Trauma, PTSD and post-traumatic stress spectrum: 15 years’ experience on a multidimensional approach to trauma related psychopathology

Claudia Carmassi, Filippo Maria Barberi, Annalisa Cordone, Alessandra Maglio, Valerio Dell’Oste, Liliana Dell’Osso

Department of Clinical and Experimental Medicine, University of Pisa, Italy

Objectives

The purpose of this article is to provide an overview of the studies conducted using the Trauma and Loss Spectrum-Self Report (TALS-SR) since its validation, also summarizing the structure of this psychometric instrument and the underlying dimensional approach. 

Methods

In this article we revise the results obtained across several studies in which the TALS-SR has been used. The Trauma and Loss Spectrum (TALS), also known as post-traumatic stress spectrum, was developed in the framework of the Spectrum Project, an Italy-USA research collaboration project aimed at developing and validating tools designed to assess the spectrum of clinical manifestations related to DSM mental disorders. It represents a multidimensional approach to Post-Traumatic Stress Disorder and includes: potentially traumatic and/or loss events to which one can be exposed across his/her lifetime; a spectrum of acute peri-traumatic reactions; a broad range of post-traumatic stress and/or Complicated Grief (CG) spectrum symptoms. Both a clinical interview and self-report instrument were developed, namely the: Structured Clinical Interview for Trauma and Loss Spectrum (SCI-TALS), and Trauma and Loss Spectrum-Self Report (TALS-SR). Both instruments consist of 116 items, coded dichotomously (yes/no) and grouped in 9 domains. Two out of nine domains explore symptoms related to the pathologic grief reactions related to the loss of a loved one, also named as CG or Persistent Complex Bereavement Disorder (PCBD), this latter to date first included in the DSM-5, in the Section III of disorders that deserve further clinical attention. 

Results

The instruments were validated and adopted in clinical samples, such as patients with PTSD, CG, affected by medical conditions (such as fibromyalgia), caregivers of children with chronic illnesses, Emergency Unit personell, as well as in general population samples (e.g. survivors to the April 2009 L’Aquila earthquake) and healthy controls. Studies comparing full and partial symptomatological PTSD, in accordance to either the DSM-IV or DSM-5 criteria, were also possible, due to the wide spectrum of trauma related sympotms encompassed by the TALS, including the DSM-5 ones. Furthermore, the relationships between post-traumatic stress spectrum and other psychopathological dimensions, such as mood, eating and adult subthreshold autism spectrum, were explored.

Conclusions

The use of the TALS-SR allows a valid exploration of the trauma and loss spectrum, in itself and in relation to other psychopathological dimensions. Moreover, it represents a valuable tool in clinical practice, for the diagnosis and management of PTSD.

Scarica il PDF