Detailed Assessment of Posttraumatic Stress (DAPS)

Detailed Assessment of Posttraumatic Stress (DAPS)

Introduction

The Detailed Assessment of Posttraumatic Stress (DAPS) is an 105-item inventory that provides detailed information on an adult client's history of various types of trauma exposure, as well as his or her immediate psychological reactions (cognitive, emotional, and dissociative), enduring posttraumatic stress symptoms (reexperiencing, avoidance, and hyperarousal), and level of posttraumatic impairment in the context of a specific traumatic event. The event-focus of the DAPS allows for a tentative DSM-IV diagnoses of Posttraumatic Stress Disorder (PTSD) and Acute Stress Disorder (ASD). The DAPS also includes two validity scales that evaluate under- and over-report of symptoms, and three supplementary scales that evaluate the event-related dissociation, substance abuse, and suicidality often associated with posttraumatic stress.

Discussion

ASSESSMENT INSTRUMENTS

Although an optimal evaluation of a patient for PTSD consists of a face-to-face interview by a mental health professional trained in diagnosing psychiatric disorders, several instruments are available to facilitate the diagnosis and assessment of posttraumatic stress disorder (PTSD). These include screening tools, diagnostic instruments, and trauma and symptom severity scales. For example, there are brief screening tools, such as the 4-item Primary Care PTSD Screen, developed by the Department of Veterans Affairs National Center for Posttraumatic Stress Disorder; self-report screening instruments, such as the Posttraumatic Diagnostic Scale; and structured or semi-structured interviews, such as the Clinician-Administered PTSD Scale (CAPS), the Structured Clinical Interview for DSM-IV (SCID), the Diagnostic Interview Schedule for DSM-IV (DIS-IV), and the Composite International Diagnostic Interview (CIDI), all of which might be used prior to or as a complement to the clinical interview. These instruments are discussed below (Dietrich, 2007). Such measures are used most frequently in research settings, some might be used clinically to provide additional sources of documentation, and others might be given to veterans at a health facility prior to their first interview with health professional. Screening tools can be useful in initiating a conversation about exposure to traumatic events or possible PTSD symptoms. However, as noted in Briere (2004) “no psychological test can replace the focused attention, visible empathy, and extensive clinical experience of a well-trained and seasoned trauma clinician.”

The components of the DAPS are:

Response Validity [16 items] - Evaluates the respondent's tendency to present as either especially symptom-free or as overly symptomatic.  This component contains two scales:

Positive Bias [8 items] - Indicates the extent of defensiveness or underendorsement of DAPS items, as reflected in a tendency to deny even common or "normal" experiences.

Negative Bias [8 items] - Indicates the extent of symptom over-endorsement, as reflected in a tendency to endorse very uncommon, if not bizarre, DAPS items.   

Trauma specification [14 items] - Reviews all potential traumatic events (i.e., involving injury or fear of injury or death) the client has been exposed to in his/her lifetime, such as natural disasters, motor vehicle accidents, rape, physical assault, and child abuse, and specifies which trauma the client experiences as most upsetting (or the one on which the refering clinician wishes to focus) and when this event occured.  A summary Relative Trauma Exposure scale indicates whether the client's lifetime ...