Symptômes de stress post-traumatique

Information sheet 6 - Impact of Event Scale – Revised (IES-R)

Name of the instrument	Impact of Event Scale – Revised
Abbreviation	IES-R
Number of items	22
Terms of use	Public domain. The source must be mentioned (Weiss and Marmar, 1996).
Language	English, French
Data collection method	Self-report questionnaire or by interview, in hard copy, in person or by telephone.
Target population	Adolescents and adults
Interpretation of the results and thresholds	The items are ranked on a five-point scale. The maximum score is 88. Scores can be calculated for the three sub-scales (intrusive symptoms, avoidance behaviour and neurovegetative hyperactivity). The authors of the IES-R recommend the use of the average score rather than simply adding up the scores, which facilitates the comparison of the scores with those of the Symptom Checklist 90 – Revised. However, the thresholds are used in the literature to screen post-traumatic stress disorder (PTSD) and they vary from 22 to 44. The threshold of 33 was used in the surveillance work related to the AZF plant in France. The items corresponding to the “intrusion” factor are questions 1, 2, 3, 6, 14, 16 and 20; those corresponding to the “avoidance” factor: 5, 7, 8, 11, 12, 13, 17 and 22; and those corresponding to the “hyperactivity” factor: 4, 10, 15, 18, 19 and 21.
Is the questionnaire available in the toolkit?	Yes, see Questionnaire 4.
Other versions	The 22-item IES-R is the revised version of the 15-item IES. There is a 13-item version for children (Information sheet 7).
References	Brunet, A., St-Hilaire, A., Jehel, L. and King, S. (2003). Validation of a French Version of the Impact of Event Scale-Revised. Canadian Journal of Psychiatry, 48(1), 55-60. Creamer, M., Bell, R., Failla, S. (2003). Psychometric properties of the impact of event scale – Revised. Behav Res Ther, 41(12), 1489-96. Diene, E., Fouquet, A. et Cogordan, C. (2015). Rapport final de la cohorte des travailleurs de l’agglomération toulousaine (cohorte santé « AZF »). Conséquences sanitaires de l’explosion survenue à l’usine AZF le 21 septembre 2001. Institut de veille sanitaire. Consulted at http://opac.invs.sante.fr/doc_num.php?explnum_id=10149 Horowitz, M. J., Wilner, N. and Alvarez, W. (1979). Impact of event scale: A measure of subjective stress. Psychosomatic Medicine, 41(3), 209-218. Weiss, D. S. and Marmar, C. R. (1996). The Impact of Event Scale-Revised. In J. P. Wilson and T. M. Keane (dir.). Assessing psychological trauma and PTSD. New York: Guildford Press.

Information sheet 7 - Children’s Revised Impact of Event Scale (CRIES)

Name of the instrument	Children’s Revised Impact of Event Scale
Abbreviation	CRIES
Number of items	13
Terms of use	Public domain. The source must be mentioned (Smith, P. et al., 2003).
Language	English. A French translation of the CRIES-8 was produced for the study of the incident at the AZF plant but the translation was only minimally validated.
Data collection method	Self-report questionnaire or by interview, in hard copy, or in person.
Target population	Children 8 years of age and over
Interpretation of the results and thresholds	The items are ranked on a four-point scale, for which the scores are 0, 1, 3 and 5 points. The maximum score is 65. The score is obtained by adding the responses to each item. The CRIES-13 is a recent tool and there are few studies on the topic and even fewer in French. There are now two recommended thresholds. A score of 30 or more on the 13-item version (CRIES-13) would be effective to screen a post-traumatic stress disorder (PTSD). A score of 17 or more on the 8-item version (CRIES-8) would be just as effective to conduct the same screening.
Is the questionnaire available in the toolkit?	Yes, see Questionnaire 5.
Other versions	The CRIES-8 is the first version adapted for young people and comprises eight questions that measure two factors, i.e. intrusion and avoidance. The DSM-IV has added hyperactivity as a criterion to diagnose a PTSD, which has given rise to the 13-item version of the CRIES in order to include five questions on the topic. While the factorial analysis confirms the existence of three factors in the CRIES-13, the items to measure hyperactivity are also markedly present on the intrusion factor. Accordingly, a study has shown that the 8-item version appears to be as valid and effective to screen this disorder, which explains the two thresholds recommended.
References	Children and War foundation. (undated) CRIES 13 Consulted at http://www.childrenandwar.org/measures/children%E2%80%99s-revised-impact-of-event-scale-8-%E2%80%93-cries-8/ies13/ Perrin, S., Meiser-Stedman, R. and Smith, P. (2005). The Children’s Revised Impact of Event Scale (CRIES): Validity as a screening instrument for PTSD. Behavioural and Cognitive Psychotherapy, 33(4), 487-498. Smith, P., Perrin, S., Dyregrov, A. and Yule, W. (2003). Principal components analysis of the impact of event scale with children in war. Personality and Individual Differences, 34(2), 315.

