Methodological considerations for assessing trauma history via self-report.

Area of Science:

• Psychiatry
• Psychology
• Trauma Studies

Background:

• Posttraumatic stress disorder (PTSD) diagnosis requires experiencing a traumatic event (Criterion A).
• The "worst-event" method, a standard for assessing Criterion A, may inaccurately identify trauma exposure.
• Misidentification can lead to incorrect PTSD diagnoses and impact treatment.

Purpose of the Study:

• To estimate the percentage of adults misidentified as non-Criterion A positive by the "worst-event" method.
• To evaluate the impact of using follow-up questions on trauma exposure assessment.

Main Methods:

• Two online samples (N=579 and N=569) completed the Life Events Checklist for DSM-5 (LEC-5).
• Sample 1 used the traditional "worst-event" method.
• Sample 2 used an extended LEC-5 with follow-up questions for all endorsed events and assessed PTSD symptoms.

Main Results:

• A majority in both samples identified a "worst event" meeting Criterion A (Sample 1: 58.5%; Sample 2: 54.3%).
• Among those in Sample 2 whose "worst event" did not meet Criterion A, 69.6% reported another Criterion A event.
• PTSD symptom severity and structure did not differ between those whose primary or secondary event met Criterion A.

Conclusions:

• Self-report trauma assessment requires follow-up questions for all endorsed events.
• The "worst-event" method alone may underestimate trauma exposure.
• Comprehensive assessment is vital for accurate PTSD diagnosis.