Trauma Symptom Check-list 33 and 40 (TSC-33 and TSC-40)
John Briere, Ph.D. and Marsha Runtz, Ph.D.
Please note: Use of this scale is limited to professional researchers. The TSC-40 is a research measure, not a clinical test. It is not intended as, nor should it be used as, a self-test under any circumstances.
This page contains a psychometric review of the TSC 33/40, with references up to mid-1998, followed by a free copy of the TSC-40 (at the end of this page) for use by researchers. Cut and paste to your word processor as needed (formatting will require adjustment).
This summary is substantially adapted from Briere, J. (1996), Psychometric review of the Trauma Symptom Checklist-40, in B.H. Stamm (Ed.). Measurement of stress, trauma, and adaptation. Lutherville, MD: Sidran Press.
TYPE OF POPULATION: Adults
COST: None
COPYRIGHT: John Briere, Ph.D. and Marsha Runtz, Ph.D.
WHAT IT MEASURES: The TSC-40 is a research measure that evaluates symptomatology in adults associated with childhood or adult traumatic experiences. It measures aspects of posttraumatic stress and other symptom clusters found in some traumatized individuals. It does not measure all 17 criteria of PTSD, and should not be used as a complete measure of that construct. The TSC-40 is a revision of the earlier TSC-33 (Briere & Runtz, 1989). Those requiring a validated psychological test of posttraumatic response, using a similar format, should consider the Trauma Symptom Inventory (TSI) or (for evaluation of a specific trauma) the Detailed Assessment of Posttraumatic Stress (DAPS).
MEASURE PROCEDURE AND CONTENT: The TSC-40 is a 40-item self- report instrument consisting of six subscales: Anxiety, Depression, Dissociation, Sexual Abuse Trauma Index (SATI), Sexual Problems,, and Sleep Disturbance, as well as a total score. Each symptom item is rated according to its frequency of occurrence over the prior two months, using a four point scale ranging from 0 (“never”) to 3 (“often”). The TSC-40 requires approximately 10-15 minutes to complete, and can be scored in approximately 5-10 minutes.
PSYCHOMETRIC PROPERTIES SUMMARY: Studies using the TSC-40 indicate that it is a relatively reliable measure (subscale alphas typically range from .66 to .77, with alphas for the full scale averaging between .89 and .91). The TSC-40 and its predecessor, the TSC-33, have predictive validity with reference to a wide variety of traumatic experiences (see reference section). The TSC-40 also appears to predict perpetration of intimate violence (e.g., Dutton, 1995) and vicarious traumatization in psychotherapists (e.g., Chrestman, 1995).
GENERAL COMMENTS: The TSC-40 is a research instrument only. It is freely available to researchers. No additional permission is required for use or reproduction of this measure, although Briere and Runtz (1989) should be cited.
MEASURE AUTHORS: John Briere, Ph.D. (USC) and Marsha Runtz, Ph.D. (Associate Professor, Department of Psychology, P.O. Box 3050, University of Victoria, Victoria, British Columbia, Canada, V8W 3P5)
PAPERS USING THE TSC-33 OR TSC-40
[Please note – this reference list is valid only up to the middle of 1998. For more recent references, do a PILOTS search under the instrument name and/or the authors’ names]
Bagley, C. (1991). The prevalence and mental health sequels of child sexual abuse in a community sample of women aged 18 to 27. Canadian Journal of Community Mental Health, 10, 103-116.
Bagley, C., Wood, M., & Young, L. (1994). Victim to abuser: mental health and behavioral sequels of child sexual abuse in a community survey of young adult males. Child Abuse and Neglect, 18, 683-697.
Binder, R.L, McNiel, D.E, & Goldstone, R.L. (1996). Is adaptive coping possible for adult survivors of childhood sexual abuse? Psychiatric Services, 47, 186-188.
Briere, J. (1989). Therapy for adults molested as children: Beyond survival. New York: Springer.
Briere, J., & Runtz, M. (1989). The Trauma Symptom Checklist (TSC-33): Early data on a new scale. Journal of Interpersonal Violence, 4, 151-163.
Briere, J., Evans, D., Runtz, M. & Wall, T. (1988). Symptomatology in men who were molested as children: A comparison study. American Journal of Orthopsychiatry, 58, 457-461.
Chrestman, K.R. (1995). Secondary exposure to trauma and self reported distress among therapists. In B.H. Stamm (Ed.), Secondary traumatic stress: self-care issues for clinicians, researchers, and educators. (pp. 29-36). Lutherville, Maryland: Sidran Press.
Dunn, G.E., Ryan, J.J., & Dunn, C.E. (1994). Trauma symptoms in substance abusers with and without histories of childhood abuse. Journal of Psychoactive Drugs, 26, 357-360.
Dutton, D.G. (1995). Trauma symptoms and PTSD-like profiles in perpetrators of intimate violence. Journal of Traumatic Stress, 8, 299-316.
Dutton, D.G., & Painter, S. (1993). The battered woman syndrome: effects of severity and intermittency of abuse. American Journal of Orthopsychiatry, 63, 614-622.