Information sheet 8 - Posttraumatic Stress Disorder Checklist for DSM-IV (PCL-S; PCL-C; PCL-M)

Name of the instrument	Posttraumatic Stress Disorder Checklist for DSM-IV
Abbreviation	PCL-S; PCL-C; PCL-M
Number of items	17
Terms of use	Public domain. The source must be mentioned (Weathers et al., 1994).
Language	English, French
Data collection method	Self-report questionnaire. Can be filled out in hard copy, in person or by telephone.
Target population	Adolescents and adults
Interpretation of the results and thresholds	The items are ranked on a five-point scale. The maximum score is 85. A threshold of 44 is recommended to screen a post-traumatic stress disorder (PTSD) in the total population although this threshold differs considerably in the literature (from 30 to 50). The threshold of 50 is recommended in a military population. The second screening method is the severity cluster. Accordingly, if at least one item from criterion B (items 1 to 5), three items from criterion C (items 6 to 12) and two items from criterion D (items 13 to 17) are ranked 3 (moderately) or more, it is possible to make a provisional diagnosis.
Is the questionnaire available in the toolkit?	Yes, see Questionnaire 6.
Other versions	There are two versions that are identical except that the specific version (PCL-S) allows for the description of reactions to a specific event (the respondent must identify the event). The version for civilians (PCL-C) applies to any stressful event experienced. The PCL-C version is used less extensively. There is also a version for the military population (PCL-M).
References	Blanchard, E. B., Jones-Alexander, J., Buckley, T. C. and Forneris, C. A. (1996). Psychometric properties of the PTSD Checklist (PCL). Behaviour Research and Therapy, 34(8), 669-673. McDonald, S. D. and Calhoun, P. S. (2010). The diagnostic accuracy of the PTSD Checklist: A critical review. Clinical Psychology Review, 30(8), 976-987. Terhakopian, A., Sinaii, N., Engel, C. C., Schnurr, P. P. and Hoge, C. W. (2008). Estimating population prevalence of posttraumatic stress disorder: an example using the PTSD checklist. Journal of Traumatic Stress, 21(3), 290-300. U.S. Department of Veterans Affairs. (2017). PTSD Checklist for DSM-5 (PCL-5). To Obtain Scale. Consulted at https://www.ptsd.va.gov/professional/assessment/adult-sr/ptsd-checklist.asp Weathers, F., Litz, B., Herman, D., Huska, J. and Keane, T. (1994). PCL-S. Washington: National Center for PTSD. Consulted at https://www.ptsd.va.gov/professional/assessment/documents/APCLS.pdf

Information sheet 9 - Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5)

