FAQs About PTSD Assessment
Frequently Asked Questions for the Public
How can I tell if I have PTSD?
Many people contact us hoping to
find a tool that they can use to assess their own PTSD symptoms. While it
may be tempting to assess your own PTSD symptoms, it is not advisable. PTSD
assessment requires a skilled clinician who (1) understands PTSD, (2) can
select an appropriate PTSD measure, and (3) is able to interpret the results.
For this reason, the American Psychological Association suggests that psychological
measures be distributed only to those with training in mental health assessment.
It is important to use the appropriate PTSD measure, and it is important that
the results be interpreted by someone who has the proper training and who
is not personally involved with the person being assessed. If you think you
may have PTSD, we recommend that you talk to your doctor or a mental health
provider. For information on how to find a mental health provider in your
area, see the "seeking help" fact sheet below.
How can I find out if a particular
mental health provider is trained to assess PTSD?
To determine if a mental health
provider is qualified to assess PTSD, you can ask questions about his or her
training and experience. Some questions you might ask include:
1. “What formal
training in assessment of PTSD have you had?” (It is preferable for a
professional to have specific training in PTSD assessment rather than in
general assessment.)
2. “How many trauma
assessments have you done?” (Experience with at least 10 prior assessments is
desirable.)
3. “What is your area
of specialization?” (Some specialization is desirable, but not too much. For
example, it is common and appropriate for a provider to specialize in assessing
and treating adult survivors of recent traumas. But if a provider specializes
in a particular trauma that does not apply to you, he or she may not have
adequate knowledge or experience in assessing trauma survivors like you. Also,
a provider who does not specialize at all but says he or she can assess and
treat any type of trauma in children or adults may not have adequate expertise
in each sub-area.)
4. “Are you a
member of any professional societies or organizations related to traumatic
stress?” (It is a good idea to explore the websites of any professional
organizations that a mental health professional mentions. This will give you
some idea of the professional’s approach to traumatic stress. Ask yourself if
the activities of the organization reflect values that seem appropriate and
important.)
5. “Can you tell me
a bit about how you assess PTSD?” (It is important that you feel comfortable
with the assessment methods that a provider will use. It is possible to conduct
a good, general assessment of PTSD without any specialized equipment or
techniques. It is common for providers to have you fill out questionnaires or
to use standardized, structured interviews to assess trauma responses.)
Who can request a PTSD or trauma measure from the National
Center for PTSD?
The American Psychological Association's ethical guidelines
on psychological test instruments require advanced graduate-level training in
the administration and interpretation of psychodiagnostic assessment
instruments. Thus, we are not able to distribute measures to people who do not
hold at least a master's degree in a clinical discipline. Graduate students
must have a professor request the measure for them and use the measure under
the professor’s supervision.
I am trying to get
compensation for my PTSD. Can I use one of these measures to help me make
my claim?
A thorough PTSD evaluation is a critical part of any PTSD compensation
claim. For this reason it is best to have an assessment with a clinician who
has experience in this area. For more
information on how to find a therapist in your area, see the "seeking
help" fact sheet below.
If you are a veteran, go to http://www.vba.va.gov/bln/21/
for information on how to submit a compensation claim for PTSD. Another helpful
site is http://www.vva.org/benefits/ptsd.htm.
What is the difference
between a trauma exposure measure and a PTSD measure?
There are two different types of measures that are frequently
used to assess PTSD. The first is a trauma exposure measure. These measures
tend to list a number of different traumatic events that you may have
experienced, such as combat, a car accident, or child sexual abuse. Some go a
bit further and ask when these events happened, and others try to assess the
degree of exposure. For example, rather than just asking if you have
experienced combat, these measures might ask your age at the time of the
experience and whether you felt your life was in danger.
The other type of measure is a PTSD measure. These measures
typically ask you to identify PTSD symptoms you may be having as a result of
the traumatic experience you identified on the first measure. Some measures
also ask about other symptoms such as depression, relationship problems, and
dissociation, even though these aspects are not part of a PTSD diagnosis.
For more information on PTSD assessment see the "Assessment
of PTSD" fact sheet below.
Frequently Asked Questions for Professionals
What is the difference between a trauma exposure measure
and a PTSD measure?
The purpose of a trauma exposure measure is to identify what
traumatic events an individual has experienced; the purpose of a PTSD measure
is to determine whether the person has PTSD symptoms related to one of the
identified events. There are a variety of trauma exposure measures. Some are
very broad and assess a range of negative life events as well as traumatic
experiences. Others have a narrower focus and only assess Criterion A traumas
that involve life threat. Similarly, there are a range of PTSD measures that
can be broad enough to include symptoms other than those related to PTSD. There
are also PTSD measures that are more focused on the 17 PTSD symptoms needed to
make a diagnosis. In most cases, a thorough PTSD assessment involves the use of
both a broad measure and a more focused measure.
What are the main
differences among PTSD measures?
PTSD measures vary in a number of ways. There are some basic
differences to consider in terms of the (1) time required to administer the
measure, (2) complexity of the format, (3) reading level of the person to be
assessed, and (4) cost of use. Format is an import difference among measures.
