Assessing Psychological Trauma and PTSD

Article excerpt

JOHN P. WILSON AND TERENCE M. KEANE, EDS.: Assessing Psychological Trauma and PTSD. Guilford Press, New York, 1997, 575 pp, $55.00, ISBN 1-57230162-7.

The recent impressive expansion of our clinical knowledge about PTSD and psychological trauma has been paralleled by a progressive introduction of a variety of self-report measures, each one with its own emphasis and relative specificity. The array of assessment instruments related to various psychological traumas and posttrauma disorders has become overwhelming if not confusing. The need for a reference book in this area was acute and crucial not only for clinicians but also for researchers. The editors have thoughtfully addressed this issue by bringing together a group of experts who have covered all the important aspects of psychological assessment in this field.

The book is divided into three main areas of assessment, each addressing a particular area of psychological trauma. The first area covers standardized measures and physiological techniques related to PTSD and child-abuse effects in adults supported by a chapter on physiological assessments and another one on psychometric theory explanatory of the degree of validity of the tests. It will be unrealistic to discuss the strength and weakness of each one of the 20 standardized tests already evaluated by the contributing authors. However, an issue affecting all these tests seems to be the questionable validity of attempting by the testdevelopers to objectify the subjective answers of the clients-patients. Like in all self-report measures, there is a subjective bias which may falsify the responses, though it may measure the degree of severity of clinical symptoms, if the specific trauma is documented independently of the client. (Trauma symptom checklist -40) Another problem with these tests is that, while they have been developed based on relatively small samples, they have not been validated against the general population. As noticed by the authors, the validation of these tests is not quite documented in terms of the discriminative validity of the PTSD measures versus other measure constructs.

The second group of articles reviews the standardized assessment of the traumatic reaction among victims and survivor populations. The articles included here assess a wide variety of psychological trauma from life-threatening medical illness to bereavement, marital strife with physical aggression, child abuse or combat-related stress trauma. They empirically evaluate the impact of a particular natural or human-induced stressor on people subjected to it, without telling us why some are affected more than others or not at all. …