Short Post-Traumatic Stress Disorder Rating Interview (SPRINT)

The SPRINT is a brief, global assessment for post-traumatic stress disorder (PTSD) that assesses symptoms of intrusion, avoidance, numbing and arousal, and related aspects of PTSD (somatic distress, stress vulnerability and impairment in function). Developed by Connor & Davidson (2001) for use with adults (18+ years), its design followed a need for a less time consuming, yet structured PTSD-specific measure.

The SPRINT is an eight-item self-report, with one item corresponding to each of the above symptoms, which is measured on a five-point likert scale (e.g. 0 = not at all, 4 = very much). The SPRINT includes two additional items that allows for the measurement of global improvement and symptom change over time, particularly useful for following up treatment. The assessment takes 5-10 minutes to complete. Sample items include:

How much have you been bothered by unwanted memories, nightmares, or reminders of the event?

How much would you get upset when stressful events or setbacks happen to you?

Scoring

Scores from each item are summed to attain a final score. The maximum score is 32 and represents the most severe symptom state, while a cutoff score of 14 has been suggested by authors to warrant further assessment using a structured interview for PTSD.

Psychometric properties

The SPRINT has demonstrated good test-retest reliability (ICC = .78), high internal consistency (α = .88), good convergent validity against a comparable PTSD symptom measure (Davidson Trauma Scale [DTS], r = .73) and good divergent validity against the Sheehan Social Support Scale (r = .10). A score of 14-17 has been associated with a 96% diagnostic accuracy. The SPRINT is sensitive to treatment effects, again significantly correlating with the DTS (r = .66). The SPRINT has also been found to correlate with the gold standard diagnostic assessment tool for PTSD, the Clinician Administered PTSD Scale (CAPS; Vaishnavi, Connor & Davidson, 2006).

Use & Availability

The SPRINT is time efficient, reliable, valid and freely available at https://www.ptsd.va.gov/professional/assessment/screens/sprint.asp, along with further information. The SPRINT is particularly useful in settings where rapid assessment is desirable, however it is not as comprehensive as the CAPS.

References

Connor, K. M., & Davidson, J. R. T. (2001). SPRINT: A brief global assessment of post-traumatic stress disorder. International Clinical Psychopharmacology, 16(5), 279-284.

National Center for Posttraumatic Stress Disorder. (2016). SPRINT. Retrieved from https://www.ptsd.va.gov/professional/assessment/screens/sprint.asp

Vaishnavi, S., Payne, V., Connor, K., & Davidson, J. R. T. (2006). A comparison of the SPRINT and CAPS assessment scales for posttraumatic stress disorder. Depression and Anxiety, 0, 1-4. doi: 10.1002/da.20202

Trauma History Screen (THS)

The Trauma History Screen (THS) was developed by Carlson et al. (2011) to address the need for a brief, simple and easy-to-read tool to assess exposure to distressful events. THS contains 14 dichotomous items (‘Yes’ or ‘No’).  Comprising of two constructs, the THS is designed to assess high magnitude stressor events (HMS) and events relating to significant and persisting posttraumatic distress (PDD). HMS items refers to global, sudden events known to illicit distress response to majority of individuals (for example, hurricane, earthquake), whilst PPD events refers to events associated with significant subjective distress persisting for longer than 1 month (e.g. abandonment by spouse). THS also assesses the individuals’ duration of distress and the distress level.

            THS is intended as a preliminary assessment of exposure to HMSs and PPDs, and the subjective experiences of individuals. As such, THS does not include a formal cut-off scoring procedure. Instead, THS is a quick and useful tool assess trauma exposure and levels and duration of distress which could inform clinicians of therapeutic conceptualisation. Clinicians can therefore utilise further measures to confirm diagnoses if needed.

            Tested across four samples (home veterans, clinical sample, community sample and university students), the THS test-retest correlations over 2 periods (between 1 week and 2 months) were found to be moderate and very high (ranging from .61 to .95). THS was found to be highly correlated to the more lengthy published measure of traumatic life events questionnaire (TLEQ) across a variety of samples such as veterans (r = .77) and young adults (r = .73). The THS is an easy-to-read tool, requiring a fifth grade reading level. It requires a short amount of time to administer and is available at no cost. While it has not been validated cross-culturally, the structure of THS can be replicated to reflect culturally appropriate items. (Jaber, 2012). One notable limitation of the THS is the reliance on self-report, which may not be entirely accurate and may be estimation influenced by current symptoms.

