Assessment of posttraumatic stress disorder’s E2 criterion: Development, pilot testing, and validation of the Posttrauma Risky Behaviors Questionnaire.

Abstract

To capture the functional role of reckless and self-destructive behaviors (RSDBs) in posttraumatic stress disorder’s (PTSD) symptomatology, the E2 symptom was added in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. However, the lack of a validated, comprehensive, and clinically useful measure is a significant barrier to the assessment/treatment of PTSD’s E2 criterion. We developed and validated a measure assessing PTSD’s E2 criterion (Posttrauma Risky Behaviors Questionnaire [PRBQ]). We used two trauma-exposed samples who completed the PRBQ with additional RSDB and mental health measures: 417 participants recruited through Amazon’s Mechanical Turk and 530 college students. We followed recommended guidelines to develop the PRBQ; the PRBQ measured a unitary construct of RSDBs and demonstrated very good–excellent internal consistency (.94 and .82 in community and student samples, respectively). The PRBQ demonstrated convergent validity with measures of RSDBs (significant r/rs/rpb range = .10–.68) and mental health (significant r/rs/rpb range = .29–.65), and construct validity wherein severity and clinically significant levels of PTSD’s E2 criterion were associated with higher PRBQ scores. The PRBQ had incremental validity in predicting PTSD’s E2 criterion above and beyond an established measure of RSDBs (Risky Behaviors Questionnaire) in the community sample. Our results provide initial support for the utility, reliability, and validity (content, convergent, construct, and incremental) of the PRBQ in uniquely assessing PTSD’s E2 criterion (posttrauma RSDBs). The PRBQ is a practical and valid alternative to using PTSD’s single-item E2 criterion or a time-consuming battery of different RSDB measurers in clinical practice.

Military Sexual Trauma and Risky Behaviors: A Systematic Review

“…However, these differences should be taken into consideration when interpreting results as they may contribute to conflicting findings. Additionally, this review defined risky behaviors according to categories of behavior identified by empirically validated measures (Contractor et al, in press; Sadeh & Baskin-Sommers, 2017; Weiss et al, 2018). Thus, our list of risky behaviors may not have been exhaustive.…”

Posttraumatic Stress Disorder Symptoms and Reckless Behaviors: A Network Analysis Approach

“…Additionally, we excluded 97 participants who were missing data on all measures and 11 participants who did not endorse a traumatic event on the Life Event Checklist for DSM‐5 (LEC‐5; Weathers, Blake, et al., 2013). Finally, we excluded 47 participants who were missing more than 30% of item‐level data on the PTSD Checklist for DSM‐5 ([PCL‐5] i.e., six items or more; Weathers, Litz, et al., 2013) or the Posttrauma Risky Behaviors Questionnaire ([PRBQ] i.e., five items or more; Contractor, Weiss, Kearns, Caldas, & Dixon‐Gordon, 2019). The final effective sample size was 417 participants.…”

Examining indirect effects of emotion dysregulation between PTSD symptom clusters and reckless/self-destructive behaviors.

“…The last two items assess functional impairment due to RSDBs and the relation of the RSDB frequency to the onset of the worst trauma. The PRBQ demonstrates good psychometrics (Contractor et al, 2019(Contractor et al, , 2020(Contractor et al, , 2021); Cronbach's alpha in the current study = .92.…”

“…This study presents both theoretical and clinical implications. Previous literature has noted that various posttrauma health outcomes may be driven by common risk factors (Contractor et al, 2019;Shaw et al, 1992); we advance this literature by suggesting that emotion dysregulation may be one such common mechanism underlying both PTSD and posttrauma RSDBs. Relatedly, this research supports the importance of targeting emotion dysregulation in trauma treatments given its central role in enhancing/maintaining posttrauma RSDBs among individuals with varied PTSD symptoms (Ehring & Quack, 2010).…”