Development and validation of a brief self-report measure of trauma exposure: The Trauma History Screen.

Abstract

Although information about individuals' exposure to highly stressful events such as traumatic stressors is often very useful for clinicians and researchers, available measures are too long and complex for use in many settings. The Trauma History Screen was developed to provide a very brief and easy-to-complete self-report measure of exposure to high magnitude stressor (HMS) events and of events associated with significant and persisting posttraumatic distress (PPD). The measure assesses the frequency of HMS and PPD events, and it provides detailed information about PPD events. Test-retest reliability was studied in four samples, and temporal stability was good to excellent for items and trauma types and excellent for overall HMS and PPD scores. Comprehensibility of items was supported by expert ratings of how well items appeared to be understood by participants with relatively low reading levels. In five samples, construct validity was supported by findings of strong convergent validity with a longer measure of trauma exposure and by correlations of HMS and PPD scores with PTSD symptoms. The psychometric properties Correspondence concerning this article should be addressed to Eve Carlson, Ph.D., National Center for PTSD (334-PTSD), 795 Willow Rd., Menlo Park, CA 94025. eve.carlson@va.gov. Publisher's Disclaimer: The following manuscript is the final accepted manuscript. It has not been subjected to the final copyediting, fact-checking, and proofreading required for formal publication. It is not the definitive, publisher-authenticated version. The American Psychological Association and its Council of Editors disclaim any responsibility or liabilities for errors or omissions of this manuscript version, any version derived from this manuscript by NIH, or other third parties. The published version is available at www.apa.org/pubs/journals/pas NIH Public Access Exposure to sudden, highly stressful events is fairly common among the general population in the U.S. (Breslau, 2002) and is even more frequent among those seeking mental health treatment (Jacobson, 1989). Information about exposure to sudden, severe stressors is clinically important because such exposure has been found to be associated with increases in later psychological disorder (Brown, Fulton, Wilkeson, & Petty, 2000;Bryant et al., 2010) and decreases in physical health (Schnurr & Green, 2004), occupational functioning (Zatzick et al., 2008), and socioeconomic well-being (Zielinski, 2009). In prospective studies and meta-analyses of trauma research, psychological disorders found to increase most following highly stressful events include depression, generalized anxiety disorder, posttraumatic stress disorder (PTSD), agoraphobia, phobia, and substance abuse (Brown et al., 2000;Bryant et al., 2010;Reed, Anthony, & Breslau, 2007). In addition, repeated, severe sudden stressors that occur during early childhood are thought to play a role in the development of borderline personality disorder (Herman & van der Kolk, 1987); some dissociative disorders (De...

Emotion-relevant impulsivity predicts sustained anger and aggression after remission in bipolar I disorder

“…The Trauma History Screen was designed to provide a brief screener for lifetime history of exposure to high magnitude stressors, including physical abuse, sexual abuse, attack with a weapon, military events, parental abandonment, accidents and natural disasters (Carlson et al, 2011). Participants are asked to clarify whether the trauma was serious enough that they were worried that they or someone else would be killed.…”

The Trauma and Life Events (TALE) checklist: development of a tool for improving routine screening in people with psychosis

“…The study indicates that the TALE shows promise in supporting clinicians to deliver trauma-informed care in routine services by facilitating routine trauma assessment. Nonetheless, measure validation is an on-going process and needs to be considered in relation to specific contexts and cultures (Carlson et al, 2011). We invite further validation studies within routine clinical services, with the aim of optimizing the TALE’s utility across the spectrum of psychosis.…”

“…In line with other trauma measure development a minimum kappa of .40 was determined as acceptable and it was anticipated that overall event reporting would show greater reliability than individual items (Carlson et al, 2011; Gray, Litz, Hsu, & Lombardo, 2004; Hooper, Stockton, Krupnick, & Green, 2011; Kubany et al, 2000). Secondly, we hypothesized the TALE would have moderate convergent validity with other trauma checklists, given that the measure would include several novel items which restricted direct comparison (Carlson et al, 2011; Gray et al, 2004; Hooper et al, 2011; Kubany et al, 2000). We specifically predicted that items relating to unwanted sexual contact, psychosis symptoms and adverse treatment experiences would show the strongest relationship to trauma items in other measures, as these items were most directly comparable against existing checklist items.…”

The American Psychiatric Association Practice Guidelines for the Psychiatric Evaluation of Adults

“…Findings of the Level 1 measure can be amplified by follow-up questioning or the use of additional measures, such as the DSM-5 Level 2 Cross-Cutting Symptom Measures. To aid in the assessment of a patient's exposure to trauma, a brief self-report screening measure, the Trauma History Screen (Carlson et al 2011), is available on request from the VA National Center for PTSD at http://www.ptsd.va.gov/professional/assessment/te-measures/ths.asp.…”