How is PTSD Measured?
A National Center for
PTSD Fact Sheet
How can one tell if distress after a personal tragedy is a normal reaction
to an upsetting life experience or something more serious?
It can be difficult to know whether distress is a normal
reaction or a symptom of something more serious. Even experts may require the results of a detailed evaluation to
answer this question. Posttraumatic
Stress Disorder (PTSD) is only one of many possible reactions to a traumatic
experience. After a trauma, some people
become anxious, some become depressed, and many find that they are not able to
deal with their responsibilities as well as they had before the trauma. Although the majority of people are
distressed for a while, over a period of a few weeks to a few months, most find
that their upset lessens and they are better able to function. Someone who continues to be profoundly
affected by their experience several months or even years later may be
struggling with PTSD.
What is PTSD?
The main features of PTSD can be summarized as follows:
Trauma
PTSD is different from most mental-health diagnoses
because it is tied to a to particular life experience. A traumatic experience
typically involves the potential for death or serious injury resulting in
intense fear, helplessness, or horror.
Symptoms
PTSD is characterized by a specific group of
symptoms that sets it apart from other types of reactions to trauma.
Increasingly, evidence points to four major types of symptoms: re-experiencing,
avoidance, numbing, and arousal.
Re-experiencing
symptoms involve a sort of mental replay of the trauma, often accompanied
by strong emotional reactions. This can
happen in reaction to thoughts or reminders of the experience when the person
is awake or in the form of nightmares during sleep.
Avoidance
symptoms are often exhibited as efforts to evade activities, places, or
people that are reminders of the trauma.
Numbing
symptoms are typically experienced as a loss of emotions, particularly
positive feelings.
Arousal
symptoms reflect excessive physiological activation and include a
heightened sense of being on guard as well as difficulty with sleep and
concentration.
Length and Severity
To qualify for a formal diagnosis, the symptoms must
persist for over one month, cause significant distress, and affect the
individual's ability to function socially, occupationally, or domestically.
How do I get an evaluation?
While it may be tempting to identify PTSD for yourself or
someone you know, the diagnosis generally is made by a mental-health
professional. This will usually involve
a formal evaluation by a psychiatrist, psychologist, or clinical social worker
who is specifically trained to assess psychological problems.
What can I expect from an evaluation for PTSD?
The nature of an evaluation for PTSD can vary widely
depending on how the evaluation will be used and the training of the
professional evaluator. An interviewer
may take as little as 15 minutes to get a sense of your traumatic experience
and the effect it has had on your life in order to determine whether treatment
for PTSD is called for. On the other
hand, a specialized PTSD assessment can take eight or more 1-hour sessions when
the information is needed for legal or disability claims. Regardless of the length of the evaluation,
you can expect to be questioned in depth about experiences that may have been
traumatic for you and about symptoms you may be experiencing as a result of
these experiences. Evaluations that are
more thorough are likely to involve detailed, structured interviews and
psychological tests on which you record your thoughts and feeling. Your spouse or partner may be asked to
provide additional information, and you may undergo a procedure that examines
your physiological reactions to mild reminders of your trauma. Whatever the particulars of your situation,
you should always be able to find out in advance from the professional
conducting the evaluation what the assessment will involve and what information
it is expected to provide.
What are some of the common assessments for PTSD?
As noted above, two main categories of PTSD
evaluations are structured interviews and self-report questionnaires. The Clinician Administered PTSD Scale (CAPS)
was developed by National Center for PTSD staff and is among the most widely
used types of interviews. It has a format
that requests information about the frequency and intensity of the core PTSD
symptoms and of some common associated symptoms, which may have important
implications for treatment and recovery.
Another widely used interview is the Structured Clinical Interview for
DSM (SCID). The SCID can be used to
assess a range of psychiatric disorders including PTSD. Other interview instruments include the
Anxiety Disorders Interview Schedule-Revised (ADIS), the PTSD-Interview, the
Structured Interview for PTSD (SI-PTSD), and the PTSD Symptom Scale Interview
(PSS-I). Each has unique features that
might make it a good choice for a particular evaluation.
Several self-report measures have also been developed
as time- and cost-efficient vehicles for obtaining information about PTSD-related
distress. These measures provide a
single score representing the amount of distress an individual is experiencing.
Among this set is another widely used measure developed by National Center
for PTSD staff, the PTSD Checklist (PCL). This measure comes in two versions, one oriented
for civilians and another specifically designed for military personnel and
veterans. Other widely used self-report
measures are the Impact of Event Scale-Revised (IES-R), the Keane PTSD Scale
of the MMPI-2, the Mississippi Scale for Combat Related PTSD and the Mississippi
Scale for Civilians, the Posttraumatic Diagnostic Scale (PDS), the Penn Inventory
for Posttraumatic Stress, and the Los Angeles Symptom Checklist (LASC).
Related Fact Sheets
Common
reactions to trauma
An explanation of common reactions to trauma by Dr.
Edna Foa
Symptoms
of PTSD
Learn about how traumatic experiences affect people,
what survivors need to know, and the common symptoms of 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
