Evaluating traumatic event scoring schemas for their predictive value to concurrent diagnostic profiles: Texas Childhood Trauma Research Network

Background: To prospectively chart pathways of risk and resiliency following childhood trauma studies need to address three limitations of prior work: 1) recruit beyond social service/ treatment settings; 2) include broad spectrum of trauma types and 3) cast a broad longitudinal measurement framework of both clinical diagnoses and traumatic exposures. The Texas-Childhood Trauma Research Network (TX-CTRN) is a multi-site collaboration that addresses these limitations. In this baseline-only report, we examined domains of trauma and evaluated the concurrent predictive validity of various traumatic event scoring schemas for clinical diagnoses. Methods: Broad-base recruitment of 8–20 year-olds (N = 1289) included trauma centers, emergency departments, pediatric and primary care clinics, and other community settings. Assessments were comprehensive and based on clinical interviews by trained research interviewers. Results: Factor analyses supported a five-factor solution of trauma domains including unintentional/acute, intentional/interpersonal, bullying, in-home versus community witnessed interpersonal harms. Trauma burden scoring schemas were examined for their predictive superiority. Domain-specific counts of traumas that met DSM-5 post-traumatic-stress disorder (PTSD) Criterion-A was the best overall schema in distinguishing among youth with no diagnosis, comorbidities, those with depression, suicidality, substance misuse, and PTSD. Limitations: There were no assessments of neglect. Conclusions: Findings largely aligned with earlier studies on the relative importance of intentional interpersonal traumas and showed bullying may be an important source of traumatic stress that independently adds to prediction of several diagnoses and should be considered in clinical practice.