The International Trauma Questionnaire – Children and Adolescent Version (ITQ-CA) is a 22 item self-report measure focusing on the core features of Post Traumatic Stress Disorder (PTSD) and Complex PTSD (CPTSD) in children and adolescents (7 – 17 years old). It was developed to be consistent with the organising principles of the ICD-11 and is the child/adolescent version of the International Trauma Questionnaire (for adults; ITQ). The ITQ-CA is designed for diagnosis and can discriminate PTSD from CPTSD by employing validated diagnostic rules. The scale has two major subscales with three symptom clusters in each:
— PTSD —
— Disturbances in self-organisation (DSO) —
Disturbances in self-organisation is important in the assessment and diagnosis of CPTSD. The ITQ-CA is useful in the assessment of children and adolescents who have experienced trauma and asks them to answer the questions in relation to a specific traumatic event.
The ITQ-CA was validated on 136 children in foster care and was found to conform to the same factor structure as the ITQ (Haselgruber et al., 2020a). Examining concurrent validity, moderate to strong bivariate correlations were found between all ITQ-CA scales and PTSD symptom clusters as assessed by the CATS (Haselgruber et al., 2020b). Larger than any other correlation among variables, the strongest correlations were found between ITQ-CA factors and respective CATS subscales: re-experiencing and intrusions (r = 0.73), avoidance from both measures (r = 0.74), threat and hyperarousal (r = 0.84), affective dysregulation and negative alterations (r = 0.84), negative self-concept and negative alterations (r = 0.78), and disturbances in relationships and negative alterations (r = 0.71). For convergent validity, PTSD and DSO correlated moderately to strongly with depression, anxiety and dissociation, whereas PTSD correlated most strongly with dissociation (r = 0.59) and DSO with anxiety (r = 0.63). Lifetime traumatisation correlated moderately with PTSD (r = 0.43) and DSO (r = 0.47).
There are two components of scoring and interpretation: Categorical scoring for the diagnosis of PTSD and CPTSD, and a dimensional component which measures symptom severity.
For PTSD and CPTSD items, endorsement of a symptom or functional impairment item is defined as a score of 2 or greater (unless otherwise specified below).
The diagnosis of PTSD is indicated based on the following criteria:
PTSD is indicated if the criteria for PTSD are met and CPTSD is NOT met.
The diagnosis of Complex PTSD (CPTSD) is indicated based on the following criteria:
CPTSD is diagnosed if the criteria for PTSD are met AND criteria for CPTSD are met.
Dimensional scores from 0 to 24 are presented for the two major subscales:
Note that the functional impairment factors do not count towards the totals of the major subscales. Each score is presented as a raw score and a scaled score. The scaled scores are between 0 and 10 and are calculated by dividing the raw score by the maximum possible score, times 10. The scaled scores are useful for comparison between symptom clusters as they are all scored out of 10. The dimensional scores can be useful in tracking symptoms at the start, middle and end of treatment to ascertain the level of treatment response.
Cloitre, M., Shevlin, M., Brewin, C. R., Bisson, J. I., Roberts, N. P., Maercker, A., … Hyland, P. (2018). The International Trauma Questionnaire: Development of a self-report measure of ICD-11 PTSD and complex PTSD. Acta psychiatrica Scandinavica, 138(6), 536–546.
Haselgruber, A., Sölva, K., & Lueger-Schuster, B. (2020a). Validation of ICD-11 PTSD and complex PTSD in foster children using the International Trauma Questionnaire. Acta Psychiatrica Scandinavica, 141(1), 60–73. https://doi.org/10.1111/acps.13100
Haselgruber, A., Sölva, K., & Lueger-Schuster, B. (2020b). Symptom structure of ICD-11 Complex Posttraumatic Stress Disorder (CPTSD) in trauma-exposed foster children: examining the International Trauma Questionnaire – Child and Adolescent Version (ITQ-CA). European Journal of Psychotraumatology, 11(1), 1818974. https://doi.org/10.1080/20008198.2020.1818974