Araştırma Makalesi | Açık Erişim
Çocuk ve Gençlik Psikolojisi Dergisi 2026, Clt. 2(2) 38-67
ss. 38 - 67
Yayın Tarihi: May 24, 2026 | Görüntüleme Sayısı: 0/0 | İndirilme Sayısı: 0/0
Özet
In this study, the psychometric properties of the Child and Adolescent Trauma Screen (CATS) were examined in a Turkish sample of children and adolescents exposed to earthquake-related trauma, together with their parents. In addition, the structure of post-traumatic stress disorder (PTSD) symptoms and the interrelationships among symptoms were investigated using network analysis. The sample consisted of 233 children aged 7–17 years and 254 parents residing in an earthquake-affected region in Türkiye. Confirmatory Factor Analysis (CFA) and Exploratory Structural Equation Modeling (ESEM) were conducted to evaluate the factorial validity of the CATS based on both DSM-5 and ICD-11 diagnostic frameworks. Model comparisons indicated that ICD-11–based structures generally demonstrated better fit indices than DSM-5–based structures. Moreover, ESEM models consistently outperformed CFA models across both self-report and caregiver-report forms, suggesting that allowing cross-loadings provided a more realistic representation of the latent symptom structure. In addition, network analysis was applied to examine symptom-level associations in both child and parent reports. Dysphoric Arousal and Re-experiencing symptoms emerged as more central nodes across both networks, whereas Avoidance and Anhedonia-related symptoms were relatively more peripheral. Furthermore, centrality analyses suggested that certain symptoms, particularly hyperarousal-related indicators, played a key role in connecting symptom clusters across both child and parent networks. Overall, the findings support the cross-cultural validity of the CATS in Turkish samples, highlight the superiority of ESEM over CFA in modeling PTSD symptom structure, and underscore the value of a multi-informant approach in understanding PTSD symptom organization following earthquake-related trauma.
Anahtar kelimeler: Traumatized child, CATS, ESEM, network analysis
APA 7th edition
CIMEN, F., & SECER, I. (2026). Turkish Adaptation of the Child and Adolescent Trauma Screen (CATS): Psychometric Evaluation of Child Self-Report and Caregiver Forms Using Exploratory Structural Equation Modeling and Network Analysis. Çocuk ve Gençlik Psikolojisi Dergisi, 2(2), 38-67.
Harvard
CIMEN, F. and SECER, I. (2026). Turkish Adaptation of the Child and Adolescent Trauma Screen (CATS): Psychometric Evaluation of Child Self-Report and Caregiver Forms Using Exploratory Structural Equation Modeling and Network Analysis. Çocuk ve Gençlik Psikolojisi Dergisi, 2(2), pp. 38-67.
Chicago 16th edition
CIMEN, Fatmanur and Ismail SECER (2026). "Turkish Adaptation of the Child and Adolescent Trauma Screen (CATS): Psychometric Evaluation of Child Self-Report and Caregiver Forms Using Exploratory Structural Equation Modeling and Network Analysis". Çocuk ve Gençlik Psikolojisi Dergisi 2 (2):38-67.
Akaike, H. (1974). A new look at the statistical model identification. IEEE Transactions on Automatic Control, 19, 716-723. https://doi.org/10.1109/TAC.1974.1100705
Akkuş, P. Z., Serdaroğlu, E., Kömürlüoğlu, A., Asena, M., Bahadur, E. İ., Özdemir, G., . . . Özmert, E. N. (2021). Screening traumatic life events in preschool aged children: Cultural adaptation of Child and Adolescent Trauma Screen (CATS) Caregiver-report 3-6 years version. The Turkish Journal of Pediatrics, 63, 95-101. https://doi.org/10.24953/turkjped.2021.01.011
Alamer, A. (2022). Exploratory structural equation modeling (ESEM) and bifactor ESEM for construct validation purposes: Guidelines and applied example. Research Methods in Applied Linguistics, 1(1), 100005. https://doi.org/10.1016/j.rmal.2022.100005
Alisic, E., Zalta, A. K., van Wesel, F., Larsen, S. E., Hafstad, G. S., Hassanpour, K., & Smid, G. E. (2014). Rates of post-traumatic stress disorder in trauma-exposed children and adolescents: Meta-analysis. British Journal of Psychiatry, 204 (5), 335-340. https://doi.org/10.1192/bjp.bp.113.131227
An, Y., Zhao, J., Shi, J., & Hou, W. K. (2022). Network analysis of posttraumatic stress disorder symptoms among adolescent survivors of a major disaster in China. Psychological Trauma: Theory, Research, Practice, and Policy, 14(1), 132–140. https://doi.org/10.1037/tra0001053
APA. (1980). Diagnostic and statistical manual of mental disorders, DSM-III (3. edition). Washington, DC: American Psychiatric Association.
