Psychometric Evaluation of the Turkish Adapted Posttraumatic Safety-Seeking Behaviours Scale (CSBS) and Network Analysis of PTSD Symptoms in Earthquake-Exposed Children and Adolescents

BackgroundThe Child Safety Behaviour Scale (CSBS) has been used in children and adolescents who have experienced a traumatic event and measures post-traumatic safety-seeking behaviours.ObjectiveThis study aimed to examine the rates of PTSD in children and adolescents exposed to a Turkish earthquake and to adapt the CSBS to Turkish culture and test its validity and reliability.MethodThe research sample consisted of 265 children and adolescents who experienced the 6 February 2023 earthquakes that took place in Hatay, Türkiye. Exploratory structural equation modelling (ESEM) and confirmatory factor analysis (CFA) were used to determine the construct validity of the adapted CSBS scale. In addition, direct and indirect relationships between safety-seeking behaviours and posttraumatic stress symptoms were evaluated by network analysis.ResultsWe found that more than half of the children and adolescents had moderate-high severity PTSD symptoms. The model created with CFA fits the data structure better and has high reliability values compared to ESEM, and it was concluded that the use of the scale in Turkish culture is valid and reliable. CFA and ESEM confirmed the two-factor model comprising "strategic hypervigilance" and "affective suppression" as key safety-seeking behaviours involved in PTSD. In addition, network analysis revealed that hyperarousal was the most important symptom linking PTSD symptoms and safety-seeking behaviours and was directly related to affective suppression.ConclusionsEven two years after the earthquake, the prevalence of moderate and high PTSD symptoms among children and adolescents was observed. The use of the CSBS for the assessment of safety-seeking behaviours emerging after trauma was found to be valid and reliable in Turkish culture. It was seen that hyperarousal was the central symptom among PTSD symptoms and was directly related to emotional suppression among safety-seeking behaviours.