International Society for Traumatic Stress Studies

BOOK REVIEW

Posted 1 April 1998 in StressPoints by Eve Carlson, PhD, National Center for PTDS

In publishing Assessing Psychological Trauma and PTSD, John Wilson and Terence Keane have given us a valuable and needed resource for research and clinical work. These two well-respected trauma experts have put together the first book to focus solely on assessment of trauma and PTSD, bringing together a vast store of useful information about measures and techniques for assessing traumatic experiences and responses. In the field of traumatic stress, the need for this book has increasingly been felt by researchers and clinicians who are faced with a dizzying array of trauma-related measures and with research subjects and clients who experienced a wide variety of traumas and who present with complex, varied, and sundry symptoms.

Good measurement is at the heart of good research and clinical work. In research, valid measures are the basis of strong methodology, and in clinical work, accurate assessments provide the foundation for diagnosis and treatment planning. But in both research and clinical settings, it is frequently difficult to obtain accurate information about traumatic experiences and symptoms that are both disturbing and ambiguous. For a variety of reasons, research subject and clients may not always be forthcoming about their experiences and symptoms. Furthermore, because symptoms of PTSD are very similar to those of other disorders, it can be a great challenge to conduct valid research and make accurate clinical diagnoses.

Wilson and Keane have come to the rescue by gathering together a group of distinguished authors who offer their considerable expertise on measurement in clear and very detailed chapters. The book is divided into three sections that are comprised of 18 chapters. The first section is comprised of chapters on four very basic topics in measurement with reviews covering self-report measures of trauma and PTSD, assessment of child abuse effects in adults, physiological assessment of PTSD, and psychometric theory. All of these chapters are up-to-date and thorough. The chapter on self-reports measures has a particularly useful table containing name, addresses, and phone numbers of contact persons for each measure. The psychometrics theory chapter is a unique and very helpful primer covering both the nuts and bolts of scale construction and some of the more complex statistical approaches used in scale validation. This chapter will be invaluable to any researcher engaged in developing a trauma-related measure, but will also be enlightening for researchers and clinicians who want to better understand and more critically evaluate reports on measure development and validation.

Section II includes chapters addressing the assessment of traumatic reactions across genders and cultures and in a variety of populations (community samples, medical patients, military personnel, children, couples and families, and the bereaved). The chapter on epidemiological methods for assessing PTSD will primarily be of interest to those conducting survey studies or consumers of such research. It details the kind of sophisticated methodology necessary if the results of survey studies are to be generalizable. The other six chapters in this section are directly relevant to both research and clinical work with persons in these particular populations. While all of the chapters provide excellent reviews of the relevant literature and will be useful to clinicians treating clients from the given population, the chapters on children, couples and families, bereaved persons, and those with medical illnesses are especially valuable because there is so little treatment of these topics elsewhere in the trauma literature. The chapter on assessing trauma and trauma responses is exceptionally broad and detailed and covers measures and issues that will be new to many readers.

Section III focuses on the use of specific methods and measures in assessing PTSD. Three of these chapters provide detailed reports of the research on particular measures: a self-report measure of PTSD, a self-report measure of peritraumatic dissociation, and a dissociative disorders structured interview. The other four chapters review methods and techniques for measuring posttraumatic responses, including neuropsychological assessment methods, structured clinical interview techniques, thematic assessment methods, and the Rorschach Ink Blot projective technique.

Assessing Psychological Trauma and PTSD provides a wealth of information about measurement of trauma and trauma responses that will be of great use to both novice and experienced researchers and clinicians. In addition, Wilson, Keane, and the chapter authors have collectively done a great service for the field of traumatic stress. Because of the thoroughness and rigor of this book, they have set high standards for future research and clinical work and provided some tools for others to meet these standards.