Dutton, D.G., & Painter, S. (1993). Emotional attachments in abusive relationships: a test of traumatic bonding theory. Violence and Victims, 8, 105-120.
Dutton, D.G., Saunders, K., Starzomski, A., & Bartholomew, K. 1994). Intimacy-anger and insecure attachment as precursors of abuse in intimate relationships. Journal of Applied Social Psychology, 24, 1367-1386.
Dutton, D.G., Starzomski, A., & Ryan, L. (1996). Antecedents of abusive personality and abusive behavior in wife assaulters. Journal of Family Violence, 11,113-132.
Dutton, D.G., Van Ginkel, C., & Landolt, M.A. (1996). Jealousy, intimate abusiveness, and intrusiveness. Journal of Family Violence, 11, 411-423.
Elklit, A. (1990). Maling af belastninger efter voldeligt verfald med TSC-33 (traume symptom checkliste). [Measurement of stress after a violent attack using the TSC-33 (Trauma Symptom Checklist)]. Nordisk Psykologi, 42, 281-289.
Elklit. A. (1996). Skuddramaet i universitetskantinen. [The shooting at the university cafeteria: An analysis of acute after-effects and coping mechanisms]. Nordisk Psykologi, 48, 279-302.
Elliott, D.M. (1994). The impact of Christian faith on the prevalence and sequelae of sexual abuse. Journal of Interpersonal Violence, 9, 95-108.
Elliot, D.M., & Briere, J. (1991). Studying the long-term effects of sexual abuse: The Trauma Symptom Checklist (TSC) scales. In A.W. Burgess (Ed.). Rape and sexual assault III. New York: Garland. Elliott, D.M., & Briere, J. (1992). Sexual abuse trauma among professional women: Validating the Trauma Symptom Checklist- 40 (TSC-40). Child Abuse & Neglect, 16, 391-398.
Elliott, D.M., & Guy, J.D. (1993). Mental health professionals versus non-mental-health professionals: childhood trauma and adult functioning. Professional Psychology: Research and Practice, 24, 83-90.
Feinauer, L.L., Callahan, E.H., & Hilton, H.G. (1996). Positive intimate relationships decrease depression in sexually abused women. American Journal of Family Therapy, 24,99-106.
Feinauer, L., Mitchell, J., Harper, J.M., & Dane, S. (1996). The impact of hardiness and severity of childhood sexual abuse on adult adjustment. American Journal of Family Therapy, 24, 206-214.
Feinauer, L.L., & Stuart, D.A. (1996). Blame and resilience in women sexually abused as children. American Journal of Family Therapy, 24, 31-40.
Follette, V.M., Polusny, M.M., Bechtle, A.E. & Naugle, A.E. (1996). Cumulative trauma: the impact of child sexual abuse, adult sexual assault, and spouse abuse. Journal of Traumatic Stress, 9, 25-35.
Follette, V.M., Polusny, M.M., & Milbeck, K. (1994). Mental health and law enforcement professionals: trauma history, psychological symptoms, and impact of providing services to child sexual abuse survivors. Professional Psychology: Research and Practice, 25, 275-282.
Gold, S.R., Milan, L.D., Mayall, A., & Johnson, A.E. (1994). A cross-validation study of the Trauma Symptom Checklist: The role of mediating variables. Journal of interpersonal Violence, 9, 12-26.
Garabedian, M.J. (1993). Relationship of child sexual, physical, and psychological abuse to eating disorders and post-traumatic stress disorder in adult women. Unpublished doctoral dissertation, University of Southern California.
Hazzard, A., Rogers, J.H., & Angert, L. (1993). Factors affecting group therapy outcome for adult sexual abuse survivors. International Journal of Group Psychotherapy, 43, 453-468.
Higgins, D.J., & McCabe-M.P. (1994). The relationship of child sexual abuse and family violence to adult adjustment: Toward an integrated risk-sequelae model. Journal of Sex Research,
31, 255-266.
Koopman, C., Gore-Felton, C., & Spiegel, D. (1997). Acute stress disorder symptoms among female sexual abuse survivors seeking treatment. Journal of Child Sexual Abuse, 6, 65-85.
(1997). Lipinski, B.J. (1992). Psychological correlates of childhood sexual abuse and adult criminal victimization in women’s experiences. Unpublished doctoral dissertation, University of Southern California.
Laviola, M. (1992). Effects of older-brother younger-sister incest: a study of the dynamics of 17 cases. Child Abuse and Neglect, 16, 409-421.
Magana, D. (1990). The impacts of client-therapist sexual intimacy and child sexual abuse on psychosexual and psychological functioning. Unpublished doctoral dissertation, University of California at Los Angeles.
Maynes, L.C., & Feinauer, L.L. (1994). Acute and chronic dissociation and somatized anxiety as related to childhood sexual abuse. American Journal of Family Therapy, 22, 165-175.
Mendel, M.P. (1995). The male survivor: The impact of sexual abuse. Thousand Oaks, CA: Sage.
Roesler, T.A. (1994). Reactions to disclosure of childhood sexual abuse: the effect on adult symptoms. Journal of Nervous and Mental Disease, 182, 618-624.
