Children's Revised Impact of Event Scale – 13

The Children's Revised Impact of Event Scale (CRIES-13) is a validated, widely used self-report measure designed to screen for post-traumatic stress…

Questions: 13
Duration: 5 min
Original title: Children's Revised Impact of Event Scale – 13 items
Adaptation: Children's Revised Impact of Event Scale – 13
Authors: Perrin, S., Meiser-Stedman, R. & Smith, P.
Created: 2005

The Children's Revised Impact of Event Scale (CRIES-13) is a validated, widely used self-report measure designed to screen for post-traumatic stress disorder in children and adolescents. Originally adapted from the adult Impact of Event Scale, this 13-item version captures the three core symptom clusters of post-traumatic stress: intrusion, avoidance, and hyperarousal. By focusing on the direct psychological aftermath of a specific stressful event, the instrument helps clinicians identify youth who may require specialized trauma-focused support, acting as a structured PTSD symptoms checklist for pediatric populations.

Using a standardized measure like the CRIES-13 provides clinicians with a reliable, repeatable baseline that goes beyond clinical observation. It offers a structured way for children to report internalizing symptoms—such as intrusive images or persistent hypervigilance—that they might struggle to articulate in a standard clinical interview. Whether used during an initial assessment to recognize PTSD risk or to monitor treatment progress, the scale delivers actionable metrics to support diagnostic formulation and guide the pacing of therapeutic interventions.

Example result

Fictitious result, computed from a sample set of answers.

Overall score

27/ 65

Brief self-report questionnaire for children and adolescents aged 8 to 18 years, designed to screen for post-traumatic stress disorder (PTSD) following a potentially traumatic event. It assesses three symptom dimensions: intrusion, avoidance, and autonomic hyperarousal, over the past 7 days.

0–29

Screening threshold not met

30–65

Probable PTSD

The score falls below the threshold of 30 used by the source to suggest probable PTSD in children and adolescents. A below-threshold score does not replace clinical assessment after a potentially traumatic event.

généralemixed · general population · trauma-exposed, non-referred (emergency department) · 10–16 years · United Kingdom · n = 63 · 2005 · Perrin et al. (2005)

065

M = 21.3 ± 17.3

cliniquemixed · condition: PTSD · children referred to specialized clinic · 7–18 years · United Kingdom · n = 52 · 2005 · Perrin et al. (2005)

065

M = 37.8 ± 12.7

Scoring

Total sum and subscale sums, total score from 0 to 65, each item is rated on a 4-point scale (from 0 to 5).

Avoidance

6/ 20

Avoidance of thoughts, memories, and reminders of the event.

items 2, 6, 7, 10

généralemixed · general population · trauma-exposed, non-referred (emergency department) · 10–16 years · United Kingdom · n = 63 · 2005 · Perrin et al. (2005)

020

M = 7.7 ± 7.1

cliniquemixed · condition: PTSD · children referred to specialized clinic · 7–18 years · United Kingdom · n = 52 · 2005 · Perrin et al. (2005)

020

M = 12.5 ± 5.1

Intrusion

10/ 20

Re-experiencing and intrusive thoughts or images related to the event.

items 1, 4, 8, 9

généralemixed · general population · trauma-exposed, non-referred (emergency department) · 10–16 years · United Kingdom · n = 63 · 2005 · Perrin et al. (2005)

020

M = 5.3 ± 5.2

cliniquemixed · condition: PTSD · children referred to specialized clinic · 7–18 years · United Kingdom · n = 52 · 2005 · Perrin et al. (2005)

020

M = 11.4 ± 5.8

Hyperarousal

11/ 25

Autonomic hyperarousal symptoms: sleep, irritability, concentration, hypervigilance, startle response.

items 3, 5, 11, 12, 13

généralemixed · general population · trauma-exposed, non-referred (emergency department) · 10–16 years · United Kingdom · n = 63 · 2005 · Perrin et al. (2005)

025

M = 8.4 ± 6.9

cliniquemixed · condition: PTSD · children referred to specialized clinic · 7–18 years · United Kingdom · n = 52 · 2005 · Perrin et al. (2005)