Name of the instrument	Posttraumatic Stress Disorder Checklist for DSM-5
Abbreviation	PCL-5
Number of items	20
Terms of use	Public domain. The source must be mentioned (Weathers et al., 2013).
Language	English, French
Data collection method	Self-report questionnaire, in hard copy, in person or by telephone.
Target population	Adults
Interpretation of the results and thresholds	The items are ranked on a five-point scale. The maximum score is 80. A threshold of 33 to 38 is proposed to screen post-traumatic stress disorder (PTSD). Another way would be to use severity clusters. Accordingly, if at least one item from cluster B (items 1 to 5), one item from cluster C (items 6 to 7), two items from cluster D (items 8 to 14), and two items from cluster E (items 15 to 20) are ranked 2 or more, it is possible to diagnose post-traumatic stress disorder.
Is the questionnaire available in the toolkit?	Yes, see Questionnaire 7.
Other versions	There are three formats of this instrument, i.e. the PCL-5 without criterion A, the PCL-5 with criterion A and the PCL-5 with the LEC-5 and the complete criterion A. The version included in this toolkit is the version without criterion A. The other two versions are readily available on the website of the U.S Department of Veterans Affairs (www.ptsd.va.gov).
References	Ashbaugh, A. R., Houle-Johnson, S., Herbert, C., El-Hage, W. and Brunet, A. (2016). Psychometric validation of the english and french versions of the posttraumatic stress disorder checklist for DSM-5 (PCL-5). Plos One, 11(10), e0161645-e0161645. Blevins, C. A., Weathers, F. W., Davis, M. T., Witte, T. K. and Domino, J. L. (2015). The Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5): Development and Initial Psychometric Evaluation. Journal of Traumatic Stress, 28(6), 489-498. National Center for PTSD. (undated). Using the PTSD Checklist for DSM-5 (PCL-5). Consulted at https://www.ohsu.edu/xd/health/for-healthcare-professionals/telemedicine-network/for-healthcare-providers/ohsu-echo/addiction-medicine/upload/Using-the-PTSD-Checklist-for-DSM-5.pdf U.S. Department of Veterans Affairs. (2017). PTSD Checklist for DSM-5 (PCL-5). To Obtain Scale. Consulted at https://www.ptsd.va.gov/professional/assessment/adult-sr/ptsd-checklist.asp Weathers, F., Litz, B., Keane, T., Palmieri, P., Marx, B. and Schnurr, P. (2013). The PTSD Checklist for DSM-5 (PCL-5) – Standard [Measurement instrument]. Consulted at https://www.ptsd.va.gov/professional/assessment/documents/PCL-5_Standard.pdf

Information sheet 10 - Mini International Neuropsychiatric Interview (MINI) – “Post-traumatic stress disorder” section

Name of the instrument	Mini International Neuropsychiatric Interview
Abbreviation	MINI (M.I.N.I)
Number of items	15
Terms of use	A licence must be obtained from Dr. David Sheehan, the lead author. The licence is free of charge if the project has a grant of less than $50 000 and if it is not used in a healthcare system, otherwise it costs $10 (see the entire array of criteria on the Harm Research Institute website: http://harmresearch.org/index.php/mini-international-neuropsychiatric-interview-mini/). MAPI manages the translations. Fees are levied for the translated versions, in particular the French translation. The cost of distribution of the translation differs according to the use. It is roughly €750 for a commercial user, €100 for a funded university research project, e.g. government funding, and free of charge for non-funded research projects.
Language	English, French and more than 70 other languages
Data collection method	Was developed to be administered through a structured interview with a trained interviewer.
Target population	Adults
Interpretation of the results and thresholds	If there are at least three “yes” responses in section 3, two “yes” responses in section 4 and one “yes” response in section 5, the individual displays symptoms of post-traumatic stress disorder (PTSD).
Is the questionnaire available in the toolkit?	No
Other versions	The MINI is frequently updated to satisfy constantly-changing criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM). At the time of dissemination of this toolkit, version 7.0.2 was the most recent version of the MINI and is based on the DSM-5. There is also a shorter MINI Screen version, suitable for screening. The MINI Kid targets children and adolescents. The MINI Plus is more comprehensive and covers 23 health problems.
References	eProvide et MAPI Research Trust. (2018). Mini-International Neuropsychiatric Interview (MINI). Consulted at https://eprovide.mapi-trust.org/instruments/mini-international-neuropsychiatric-interview

Last modified:

January-12-21

How to cite: Canuel, M., Gosselin, P., Duhoux, A., Brunet, A., et Lesage, A. (2019). Post-Disaster Mental Health Impacts Surveillance Toolkit. Institut national de santé publique du Québec. Found at https://www.inspq.qc.ca/en/publications/2676(link is external).

INSPQ