In sum, THS is a reliable and valid tool to assess exposure to traumatic events that is brief, cost effective, therefore easy to administer. It can be a valuable measure when conceptualising cases as well as a screening tool towards diagnosis.

References

Carlson, E.B., Smith, S. R., Palmieri, P. A., Dalenberg, C., Ruzek, J. I., Kimerling, R., Burling, T. A., Spain, D. A. (2011). Development and validation of a brief self-report measure of trauma exposure: the Trauma History Screen. Psychological Assessment, 23, 463–477.

Jaber, S. (2012). Developing a self-help guide for traumatised university students in Iraq. UK: University of Nottingham, PhD thesis.

The Trauma History Screen (2005). Available from http://www.ptsd.va.gov

 

 

Traumatic Events Screening Inventory (TESI)

Traumatic Events Screening Inventory (TESI-C; TESI-C-Brief Form; TESI-PRF-R; TESI-CRF-R)

  • Assesses a child’s experience of a variety of potential traumatic
    events including current and previous injuries, hospitalizations,
    domestic violence, community violence, disasters, accidents,
    physical abuse, and sexual abuse.
  • Additional questions assess DSM-IV PTSD Criterion A and other additional information about the specifics of the event(s).

Applicable population

  • Children – Ages vary according to version-TESI-C-age 6-18
  • Normative data – Yes
  • Publisher – The National Center for PTSD; Dartmouth Child Trauma Research Group

Administration

  • TESI-C is administered as an interview
  • TESI-PR-R parent report (demonstrated test–retest reliability
    kappas ranging from .50 to .79 (Berent et al., 2008)
  • The TESI-PRR provides a comprehensive analysis of child’s trauma exposure and
    is recommended as the best available option for assessing children’s trauma exposure under 10 (Stover & Berkowitz, 2005)

TESI-CR-F child report form

  • Adminstration time 10-30 min
  • Question format for 24 item version – Yes/No answers plus spaces
  • For example: Has someone ever told you they were going to hurt you really
    badly, or acted like they were going to hurt you really badly?
  • Followed by: When this happened, were you really hurt? Was someone else
    really hurt or even killed?

Developer

Ford et al (2002) Veteran affairs National Centre for PTSD.  The TESI-C/ TESI-C-Brief Form is downloadable at: The National Centre for PTSD http://www.ptsd.va.gov/professional/pages/assessments/tesi.asp

References

Berent, R., Crusto, C. A., Lotyczewski, B. S., Greenberg, S. R., Hightower, A. D., & Kaufman, J. S. (2008). Development and psychometric refinement of a measure assessing young children’s exposure to violence. Best Practices in Mental Health, 4(1), 19-30.

Ford, J. (2002). Traumatic Events Screening Inventory–Parent Report Revised (TESI). Unpublished manuscript. Storrs, CT: University of Connecticut.

Ford, J., Racusin, R., Rogers, K., Ellis, C., Schiffman, J., Ribbe, D., & Edwards, J. (2002). Traumatic Events Screening Inventory for Children (TESI-C) Version 8.4. National Center for PTSD and Dartmouth Child Psychiatry Research Group, Dartmouth VT.

Ghosh-Ippen, C., Ford, J., Racusin, R., Acker, M., Bosquet, K., Rogers, C., & Edwards, J. (2002). Trauma events screening inventory-parent report revised. San Francisco: The Child Trauma Research Project of the Early Trauma Network and The National Center for PTSD Dartmouth Child Trauma Research Group.

Stover, C. S., & Berkowitz, S. (2005). Assessing violence exposure and trauma symptoms in young children: A critical review of measures. Journal of Traumatic Stress, 18(6), 707-717.

Strand, V. C., Sarmiento, T. L., & Pasquale, L. E. (2005). Assessment and screening tools for trauma in children and adolescents: A review. Trauma, Violence, & Abuse, 6(1), 55-78.

Clinician-Administered PTSD Scale (CAPS-5)

The Clinician-Administered PTSD Scale (CAPS) is considered to be the gold standard for posttraumatic stress disorder (PTSD) diagnosis.  The 30-item structured interview corresponds to the diagnostic criteria for PTSD described in version 5 of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).   The Life Events Checklist (LEC) is used in conjunction with the CAPS to assess PTSD Criterion A (the trauma experienced).  The full interview typically takes 45-60 minutes to administer.

