(PS1-A10) Trauma Informed Approaches to Assess COVID-19 Exposure in Children

Based on trauma literature, there are four common approaches to assess direct exposure (i.e., harm or threat of harm related to the trauma) and indirect exposure (i.e., witnessed another person experience the trauma or being related to the victim). “Categorical” captures whether trauma occurred (i.e., yes/no). “Sum of types” reports the total amount that occurred (Kan & Feinberg, 2010). “Severity weighted” captures the sum of occurrences weighted based on severity (Fortier et al., 2009). Lastly, “ordinal” ranks experiences based on severity and captures the most severe (Fortier et al., 2009). In studies of interpersonal violence (e.g., Kan & Feinberg, 2010), severity weighted has been found to be most sensitive in the prediction of mental health symptoms and overall distress.

Direct and indirect exposure to pandemics have been associated with children’s posttraumatic stress disorder (PTSD), anxiety, and depression severity (Hawryluck et al., 2004; Usami et al., 2012). Studies on the impact of COVID-19, measured using sum of types, found positive correlations with children’s PTSD, anxiety, and depression severity (Murata et al., 2020; Panda et al., 2020). Due to only using one assessment approach, we may not have the most sensitive understanding of the relation between COVID-19 exposure and children’s symptoms.

Using data from a study of COVID-19 exposure and mental health symptoms in 500 New York City children (ages 9-17; M = 13.9; SD = 1.8), we examined the four approaches for COVID-19 exposure. It was hypothesized that severity weighted will be the most sensitive in the prediction of children’s PTSD, anxiety, and depression severity. Child COVID-19 exposure, defined as illness or death in self, family, or friends, was assessed using the Child HELP Partnership Scale on Child Exposure to COVID-19 (Brown & Goodman, 2020) and was coded as: categorical (none, illness, illness & death exposure), sum of types (sum of equally weighted exposures), severity-weighted (sum of exposures coded by severity (e.g., response to first item was multiplied by 1, second item multiplied by two, etc.), and ordinal (most severe). Child PTSD, depression, and anxiety were assessed using the Child PTSD Symptom Scale for DSM-5 (CPSS-5; Foa et al., 2018), the Mood and Feelings Questionnaire (MFQ; Angold et al., 1995), and the Generalized Anxiety Disorder scale (GAD-7; Spitzer et al., 2006), respectively.

Correlations were conducted with COVID exposure variables (categorical, sum of types, severity-weighted, ordinal) and PTSD, depression, and anxiety severity. Results revealed sum of types, severity-weighted, and ordinal were significantly positively associated with child PTSD, depression, and anxiety severity. Severity weighted was the most sensitive (PTSD r = .221, depression r = .248, anxiety r = .216) and sum of types was the second most sensitive (PTSD r = .210, depression r =.236, anxiety r = .215). However, the sensitivity of sum of types and severity weighted were not significantly different for PTSD (CI -.025, .002), anxiety (CI -.012, .014), or depression (CI -.026, .001). Categorical was not significantly associated with any outcomes. Implications related to intervention and assessment of COVID-19 exposure and virus-related outbreaks will be discussed.