Determinants of PTSD symptom severity in child victims of violence in southern Algeria: A forensic cross-sectional study.

BACKGROUND

Violence against children often remains hidden in conservative societies where family honor and stigma discourage disclosure. Beyond physical harm, such violence is a major driver of post-traumatic stress symptoms. In Algeria, despite child protection laws, cases remain under-detected, particularly in southern regions with limited psychosocial resources.

OBJECTIVE

To identify socio-demographic, family and incident-related determinants of post-traumatic stress symptom severity among child victims of interpersonal violence in southern Algeria.

METHODS

A prospective cross-sectional study was conducted in the Department of Forensic Medicine, Hmida Ben Adjila Hospital (Laghouat), from November 2024 to February 2025. All children <18 years examined for confirmed interpersonal violence were included. A standardized trauma-informed case report form captured sociodemographic, family, perpetrator and incident characteristics. Post-traumatic stress symptoms were assessed with the Child post-traumatic stress disorder (PTSD) Symptom Scale for the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (CPSS-5); scores ≥31 defined probable PTSD. Bivariate analyses (high vs low CPSS-5 category) were performed for descriptive comparison, and a forced-entry multivariable linear regression model was used to identify factors independently associated with CPSS-5 total score.

RESULTS

Among 596 forensic examinations, 84 involved child victims of interpersonal violence (15.3%; mean age 11.8 ± 3.5 years; 63.1% boys); 46.4% exceeded the CPSS-5 cut-off for probable PTSD. In bivariate analyses, parental substance abuse, parental tobacco use, recent divorce, home-based assaults, verbal violence and economic violence were more frequent among children with high CPSS-5 scores. In the fully adjusted multivariable model, verbal violence remained independently associated with higher CPSS-5 scores (B = 13.589, p = 0.035), while sexual violence and assault location showed borderline associations. In a complementary model including parental tobacco use, conclusions were unchanged.

CONCLUSION

Nearly one in two child victims examined in this southern Algerian forensic department presented with probable PTSD-level symptom burden. Findings should be interpreted as preliminary and screening-level in an acute post-assault context. Systematic trauma-informed screening and family-centred referral pathways are needed in medico-legal and primary care settings.