.D.

  4. Department of Pediatrics, Bronx Lebanon Hospital Center, Bronx, NY, USA

    Richard Neugebauer Ph.D.

  5. Training and Research Institute in Self Psychology, New York, NY, USA

    Patricia Walter M.S.W.

  6. The Children’s Village, Dobbs Ferry, New York, NY, USA

    E. Steven Dummit III M.D.

  7. Child & Adolescent Psychiatry, New York University/Bellevue Hospital Center, New York, NY, USA

    Raul R. Silva M.D.

Authors
  1. Pamela A. Geller Ph.D.
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  2. Richard Neugebauer Ph.D.
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  3. A. Kyle Possemato M.S.
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  4. Patricia Walter M.S.W.
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  5. E. Steven Dummit III M.D.
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  6. Raul R. Silva M.D.
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Corresponding author

Correspondence to Pamela A. Geller Ph.D..

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Geller, P.A., Neugebauer, R., Possemato, A.K. et al. Psychometric Properties of Darryl, a Cartoon Based Measure to Assess Community Violence-Related PTSD in Children. Psychiatr Q 78, 157–168 (2007). https://doi.org/10.1007/s11126-006-9035-6

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  • DOI: https://doi.org/10.1007/s11126-006-9035-6

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