Use & availability

The CAPS is the intellectual property of the National Center for PTSD, a division of the US Department of Veterans Affairs (VA).  It is available at no cost to health professionals, but a request for use must be submitted to VA.  This can be done online at https://www.ptsd.va.gov/professional/assessment/ncptsd-instrument-request-form.asp.

Psychometric properties

The CAPS has proven reliability and is well-validated.  Initial validation of the DSM-5-aligned version shows r = .83 convergent validity with the widely-validated CAPS-IV.  It has been translated into more than 10 languages, with validation studies occurring in Bosnian and Swedish.

References

Department of Veterans Affairs, United States of America. (2017). National Center for PTSD.  http://www.ptsd.va.gov/ (accessed 1 September 2017).

Weathers, F.W., Keane, T.M., & Davidson, J.R.T. (2001). Clinician Administered PTSD Scale: The first 10 years of research. Depression and Anxiety, 13(3), 132-156.

Weathers, F.W., Blake, D.D., Schnurr, P.P., Kaloupek, D.G., Marx, B.P., & Keane, T.M. (2015). The Clinician-Administered PTSD Scale for DSM-5 (CAPS-5) – Past Month. Available from https://www.ptsd.va.gov/professional/assessment/documents/ptsd_trauma_assessments.asp.

Pediatric Emotional Distress Scale (PEDS)

The Pediatric Emotional Distress Scale (PEDS) was designed to serve as a rapid and inexpensive screening measure to assess the presence and severity of trauma-related behaviours in children aged 2-10 years. (Spilsbury et al., 2005).

The PEDS was developed in America in the late 90’s as a response to an underdeveloped knowledge base for large-scale disasters with regard to children’s psychological needs (Saylor et al., 1999). Based on the literature, Saylor et al. (1999) concluded there was a need for brief screening instruments that can be used to assess children exposed to traumatic events without burdening parents, professionals or child victims themselves. Research suggested children exposed to trauma may have elevated behaviour problems as measured by widely-used behaviour checklists, as well as elevated symptoms characteristic of PTSD (La Greca et al. 1996).

Based on this, a 21-item parent or guardian report measure consisting of 17 general behaviour items and 4 trauma-specifc items was generated for children and is meant to take only 5-8 minutes to administer. For each item the frequency of behaviour is rated on a 4-point Likert scale ranging from 1 (almost never) to 4 (very often). The scale’s first 17 items are grouped into three subscales, Anxious/Withdrawn, Fearful and Acting Out. Two of the four trauma specific items, loaded onto a separate Talk/Play factor. These behaviour items are then summed to produce and overall distress score.

Four independent samples provided data for preliminary psychometric studies from a clinical and school group that was geographically and developmentally diverse (i.e. Boston, Utah, Hurricane Hugo and Children’s Evaluation Centre). The total sample size was 475, however the sample is not considered a representative sample as 93% were Caucasian and predominantly middle to upper class (Saylor et al., 1999).

Initial factor analysis was performed on the first 17 items of the scale for all participants, using a principal components extraction and the three subscale factors emerged. Factor analysis on the full 21-item scale were only conducted with children exposed to trauma, however also yielded identical factors as the first 17 items (Saylor et al., 1999).

Saylor et al. (1999) reported acceptable internal consistency using Cronbach’s alpha (α) for subscales ranging from .72 to .78 and .85 for the 17-item PEDS total score. Acceptable test-retest reliability after a 6-8 week follow up in one sample was found, and interrater reliability using Pearson correlation (r) between mothers and fathers score ratings was also found. Strength of correlations between PEDS total and subscale scores on the Eyberg Child Behaviour Inventory (ECBI) and the Reaction Index (RI) from the Children’s Evaluation Centre sample provided evidence of convergent and divergent validity (Spilsbury et al., 2005).

Discriminant analysis determined clinical cut off scores, however when maternal education was used as a blocking variable more cases could be correctly classified. Therefore different cut off scores are available based on parental education levels. Importantly, PEDS is not intended to be a diagnostic criterion or a substitute for a more in-depth psychiatric interview. Access to PEDS is free and can be gained by emailing the author [email protected].

References

La Greca, A. M., Silverman, W. K., Vernberg, E. M., & Prinstein, M. J. (1996). Symptoms of posttraumatic stress in children after Hurricane Andrew: A prospective study. Journal of Consulting and Clinical Psychology, 64(7), 12-723.