APA. (1994). Diagnostic and statistical manual of mental disorders, DSM-IV (4. edition). Washington, DC: American Psychiatric Association.
APA. (2013). Diagnostic and Statistical Manual of Mental Disorders(fifth edition (DSM-V)). Arlington, VA.
Armour, C., Tsai, J., Durham, T. A., Charak, R., Biehn, T. L., Elhai, J. D., & Pietrzak, R. H. (2015). Dimensional structure of DSM-5 posttraumatic stress symptoms: support for a hybrid Anhedonia and Externalizing Behaviors model. Journal of Psychiatric Research, 61, 106–113. https://doi.org/10.1016/j.jpsychires.2014.10.012
Armour, C., Contractor, A., Shea, T., Elhai, J. D., & Pietrzak, R. H. (2016). Factor Structure of the PTSD Checklist for DSM-V. The Journal of Nervous and Mental Disease, 204(2), 108-115. https://doi.org/10.1097/NMD.0000000000000430
Asparouhov, T., & Muthén, B. (2009). Exploratory structural equation modeling. Structural Equation Modeling: A Multidisciplinary Journal, 16, 397–438. https://doi.org/10.1080/10705510903008204
Benfer, N., Bardeen, J. R., Spitzer, E. G., & Rogers, T. A. (2021). A network analysis of two conceptual approaches to the etiology of PTSD. Journal of Anxiety Disorders, 84, 102479. https://doi.org/10.1016/j.janxdis.2021.102479Benfer
Birkeland, M. S., Greene, T., & Spiller, T. R. (2020). The network approach to posttraumatic stress disorder: A systematic review. European Journal of Psychotraumatology, 11, 1700614. https://doi.org/10.1080/20008198.2019.1700614
Bloch, F., Jackson, M. O., & Tebaldi, P. (2023). Centrality measures in networks. Social Choice and Welfare, 61, 413–453. https://doi.org/10.1007/s00355-023-01456-4
Borsboom, D. (2017). A network theory of mental disorders. World Psychiatry, 16(1), 5-13. https://doi.org/10.1002/wps.20375
Bridges-Curry, Z., Christian, C., & Levinson, C. A. (2022). Network analysis of PTSD symptoms in a sample of polyvictimized youth. Journal of Trauma & Dissociation, 23(4), 401-415. https://doi.org/10.1080/15299732.2021.1989115
Bringmann, L. F., Elmer, T., Epskamp, S., Krause, R. W., Schoch, D., Wichers, M., . . . Snippe, E. (2019). What do centrality measures measure in psychological networks? Journal of Abnormal Psychology, 128(8), 892-903. https://doi.org/10.1037/abn0000446
Cao, X., Wang, L., Cao, C., Zhang, J., & Elhai, J. D. (2017). DSM-5 Posttraumatic Stress Disorder Symptom Structure in Disaster-Exposed Adolescents: Stability across Gender and Relation to Behavioral Problems. Journal of Abnormal Child Psychology, 45(4), 803–814. https://doi.org/10.1007/s10802-016-0193-1
Chafouleas, S. M., Koriakin, T. A., Roundfield, K. D., & Overstreet, S. (2019). Addressing childhood trauma in school settings: A framework for evidence-based practice. School Mental Health, 11(1) , 40-53. https://doi.org/10.1007/s12310-018-9256-5
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. https://doi.org/10.1111/acps.12956
Cohen, J. A. (2010). Practice parameter for the assessment and treatment of children andadolescents with posttraumatic stress disorder. Journal of the American Academy of Child & Adolescent Psychiatry, 49(4), 414-430. https://doi.org/10.1016/j.jaac.2009.12.020
Cramer, A. O., Waldorp, L. J., van der Maas, H. L., & Borsboom, D. (2010). Comorbidity: a network perspective. The Behavioral and Brain Sciences, 33(2-3), 137–193. https://doi.org/10.1017/S0140525X09991567
