Evaluating PTSD: The Role of the TSI-2 in Improving Treatment Outcomes for Adults with Posttraumatic Symptoms

We all experience moments of stress in our lives, but some events can leave a lasting effect. Posttraumatic stress disorder (PTSD) is a mental health condition caused by experiencing or witnessing an extremely traumatic event. While it’s common to have difficulty coping after a traumatic event, people with PTSD will have symptoms—such as flashbacks, nightmares, severe anxiety, or uncontrollable thoughts about the event—that worsen or persist months to years later.

June marks PTSD Awareness Month, a time to bring attention to this condition and how to access treatment. As we focus on understanding PTSD, we must also look at how we provide support to those affected by it.

Treatment for PTSD is key for helping people feel better and improve their ability to function daily. Tools designed to evaluate posttraumatic symptomatology assist mental health professionals with their assessments, allowing them to gain a better picture of patient symptoms and make tailored treatment recommendations based on this information. The Trauma Symptom Inventory™-2 (TSI™-2) is one such tool that is widely used as a test of trauma-related symptoms and behaviors.

In this blog, we will discuss the symptoms of PTSD, how it is assessed, and the value of the TSI-2 in evaluating people with PTSD.

Understanding the Cause and Symptoms of PTSD

PTSD develops in about one in three people who experience severe trauma. There is no way to tell if a traumatic event will cause PTSD or not, and experts are still unsure why some people get it while others don’t. People who repeatedly experience traumatic events or situations may develop complex PTSD, which has similar symptoms and may not develop until years later. While PTSD is often associated with military veterans due to the increased likelihood of experiencing a traumatic event, anyone can develop PTSD if they have experienced a severely stressful or disturbing event. These events may involve:

• Actual or threatened death
• Serious injury
• Sexual assault
• Abuse (including childhood or domestic abuse)
• Torture
• Serious health problems
• War and conflict

Additionally, there may be genetic and biological factors that increase the likelihood of some people developing PTSD after a traumatic event. These include having a parent with a mental health problem and pre-existing depression or anxiety. Women are also more likely to develop PTSD than men, likely due in part to the types of trauma that women experience.

Symptoms of PTSD may begin to appear within the first three months following a traumatic event. However, symptoms sometimes appear later—even years after the event has occurred. These symptoms are grouped into four types:

Intrusive Memories/Intrusion

• Recurring memories of the event that are distressing and unwanted
• Distressing dreams or nightmares about a traumatic event
• Flashbacks of the event, or reliving it as it were happening again
• Severe emotional or physical reactions to things that remind you of the event

Avoidance

• Not wanting to think or talk about the traumatic event
• Avoiding anything that reminds you of the event, including places, activities, or people

Negative Changes in Thinking and Mood

• Depressive symptoms like low mood, lack of interest in activities that were once enjoyed, or an inability to feel happiness
• Negative thoughts about yourself or others
• Memory problems, including forgetting important aspects of a traumatic event
• Detaching from family and friends
• Ongoing negative emotions of fear, anger, guilt, or shame
• Emotional numbness

Changes in Physical and Emotional Reactions/Arousal and Reactivity

• Increased irritability
• Physical reactions like sweating, fast heartbeat, shaking, or rapid breathing
• Trouble sleeping
• Being easily frightened or startled
• Remaining on guard for danger
• Difficulty concentrating
• Exhibiting self-destructive behaviors, such as driving too fast or drinking too much
• Angry outbursts

Children six years and younger with PTSD may also show signs like reenacting the traumatic event through play or having frightening dreams.

If symptoms last for more than a month, it’s important to seek help from a healthcare provider or mental health professional. Untreated, PTSD symptoms can affect everyday functions and worsen over time. The severity of symptoms can vary with time, especially during periods of stress or after encountering reminders of the traumatic event.

The Importance of Evaluating PTSD

While it’s difficult to estimate the exact number of people who have PTSD, it’s estimated that about six out of every 100 people (approximately six percent of the U.S. population) will have PTSD at some point in their lives. The effects of PTSD are disruptive and potentially destructive, impacting almost every aspect of day-to-day life. Because of this and the complexity of the condition, assessment for PTSD is key for determining the best possible treatment.

PTSD is most often diagnosed by a mental health provider. The assessment process for PTSD will include several steps, including a short screening and a more in-depth assessment. During this part of the process, questions are used to get a better picture of the patient’s thoughts, feelings, and behaviors since the trauma. This is where tools like the TSI-2 come into play, providing reliable information about the effects of trauma on the individual.

Why the TSI-2?

With an administration time of just 20 minutes, the TSI-2 is a broadband measure that evaluates acute and chronic posttraumatic symptomatology. It is a self-report designed with a variety of features and benefits, including:

• Three scales (Insecure Attachment, Somatic Preoccupations, and Suicidality) and several subscales, as well as four summary factors (Self-Disturbance, Posttraumatic Stress, Externalization, and Somatization).
• Items that assess clients’ tendencies to deny symptoms that are commonly endorsed, to over endorse unusual or bizarre symptoms, or to respond in a random manner; the instrument now addresses malingering.
• A standardization sample (N = 678) that closely matches U.S. Census statistics.
• Easy administration and scoring, including online options available on PARiConnect.
• TSI-2 Alternative Form (TSI-2-A, does not contain any sexual symptom items) and Spanish versions available.

The information provided by the TSI-2 can make all the difference for clinicians and their patients, providing integral insights that lead to improved outcomes.

Moving Forward: Raising Awareness About PTSD

Understanding and addressing PTSD is crucial for improving the lives of those affected by this condition. The Trauma Symptom Inventory™-2 (TSI™-2) plays a vital role in evaluating posttraumatic symptoms, providing mental health professionals with the insights needed to tailor treatment plans effectively.

By utilizing tools like the TSI-2, we can better support individuals on their journey to recovery, ensuring they receive the care and attention they deserve. As we continue to raise awareness about PTSD, let us strive to create a more compassionate and informed society that prioritizes mental health and well-being.