Post-traumatic stress disorder symptoms

Impact of Event Scale – Revised (IES-R)

The IES-R is a self-report measuring instrument that assesses the response to a traumatic event, i.e. post-traumatic stress disorder (PTSD). The first version comprised 15 items. The revised version comprises 22 items that measure 14 of the 17 symptoms of PTSD according to the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) (Horowitz, Wilner and Alvarez, 1979; Weiss, 2007). The IES-R is the tool that the committee of experts recommends to evaluate PTSD in population-based surveys (Information sheet 6, Questionnaire 4). The instrument’s authors recommend using the average score but there are, nonetheless, thresholds recommended in the literature to screen PTSD. The thresholds can range from 22 to 44 (Morina, Ehring and Priebe, 2013). Consequently, special attention must be paid when the results are compared and interpreted. This instrument is, nevertheless, one of the best ones to screen PTSD. However, as is true of the majority of the other instruments recommended in this toolkit, the IES-R cannot be used to make a diagnosis.

Children’s Revised Impact of Event Scale (CRIES)

The CRIES is 13-item version of the IES, but for children (Information sheet 7). The child responds to it in the presence of an adult who ensures the child’s understanding. While there is no validated French translation, the Institut de veille sanitaire (InVS) translated a version for the epidemiological study of the AZF plant (Questionnaire 5). There are few publications on this instrument adapted for children but the first results are promising (Giannopoulou et al., 2006; Perrin, Meiser-Stedman and Smith, 2005; Smith et al., 2003). What is more, the eight-item version would be just as effective to screen post-traumatic stress disorder (PTSD) among children as the 13-item version (Perrin, Meiser-Stedman and Smith, 2005).

Posttraumatic Stress Disorder Checklist for DSM-IV (PCL-S)

The PCL-S is a self-report measuring instrument with 17 items that evaluates the symptoms of post-traumatic stress disorder (PTSD) according to the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) (Information sheet 8, Questionnaire 6) (Blanchard et al., 1996). There are three versions of the instrument, one intended for military personnel (PCL-M), one for the total population but that is specific to an event (PCL-S), and a version for civilians (PCL-C) that applies to any stressful event. The PCL is one of the most widely used instruments to screen PTSD (Terhakopian et al., 2008) and it displays sound metrological properties (McDonald and Calhoun, 2010; Wilkins, Lang and Norman, 2011). Since this instrument ties in with the definitions of the DSM, it can be updated with each new version of the DSM. In fact, a more recent version, which ties in with the DSM-5, has just been developed (see below).

Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5)

The PCL-5 is a 20-item self-report measuring instrument that evaluates 20 symptoms of post-traumatic stress disorder (PTSD), according to the latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) (Information sheet 9, Questionnaire 7) (Blevins et al., 2015). This instrument does not produce a diagnosis of PTSD but allows for screening of it. This version is similar to that of the PCL-S, but it reflects the changes made in the symptoms in the DSM-5. A French version was validated in 2016 (Ashbaugh et al., 2016). Since this instrument was recently updated to tie in with the DSM-5, it is still hardly used but its use should grow over time.

Mini-International Neuropsychiatric Interview (MINI)

The MINI, as described above, is an instrument that could be used for smaller surveys since a trained interviewer must use it during a structured interview, which is usually more costly than a self-report questionnaire (Information sheet 10) (Sheehan et al., 1998). The MINI evaluates 17 mental health problems, including post-traumatic stress disorder (PTSD). The module that allows the diagnosis of major post-traumatic stress disorder can be used alone (independently of the other modules in the MINI) and contains 15 items. The instrument is protected and a licence must be obtained to use it. The licence is often free of charge for the English-language version while a fee may apply to the translated versions, depending on the user profile. Accordingly, since the instrument is protected and is updated with each new version of the Diagnostic and Statistical Manual of Mental Disorders (DSM) (the most recent version of the MINI is 7), the questionnaires are not included in this toolkit (Sheehan and Lecrubier, 2018).

See sections 6.1.1 and 6.1.2 on anxiety and depression for additional information on the MINI.