Çeri, V., Hamidi, F., Çakır, B., Bilaç, Ö., İz, M., İz, F. B. A., & Aydemir, Ö. (2021). Child revised impact of event scale (CRIES): validity and reliability study of Turkish version. Neuropsychiatric Investigation, 59(1), 21-26. http://dx.doi.org/10.5455/NYS.20201101115427
Çimen, F., & Seçer, İ. (2025). The psychometric properties of the International Trauma Questionnaire–Child and Adolescent version in Turkish culture. European Journal of Psychotraumatology, 16(1), 2590402. https://doi.org/10.1080/20008066.2025.2590402
Çimen, F., Seçer, İ. (2026). Academic adjustment in children and adolescents with adverse childhood experiences: A multi-level meta-analysis. European Journal of Psychology of Education, https://doi.org/10.1007/s10212-026-01139-5
Çimen, F., Seçer, İ., & Pakiş, A. K. (2025). Assessment of PTSD and CPTSD Symptoms in Children and Adolescents Exposed to Earthquakes: An Evaluation Using Latent Profile. Clinical Psychology & Psychotherapy, 32(6), e70168. https://doi.org/10.1002/cpp.70168
Çimen, F., Seçer, İ., Alberici, A., & Meiser-Stedman, R. (2026). Psychometric evaluation of the Turkish adapted posttraumatic safety-seeking Behaviours scale (CSBS) and network analysis of PTSD symptoms in earthquake-exposed children and adolescents. Clinical Child Psychology and Psychiatry, 31(2), 825-843. https://doi.org/10.1177/13591045251396299
Dowdy-Hazlett, T., Killian, M., & Woods, M. (2021). Measurement of traumatic experiences of children within survey and intervention research: A Systematic Review of the Child and Adolescent Trauma Screen. Children and Youth Services Review, 131, 106259. https://doi.org/10.1016/j.childyouth.2021.106259
Düken, M.E., Küçükoğlu, S., & Kılıçaslan, F. (2025). Investigation of posttraumatic stress and depression symptoms in children who experienced the Kahramanmaraş earthquake. Journal of the American Psychiatric Nurses Association, 31(2) 165–175. https://doi.org/10.1177/10783903241257631
Ehlers, A., & Clark, D. M. (2000). A cognitive model of posttraumatic stress disorder. Behaviour Research and Therapy, 38(4), 319–345. https://doi.org/10.1016/s0005-7967(99)00123-0
Eklund, K., Rossen, E., Koriakin, T., Chafouleas, S. M., & Resnick, C. (2018). A systematicreview of trauma screening measures for children and adolescents. School Psychology Quarterly, 33, 30-43. https://doi.org/10.1037/spq0000244
Forbes, D., Lockwood, E., Creamer, M., Bryant, R. A., McFarlane, A. C., Silove, D., Nickerson, A., & O'Donnell, M. (2015). Latent structure of the proposed ICD-11 post-traumatic stress disorder symptoms: implications for the diagnostic algorithm. The British Journal of Psychiatry, 206(3), 245–251. https://doi.org/10.1192/bjp.bp.114.150078
Friedman, M. J. (2013). Finalizing PTSD in DSM-V: Getting here from there and where to go next. Journal of Trauma Stress, 26(5), 548-556. https://doi.org/10.1002/jts.21840
Garabiles, M. R., Mordeno, I. G., & Nalipay, J. N. (2023). A comparison of DSM-V and ICD-11 models of PTSD: Measurement invariance and psychometric validation in Filipino trauma samples. Journal of Psychiatric Research, 163, 24-31. https://doi.org/10.1016/j.jpsychires.2023.05.006
