International Trauma Questionnaire ITQ PTSD

What is ITQ

The International Trauma Questionnaire (ITQ) is a self-report diagnostic measure of post-traumatic stress disorder (PTSD) and complex PTSD (CPTSD), as defined in the 11th version of the International Classification of Diseases (ICD-11). The ITQ is a brief, simply worded measure, focusing only on the core features of PTSD and CPTSD, and employs straightforward diagnostic rules. The ITQ was developed to be consistent with the organizing principles of the ICD-11, as set forth by the World Health Organization, which are to maximize clinical utility and ensure international applicability through a focus on the core symptoms of a given disorder.

ITQ Printable PDF

You can create a free account on PsyPack to access fillable PDFs, manuals and educational resources for the ITQ

ITQ Scoring and Interpretation

Diagnostic scoring for PTSD and CPTSD

PTSD

If P1 or P2 ≥ 2 criteria for Re-experiencing in the here and now (Re_dx) met

If P3 or P4 ≥ 2 criteria for Avoidance (Av_dx) met

If P5 or P6 ≥ 2 criteria for Sense of current threat (Th_dx) met

AND

At least one of P7, P8, or P9 ≥ 2 meets criteria for PTSD functional impairment (PTSDFI)

If criteria for ‘Re_dx’ AND ‘Av_dx’ AND ‘Th_dx’ AND ‘PTSDFI’ are met, the criteria for PTSD are met.

CPTSD

If C1 or C2 ≥ 2 criteria for Affective dysregulation (AD_dx) met

If C3 or C4 ≥ 2 criteria for Negative self-concept (NSC_dx) met

If C5 or C6 ≥ 2 criteria for Disturbances in relationships (DR_dx) met

AND

At least one of C7, C8, or C9 ≥ 2 meets criteria for DSO functional impairment (DSOFI)

If criteria for ‘AD_dx’ AND ‘NSC_dx’ AND ‘DR_dx’, and ‘DSOFI’ are met, the criteria for DSO are met.

PTSD is diagnosed if the criteria for PTSD are met but NOT for DSO.

CPTSD is diagnosed if the criteria for PTSD are met AND criteria for DSO are met.

Not meeting the criteria for PTSD or meeting only the criteria for DSO results in no diagnosis.

Dimensional scoring for PTSD and CPTSD.

Scores can be calculated for each PTSD and DSO symptom cluster and summed to produce PTSD and DSO scores.

PTSD

Sum of Likert scores for P1 and P2 = Re-experiencing in the here and now score (Re)

Sum of Likert scores for P3 and P4 = Avoidance score (Av)

Sum of Likert scores for P5 and P6 = Sense of current threat (Th)

PTSD score = Sum of Re, Av, and Th

DSO

Sum of Likert scores for C1 and C2 = Affective dysregulation (AD)

Sum of Likert scores for C3 and C4 = Negative self-concept (NSC)

Sum of Likert scores for C5 and C6 = Disturbances in relationships (DR)

DSO score = Sum of AD, NSC, and DR

PTSD is diagnosed if the criteria for PTSD are met but NOT for DSO.

CPTSD is diagnosed if the criteria for PTSD are met AND criteria for DSO are met.

Not meeting the criteria for PTSD or meeting only the criteria for DSO results in no diagnosis.

PsyPack can automatically score the ITQ assessment and prepare corresponding tables and graphs.

Further, PsyPack automatically plots a graph to help you easily track progress over time.

Sample Report of ITQ

Domain

Post-Traumatic Stress Disorder (PTSD)

What does ITQ measure

The purpose of the evaluation is to:

capture the ICD-11 PTSD and CPTSD diagnoses.

Administration

Self-administered

Type of outcome tool

Clinical

Assessment modes

Questionnaire

Age and eligibility

18 years and above

Estimated time

Approximately 10 minutes

Notes

Since the questionnaire relies on client self-report, all responses should be verified by the clinician, and a definitive diagnosis is made on clinical grounds taking into account how well the client understood the questionnaire, as well as other relevant information from the client.

The World Health Organization (WHO) published the 11th revision of the International Classification of Diseases (ICD-11) in 2018, the first major revision to the ICD in 26 years. The organizing principles underpinning revisions to mental disorders in ICD-11 were that disorders should have clinical utility, be focused on a limited set of core symptoms and have international applicability. A revised definition of post-traumatic stress disorder (PTSD), comprised of six symptoms distributed across three symptoms clusters (Re-experiencing in the here and now, avoidance of traumatic reminders and a sense of threat), is included within the category of ‘Disorders Specifically Associated with Stress’. A sibling diagnosis of complex PTSD (CPTSD) is also included in this category and is comprised of the core PTSD symptom clusters plus three additional symptom clusters (affective dysregulation, negative self-concept and disturbances in relationships) that collectively represent ‘Disturbances in Self Organization’ (DSO).

DIAGNOSTIC ALGORITHMS are as follows:

PTSD. A diagnosis of PTSD requires the endorsement of one of two symptoms from the symptom clusters of (1) re-experiencing in the here and now, (2) avoidance, and (3) sense of current threat, plus endorsement of at least one indicator of functional impairment associated with these symptoms. Endorsement of a symptom or functional impairment item is defined as a score ≥ 2.

CPTSD. A diagnosis of CPTSD requires the endorsement of one of two symptoms from each of the three PTSD symptoms clusters (re-experiencing in the here and now, avoidance, and sense of current threat) and one of two symptoms from each of the three Disturbances in Self-Organization (DSO) clusters: (1) affective dysregulation, (2) negative self-concept, and (3) disturbances in relationships. Functional impairment must be identified where at least one indicator of functional impairment is endorsed related to the PTSD symptoms and one indicator of functional impairment is endorsed related to the DSO symptoms. Endorsement of a symptom or functional impairment item is defined as a score ≥ 2.

An individual can receive either a diagnosis of PTSD or CPTSD, not both. If a person meets the criteria for CPTSD, that person does not also receive a PTSD diagnosis.

Attribution and References

Cloitre, M., Shevlin M., Brewin, C.R., Bisson, J.I., Roberts, N.P., Maercker, A., Karatzias, T., Hyland, P. (2018). The International Trauma Questionnaire: Development of a self-report measure of ICD-11 PTSD and Complex PTSD. Acta Psychiatrica Scandinavica. 138(6), 536–546. https://doi.org/10.1111/acps.12956

Archived link