Child Revised Impact of Events Scale (CRIES)

Overview

The Children’s Revised Impact of Event Scale (CRIES) is a brief child-friendly measure designed to screen children at risk for Post-Traumatic Stress Disorder (PTSD), developed by the Children and War Foundation (Perrin et al. 2005). The tool is designed for use with children aged 8 years and above who are able to read independently.

Both an 8-item and 13-item versions exist, and as the CRIES-8 performs equally well it is recommended over CRIES-13 as a screening tool.

Terms of use

The CRIES measures are free to use, but must not be amended without permission from the Children and War Foundation: https://www.childrenandwar.org/measures

Scales and subscales

Suitability

The CRIES-8 and CRIES-13 can be used with children and young people aged 8 to 18.

We are not currently aware of any evidence regarding the accessibility of this measure for children and young people with learning disabilities.

Although a range of studies have explored the validity and reliability of the CRIES in different populations, to our knowledge no study has been published regarding the suitability of the measure across different ethnic or linguistic groups.

Please do get in touch at CORC@annafreud.org if you are aware of any information that may be of interest to users of the measure as we may be able to update our webpage to include it.

Administration

The CRIES-8 is self-completed by children and young people and takes between 5 and 10 minutes to complete. Attention should be made to how it is introduced and explained to children and young people, providing opportunities to for them ask questions and discuss responses. The questionnaire refers to a stressful life event and this should be explained to users to also relate to a specific period of time in which stressful or traumatic events occurred.

For more guidance on how to use measures in collaboration with children and young people please take a look at a short video that CORC has produced: https://youtu.be/bU4n_WApnHc

Additional instructions have been developed, in addition to the standards CRIES-8 instructions, to facilitate the use of the measure with looked after children. More information can be found in Morris et al. (2015).

Working remotely

Provided below is a fillable PDF version of CRIES. To open and complete the PDF electronically you need access to PDF reader software on your computer, smartphone or tablet. If you don’t have this, one option that is free to download is Adobe Acrobat Reader.

Download here

For more information of working remotely with outcome measures, please read our guide: https://www.corc.uk.net/outcome-experience-measures/using-outcome-and-experience-measures-remotely/

Scoring & Interpretation

All items on the scale can be scored as follow:

Not at all = 0

Rarely = 1

Sometimes = 3

Often = 5

For the CRIES-8, two subscales can be calculated:

Intrusion = sum of items 1+3+6+7
Avoidance = sum of items 2+4+5+8

Total scores range from 0 to 40, with higher scores indicated higher PTSD symptoms.

For the CRIES-13, three subscales can be calculated:

Intrusion = sum of items 1+4+8+9
Avoidance = sum of items 2+6+7+10
Arousal = sum of items 3+5+11+12+13

Total scores range from 0 to 65, with higher scores indicated higher PTSD symptoms.

Psychometric properties

Property	Definition	CRIES-8 and CRIES-13
Internal consistency	Degree to which similar items within a scale correlate with each other.	Internal consistency was found to be good for the CRIES-8 and CRIES-13, for both the overall measures and individual sub-scales (e.g. Dyregrov et al. 1996; Giannopoulou et al. 2006).
Construct validity	Degree to which the questionnaire actually measures the specific trait or attribute it is intended to measure.	Current evidence generally supports a 3-factor structure of the CRIES-13 (e.g. Giannopoulou et al. 2006, Smith et al. 2001), however other studies also suggest that a 2-factor model may be appropriate (e.g. Pereira et al. 2020; Smith et al. 2003).
Test-retest reliability	Degree to which the same respondents have the same score after period of time when trait shouldn't have changed.	Test-retest reliability of both the CRIES-8 and CRIES-13 was found to be good over a 7-day period (Verlinden et al. 2014) and a 3.5-month period (Deeba et al. 2014).
Convergent validity	Degree to which two measures of constructs that theoretically should be related are in fact related.	The CRIES-8 and CRIES-13 were positively correlated with measures of anxiety and depression (e.g. Deeba et al. 2014; Lau et al. 2013).
Concurrent validity	Correlation of the measure with others measuring same concept.	The Intrusion sub-scale was positively correlated with the Intrusion sub-scale of the Children’s Post-Traumatic Stress Disorder Reaction Index, another measures of PTSD symptoms (Giannopoulou et al. 2006).
Discriminant validity	Lack of correlation with opposite concepts.	Children diagnosed with PTSD had significantly higher scores on the CRIES-8 compared to children without PTSD (Stallard et al. 1999).

Translation

There are a wide range of translations of the CRIES available on the Children and War Foundation website: https://www.childrenandwar.org/measures

Any clinician or researcher wishing to make a new language translation should get in touch with the Children and War Foundation. If a proper procedure (translation and back-translation) has been followed, the translation will be made available on their website.

Useful resources

For more information please visit the Children and War Foundation website at: http://www.childrenandwar.org/

References

Deeba, F., Rapee, R. M., & Prvan, T. (2014). Psychometric properties of the Children’s Revised Impact of Events Scale (CRIES) with Bangladeshi children and adolescents. PeerJ, 2, e536.

Dyregrov, A., Kuterovac, G., and Barath, A. (1996). "Factor analysis of the impact of event scale with children in war." Scandinavian journal of Psychology 37, 4:339-350.

Giannopoulou, I., Smith, P., Ecker, C., Strouthos, M., Dikaiakou, A., & Yule, W. (2006). Factor structure of the Children’s Revised Impact of Event Scale (CRIES) with children exposed to earthquake. Personality and Individual Differences, 40(5), 1027-1037.

Lau, J. T., Yeung, N. C., Yu, X. N., Zhang, J., Mak, W. W., & Lui, W. W. (2013). Validation of the Chinese version of the Children's Revised Impact of Event Scale (CRIES) among Chinese adolescents in the aftermath of the Sichuan Earthquake in 2008. Comprehensive psychiatry, 54(1), 83-90.

Morris, L., Salkovskis, P., Adams, J., Lister, A., & Meiser-Stedman, R. (2015). Screening for post-traumatic stress symptoms in looked after children. Journal of Children's Services.

Pereira, J., Vagos, P., Fonseca, A., Moreira, H., Canavarro, M. C., & Rijo, D. (2021). The Children's Revised Impact of Event Scale: dimensionality and measurement invariance in a sample of children and adolescents exposed to wildfires. Journal of Traumatic Stress, 34(1), 35-45.

Perrin, S., Meiser-Stedman, R., & Smith. P. (2005). The children’s revised impact of event scale (CRIES): validity as a screening instrument for PTSD. Behavioural and Cognitive Psychotherapy, 33, 487–498.

Smith, P., Perrin, S., Dyregrov, A., & Yule, W. (2003). Principal components analysis of the impact of event scale with children in war. Personality and individual differences, 34(2), 315-322.

Smith, P., Perrin, S., Yule, W., & Rabe‐Hesketh, S. (2001). War exposure and maternal reactions in the psychological adjustment of children from Bosnia‐Hercegovina. Journal of Child Psychology and Psychiatry, 42(3), 395-404.

Stallard, P., Velleman, R., and Baldwin, S. (1999). "Psychological screening of children for post‐traumatic stress disorder." Journal of Child Psychology and Psychiatry 40, 7: 1075-1082.

Verlinden, E., van Meijel, E. P., Opmeer, B. C., Beer, R., de Roos, C., Bicanic, I. A., ... & Lindauer, R. J. (2014). Characteristics of the Children's Revised Impact of Event Scale in a clinically referred Dutch sample. Journal of traumatic stress, 27(3), 338-344.