Hansen, M., Hyland, P., Armour, C., Shevlin, M., & Elklit, A. (2015). Less is more? Assessing the validity of the ICD-11 model of PTSD across multiple trauma samples. European Journal of Psychotraumatology, 6, 28766. https://doi.org/10.3402/ejpt.v6.28766
JASP Team (2019). JASP (Version 0.11.1) [Computer software]
Karatzias, T., Shevlin, M., Hyland, P., Ben-Ezra, M., Cloitre, C., Owkzarek, M., & McElroy, E. (2020). The network structure of ICD-11 complex post-traumatic stress disorder across different traumatic life events. World Psychiatry Official Journal of the World Psychiatric Association (WPA), 19 (3), 400-401. https://doi.org/10.1002/wps.20795
Kessler, R. C., Aguilar-Gaxiola, S., Alonso, J., Benjet, C., Bromet, E. J., Cardoso, G., . . . Karam, E. G. (2017). Trauma and PTSD in the WHO World Mental Health Surveys. European Journal of Psycotraumatology, 8, 1353383. https://doi.org/10.1080/20008198.2017.1353383
Kline, R. B. (2016). Principles and practice of structural equation modeling (Fourth Edition). New York: The Guilford Press.
Knefel, M., Karatzias, T., Spinazzola, J., Shevlin, M., & Ford, J. D. (2023). The relationship of posttraumatic stress disorder and developmental trauma disorder with childhood psychopathology: A network analysis. Journal of Anxiety Disorders, 99, 102766. https://doi.org/10.1016/j.janxdis.2023.102766
Lehmann, S., Breivik, K., Monette, S., & Minnis, H. (2020). Potentially traumatic events in foster youth, and association with DSM-V trauma- and stressor related symptoms. Child Abuse & Neglect, 101, 104374. https://doi.org/10.1016/j.chiabu.2020.104374
Li, J., Jin, Y., Xu, Y., Wilson, A., Chen, C., & Wang, Y. (2024). Hazardous drinking in young adults with co-occurring PTSD and psychosis symptoms: A network analysis. Journal of Affective Disorders, 351, 588-597. https://doi.org/10.1016/j.jad.2024.01.261
Lieberman, A. F., & Van Horn, P. (2009). Giving voice to the unsayable: Repairing the effects of trauma in infancy and early childhood. Child and Adolescent Psychiatric Clinics of North America, 18, 707–720. https://doi.org/10.1016/j.chc.2009.02.007
Liu, L., Wang, L., Cao, C., Qing, Y., & Armour, C. (2016). Testing the dimensional structure of DSM-5 posttraumatic stress disorder symptoms in a nonclinical trauma-exposed adolescent sample. Journal of Child Psychology and Psychiatry, and Allied Disciplines, 57(2), 204–212. https://doi.org/10.1111/jcpp.12462
Ma, Z., Zhu, Y., Tao, Y., Yang, Z., Huang, S., Liu, W., . . . Fan, F. (2022). Using network analysis to explore the key bridge symptoms between posttraumatic stress symptoms and posttraumatic growth among survivors 10 years after the Wenchuan earthquake in China. Journal of Psychiatric Research, 150, 173-179. https://doi.org/10.1016/j.jpsychires.2022.03.011
Maercker, A., Brewin, C. R., Bryant, R. A., Cloitre, M., van Ommeren, M., Jones, L. M., Humayan, A., Kagee, A., Llosa, A. E., Rousseau, C., Somasundaram, D. J., Souza, R., Suzuki, Y., Weissbecker, I., Wessely, S. C., First, M. B., & Reed, G. M. (2013). Diagnosis and classification of disorders specifically associated with stress: proposals for ICD-11. World Psychiatry, 12(3), 198–206. https://doi.org/10.1002/wps.20057
