Trauma-informed assessment for a trauma-pervasive age

Research has demonstrated that trauma in its various forms is associated with deleterious physical and psychological health effects. Most people seeking psychological assessment are doing so for diagnosis; yet, factors such as limitations in the Diagnostic and Statistical Manual of Mental Disorders, fifth edition, definition of trauma; the mostly etiology-agnostic approach of the Diagnostic and Statistical Manual of Mental Disorders, fifth edition; and lack of awareness of the pervasiveness of non-"Criterion A" traumas confound our ability to adequately consider the effects of trauma during assessment. This leads to the risk of misdiagnosis and mistreatment.

After reviewing the scientific evidence related to the pervasiveness of trauma and the need to conceptualize more broadly than the Diagnostic and Statistical Manual of Mental Disorders, the authors describe an application of the recent American Psychological Association (2025a) Guidelines for Psychologists in the Assessment of Psychological Trauma in Adults, an approach to antioppressive, comprehensive assessment (grounded in therapeutic assessment).

A trauma-informed approach to each step of the assessment process, from precontact (e.g., phone consultation) through feedback and termination, is outlined. Recommendations are provided for taking an antioppressive, trauma-informed approach in both process and content (i.e., tests and measures).

Too often, the effects of trauma are not considered, and diagnostic criteria are not fully attended to, resulting in underidentification of trauma. Further yet, modern trends in psychology have shifted toward complicity in neoliberal capitalism, resulting in an emphasis on rushed assessment; short-term, symptom-focused treatment; and medicalization in the service of supporting capitalist production rather than healing. As a result, overdiagnosis of serious disorders that beget medication proliferates. Given the proliferation of trauma, taking an antioppressive, trauma-informed approach grounded in therapeutic assessment is crucial to adequate diagnosis and treatment. (PsycInfo Database Record (c) 2026 APA, all rights reserved).