Roesler, T.A., & Dafler, C.E. (1993). Chemical dissociation in adults sexually victimized as children: alcohol and drug use in adult survivors. Journal of Substance Abuse Treatment,
10, 537-543.
Roesler, T.A., & McKenzie, N. (1994). Effects of childhood trauma on psychological functioning in adults sexually abused as children. Journal of Nervous and Mental Disease, 182, 145-150.
Russ, M.J., Shearin, E.N., Clarkin, J.F., Harrison, K., & Hull, J.W. (1993). Subtypes of self-injurious patients with borderline personality disorder. American Journal of Psychiatry, 150, 1869-1871.
Schlaff, K.L. (1992). An investigation of the relationship between chronic pelvic pain in adult women and child sexual abuse utilizing the Trauma Symptom Checklist – 40. Unpublished doctoral dissertation, University of Southern California. (Dissertation Abstracts International, 1993 June. Vol 53(12-A)# 4214).
Sigmon, S.T, Greene, M.P., Rohan, K.J., & Nichols, J.E. (1996). Coping and adjustment in male and female survivors of childhood sexual abuse. Journal of Child Sexual Abuse, 5, 57-75.
Silvern, L., Karyl, J., Waelde, L., Hodges, W.F., Starek, J., Heidt, E., & Min, K (1995). Retrospective reports of parental partner abuse: relationships to depression, trauma symptoms and self-esteem among college students. Journal of Family Violence 10, 177-202.
Testa, M., Miller, B.A., Downs, W.R., & Panek, D. (1992). The moderating impact of social support following childhood sexual abuse. Violence and Victims, 7, 173-186.
Wenninger, K., & Ehlers, A. (1998). Dysfunctional cognitions and adult psychological functioning in child sexual abuse survivors. Journal of Traumatic Stress (ISSN: 0894-9867), 11, 281-300.
Williams, M.B. (1990). Child sexual abuse and posttraumatic stress disorder: The enduring effect. Unpublished doctoral dissertation, Fielding Institute, Santa Barbara, CA.
Wind, T.W., & Silvern, L.E. (1992). Type and extent of child abuse as predictors of adult functioning. Journal of Family Violence, 7, 261-281.
Zlotnick, C., Shea, M.T., Begin, A., Pearlstein, T., Simpson, E., & Costello, E. (1996). The validation of the Trauma Symptom Checklist-40 (TSC-40) in a sample of inpatients. Child Abuse
and Neglect, 20, 503-510.
Trauma Symptom Checklist – 40 (TSC-40)
Subscale composition and scoring for the TSC-40 The score for each subscale is the sum of the relevant items, listed below:
Dissociation: 7,14,16,25,31,38
Anxiety: 1,4,10,16,21,27,32,34,39
Depression: 2,3,9,15,19,20,26,33,37
SATI (Sexual Abuse Trauma Index): 5,7,13,21,25,29,31
Sleep Disturbance 2,8,13,19,22,28
Sexual Problems 5,9,11,17,23,29,35,40
TSC-40 total score: 1-40
TSC-40
How often have you experienced each of the following in the last two months?
0 = Never 3 = Often
1. Headaches 0 1 2 3
2. Insomnia (trouble getting to sleep) 0 1 2 3
3. Weight loss (without dieting) 0 1 2 3
4. Stomach problems 0 1 2 3
5. Sexual problems 0 1 2 3
6. Feeling isolated from others 0 1 2 3
7. “Flashbacks” (sudden, vivid, distracting memories) 0 1 2 3
8. Restless sleep 0 1 2 3
9. Low sex drive 0 1 2 3
10. Anxiety attacks 0 1 2 3
11. Sexual overactivity 0 1 2 3
12. Loneliness 0 1 2 3
13. Nightmares 0 1 2 3
14. “Spacing out” (going away in your mind) 0 1 2 3
15. Sadness 0 1 2 3
16. Dizziness 0 1 2 3
17. Not feeling satisfied with your sex life 0 1 2 3
18. Trouble controlling your temper 0 1 2 3
19. Waking up early in the morning and can’t get back to sleep 0 1 2 3
20. Uncontrollable crying 0 1 2 3
21. Fear of men 0 1 2 3
22. Not feeling rested in the morning 0 1 2 3
23. Having sex that you didn’t enjoy 0 1 2 3
24. Trouble getting along with others 0 1 2 3
25. Memory problems 0 1 2 3
26. Desire to physically hurt yourself 0 1 2 3
27. Fear of women 0 1 2 3
28. Waking up in the middle of the night 0 1 2 3
29. Bad thoughts or feelings during sex 0 1 2 3
30. Passing out 0 1 2 3
31. Feeling that things are “unreal” 0 1 2 3
32. Unnecessary or over-frequent washing 0 1 2 3
33. Feelings of inferiority 0 1 2 3
34. Feeling tense all the time 0 1 2 3
35. Being confused about your sexual feelings 0 1 2 3
36. Desire to physically hurt others 0 1 2 3
37. Feelings of guilt 0 1 2 3
38. Feelings that you are not always in your body 0 1 2 3
39. Having trouble breathing 0 1 2 3
40. Sexual feelings when you shouldn’t have them 0 1 2 3