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Type of Instrument

The Trauma Symptom Inventory (TSI) is a test containing 100items claiming to measure ‘posttraumatic stress and other psychologicalsequelae of traumatic events’. It was devised to be used in the assessment of‘acute and chronic traumatic symptomatology’, such as rape, physicalassault, spouse abuse, major accidents, combat trauma, natural disasters and theenduring effects of childhood abuse and early childhood trauma (Briere, 1995).

The TSI has 3 validity scales and 10 clinical scales thatassess a broad range of psychological symptoms including those related toPosttraumatic Stress Disorder (PTSD) and Acute Stress Disorder (ASD) plus intraand interpersonal difficulties associated with chronic psychological trauma. Thetest is self-administered and is intended for a fifth grade and above readinglevel (Briere 1995). Items are scored on a four point scale with 0 = Neverthrough to 3 = Often, and are rated in terms of frequency of occurrence over theprevious six months. Due to this time frame the TSI was ