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The International Trauma Questionnaire

Published: June 15, 2023
Last updated on August 20, 2024

The International Trauma Questionnaire (ITQ) is a self-report measure of ICD-11 post-traumatic stress disorder (PTSD) and complex PTSD (C-PTSD).

Basic information
Statements: 18
Duration: 3–5 minutes
Type: screening tool
Authors: Cloitre, M., Shevlin M., Brewin, C.R., Bisson, J.I., Roberts, N.P., Maercker, A., Karatzias, T., Hyland, P.
Publishing year: 2018
Seminal paper: The International Trauma Questionnaire: Development of a self-report measure of ICD-11 PTSD and Complex PTSD. (Cloitre, Shevlin, et al., 2018)

 

Take the test here:

Note

The following test asks you to review
previous traumatic experiences.

Please forgo the test if you feel
it will traumatize you.

Dr. Natalie’s rating: 4 stars for appropriate and respectful wording, 2 stars for clarity & lack of ambiguity, and 5 stars for testing accuracy.Dr. Natalie’s rating: 4 stars for appropriate and respectful wording, 2 stars for clarity & lack of ambiguity, and 5 stars for testing accuracy.

Who the test is designed for

  • Adults (age 18+) judged to have an IQ in the normal range (IQ >=85).
  • Versions for adolescents and children are also available.

Versions & translations

Taking the test

The ITQ consists of 18 items, giving you 5 choices for each item:

  1. Not at all = 0 points
  2. A little bit = 1 point
  3. Moderately = 2 points
  4. Quite a bit = 3 points
  5. Extremely = 4 points

The 18 items of the ITQ are broken down into four categories:

  • 9 questions on responses to traumatic or stressful events (PTSD)
  • 3 questions on the affects of those responses (PTSD)
  • 6 statements on how true a statement is of you (C-PTSD)
  • 3 questions on those beliefs and emotions (C-PTSD)

Scoring

1. Diagnostic scoring for PTSD and C-PTSD

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 (PTSD-FI)
  • If criteria for ‘Re_dx’ AND ‘Av_dx’ AND ‘Th_dx’ AND ‘PTSD-FI’ are met
  • Then 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 (DSO-FI)
  • If the criteria for ‘AD_dx’ AND ‘NSC_dx’ AND ‘DR_dx’, and ‘DSO-FI’ are met, the criteria for DSO are met.
Diagnosis
  • 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 the criteria for DSO are met
  • Not meeting the criteria for PTSD or meeting only the criteria for DSO results in no diagnosis

2. Dimensional scoring for PTSD and C-PTSD.

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 (Re) score
  • Sum of Likert scores for P3 and P4 = Avoidance (Av) score
  • Sum of Likert scores for P5 and P6 = Sense of current threat (Th) score
  • 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

Validity

How reliable, accurate, valid, and up-to-date is the test?

Psychometric investigations in 2022 of the ITQ have provided good evidence of its reliability and validity as a measure of ICD-11 PTSD and CPTSD.[1]A psychometric evaluation of the International Trauma Questionnaire (ITQ) in a trauma-exposed college sample (Camden et al., 2022)

Dr. Natalie Engelbrecht pointing to the title ‘Discussion’.

Discussion

Natalie:

I disliked having to purposely bring up something upsetting; this test can be quite triggering for people with trauma.

I also don’t understand why, in this test, you can’t have C-PTSD without PTSD, as a C-PTSD diagnosis doesn’t rely on a PTSD diagnosis in practice.

 

Kendall:

As an experiment, I did the test three times, with three different traumas—from more than 20 years, 5–10 years, and less than six months ago. The results were similar. This experiment was due to the conundrum of identifying the experience that ‘troubles you the most’. The more recent a trauma, the more it impacts my day-to-day functioning, but distant traumas though currently less active in my mind, are no less troubling. Recalling a traumatic event to take the test is an unfortunate necessity.

Dr. Natalie Engelbrecht pointing at a psychometric test.

The ITQ

Briefly describe the experience that troubles you the most, and indicate how long ago it occurred. Then, for items P1–P9, enter your responses concerning its effects during the past month.

Items C1–C9 refer to the ways you typically feel, typically think about yourself, and typically relate to others. Answer them thinking about how true each statement is of you.

Challenging experience
Instructions: Please identify the experience that troubles you most and answer the questions in relation to this experience.

Brief description of the experience:
When did the experience occur?
PTSD
Instructions: Below are a number of problems that people sometimes report in response to traumatic or stressful life events. Please read each item carefully, then select one to indicate how much you have been bothered by that problem in the past month.
P1. Having upsetting dreams that replay part of the experience or are clearly related to the experience?
P2. Having powerful images or memories that sometimes come into your mind in which you feel the experience is happening again in the here and now?
P3. Avoiding internal reminders of the experience (for example, thoughts, feelings, or physical sensations)?
P4. Avoiding external reminders of the experience (for example, people, places, conversations, objects, activities, or situations)?
P5. Being “super-alert”, watchful, or on guard?
P6. Feeling jumpy or easily startled?
In the past month have the above problems:
P7. Affected your relationships or social life?
P8. Affected your work or ability to work?
P9. Affected any other important part of your life such as parenting, or school or college work, or other important activities?
C-PTSD
Instructions: Below are problems that people who have had stressful or traumatic events sometimes experience. The questions refer to ways you typically feel, ways you typically think about yourself and ways you typically relate to others. Answer the following thinking about how true each statement is of you.
How true is this of you?
C1. When I am upset, it takes me a long time to calm down.
C2. I feel numb or emotionally shut down.
C3. I feel like a failure.
C4. I feel worthless.
C5. I feel distant or cut off from people.
C6. I find it hard to stay emotionally close to people.
In the past month, have the above problems in emotions, in beliefs about yourself and in relationships:
C7. Created concern or distress about your relationships or social life?
C8. Affected your work or ability to work?
C9. Affected any other important parts of your life such as parenting, or school or college work, or other important activities?

Recommended next steps

After the ITQ, consider taking one of the tests below.

Toronto Alexithymia Questionnaire

Measures difficulty in identifying and
describing emotions and feelings

Empathy Quotient

Measures your ability to tune into how someone else
is feeling, or what they might be thinking

Toronto Empathy Questionnaire

Measures your emotional ability to
understand and respond to others.

Online autism tests can play an essential role in the process of self-discovery, and may inform your decision to pursue a formal diagnosis. For a formal assessment, please see a knowledgeable medical professional trained in assessing autism.

An illustration of a clipboard with a checklist or assessment.

If you are looking for an autism assessment,
Dr. Natalie Engelbrecht can offer help!
You can find more information here:

Online autism assessments

References

 

This article
was written by:
dr-natalie-engelbrecht
Dr. Natalie Engelbrecht ND RP

Dr. Natalie Engelbrecht ND RP is a dually licensed naturopathic doctor and registered psychotherapist, and a Canadian leader in trauma, PTSD, and integrative medicine strictly informed by scientific research.

She was diagnosed at 46, and her autism plays a significant role in who she is as a doctor, and how she interacts with and cares for her patients and clients.

Want to know more about her? Read her About me page.

Disclaimer

Although our content is generally well-researched
and substantiated, or based on personal experience,
note that it does not constitute medical advice.

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