Marsh, H., Morin, A., Parker, P., & Kaur, G. (2014). Exploratory structural equation modeling: An integration of the best features of exploratory and confirmatory factor analysis. Annual Review of Clinical Psychology, 10, 85-110. https://doi.org/10.1146/annurev-clinpsy-032813-153700
McElroy, E., Shevlin, M., Murphy, S., Roberts, B., Makhashvili, N., Javakhishvili, J., Bisson, J., Ben-Ezra, M., & Hyland, P. (2019). ICD-11 PTSD and complex PTSD: structural validation using network analysis. World Psychiatry, 18(2), 236–237. https://doi.org/10.1002/wps.20638
McLaughlin, K. A., Koenen, K. C., Hill, E. D., Petukhova, M., Sampson, N. A., Zaslavsky, A. M., & Kessler, R. C. (2013). Trauma exposure and posttraumatic stress disorder in a national sample of adolescents. Journal of the American Academy of Child and Adolescent Psychiatry, 52(8), 815–830.e14. https://doi.org/10.1016/j.jaac.2013.05.011
Menand, E., & Cox, L. J. (2022). The overlap between Trauma & Disruptive Behavior Disorders. Not Just Bad Kids, 251–289. https://doi.org/10.1016/b978-0-12-818954-2.00033-x
Miller, M. W., & Sadeh, N. (2014). Traumatic stress, oxidative stress and post-traumatic stress disorder: neurodegeneration and the accelerated-aging hypothesis. Molecular Psychiatry, 19(11), 1156-1162. https://doi.org/10.1038/mp.2014.111
Morin, A. J., Meyer, J. P., Creusier, J., & Biétry, F. (2015). Multiple-group analysis of similarity in latent profile solutions. Organizational Research Methods, 19(2), 231-254. https://doi.org/10.1177/1094428115621148
Nilsson, D., Dävelid , I., Ledin, S., & Svedin, C. G. (2021). Psychometric properties of the Child and Adolescent Trauma Screen (CATS) in a sample of Swedish children. Nordic Journal of Psychiatry, 75(4), 247-256. https://doi.org/10.1080/08039488.2020.1840628
Nilsson, D., Dävelid, I., Ledin, S., & Svedin, C. G. (2020). Psychometric properties of the Child and Adolescent Trauma Screen (CATS) in a sample of Swedish children. Nordic Journal of Psychiatry, 75(4), 247-256. https://doi.org/10.1080/08039488.2020.1840628
Pai, A., Suris, A. M., & North, C. S. (2017). Posttraumatic Stress Disorder in the DSM-V: Controversy, change, and conceptual considerations. Behavioral Sciences, 7(1), 1-7. https://doi.org/10.3390/bs7010007
Pietrzak , R. H., Tsai , J., Armour , C., Mota , N., Harpaz-Rotem, I., & Southwick , S. M. (2015). Functional significance of a novel 7-factor model of DSM-V PTSD symptoms: Results from the National Health and Resilience in Veterans study. Journal of Affective Disorders, 174, 522–526. https://doi.org/10.1016/j.jad.2014.12.007
Qi, J., Ye, Y., Sun, R., Zhen, R., & Zhou, X. (2023). Comorbidity of posttraumatic stress disorder and depression among adolescents following an earthquake: A longitudinal study based on network analysis. Journal of Affective Disorders, 324, 354-363. https://doi.org/10.1016/j.jad.2022.12.119
Raftery, A. E. (1995). Bayesian model selection in social research. Sociological Methodology, 25, 111-163. https://doi.org/10.2307/271063
Robinaugh , D. J., Hoekstra , R. H., Toner , E. R., & Borsboom, D. (2020). The network approach to psychopathology: a review of the literature 2008–2018 and an agenda for future research. Psychological Medicine, 50(3), 353-366. https://doi.org/10.1017/S0033291719003404
