Assessing traumatic event exposure: Comparing the Traumatic Life Events Questionnaire to the Structured Clinical Interview for DSM-IV.

Abstract

Posttraumatic stress disorder (PTSD) diagnosis requires first identifying a traumatic event, but very few studies have evaluated methods of potential traumatic event assessment and their impact on PTSD diagnosis. We compared a behaviorally-specific comprehensive multiple-item traumatic event measure to a single-item measure to determine their impact on traumatic event identification and subsequent PTSD diagnosis. In a within-subject, counterbalanced design, the Traumatic Life Events Questionnaire (TLEQ; Kubany et al., 2000) was compared to the single-question traumatic event assessment in the Structured Clinical Interview for DSM-IV (SCID; First, Spitzer, Gibbon, & Williams, 1998) in 129 participants in opioid dependence treatment. The TLEQ produced a 9-fold higher rate of traumatic events reported by the participants as compared to the SCID. As a result, PTSD diagnoses in the sample increased to 33% after the TLEQ measure from 24% after the SCID. The increase in potential traumatic event identification and PTSD diagnosis was greater in women than men. This study provides strong support for the use of comprehensive traumatic event assessments to measure traumatic events and PTSD diagnoses, particularly in women.

The challenge of estimating PTSD prevalence in the context of ongoing trauma: The example of Israel during the Second Intifada

“…Because these interviews rely on one or very few questions (probes) to screen out cases considered unlikely to have the diagnosis, some sensitivity may be sacrificed. For example, Pierce et al (Peirce, Burke, Stoller, Neufeld, & Brooner, 2009) found that the Structured Clinical Interview for DSM-IV, which utilizes a clinical interviewer but has a single probe for criterion A, identifies fewer traumatic events than the more detailed Traumatic Life Events Questionnaire. Thus, if any bias exists with the CIDI, it would appear to be in the direction of underestimating PTSD.…”

Traumatic Event Re-exposure in Injecting Drug Users

“…The well-validated TLEQ is considered the "gold standard" of traumatic event assessments, 23,24 and appears preferable to other measures of traumatic events in drug user populations. 1 It contains a comprehensive list of 22 behaviorally descriptive potential traumatic events (and a 23rd category of "other events" with examples) to assess the DSM-IV criterion A(1) for PTSD. 21 The following question for adult physical assault is an example of the type of questions on the assessment: "Have you been robbed or been present during a robbery where the robber(s) used or displayed a weapon?"…”

“…Indeed, drug users have one of the highest rates of PTSD among any clinical population, with most prevalence estimates ranging over 25%. 1,2 PTSD and other psychiatric disorders precipitated by traumatic events convey considerable disease burden to drug users, through the direct effects of psychiatric symptoms and the indirect effects of these symptoms on drug use and response to substance abuse treatment. 4,5 In view of the high rates of lifetime traumatic event exposure in drug users, it is remarkable that so little is known about rates of trauma re-exposure in this high-risk population.…”

“…1,2 Traumatic events cause considerable psychiatric distress and increase risk of subsequent psychiatric problems, including posttraumatic stress disorder 3 (PTSD). Indeed, drug users have one of the highest rates of PTSD among any clinical population, with most prevalence estimates ranging over 25%.…”

Stress and Maternal Postpartum Depression: The Importance of Stress Type and Timing

“…The FFCWS does not include acute life event stress checklists like those traditionally found in the stress process literature; therefore, some of the more common acute stressors frequently cited in the stress process literature, such as racism, bereavement, or job loss, are not included here. However, the FFCWS does contain many other items that are consistent with these checklists, including marital divorce and separation, imprisonment, and forced sexual activity (for more examples, see Tuner and Lloyd 2004;Peirce et al 2009). Thus, we created two acute life event stress indices (prenatal and postnatal) based on relevant measures to approximate stress checklists.…”