Development and Psychometric Validation of the Pandemic-Related Traumatic Stress Scale for Children and Adults

Courtney K. Blackwell, Phillip Sherlock, Kathryn L. Jackson, Julie A. Hofheimer, David Cella, Molly A. Algermissen, Akram N. Alshawabkeh, Lyndsay A. Avalos, Tracy Bastain, Clancy Blair, Michelle Bosquet Enlow, Patricia A. Brennan, Carrie Breton, Nicole R. Bush, Aruna Chandran, Shaina Collazo, Elisabeth Conradt, Sheila E. Crowell, Sean Deoni, Amy J. ElliottJean A. Frazier, Jody M. Ganiban, Diane R. Gold, Julie B. Herbstman, Christine Joseph, Margaret R. Karagas, Barry Lester, Jessica A. Lasky-Su, Leslie D. Leve, Kaja Z. LeWinn, W. Alex Mason, Elisabeth C. McGowan, Kimberly S. McKee, Rachel L. Miller, Jenae M. Neiderhiser, Thomas G. O’Connor, Emily Oken, T. Michael O’Shea, David Pagliaccio, Rebecca J. Schmidt, Anne Marie Singh, Joseph B. Stanford, Leonardo Trasande, Rosalind J. Wright, Cristiane S. Duarte, Amy E. Margolis

Research output: Contribution to journalArticlepeer-review


To assess the public health impact of the COVID-19 pandemic on mental health, investigators from the National Institutes of Health Environmental influences on Child Health Outcomes (ECHO) research program developed the Pandemic-Related Traumatic Stress Scale (PTSS). Based on the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) acute stress disorder symptom criteria, the PTSS is designed for adolescent (13–21 years) and adult self-report and caregiver-report on 3–12-year-olds. To evaluate psychometric properties, we used PTSS data collected between April 2020 and August 2021 from non-pregnant adult caregivers (n = 11,483), pregnant/postpartum individuals (n = 1,656), adolescents (n = 1,795), and caregivers reporting on 3–12-year-olds (n = 2,896). We used Mokken scale analysis to examine unidimensionality and reliability, Pearson correlations to evaluate relationships with other relevant variables, and analyses of variance to identify regional, age, and sex differences. Mokken analysis resulted in a moderately strong, unidimensional scale that retained nine of the original 10 items. We detected small to moderate positive associations with depression, anxiety, and general stress, and negative associations with life satisfaction. Adult caregivers had the highest PTSS scores, followed by adolescents, pregnant/postpartum individuals, and children. Caregivers of younger children, females, and older youth had higher PTSS scores compared to caregivers of older children, males, and younger youth, respectively.

Original languageEnglish (US)
Pages (from-to)1054-1067
Number of pages14
JournalPsychological assessment
Issue number11
StatePublished - 2023


  • COVID-19
  • Mokken scaling
  • pandemic
  • survey
  • traumatic stress

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Clinical Psychology


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