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At the current time, the PTSD diagnostic gold standard remains structured clinical
interview to predefined criteria (DSM-IV). However, standardised interview is not
always practically possible at ICU follow-up, and the administration of self-report
inventories allows the identification of PTSD symptomatology. Thus, a variety of selfreport measures have been used to screen for the symptoms of PTSD, and some of these
are described below.
1. Davidson JR, Book SW, Colket JT, Tupler LA, Roth S, David D, Hertzberg M,
Mellman T, Beckham JC, Smith RD, Davison RM, Katz R, Feldman ME (1997)
Assessment of a new self-rating scale for post-traumatic stress disorder. Psychol Med
27:153-160
2. Cuthbertson BH, Hull A, Strachan M, Scott J (2004) Post-traumatic stress disorder
after critical illness requiring general intensive care. Intensive Care Med 30:450-455
The IES was originally tested on 66 adults seeking psychotherapy for stress response
syndromes in an outpatient setting. Nearly half of the group were bereaved, the remainder
had personal injuries from violence, accidents, illness or surgery. The split-half reliability
of the IES scale was high (r=0.86) [1].The subscales of the IES show very good internal
consistency based on 2 separate sample groups [2]. The coefficients ranged from 0.79 to
0.92, with an average of 0.86 for the intrusive subscale and 0.90 for the avoidance
subscale.
Internal consistency of the subscales, calculated using Cronbach's Alpha, was also high
(r= 0.78 intrusion, r = 0.82 avoidance). A correlation of 0.42 (p>0.0002) between the
intrusion and avoidance subscales indicates that the two subsets are associated, but do not
measure identical dimensions. The IES has also displayed the ability to discriminate a
variety of traumatised groups from non-traumatised groups [3].
References
1. Horowitz M, Wilner M, Alvarez W (1979) Impact of Event Scale: A measure of
subjective stress. Psychosomatic Medicine. 41; 209-218.
2. Weiss D, Marmar C (1997) The Impact of Event Scale -Revised. In J. Wilson & T.
Keane (Eds), Assessing psychological trauma and PTSD. New York: Guildford.
3. Briere J (1997) Psychological assessment of adult posttraumatic states. Washington,
D.C.: American Psychological Association.
Not at
all
Rarely Sometimes
Often
I was aware that I still had a lot of feelings about it, but I
didn't deal with them
Scoring:
Not at all = 0; Rarely = 1;
Total = total the scores.
Sometimes = 3;
Often = 5
demonstrated good predictive validity with regard to trauma and the intrusion and
avoidance subscales have been shown to detect change in repondents' clinical status over
time and detect relevant differences in the response to traumatic events of varying
severity [1][2].
References
1. Horowitz M, Wilner M, Alvarez W (1979) Impact of Event Scale: A measure of
subjective stress. Psychosomatic Medicine 41: 209-218.
2. Weiss D, Marmar C (1997) The Impact of Event Scale -Revised. In J. Wilson & T.
Keane (Eds), Assessing psychological trauma and PTSD. New York: Guildford.
A little bit
Moderately
Quite a bit
Extremely
I felt as if it hadnt
happened or wasnt real
My feelings about it
were kind of numb
I had trouble
concentrating
Reminders of it caused
me to have physical
reactions, such as
sweating, trouble
breathing, nausea, or a
pounding heart
Scoring:
Avoidance Subscale = mean of items 5, 7, 8, 11, 12, 13, 17, 22
Intrusion Subscale = mean of items 1, 2, 3, 6, 9, 14, 16, 20
Hyperarousal Subscale = mean of items 4, 10, 15, 18, 19, 21
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References
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1. Weisaeth L (1989) The stressors and the post-traumatic stress syndrome after an
industrial disaster. Acta Psychiatr Scand Suppl 355: 25-37
2. Weisaeth L (1989) Torture of a Norwegian ship's crew. The torture, stress reactions and
psychiatric after-effects. Acta Psychiatr Scand Suppl 355: 63-72
3. Stoll C, Kapfhammer HP, Rothenhausler HB, Haller M, Briegel J, Schmidt M,
Krauseneck T, Durst K, Schelling G (1999) Sensitivity and specificity of a screening test
to document traumatic experiences and to diagnose post-traumatic stress disorder in
ARDS patients after intensive care treatment. Intensive Care Med 25: 697-704
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