Assessing trauma and posttraumatic stress disorder: Single, open-ended question versus list-based inventory.

Abstract

Trauma exposure is a precursor to a diagnosis of posttraumatic stress disorder (PTSD). A dearth of empirical evidence exists on the impact of different measurement practices on estimates of trauma exposure and PTSD within representative epidemiological samples. In the present study, we examined differences in reported trauma exposure and rates of PTSD using single, open-ended question versus list-based trauma assessments in a general community sample. Using data from the third wave of the Montreal epidemiological catchment area study (N = 1029), participants were interviewed in person by a lay interviewer about lifetime history of trauma exposure and PTSD. Prevalence rates of trauma exposure and PTSD diagnosis using single, open-ended question and list-based assessment were compared using a within-subject design. A single, open-ended question versus list-based trauma assessment yielded trauma-exposure rates of 61%, 95% CI [57.8, 63.8] and 78%, 95% CI [75.2, 80.3], respectively. Conditional rates of lifetime PTSD decreased from 6.7%, 95% CI [5.8, 9.4] to 6%, 95% CI [4.4, 7.7], respectively. Increases in trauma exposure were more pronounced in women (33.7%) than men (21.5%), as well as in the younger stratum of study participants (15-24 years old; 36.1%). Underestimation of PTSD using a single, open-ended question assessment was minimal, although all missing cases were women. Our results lend support to the importance of using comprehensive assessments of exposure to potentially traumatic events when conducting epidemiological research, especially when reporting conditional rates of PTSD. Previous research may have underestimated the prevalence of trauma exposure, particularly among young women. (PsycINFO Database Record

Describing the healthcare experiences and strategies of women survivors of violence

“…Asking more open questions about trauma exposure, such as “What traumatic events have happened to you?” (Crosby, , p. 522), could be an effective way to begin screening for diverse traumatic life events. However, other researchers have advocated for using comprehensive multi‐item trauma exposure assessments because they found that single, open‐ended questions resulted in underestimation of trauma exposure among women (Monson, Lonergan, Caron, & Brunet, ). Future research should work towards determining best practices for comprehensive trauma history screening.…”

Psychiatric Hospital Workers’ Exposure to Disturbing Patient Behavior and Its Relation to Post-Traumatic Stress Disorder Symptoms

“…A strength of our measurement of PTSD was that we did not limit it to a single item, which yields lower prevalence estimates than a list-based assessment (e.g., Monson, Lonergan, Caron, & Brunet, 2016). However, we could not determine whether the exposure met the PTSD diagnostic criterion that requires the stressor to relate to actual or threatened death, serious injury, or sexual violation, and so we are unable to determine whether the extent of PTSD symptomatology accurately reflects the prevalence of PTSD among psychiatric hospital workers in this study.…”

Trauma Exposure Among Women in the Pacific Rim

“…The authors of the LSC‐R recognized sex‐based disparities in trauma exposure, and developed the LSC‐R for use with women, beginning with focus group discussions with older women to learn about trauma across the lifespan to inform the content of the instrument (McHugo et al., ). A recent study found using a single, open‐ended question resulted in underestimation of trauma exposure among women, as compared to a comprehensive multi‐item assessment (Monson, Lonergan, Caron, & Brunet, ).…”