Assessment of a new self-rating scale for post-traumatic stress disorder

Background: Dialectical behaviour therapy for posttraumatic stress disorder (DBT-PTSD), which is tailored to treat adults with PTSD and co-occurring emotion regulation difficulties, has already demonstrated its efficacy, acceptance and safety in an inpatient treatment setting. It combines elements of DBT with trauma-focused cognitive behavioural interventions. Objective: To investigate the feasibility, acceptance and safety of DBT-PTSD in an outpatient treatment setting by therapists who were novice to the treatment, we treated 21 female patients suffering from PTSD following childhood sexual abuse (CSA) plus difficulties in emotion regulation in an uncontrolled clinical trial. Method: The Clinician Administered PTSD Symptom Scale (CAPS), the Davidson Trauma Scale (DTS), the Borderline Section of the International Personality Disorder Examination (IPDE) and the Borderline Symptom List (BSL-23) were used as primary outcomes. For secondary outcomes, depression and dissociation were assessed. Assessments were administered at pretreatment, post-treatment and six-week follow-up. Results: Improvement was significant for PTSD as well as for borderline personality symptomatology, with large pretreatment to follow-up effect sizes for completers based on the CAPS (Cohens d = 1.30), DTS (d = 1.50), IPDE (d = 1.60) and BSL-23 (d = 1.20). Conclusion: The outcome suggests that outpatient DBT-PTSD can safely be used to reduce PTSD symptoms and comorbid psychopathology in adults who have experienced CSA.

Section: Methodsmentioning

confidence: 99%

“…The sum score ranges from zero to 136. Cronbach’s α was found to be α = .99 (Davidson et al, 1997), indicating very good reliability.…”

Section: Methodsmentioning

confidence: 99%

Dialectical behaviour therapy for posttraumatic stress disorder related to childhood sexual abuse: a pilot study in an outpatient treatment setting

Steil

Dittmann

Müller‐Engelmann

et al. 2018

“…Self-ratings included the Davidson Trauma Scale (DTS; Davidson et al, 1997), the Borderline Symptom List-23 (BSL-23; Bohus et al, 2009), and the Beck Depression Inventory II (BDI-II; Beck, Steer, & Brown, 1996). Traumatic childhood adversity was assessed using the Childhood Trauma Questionnaire (CTQ; Bernstein et al, 2003).…”

Section: Methodsmentioning

confidence: 99%

Trauma-related memories in PTSD after interpersonal violence: an ambulatory assessment study

Kleindienst

Priebe

Petri

et al. 2017

Background: Ambulatory assessment (AA) is increasingly recommended for assessing symptoms of posttraumatic stress disorder (PTSD). Previous AA studies provided new insights into the phenomenology of trauma-related memories, but also divergent findings. Notably, the range of trauma-related memories (a major target of psychotherapeutic interventions) reported in AA studies was as wide as 7.3 to 74.5 per week which might result from different methods used in these studies. Objective: We aimed at assessing the frequency of trauma-related memories in PTSD related to interpersonal violence and investigated whether this frequency is dependent upon the method. Method: For each patient trauma-related memories were assessed using two variants of smartphone-based AA: (1) Event-based sampling (EBS), i.e. participants entered data on each intrusive memory as it occurred; (2) Time-based sampling (TBS), i.e. participants reported the number of trauma-related memories they had experienced during the last two hours after they had been alerted by the smartphone. The numbers reported during the TBS-block were either analysed as reported by the participants or restricted to one per hour (rTBS). The impact of smartphone-assessments on trauma-related memories was assessed during a post-monitoring questionnaire. Results: While trauma-related memories were frequent across assessments, the methodology had a huge impact on the numbers: EBS (median = 7) and rTBS (median = 6) yielded significantly lower weekly numbers of intrusive trauma-related memories than TBS (median = 49). Accordingly, the possibility to report unrestricted numbers of trauma-related memories clearly impacted the results. The post-monitoring questionnaire identified another source for the divergent findings: while feeling disrupted by the smartphone-assessments was unrelated to the numbers reported during EBS, feeling disrupted was related to an increase of trauma-related memories during TBS and rTBS. Conclusions: The method clearly impacts the recorded number of trauma-related memories. Future research should clarify whether other variables (e.g. the subjective stress related to intrusive memories) are less dependent on the methodology.

