Screening for PTSD
(11-19-03)

1. Obtaining an accurate and complete trauma history is essential in evaluating for PTSD and Acute Stress Disorder

2. SPAN

SPAN is a screening inquiry comprising four questions taken from the Davidson Trauma Scale (DTS) which often indicate a likelihood of PTSD:

S Startle reaction: "Have you been jumpy or easily startled?"

P Physiologic distress: "Have you been physically upset by reminders of the event?" (This includes sweating, trembling, racing heart, shortness of breath, nausea, or diarrhea)

A Anger: "Have you been irritable or had outbursts of anger?"

N Numbness: "Have you been unable to have sad or loving feelings?"

3. DREAMS

DREAMS is a mnemonic for questions regarding symptoms of PTSD

D Detached--is the client is feeling detached from others?

R Re-experiencing the trauma--is the client re-experiencing the trauma?

E Emotional distress--does the client feel distressed?

A Avoidance--is the client avoiding stimuli that trigger memories of the trauma?

M Months--have the symptoms been present for one month or more?

S Sympathetic hyperarousal--is the client showing autonomic arousal?

4. Peritraumatic Distress Inventory

Brunet et al., (2001) provide a self-report inventory to evaluate the A2 criteria for DSM-IV PTSD.

5. Jacobs & Dalenberg (1998) discuss using a Cultural Context Interview for PTSD is you suspect failure to report for culturally relevant reasons, asking for ratings of items from the Weiss and Marmar's Impact of Event Scale--Revised in terms of similarity of cultural interpretation to original item, estimated frequency within culture (cultural expectation), rating of respect for person meeting cultural self-definition (another Hispanic man) reporting the symptom (cultural value), and estimated difficulty in answering the question honestly (cultural undesirability); they suggest that: "Low cultural expectation, low cultural value, and high cultural undesirability predict lower report of traumatic symptoms after an abuse experience in black adults." (p. 843). Low cultural interpretation was associated with higher item-total discrepancy and could indicate that an item was not valid for the individual being evaluated.