Protective Factors Based Model for Screening for Posttraumatic Distress in Adolescents

Background: There is growing application of school-based screening to identify post-traumatic distress in students following exposure to trauma. The consensus method is based on self-report questionnaires that assess posttraumatic symptoms, functional impairment, depression or anxiety. Objective: The current research explored the possibility of using a model, based on the assessment of protective factors, as a screening method for identifying youth who may suffer from posttraumatic distress and need professional help in the aftermath of war. Method: Participants were 482 Israeli high-school students who were exposed to ongoing missile attacks during Operation Cast Lead in Gaza in 2008. The data collected included symptom scales and three protective factor scales assessing perceived self-efficacy, cognitive-emotion regulation and flexibility in the use of various coping strategies. Results: The results showed that all three protective factors were significant predictors of symptom severity. The protective-factor-based model utilized logistic regression and receiver operating characteristics analysis. The model correctly classified 84 % of adolescents presenting with probable post traumatic stress disorder, identifying them as distressed. Cross-validation was conducted to assess the stability and reliability of the model, which were found to be acceptable. Conclusion: The protective factors based model could be important as a part of preliminary triage before referral for intervention and for identification of distressed adolescents. School based screening which focuses on assessing protective factors may facilitate cooperation by both adolescent students and the education system.