Assessment and Diagnosis of Posttraumatic Stress Disorder

An Overview of Measures

By Edna B. Foa, PhD and Elna Yadin, PhD | July 1, 2011

Dr Foa is professor of clinical psychology and Dr Yadin is a research associate at the Center for Treatment and Study of Anxiety in the department of psychiatry at the University of Pennsylvania in Philadelphia. Dr Foa reports that she has received research support from Pfizer, Solvay, Eli Lilly, Smith-Kline Beecham, GlaxoSmithKline, Cephalon, Bristol-Myers Squibb, Forest, Ciba Geigy, Kali-Duphar, and the American Psychiatric Association; she has been on the speakers’ bureau for Pfizer, GlaxoSmithKline, Forest Pharmaceuticals, the American Psychiatric Association, and Jazz Pharmaceuticals; and she has been a consultant for Actelion Pharmaceuticals. In addition, she has received royalties from NCS Pearson for the sale of the PDS. Dr Yadin reports no conflicts of interest concerning the subject matter of this article.

Multiscale personality inventories

The Minnesota Multiphasic Personality Inventory (MMPI) is one of the oldest and most widely used psychological assessment instruments.³⁶ The MMPI was revised in 1989, and the MMPI-2, which incorporates a number of new features, has continued the tradition of the MMPI as a preeminent multiscale personality inventory.³⁷ The MMPI-2 permits a broad, psychometrically sound assessment of personality, psychopathology, and various forms of response bias.

The MMPI-2 assesses the wide range of problems typically seen in the clinical presentation of PTSD and provides sophisticated methods for detecting malingering and other types of response bias. Penk and associates³⁸ provide a thorough overview of the various clinical applications of the MMPI-2 and describe in some detail how information from the MMPI-2 can be integrated effectively with information from other sources.

Developed in 1991, the Personality Assessment Inventory (PAI) has grown rapidly in popularity in clinical, research, and forensic settings.³⁹ Because the PAI is a relatively new instrument, only a limited number of studies have investigated its use in the assessment of PTSD. However, the studies that have emerged indicate that the PAI has considerable promise and could be very useful as a research and clinical tool with trauma survivors.

Based on the relatively small amount of literature thus far, the PAI appears to have considerable merit for the assessment of PTSD. As with the MMPI-2, the PAI rigorously evaluates various forms of response bias, assesses a wide range of comorbid syndromes, and contains a specialized PTSD scale. Because it was developed in a construct validation approach, the PAI provides a straightforward assessment of contemporary constructs related to diagnosis and clinical management. In addition, preliminary evidence suggests that it has discriminant validity for distinguishing PTSD from other commonly comorbid disorders, such as depression.

SUMMARY

Considerable progress has been made in the development and evaluation of standardized measures for assessing trauma exposure and PTSD. A wide variety of instruments and protocols that can provide psychometrically sound and practicable measurement of PTSD for almost any application across settings is available. The use of such instruments is de rigueur for empirical studies and is increasingly expected in clinical settings as well. The growing focus on the use of evidence-based assessment procedures will foster the continued dissemination of such measures until they become part of routine clinical practice.

It is clear that scientific knowledge regarding the phenomenology, etiology, and treatment of PTSD will continue to broaden and deepen, and that sound measurement will play a vital role. The construct of PTSD has fostered a sustained and systematic investigation of the human response to trauma, and evidence-based assessment will continue to provide the foundation for the study and care of those persons who suffer the psychological toll of catastrophe.

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by Greg Maloney | August 18, 2010 5:54 PM EDT

This pedantic paper and pen tests approach sounds like ordering from a chinese restaurant; any 3 from column A, 5 from column B, 7 from column C. Is it any wonder medical scientists and the public question the validity of psychology and psychiatry? Would it make sense to give a questionair to a person with a broken leg when there are x-ray machines available. Unfortunately the reality of PTSD has been contaminated by political and legal issues having nothing to do with real brain science.

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Assessment and Diagnosis of Posttraumatic Stress Disorder

An Overview of Measures

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