Assessment of functional impairment related to post-traumatic stress in children and adolescents: a systematic review.

TL;DR

A systematic review of 30 studies identified 13 PTSS-specific instruments and generic functional impairment measures used in youth, but found substantial inconsistency in domains assessed, scoring methods, and reporting of psychometric properties, highlighting the need for standardized instruments.

Key findings

• Current PTSS assessment tools in children and adolescents vary widely in coverage of 11 different life domains without consensus on which domains should be included
• Scoring methods are heterogeneous, with roughly half using dichotomous formats and the remainder using multi-categorical scales
• Psychometric properties of functional impairment scales were reported in only 20.7% of the identified publications, limiting evidence-based instrument selection
• Functional impairment is a required diagnostic criterion for PTSD in DSM-5 and ICD-11, but assessment standardization remains inadequate

Why this matters at the bedside

Clinicians assessing PTSD in youth face inconsistent measurement tools with unclear psychometric validity, making standardized functional impairment assessment challenging and potentially affecting diagnostic accuracy and treatment monitoring.