Saylor, C.F, Swenson, C. C., Reynolds, S.S., & Taylor, M. (1999). The Pediatric Emotional Distress Scale: A brief screening measure for young children exposed to traumatic events. Journal of Clinical Child Psychology, 28(1), 70-81.

Spilsbury, J.C, Drotar, D., Burant, C., Flannery, D., Creeden, R., & Friedman, S. (2005). Psychometric Properties of the Pediatric Emotional Distress Scale in a Diverse Sample of Children Exposed to Interpersonal Violence, Journal of Clinical Child & Adolescent Psychology, 34(4), 758-764, doi:10.1207/s15374424jccp3404_17

The National Child Traumatic Stress Network. (2012). Pediatric Emotional Distress Scale. Retrieved March 25, 2017, from http://www.nctsn.org/content/pediatric-emotional-distress-scale

Posttraumatic Stress Disorder Checklist (PCL-5)

The Posttraumatic Stress Disorder Checklist (PCL-5) is a 20 item self-report measure that assesses the DSM-5 symptoms of PTSD in adults (18+ years). The PCL-5 has a variety of purposes including:

Monitoring symptom change before and after treatment

Screening individuals for PTSD

Making a provisional diagnosis of PTSD

Each item is scored on a 5 point Likert scale (0 = not at all; 4 = extremely), and the form takes about 5-10 minutes to complete. The PCL-5 is a relatively recent revision of the PTSD checklist (PCL), one of the most widely used self-report measures of PTSD.

Although there is only one version of the symptom list for PCL-5, there are three formats of the checklist available. The first version does not assess Criterion A (refer to DSM-5 on PTSD). This method is appropriate when trauma exposure is measured by some other tool. The second version defines Criterion A, provides examples of stressful events, and asks individuals to identify their worst event. The third version includes the Life Events Checklist for DSM-5 (LEC-5) and a more detailed assessment of Criterion A. Example items on the PCL-5 include:

Feeling distant or cut off from other people

Being “superalert”, watchful or on guard

Psychometric Properties

There is limited literature available assessing the psychometric properties of the recently revised PTSD checklist. Like its predecessor, the available data suggests that the PCL-5 is psychometrically sound, demonstrating high internal consistency (α = .94), and good test-retest reliability (r = .82). It demonstrates strong convergent validity with other measures of PTSD (rs = .85) and adequate discriminant validity, correlating moderately with constructs like Depression (r = .60), and least strongly with unrelated constructs like Mania (r = .31). Additionally, the test (PCL) has been translated for use with French, Spanish, and Chinese populations.

Use & Availability

The checklist and information regarding the scale is available at http://www.ptsd.va.gov/professional/assessment/adult-sr/ptsd-checklist.asp . Although the test is freely accessible, interpretation of the PCL-5 should only be undertaken by a clinician. Given the short time required to complete the checklist, and its ability to be used as a pre and post measure following an intervention, the checklist is popular in both clinical and research settings.

References

Ashbaugh, A. R., Houle-Johnson, S., Herbert, C., El-Hage, W., & Brunet, A. (2016). Psychometric Validation of the English and French Versions of the Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5). PLOS ONE, 11(10), e0161645. doi:10.1371/journal.pone.0161645

Blevins, C., Weathers, F., Davis, M., Witte, T., & Domino, J. (2015). The Posttraumatic Stress Disorder Checklist for DSM‐5 (PCL‐5): Development and Initial Psychometric Evaluation. Journal of Traumatic Stress, 28(6), 489-498. doi:10.1002/jts.22059

PTSD Checklist for DSM-5 (PCL-5) – PTSD: National Center for PTSD. (2016). Retrieved 8 March 2017, from http://www.ptsd.va.gov/professional/assessment/adult-sr/ptsd-checklist.asp

Weathers, F.W., Litz, B.T., Keane, T.M., Palmieri, P.A., Marx, B.P., & Schnurr, P.P. (2013). The PTSD Checklist for DSM-5 (PCL-5). Scale available from the National Center for PTSD at www.ptsd.va.gov.

Wortmann, J. H., Jordan, A. H., Weathers, F. W., Resick, P. A., Dondanville, K. A., Hall-Clark, B., … Litz, B. T. (2016). Psychometric analysis of the PTSD Checklist-5 (PCL-5) among treatment-seeking military service members. Psychological Assessment, 28(11), 1392–1403. doi:10.1037/pas0000260