![handle is hein.journals/psyinjl5 and id is 1 raw text is: Psychol. Inj. and Law (2012) 5:1-11
DOI 10.1007/s12207-012-9118-7
Assessment of Post-Traumatic Stress Disorder:
Differences in Standards and Practice between Licensed
and Board-Certified Psychologists
Loandra Torres - Sherry Skidmore - Nicole Gross
Received: 28 December 2011 /Accepted: 29 March 2012 /Published online: 8 May 2012
© Springer Science + Business Media, LLC. 2012
Abstract The purpose of this study was to examine the cur-
rent diagnostic standards and assessment practices of psychol-
ogists when diagnosing post-traumatic stress disorder (PTSD).
A web-based survey was employed to gather information on
opinions and assessment practices of psychologists who were
either licensed with no board certification, board certified in
clinical psychology, or board certified in forensic psychology.
Significant differences were found between the three groups of
psychologists in frequency of inclusion of Diagnostic and
Statistical Manual-Fourth Edition-Text Revision Criterion A,
in use of recommended collateral information sources, in use of
assessment methods or types of recommended instruments, and
in assessing for over-reported PTSD symptoms. Results indi-
cated that board certification status had significant impact on
psychologists' diagnostic standards and assessment practices
related to PTSD.
Keywords PTSD - Assessment - Board-certification-
Forensic - Clinical
The accurate assessment of post-traumatic stress disorder
(PTSD) remains a controversy in the field of psychology.
Allegedly, there are psychologists who do not consider the
seventeen most recent criteria as they are articulated in the
Diagnostic and Statistical Manual-Fourth Edition (DSM-IV;
American Psychiatric Association [APA], 1994) and DSM-IV-
Text Revision (DSM-IV-TR; APA, 2000) when they make this
L. Torres (W) - S. Skidmore
Alliant International University,
Los Angeles, CA, USA
e-mail: Dr.LoandraTorres@gmail.com
N. Gross
Texas Tech University,
Lubbock, TX, USA
diagnosis. Of particular interest is Criterion A, the criterion that
briefly defines a traumatic event. Criterion A outlines two
requirements that need to be met in order for PTSD to be
diagnosed. First, the person experienced, witnessed, or was
confronted with an event or events that involved actual or
threatened death or serious injury, or a threat to the physical
integrity of self or others. Second, the person's response
involved intense fear, helplessness, or horror (APA, 2000,
p.467). The purpose of the second requirement, the subjective
response, was to limit diagnostic rates of PTSD in light of the
broadening definition of a traumatic event. With this limitation
the conceptualization of the disorder was thought to be pro-
tected (Avina & O'Donohue, 2002; Weathers & Keane, 2007).
Traumatic events are a relatively common occurrence in the
USA, with 50-70 % of the population having experienced a
traumatic event at some point in their lives. However, the
development of PTSD only occurs within 7-12 % of those
individuals (Taylor & Asmundson, 2008). PTSD often coexists
and is sometimes confused with other anxiety-related disorders.
The differentiating feature of PTSD is that it requires a specific
event to occur, prior to symptom development (APA, 2000).
Symptoms alone, and a significant stressful event alone, are
insufficient for diagnosis.
A debate surrounding Criterion A has become the topic of
much scrutiny as of recent (Kudler, 2000; McNally, 2003;
Weathers & Keane, 2007). There appears to be a split among
the psychological community: those who claim that minor
events (i.e., exposure to offensive remarks, chronic disease,
serious work or relationship problems) could qualify as trau-
matic events (Avina & O'Donohue, 2002; Olff et al., 2005;
Gold, Marx, Soler-Baillo, & Sloan, 2005; Mol et al., 2005),
and others who believe that this liberal expansion of the
criterion places the credibility of PTSD diagnosis in danger
(McNally, 2003). The former group holds that the other diag-
nostic criteria can preserve the overall conceptualization ofthe
e Springer](ViewImageLocal?handle=hein.journals/psyinjl5&div=1&collection=&method=preview&ext=.png&size=3)
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