RESEARCH UPDATE REVIEW
Ten-Year Review of Rating Scales. IV: Scales Assessing Trauma and Its Effects

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ABSTRACT

Objective:

This article summarizes scales assessing trauma and its effects on youths.

Method:

We sampled trauma-related articles published over the past 25 years, with an emphasis on the past decade, selected scales with at least several publications, and reviewed their properties. Those with minimally adequate psychometric properties and continued literature citations or a special niche are presented.

Results:

Most of trauma-related scales are relatively new, reflecting the evolving interest in juvenile trauma. Therefore, they do not have the depth of psychometric examination nor the breadth of applications described for previously reviewed scales. However, they have been applied to various traumatic situations. These scales assess a range of trauma-related symptoms and behaviors, including posttraumatic stress disorder, symptoms related to posttraumatic stress disorder, and dissociation. Additionally, several scales assess the trauma itself.

Conclusions:

Trauma-related scales show promise for research and clinical use in understanding youths’ responses to trauma. However, their utility for treatment planning and for accountability in practice is generally not as clear. The potential user must clearly define the goals of measurement and use these scales within their limited roles. With these caveats, trauma-related scales may assist our work with traumatized youths.

Section snippets

POSTTRAUMATIC STRESS DISORDER RATING SCALES

Until recently, children were viewed as largely unaffected by trauma (Rigamer, 1986). It is now well recognized that traumatized children often demonstrate posttraumatic stress symptoms and even the full PTSD syndrome after a variety of traumatic experiences (Fletcher, 1996;Saigh, 1991;Yule, 1992). In fact, younger children appear more likely to develop PTSD than adolescents and adults (Fletcher, 1996). Girls may be at greater risk for PTSD than boys (Shannon et al., 1994), although this

SCALES MEASURING DISSOCIATION

Dissociation is a well-recognized reaction to trauma. Although challenging to define, it has been conceptualized as a person's attempts to protect himself or herself from an overwhelming stressor by altering self-awareness (Herman, 1992). Dissociation is hypothesized to exist along a continuum from normal to pathological; for example, from daydreaming to absorption in typical daily issues to preference for fantasy over reality in dealing with stressors. However, some dissociative phenomena,

OTHER TRAUMA-RELATED SCALES

This section covers scales that are neither PTSD based nor symptom scales, but scales that evaluate the traumatic experience itself, assess youths’ perception of the trauma and its impact on their lives, and measure others’ responses to youths following their trauma. The traumatic events include childhood abuse and neglect, sexual abuse, and environmentally related traumas.

Childhood abuse differs from other trauma because it is so often characterized by recurrence, chronicity, and perpetration

SUMMARY AND CONCLUSIONS

Because work with traumatized youths is relatively new, so are the available rating scales. Most have been developed during the past decade or are still in development. They do not yet have a rich database of applications. Therefore, the contribution of these scales to understanding the experience and needs of traumatized youths is not yet clear. Scales measuring PTSD, related symptoms, and dissociation appear useful for documenting youths’ symptoms and distress across multiple areas, but it is

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