International Trauma Questionnaire (ITQ)

Overview

• The ITQ is a concise tool focusing on core symptoms of PTSD and Complex PTSD (CPTSD), adhering to ICD-11 principles.
• Designed to maximize clinical and international applicability by focusing on core symptoms.
• The questionnaire is free and open to anyone interested.
• Ongoing evaluation, especially regarding the definition of functional impairment for both PTSD and CPTSD.

Diagnostic Algorithms

PTSD

• Requires at least one of two symptoms from each symptom group:
  1. Re-experiencing the traumatic event in the present.
  2. Avoidance.
  3. Sense of threat.
• At least one indicator of functional impairment associated with these symptoms must be present.
• A score of 2 or more indicates the presence of a symptom or functional impairment.

CPTSD

• Requires at least one of two symptoms from each of the PTSD symptom groups and from each of the three self-organization disturbance symptoms:
  1. Affective dysregulation.
  2. Negative self-concept.
  3. Disturbances in relationships.
• Functional impairment must be demonstrated with at least one indicator associated with PTSD symptoms and self-organization disturbances.
• A score of 2 or more indicates the presence of a symptom or functional impairment.
• A person cannot be diagnosed with both PTSD and CPTSD. If criteria for CPTSD are met, PTSD is not additionally diagnosed.

Scoring Instructions

• Available at the end of the document.

Key References

• Cloitre et al. (2018) on the development of ITQ.
• Bøkkelund, Sele, & Berg (2019) for the Norwegian version.
• Articles providing background on ITQ include works by Brewin et al., Karatzias et al., Hyland et al., Shevlin et al.

Questionnaire Instructions

• Respondents are asked to specify the event causing distress and answer questions based on that event.

Time Since Event

• Options range from less than 6 months ago to more than 20 years ago.

List of Problems

• Respondents rate the extent of their distress based on frequency and impact, using a scale from 0 (Nothing) to 4 (Extremely).

PTSD Related Questions

• Disturbing dreams, intrusive memories.
• Avoidance of internal or external reminders.
• Hypervigilance, startle response.
• Impact on relationships, work, and other life areas.

DSO Related Questions

• Difficulty calming down, emotional numbing.
• Feelings of failure, worthlessness.
• Detachment from others, difficulty in emotional closeness.
• Impact on relationships, work, and other life areas.

Diagnostic Scoring

PTSD

• Re-experiencing: If P1 or P2 ≥ 2.
• Avoidance: If P3 or P4 ≥ 2.
• Threat: If P5 or P6 ≥ 2.
• Functional Impact: At least one of P7, P8, or P9 ≥ 2.
• Criteria for PTSD are met if all above groups have scores indicating presence.

CPTSD

• Affective Dysregulation: If C1 or C2 ≥ 2.
• Negative Self-Concept: If C3 or C4 ≥ 2.
• Relationship Disturbance: If C5 or C6 ≥ 2.
• DSO Functional Impact: At least one of C7, C8, or C9 ≥ 2.
• Criteria for DSO are met if all above groups have scores indicating presence.
• PTSD is diagnosed if PTSD criteria are met but not DSO.
• CPTSD is diagnosed if both PTSD and DSO criteria are met.

Dimensional Scoring

PTSD

• Re-experiencing: Sum of P1 and P2.
• Avoidance: Sum of P3 and P4.
• Threat: Sum of P5 and P6.
• PTSD score: Sum of Re-experiencing, Avoidance, and Threat.

DSO

• Affective Dysregulation: Sum of C1 and C2.
• Negative Self-Concept: Sum of C3 and C4.
• Relationship Disturbance: Sum of C5 and C6.
• DSO score: Sum of Affective Dysregulation, Negative Self-Concept, and Relationship Disturbance.