PTSD Psychological Testing and Clinical Diagnosis

PTSD: Psychological Testing and Clinical Diagnosis

Grand Canyon University: PCN-523

PTSD: Psychological Testing and Clinical Diagnosis

Introduction

According to DiCecco, “The traumatic events that can precipitate the onset of PTSD are varied, numerous, and the manifestations of the disorder are highly individualized” (2011). Though this general summation can be applied to many mental disorders, there are unique characteristics that correlate specifically to the occurrence of Post-Traumatic Stress Disorder. As is the case, there are specific tools that are valuable to the professional counselor when through the assessment and diagnosis process.

An Overview of PTSD

PTSD, formally known as Post-Traumatic Stress Disorder, is a condition that is prominently exhibited after exposure to a life threatening, violent, extremely abusive or otherwise traumatic event (DSM-5, 2013). PTSD can likewise result from witnessing such events, which is most commonly encompassed by the professional duties of military personnel, firefighters, police officers, and others regularly exposed to traumatic situations (DSM-5, 2013). Though PTSD presents based on individual experience, symptoms commonly transgress approximately three months post exposure; these issues are sometimes eliminated after twelve months of treatment, but have been known to reemerge when the affected individual experiences stressful life evens (DSM-5, 2013). Some symptoms include uncontrollable flashbacks, dreams, and memories of the traumatic events, distress when subjected to triggers that elicit memories of the event, negative changes in mood/cognition as a result of the traumatic experience(s), and detriment to the ability of the affected individual to function both personally and professionally (DSM-5, 2013). With PTSD comes an increased risk for suicide, hostility and aggravation – such symptoms usually present for a greater time period than one month (DSM-5, 2013). The DSM-5 likewise states that PTSD may initially present as Acute Stress Disorder, but the aforementioned symptoms grow increasingly severe over the course of a few months (2013). Based on the DSM-IV criteria, the risk of experiencing PTSD, by the time an individual reaches the age of 75, is 3.5% (DSM-5, 2013). When contrasted with U.S. non-Latino whites, PTSD is more common among U.S. Latinos, African Americans, and American Indians and less common in Asian Americans (DSM-5, 2013). PTSD can occur throughout the entire life span of an individual, though the symptoms of PTSD are different among children than adults (DSM-5, 2013).

Diagnostic Tools

In order to provide an accurate diagnosis, it is imperative for the professional counselor to interact with the patient to discover his or her experiences, ailments, and perceptions. Cohen, Swerdlik, and Sturman suggest the tool of the interview as one measure in determining the answers to the aforementioned questions (2013). Some topics that should be addressed throughout the interview process include the reason for seeking treatment, the expressed feelings of the client both expressed and conveyed through body language, cultural origins, and any additional factors that may be useful in assisting in treatment (Cohen, Swerdlik, & Sturman, 2013). Case history may be discovered through the interview process, and/or the review of previous medical records; such information can likewise be invaluable in determining the root of an individual’s psychological issues (Cohen, Swerdlik, & Sturman, 2013). To provide a more objective basis within assessment and diagnosis, the Diagnostic and Statistical Manual of Mental Disorders (DSM) and psychological testing are available for use by mental healthcare providers (Cohen, Swerdlik, & Sturman, 2013).

Psychological Tests Part 1: PTSD & Suicide Screener

The PTSD & Suicide Screener is a fourteen item, self-inventory reporting method, which is appropriately utilized in determining the occurrence of PTSD, as well as suicide risk, in an adult patient (Briere, 2013). This psychological test can be completed relatively quickly with an average completion time between one and five minutes, and serves a modified extension of the Detailed Assessment of Posttraumatic Stress (DAPS) (Briere, 2013). Asserting reliability of the test, the manual indicates internal consistency based on PR & SR scale values (Briere, 2013). Validity is supported through further assertions of discriminant and convergent validity based on various case studies (Briere, 2013). Predictive validity is likewise addressed, as the test manual recognizes a significant rate of accuracy of the PTSD & Suicide Screener within the context of both identifying and eliminating occurrences of PTSD in test subjects (Briere, 2013). In 2015, the cost of the intro kit, which includes the manual and 25 answer sheets, amounted to $82.00; rates for online administration were $1.00 per test (Briere, 2013). Due to these characteristics, this test could prove valuable in providing quick insight into the stress and suicide risk levels of a client, but should be used in conjunction with other assessment tools in forming a clinical diagnosis.

Psychological Tests Part 2: Davidson Trauma Scale

The Davidson Trauma Scale is a paper and pencil formatted, self-inventory assessment, developed to assist in the process of assessment and treatment of PTSD (Davidson, 1996). The manual explicitly states that the test is to be used in conjunction with other methods within the process of diagnosis, but this tool provides a valuable indication of severity and particularity of symptoms (Davidson, 1996). The duration of the test is approximately ten minutes, depending on test-taker, and the starter kit of the manual and 25 Quickscore Forms costs $115.00 (Davidson, 2016). Four studies were utilized to support claims of reliability pertaining to the Davidson Trauma Scale; after a one-week interval, the retest coefficient was numerically represented as .86 (Davidson, 1996). Support for validity, within the test manual, rests in attention to classification accuracy, convergent validity, divergent validity, group differences, and treatment change – comparisons of the Davidson Trauma Scale score with various rates of efficacy when contrasted the Clinician Administered PTSD Scale, Impact of Events Scale, and Symptom Checklist (Davidson, 1996). Though this test cannot be used as the primary basis in diagnosing PTSD, it can answer valuable questions relating to severity of the case and appropriate course of treatment.

Conclusion

There are many standardized, empirically based tools available for use throughout the process of assessment and diagnosis specifically within the context of mental health disorders. However, within the instructions for each method, the counselor is required to consider the individual needs and experiences of the client. Though objective testing and assessment measures are useful, providing a baseline standardization, the ability of the professional counselor to properly diagnose a client extends far beyond the confines of science by requiring empathy, compassion, and deep understanding of another.

References

Briere, J. (2013). PTSD and Suicide Screener. Mental Measurements Yearbook with Tests in Print. Retrieved from https://lopes.idm.oclc.org/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=mmt&AN=test.6505&site=ehost-live&scope=site

Cohen, R. J., Swerdlik, M. E., & Sturman, E. D. (2013). Psychological testing and assessment: An introduction to tests and measurement (8th ed.). Retrieved from http://www.gcumedia.com/digital-resources/mcgraw-hill/2012/psychological-testing-and-assessment_an-introduction-to-tests-and-measurement_ebook_8e.php

Davidson, J. (1996). Davidson Trauma Scale. Mental Measurements Yearbook with Tests in Print. Retrieved from https://lopes.idm.oclc.org/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=mmt&AN=test.20

Diagnostic and statistical manual of mental disorders: DSM-5. (2013). Washington, D.C.: American Psychiatric Association.

DiCecco, K. (2011). Post-traumatic Stress Disorder (PTSD). Journal Of Legal Nurse Consulting, 22(3), 20-22.