The Structured Trauma-Related Experiences and Symptoms Screener (Stress): Assessing Factor Structure and Clinical Utility in a Juvenile Justice Sample
Exposure to traumatic events (TEs) and subsequent trauma reactions (TRs) are highly prevalent among adolescents involved in the justice system (Meservey & Skowyra, 2015; OJJDP, 2017a; Teplin et al., 2002; Vincent et al., 2008). In the past ten years, mental health screening for justice-involved adolescents has become standard practice, with a more recent emphasis on screening for TE exposures and TRs (Ford et al., 2018; Grisso, 2007). Currently, there is no one widely accepted screening tool to assess for trauma among system-involved adolescents. An additional concern is that minimal attention has been given to establish thresholds on the tools that best signal level of risk for the disorder being screened (Grisso, 2007). Therefore, the field is in need of research establishing psychometric properties of trauma screening tools to determine clear recommendations for how the tools can be used to appropriately identify adolescents requiring intervention. The present study aimed to replicate and expand on Grasso and colleagues’ (2015) findings related to the factor structure and construct validity of the STRESS, a comprehensive trauma screen. While the prior study was conducted with a child welfare sample, the present study intended to extend findings to a juvenile justice sample. As such, the present study examined: (a) the STRESS factor structure and fit with the DSM-5 four-factor PTSD model and (b) construct validity of the STRESS, as measured through associations between STRESS-identified TRs and both internalizing disorders (i.e., depression) and externalizing behaviors (i.e., delinquency). The sample consisted of 132 incarcerated adolescents in Georgia’s Department of Juvenile Justice who completed screening measures at intake into detention. Consistent with Grasso and colleagues’ (2015) results, a confirmatory factor analysis (CFA) revealed that the STRESS had excellent fit with the DSM-5 four-factor PTSD model. Inconsistent with prior literature, the STRESS also fit a single factor and second-order model. Construct validity of the STRESS was tested using negative binomial regressions. TRs reported on the STRESS were significantly associated with depressive symptoms reported on the Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS-PL), but were not associated with lifetime delinquency. Results suggest that both STRESS total symptom and criterion symptom count scores have clinical utility for intake-level mental health decision making in juvenile justice settings. Further, preliminary evidence of construct validity of the STRESS is confirmed through the association of TRs and depression. Results support expanding use of the STRESS for detecting TRs and informing appropriate interventions for justice-involved adolescents.
Clinical psychology|Developmental psychology|Criminology
Weinberger, Emily C, "The Structured Trauma-Related Experiences and Symptoms Screener (Stress): Assessing Factor Structure and Clinical Utility in a Juvenile Justice Sample" (2020). ETD Collection for Fordham University. AAI28028456.