Sachser, C., Berliner , L., Holt, T., Jensen, T., Jungbluth, N., Risch, E., . . . Goldbeck, L. (2017). Comparing the dimensional structure and diagnostic algorithms between DSM-V and ICD-11 PTSD in children and adolescents. European Child & Adolescent Psychiatry, 27, 181-190. https://doi.org/10.1007/s00787-017-1032-9
Sadeh, N., Miller, M. W., Wolf, E. J., & Harkness, K. L. (2015). Negative emotionality and disconstraint influence PTSD symptom course via exposure to new major adverse life events. Journal of Anxiety Disorders, 31, 20–27. https://doi.org/10.1016/j.janxdis.2015.01.003
Saini, S. M., Hoffmann, C. R., Pantelis, C., Everall, I. P., & Bousman, C. A. (2019). Systematic review and critical appraisal of child abuse measurement instruments. Psychiatry Research, 272, 106-113. https://doi.org/10.1016/j.psychres.2018.12.068
Saxe, G., Chawla, N., Stoddard, F., Kassam-Adams, N., Courtney, D., Cunningham, K., . . . King, L. (2003). Child stress disorders checklist: A measure of ASD and PTSD in children. Journal of the American Academy of Child & Adolescent Psychiatry, 42(8), 972-978. https://doi.org/10.1097/01.CHI.0000046887.27264.F3
Seçer, İ., Briegel, W., & Çimen, F. (2024). Turkish Validity and Reliability Study of Child stress disorders checklist [Oral Presentation]. Burdur: 2. International 21. Century Educational Research Congress.
Soberón, C., Crespo, M., Del Mar Gómez-Gutiérrez, M., Fernández-Lansac, V., & Armour, C. (2016). Dimensional structure of DSM-5 posttraumatic stress symptoms in Spanish trauma victims. European Journal of Psychotraumatology, 7, 32078. https://doi.org/10.3402/ejpt.v7.32078
van den Hout, M. A., & Engelhard, I. M. (2004). Pretrauma neuroticism, negative appraisals of intrusions, and severity of PTSD symptoms. Journal of Psychopathology and Behavioral Assessment, 26(3), 181-183. https://psycnet.apa.org/doi/10.1023/B:JOBA.0000022110.17639.60
van Zyl, L. E., & ten Klooster, P. M. (2022). Exploratory structural equation modeling: Practical guidelines and tutorial with a convenient online tool for Mplus. Frontiers in Psychiatry, 12, 795672. https://doi.org/10.3389/fpsyt.2021.795672
Wang, L., Zhang, L., Armour, C., Cao, C., Qing, Y., Zhang, J., Liu, P., Zhang, B., Wu, Q., Zhao, Z., & Fan, G. (2015). Assessing the underlying dimensionality of DSM-5 PTSD symptoms in Chinese adolescents surviving the 2008 Wenchuan earthquake. Journal of Anxiety Disorders, 31, 90–97. https://doi.org/10.1016/j.janxdis.2015.02.006
Weathers, F.W., Litz, B.T., Keane, T.M., Palmieri, P.A., Marx, B.P., & Schnurr, P.P. (2013). The PTSD Checklist for DSM-V (PCL-5). http://www.ptsd.va.gov/
Yakşi, N., & Eroğlu, M. (2024). Determinants of Posttraumatic Stress Disorder (PTSD) among children and adolescents in the subacute stage of Kahramanmaras earthquake, Turkey. Archives of Public Health, 82(199), 8-12. https://doi.org/10.1186/s13690-024-01434-x
Zhang L., Pan R., Cai Y., Pan J. (2021) The prevalence of post-traumatic stress disorder in the general population during the COVID-19 pandemic: A systematic review and single-arm meta-analysis. Psychiatry Investigation, 18(5), 426–433. https://doi.org/10.30773/pi.2020.0458
Zhou, X., Wu, X., & Zhen, R. (2017). Assessing the latent structure of DSM-V PTSD among Chinese adolescents after the Ya’an earthquake. Psychiatry Research, 254, 33-39. https://doi.org/10.1016/j.psychres.2017.04.029