“… a Numbers in the scale × study cells represent the number of times when the specific instrument/question was used to assess participants. b Unpublished at the time of data transfer.PTSD, post-traumatic stress disorder; ICU, intensive care unit; MVA, motor vehicle accident; JTOPS, Jerusalem Trauma Outreach and Prevention Study; TCOM, Tachikawa Cohort of Motor Vehicle Accident; ASD, acute stress disorder; DSM, Diagnostic and Statistical Manual of Mental Disorders; CAPS, Clinician Administered PTSD Scale (Blake et al, 1998); IES, Impact of Event Scale (Horowitz, Wilner, & Alvarez, 1979); IES-R, Impact of Event Scale – Revised (Weiss, 2007); MISS, Mississippi PTSD Scale (Vreven, Gudanowski, King, & King, 1995); PDS, PTSD Diagnostic Scale (Foa, 1995); PSS, PTSD Symptom Scale (Foa & Tolin, 2000); DTS, Davidson Trauma Scale (Davidson et al, 1997); PDEQ, Peritraumatic Dissociative Experiences Questionnaire (Marmar, Weiss, & Metzler, 1997); PDI, Peritraumatic Distress Inventory (Brunet et al, 2001); ASDI, Acute Stress Disorder Structured Interview (Bryant, Harvey, Dang, & Sackville, 1998); HADS, Hospital Anxiety and Depression Scale (Zigmond & Snaith, 1983); BDI, Beck Depression Inventory (Beck, Steer, & Brown, 1996); CESD, Center for Epidemiologic Studies Depression Scale (Radloff, 1977); STAI, State–Trait Anxiety Inventory (Spielberger, Gorsuch, & Lushene, 1970); AUDIT, Alcohol Use Disorders Identification Test (Saunders, Aasland, Babor, De La Fuente, & Grant, 1993); SCID, Structured Clinical Interview for DSM Disorders (First, Spitzer, Gibbon, & Williams, 1997); MINI, Mini-International Neuropsychiatric Interview (Lecrubier et al, 1997); WHOQOL, World Health Organization Quality of Life (Kuyken et al, 1995); SF-36, 36-item Short Form Health Survey (Ware & Sherbourne, 1992). …”

Section: Methodsmentioning

confidence: 99%

Application of data pooling to longitudinal studies of early post-traumatic stress disorder (PTSD): the International Consortium to Predict PTSD (ICPP) project

Ratanatharathorn

Gevonden

et al. 2018

Background: Understanding the development of post-traumatic stress disorder (PTSD) is a precondition for efficient risk assessment and prevention planning. Studies to date have been site and sample specific. Towards developing generalizable models of PTSD development and prediction, the International Consortium to Predict PTSD (ICPP) compiled data from 13 longitudinal, acute-care based PTSD studies performed in six different countries.Objective: The objectives of this study were to describe the ICPP’s approach to data pooling and harmonization, and present cross-study descriptive results informing the longitudinal course of PTSD after acute trauma.Methods: Item-level data from 13 longitudinal studies of adult civilian trauma survivors were collected. Constructs (e.g. PTSD, depression), measures (questions or scales), and time variables (days from trauma) were identified and harmonized, and those with inconsistent coding (e.g. education, lifetime trauma exposure) were recoded. Administered in 11 studies, the Clinician Administered PTSD Scale (CAPS) emerged as the main measure of PTSD diagnosis and severity.Results: The pooled data set included 6254 subjects (39.9% female). Studies’ average retention rate was 87.0% (range 49.1–93.5%). Participants’ baseline assessments took place within 2 months of trauma exposure. Follow-up durations ranged from 188 to 1110 days. Reflecting studies’ inclusion criteria, the prevalence of baseline PTSD differed significantly between studies (range 3.1–61.6%), and similar differences were observed in subsequent assessments (4.3–38.2% and 3.8–27.0% for second and third assessments, respectively).Conclusion: Pooling data from independently collected studies requires careful curation of individual data sets for extracting and optimizing informative commonalities. However, it is an important step towards developing robust and generalizable prediction models for PTSD and can exceed findings of single studies. The large differences in prevalence of PTSD longitudinally cautions against using any individual study to infer trauma outcome. The multiplicity of instruments used in individual studies emphasizes the need for common data elements in future studies.