025

M = 13.8 ± 5.1

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What the test measures

The CRIES-13 measures the frequency and severity of post-traumatic stress reactions in children and adolescents over the past seven days, anchored to a specific traumatic or stressful life event. It captures three distinct dimensions of the post-traumatic response:

Intrusion: The presence of unbidden, involuntary thoughts, images, and overwhelming feelings regarding the traumatic event.
Avoidance: The active effort to suppress memories, evade reminders, and avoid talking or thinking about what happened, which is a central maintaining factor in the Ehlers & Clark cognitive model of PTSD.
Hyperarousal: Elevated physiological reactivity of the autonomic nervous system, including sleep disturbances, exaggerated startle response, irritability, and hypervigilance.

This scale is specifically validated for children and adolescents aged 8 and older who have been exposed to potentially traumatizing events, helping to map their common reactions to trauma.

When and why to use it

Clinicians typically administer the CRIES-13 when a child has a known history of trauma or when symptoms of severe stress are suspected. It serves as a rapid, focused tool to evaluate the immediate psychological impact of a specific event.

Intake baseline: To establish a standardized symptom profile during the initial assessment of a trauma-exposed child, before exploring broader clinical pictures like Complex PTSD.
Screening for PTSD: To determine if the child's distress crosses the clinical threshold for probable PTSD, signaling the need for a comprehensive diagnostic interview.
Monitoring change: To track the trajectory of intrusion, avoidance, and arousal symptoms over time, evaluating whether therapeutic efforts successfully change avoidance and reduce distress.
Differential support: To clarify whether presenting issues—like sleep problems or behavioral outbursts—are rooted in a post-traumatic hyperarousal presentation.

Using a validated score adds objective clarity to the clinical impression, quantifying the severity of internal distress and helping to prioritize treatment targets.

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The questions

Below is a list of comments made by people after stressful life events. Please answer each question by indicating how frequently you have experienced these reactions during the past seven days.
1. Do you think about it even when you don't want to?
This item probes the occurrence of intrusive, unwanted thoughts about the trauma.
- Not at all
- Rarely
- Sometimes
- Often
2. Do you try to get the event out of your mind?
This item assesses the child's deliberate cognitive efforts to erase the memory of the event.
- Not at all
- Rarely
- Sometimes
- Often
3. Do you have trouble paying attention or concentrating?
This item evaluates cognitive disruption and concentration difficulties, often linked to hyperarousal.
- Not at all
- Rarely
- Sometimes
- Often
4. Do you suddenly get strong feelings about it?
This item screens for sudden, unprovoked surges of intense emotion tied to the trauma.
- Not at all
- Rarely
- Sometimes
- Often
5. Are you more easily scared or do you feel more jumpy than before the incident?
This item measures the exaggerated startle response and baseline nervousness following the event.
- Not at all
- Rarely
- Sometimes
- Often
6. Do you try to stay away from things that might remind you of the event? (e.g., places or situations)
This item captures behavioral avoidance of physical triggers, places, or situations associated with the trauma.
- Not at all
- Rarely
- Sometimes
- Often
7. Do you try not to talk about it?
This item examines the child's reluctance or refusal to speak about what happened.
- Not at all
- Rarely
- Sometimes
- Often
8. Do you get pictures of the event in your mind?
This item specifically identifies the presence of involuntary, distressing visual images of the event.
- Not at all
- Rarely
- Sometimes
- Often
9. Do other things make you think about it?
This item probes whether external cues frequently trigger unwanted thoughts about the trauma.
- Not at all
- Rarely
- Sometimes
- Often
10. Do you try not to think about the event?
This item assesses ongoing cognitive avoidance and attempts to block thoughts of the event.
- Not at all
- Rarely
- Sometimes
- Often
11. Do you get irritated easily?
This item evaluates post-traumatic irritability and reduced emotional tolerance.
- Not at all
- Rarely
- Sometimes
- Often
12. Are you on alert and watchful even when there's apparently no reason to be?
This item screens for hypervigilance and an elevated sense of ongoing threat.
- Not at all
- Rarely
- Sometimes
- Often
13. Do you have trouble sleeping?
This item identifies sleep disturbances commonly associated with post-traumatic physiological arousal.
- Not at all
- Rarely
- Sometimes
- Often