Distress symptoms among urban African American children and adolescents: a psychometric evaluation of the Checklist of Children's Distress Symptoms.

OBJECTIVES To explore the factor structure of the Checklist of Children's Distress Symptoms (CCDS); to examine whether there is a higher-order single construct underlying the CCDS measure; and, to assess the association between children's distress symptoms, as reflected by the CCDS factors, and children's self-reported exposure to community violence (both victimization and witness events). DESIGNS Community-based cross-sectional survey. SETTINGS Ten public housing developments in an eastern metropolis. PARTICIPANTS A total of 349 low-income urban African American children and adolescents (198 males; 151 females), 9 through 15 years of age. MEASURES Children's distress symptoms, exposure to community violence, and selected demographic information including parental education, parental employment status, perceived health status, and school performance. ANALYSIS Exploratory factor analysis was performed to determine the factorial structure of the CCDS measure. Second-order confirmatory factor analysis was performed to determine if there is a higher-order single underlying construct among CCDS factors. Pearson correlation coefficients were computed to assess the relationship between exposure to violence and CCDS factors. MAJOR FINDINGS The exploratory factor analysis yielded a 6-factor solution for the CCDS measure with satisfactory internal consistency. The confirmatory factor model with a single second-order construct yielded a good fit to the data. In general, youth who experienced violent victimization or witnessed violent events reported higher levels of distress symptoms than those who did not. Distress symptoms labeled as "intrusive thoughts," "distraction," and "lack of belongingness" were most frequently associated with exposure to violence. Distress symptoms did not differ on the basis of sex or age. CONCLUSIONS The CCDS has utility as a measure of distress symptoms among urban African American children and adolescents. Whereas analysis provided support for a single higher-order construct, using the proposed 6-factor structure should enhance our understanding of the psychological impact of exposure to violence on youth and contribute to more effective intervention efforts.