Initial Trauma Review – Revised
John Briere, Ph.D.
Please note: Use of this scale is limited to professional therapists and researchers. It is not intended as – nor should it be used as – a self-test.
The Initial Trauma Review, Revised (ITR-R; Briere, 2004) is a behaviorally-anchored, semi-structured interview that allows the clinician to evaluate most major forms of trauma exposure. It also inquires about subjective distress in response to these traumas, as required by DSM-IV’s A2 criteria for PTSD and ASD. The clinician should feel free, however, to paraphrase the items of the ITR-R, and to add any additional traumas that he or she thinks are relevant to the client’s situation. Cut and paste this measure, as needed, into your word processor.
This measure appears as an appendix in:
Briere, J. (2004). Psychological assessment of adult posttraumatic states: Phenomenology, diagnosis, and measurement, 2nd edition. Washington, D.C.: American Psychological Association.
An expanded version (the ITR-3) can be found in Briere, J. & Scott, C. (2006). Principles of trauma therapy. Newbury Park, CA: Sage.
Initial Trauma Review – Revised (ITR-R)
CHILDHOOD QUESTIONS:
1) [Physical abuse questions] “Before you were age 18, did a parent or another adult ever hurt or punish you in a way that left a bruise, cut, scratches, or made you bleed?”
Yes__ No__ [Yes = physical abuse]
If yes:
- “When this happened, did you ever feel very afraid, horrified, or helpless?“
Yes__ No__
- “Did you ever think you might be injured or killed?“
Yes__ No__
- [Sexual abuse questions] “Before you were age 18, did anyone who was 5 or more years older than you ever do something sexual with you or to you?“
Yes__ No__ [Yes = sexual abuse]
If yes:
- “Did the person ever put their penis, a finger, or an object into your vagina, or anus, or a penis in your mouth?“
Yes__ No__ [Yes = sexual abuse with penetration]
- “Was this ever done against your will or when you couldn’t defend yourself (for example when you were asleep or intoxicated)?”
Yes__ No__ [Yes = sexual abuse]
- “When this happened, did you ever feel very afraid, horrified, or helpless?“
[NOTE: For sexual abuse only, this part is not necessary for PTSD Criterion A]
Yes__ No__
- “Did you ever think you might be injured or killed?“
[NOTE: For sexual abuse only, this part is not necessary for PTSD Criterion A]
Yes__ No__
- [Peer sexual assault questions] “Before you were age 18, did anyone who was less than 5 years older than you ever do something sexual to you that was against your will or that happened when you couldn’t defend yourself (for example when you were asleep or intoxicated)?“
Yes__ No__ [Yes = peer child sexual assault]
If yes:
- “Did the person ever put their penis, a finger, or an object into your vagina, anus, or mouth?“
Yes__ No__ [Yes = peer child rape if any insertion in vagina or anus, or penile insertion in mouth]
- “When this happened, did you ever feel very afraid, horrified, or helpless?“
Yes__ No__
- “Did you ever think you might be injured or killed?“
Yes__ No__
- [Disaster questions] “Before you were age 18, were you ever involved in a serious fire, earthquake, flood, or other disaster?“
Yes__ No__ [Yes = childhood exposure to disaster]
If yes:
- “When this happened, did you ever feel very afraid, horrified, or helpless?“
Yes__ No__
- “Did you ever think you might be injured or killed?“
Yes__ No__
- [Motor vehicle accident question] “Before you were age 18, were you ever involved in a serious automobile accident?“
Yes__ No__ [Yes = childhood exposure to MVA]
If yes:
- “When this happened, did you ever feel very afraid, horrified, or helpless?“
Yes__ No__
- “Did you ever think you might be injured or killed?“
Yes__ No__
- [Witnessing trauma questions] “Before you were age 18, did you ever see someone else get killed or badly hurt?”