Measure formats range from 17-item self-report measures with a single rating
for each item to structured interviews with detailed inquiries about each
symptom and interviewer ratings regarding the validity of reports. Structured
interviews also differ in (1) whether they have a single gate-keeping item, (2)
the level of sophistication for assessing each PTSD symptom, and (3) how well
the ratings reflect symptom severity and frequency. Although interview measures
require more interviewer training and administration time, they result in a
more comprehensive assessment of PTSD. The right measure for a particular
purpose depends on your goal. If you want a quick screen, a self-report measure
may be best. However, if you are conducting a PTSD treatment study, you may
want a sensitive interview that assesses for frequency and severity of
symptoms.
What are the main differences among trauma exposure measures?
Trauma exposure measures differ a
great deal in length, the range of trauma types assessed, and the degree of
detailed inquiry about each traumatic event. Many simply assess exposure to
high-magnitude stressors that could cause traumatic stress, and others have
detailed questions to follow up endorsed events. For example, one measure may
have detailed questions about certain elements of an interpersonal violence
experience, and another measure may only require a “yes” or “no” to the
question of whether the person was exposed to a particular type of
interpersonal violence. Some measures have been better validated than other
measures, and some differ as to whether they assess the nature, degree, and
duration of emotional responses to the stressor.
What is the best measure for assessing PTSD symptoms?
Although we are frequently asked this question, there is no
one “best” PTSD measure. The best measure really depends on what you need. Some
important considerations in choosing a PTSD measure include: the time required
to administer the measure, the reading level of the population being sampled,
whether the desire is to assess symptoms related to a single traumatic event or
to assess symptoms related to multiple traumatic events (or to assess symptoms
when the trauma history is unknown), the need for the assessment to correspond
to DSM criteria for PTSD, the psychometric strengths and weaknesses of the
measure, and the cost of using the measure. In addition, it is important that
the overall complexity and language of the measure be appropriate to the
population being sampled.
If you are looking to make a diagnosis of PTSD (rather than
simply assessing symptoms), in general, structured interviews will yield more
valid results than other types of measures. An exception is that structured
interviews that begin with a single gate-keeping item have poor validity for
particular types of traumatic experiences. Also, structured interviews with brief,
single-item, closed-ended questions for each PTSD symptom are likely to be no
more valid for making a diagnosis than self-report measures. Lastly, the
validity of a structured interview will be greatly affected by the level of
training of the interviewer. If interviewers do not have specific training in
mental disorders, clinical assessment, traumatic stress, and administration of
the particular structured interview being used, results of the interview may be
invalid. Brief scales and self-report measures cannot be used to establish a
diagnosis of PTSD because there is too much chance for error in responses.
How do I choose a measure
to assess trauma history?
It is difficult to assess trauma history because researchers
cannot firmly establish the validity of trauma exposure measures. It is so
difficult to determine whether trauma reports are accurate that the validity of
even the best measures has not been very rigorously studied. That being said,
it seems likely that trauma-exposure assessments will have some validity, and their clinical relevance makes them necessary.
In choosing a measure of trauma history or exposure, there
is generally a trade-off between the specificity of the assessed traumatic
events and the length of the assessments. Measures that query about the widest
range of potentially traumatic events, and presumably yield the most accurate
reports, will be the longest. Measures that are quick and easy will inquire
very broadly about types of events and may “miss” idiosyncratic traumatic events.
Thus, in choosing a trauma exposure measure for research, investigators will
typically need to weigh the need for a detailed trauma exposure assessment
against the time limitations for the administration. Another consideration is
whether the researcher is more interested in data regarding exposure to
potentially traumatic (or high-magnitude) stressors or regarding exposures that
resulted in significant emotional responses. Only a few measures assess the
nature, degree, and duration of emotional responses to the stressor.
How can I obtain PTSD
assessment measures?
By clicking on the name of a measure in any of the measure
tables listed here, you can
find additional information about the measure, including a contact name and
address for obtaining the measure.
Where can I get more information about assessment of trauma
and PTSD?
http://www.ncptsd.org//publications/assessment/assessment_readings.html
http://www.measurementexperts.org
http://www.criminology.unimelb.edu.au/victims/resources/assessment/ptsd/assessment_ptsd.html
Where can I get more general information about PTSD?
http://www.ncptsd.org/facts/index.html
http://www.ncptsd.org/links.html
http://www.nctsnet.org/nccts/nav.do?pid=hom_main
http://mirecc.stanford.edu/content/ptsd/ptsd_core.htm
http://www.acpmh.unimelb.edu.au/mentalhealth/default.html
http://www.istss.org/resources/index.htm
http://www.aabt.org/091101%20Folder/091101/index.html
http://www.apa.org/topics/topic_trauma.html
http://www.dva.gov.au/health/counsell/ptsd/ptsdbook.pdf
http://www.sidran.org/resources.html
Related Fact Sheets
Assessment
of PTSD
Provides brief information about how PTSD is assessed
Seeking
help
A general overview of the nature of PTSD and the resources
available to individuals suffering from PTSD
Treatment
and assessment
Description of the phases of coping with traumatic stress
and the typical symptoms expressed following trauma
What
is PTSD?
Answers basic questions about the signs and symptoms of PTSD,
who gets it, how common it is, and what treatments are available
