In an analysis of the scores of 87 survivors of the sinking of
the Jupiter, it was found that the 62 children who received a
DSM diagnosis of PTSD scored 26.0 on the 8-item version
while the 25 who did not reach DSM criteria for a diagnosis
of PTSD only scored 7.8 (P < 0.001). Using these data, it
was found that a combined score (Intrusion + Avoidance) of
17 or more misclassied fewer than 10% of the children.
The 13-item version was used in a survey of 2,976 children
aged 9-14 years who had experienced the war in Mostar,
Bosnia (Smith, Perrin, Dyregrov and Yule, 2002). The
scale was translated into Bosnian and back-translated by
a separate Bosnian speaker to establish its accuracy. No
major differences were found between boys and girls in
respect of the factors identied and so only the total results
are presented here.
The Scales had satisfactory internal consistency. Cronbach
alphas were as follows:
Intrusion = 0.70; Avoidance = 0.73; Arousal = 0.60;
Total = 0.80
The analysis revealed a three-factor solution corresponding
to the three hypothesised sub-scales. The solution
accounted for 49.3% of the total variance.
Despite the theoretical criticisms often made against using
such self-completed scales in different cultures, the IES
has now been applied in a variety of cultures, including
studies with children. It is now clear that posttraumatic
stress symptoms in children are more similar across cultures
than they are different. Indeed, Intrusion and Arousal are
robust factors of the Impact of Event Scale in children from
We remind people using the scales that one cannot make a
clinical diagnosis from scores on the self-completed scales
alone. A proper clinical diagnosis relies on much more
detailed information obtained from a structured interview
that assesses not only the presence and severity of stress
symptoms, but also the impact on the child’s overall social
At present, there are no studies that have used the IES-13
and validated it against an independent clinical diagnosis.
Therefore, for screening purposes we recommend that
people use the results from the Intrusion and Avoidance
THE CHILDREN’S IMPACT OF EVENT SCALE (13) CRIES-13
scales only. If the sum of the scores on these two scales is
17 or more, then the probability is very high that that child
will obtain a diagnosis of PTSD.
Dyregrov, A., Kuterovac, G. & Barath, A.(1996) Factor
analysis of the Impact of Event Scale with children in war.
Scandinavian Journal of Psychology, 36, 339-350.
Horowitz, M. J., Wilner, N., and Alvarez, W. (1979). Impact
of event scale: A measure of subjective stress. Psychosom.
Med., 41, 209-218
Kuterovac, G., Dyregrov, A.& Stuvland, R. (1994) Children
in war: A silent majority under stress. British Journal of
Medical Psychology, 67, 363-375.
Smith, P., Perrin, S., Dyregrov, A. & Yule, W. (2002)
Principal components analysis of the Impact of Event Scale
with children in war. Personality and Individual Differences,
Weiss, D. S., & Marmar, C. R. (1997). The impact of
event scale-revised. In J. P. Wilson, & T. M. Keane (Eds.),
Assessing Psychological Trauma and PTSD. New York: The
Yule, W. (1992) Post Traumatic stress disorder in child
survivors of shipping disasters: The sinking of the “Jupiter”.
J. Psychother. Psychosomatics, 57, 200-205.
Yule, W. (1997) Anxiety, Depression and Post-Traumatic
Stress in Childhood. In I. Sclare (Ed) Child Psychology
Portfolio. Windsor: NFER-Nelson
Yule, W., Ten Bruggencate, S & Joseph, S. (1994) Principal
components analysis of the Impact of Event Scale in
children who survived a shipping disaster. Personality and
Individual Differences, 16, 685-691.