Yes__ No__ [Yes = childhood witness to trauma]
If yes:
- “When this happened, did you ever feel very afraid, horrified, or helpless?“
Yes__ No__
- “Did you ever think you might be injured or killed?” [Not required for PTSD Criterion A
Yes__ No__
ADULTHOOD QUESTIONS
1) [Adult sexual assault questions] “Since you were 18 or older, has something sexual ever been done to you against your will or when you couldn’t defend yourself (for example when you were asleep or intoxicated)?”
Yes__ No__ [Yes = Adult sexual assault]
If yes:
- “Did the person ever put their penis, a finger, or an object into your vagina or anus, or a penis in your mouth?“
Yes__ No__ [Yes = adult rape]
- “When this happened, did you ever feel very afraid, horrified, or helpless?“
Yes__ No__
- “Did you ever think you might be injured or killed?“
Yes__ No__
- “Did this ever happen on a date, or with a sexual/romantic partner or spouse?
Yes__ No__ [Yes = date/partner/marital sexual assault or rape]
2) [Spouse/partner abuse questions] “Since you were 18 or older, have you
- ever been slapped, hit, or beaten in a sexual or marital relationship?“
Yes__ No__ [Yes = partner battering]
- ever been shot, shot at, stabbed, or nearly strangled in a sexual or marital relationship?“
Yes__ No__ [Yes = partner battering and possible attempted murder]
If yes to either:
- “When this happened, did you ever feel very afraid, horrified, or helpless?“
Yes__ No__
- “Did you ever think you might be injured or killed?“
Yes__ No__
3) [Non-intimate assault questions] “Since you were 18 or older, have you ever been physically attacked, assaulted, stabbed, or shot at by someone who wasn’t a sex partner or husband/wife?”
Yes__ No__ [Yes = non-intimate assault and possible attempted murder]
If yes:
- “When this happened, did you ever feel very afraid, horrified, or helpless?“
Yes__ No__
- “Did you ever think you might be injured or killed?“
Yes__ No__
4) [War questions] “Since you were 18 or older, have you ever experienced combat or fought in a war?”
Yes__ No__ [Yes = combat exposure]
If yes:
- “When this happened, did you ever feel very afraid, horrified, or helpless?“
Yes__ No__
- “Did you ever think you might be injured or killed?“
Yes__ No__
5) [Motor vehicle accident questions] “Since you were 18 or older, were you ever involved in an serious automobile accident?”
Yes__ No__ [Yes = motor vehicle accident]
If yes:
- “When this happened, did you ever feel very afraid, horrified, or helpless?“
Yes__ No__
- “Did you ever think you might be injured or killed?“
Yes__ No__
6) [Disaster questions] “Since you were 18 or older, were you ever involved in a serious fire, earthquake, flood, or other disaster?”
Yes__ No__ [Yes = disaster exposure]
If yes:
- “When this happened, did you ever feel very afraid, horrified, or helpless?“
Yes__ No__
- “Did you ever think you might be injured or killed?“
Yes__ No__
7) [Torture questions — If client is an immigrant from another country] “In the country where you used to live, were you ever tortured by the government or by people against the government?”
Yes__ No__ [Yes = torture]
If yes:
- “When this happened, did you ever feel very afraid, horrified, or helpless?“
Yes__ No__
- “Did you ever think you might be injured or killed?“
Yes__ No__
8) [Police trauma questions] “In this country, have you ever been hit, beaten, assaulted, or shot by the police or other law enforcement officials, during or after an arrest, or at some other time?”
Yes__ No__ [Yes = police trauma]
If yes:
- “When this happened, did you ever feel very afraid, horrified, or helpless?“
Yes__ No__
- “Did you ever think you might be injured or killed?“
Yes__ No__
9) [Witnessing questions] “Since you were 18 or older, did you ever see someone else killed or badly hurt?
Yes__ No__ [Yes = adult witness to trauma]
If yes:
- “When this happened, did you ever feel very afraid, horrified, or helpless?“
Yes__ No__
- “Did you ever think you might be injured or killed?” [NOTE: For witnessing trauma, this part is not necessary for DSM-IV Criterion A]
Yes__ No__