Tunisian validation of the Children's Revised Impact of Event Scale 13

Post-traumatic stress disorder (PTSD) is a common consequence of traumatic experiences in children, highlighting the need for culturally adapted screening instruments. The objective of this study was to translate and validate the self-report questionnaire, the Children's Revised Impact of Event Scale-13 (CRIES-13), into Tunisian Arabic.

We conducted a cross-sectional study among children aged eight to 18 years, recruited from the Child and Adolescent Psychiatry Department of Mongi Slim Hospital between February 2024 and February 2025, who had experienced a stressful life event. Non-inclusion criteria included insufficient cognitive or linguistic abilities to complete the questionnaire. Exclusion criteria were refusal to participate and incomplete questionnaires. The CRIES-13 questionnaire was translated using the forward-backward translation method. Its psychometric properties were evaluated in terms of content validity, reliability, and construct validity. The internal structure was assessed using confirmatory factor analysis. For preliminary external validation, the Tunisian version of the Clinician-Administered PTSD Scale for Children and Adolescents, Fifth Edition (CAPS-CA-5), was used.

A total of 300 children were included in the study. The translated version was deemed satisfactory. Internal consistency was good, with a Cronbach's alpha of 0.841. Item - subscale correlations were statistically significant and conceptually coherent. Confirmatory factor analysis supported the three-factor model and demonstrated acceptable model fit indices, as follows: χ²/df=2.78; root mean square error of approximation (RMSEA)=0.077; Standardized Root Mean Square Residual=0.092; Comparative Fit Index=0.897; Tucker-Lewis Index=0.871; Goodness-of-Fit Index=0.918; Adjusted Goodness-of-Fit Index=0.880; and Akaike Information Criterion=230. Statistically significant correlations were found between the CRIES-13 and its external validator, the Clinician-Administered PTSD Scale for Children and Adolescents, Fifth Edition (CAPS-CA-5) (r=0.897; P<0.01).

The Tunisian Arabic version of the CRIES-13 demonstrated satisfactory psychometric properties. It can be considered a reliable and valid screening tool for PTSD among Tunisian children.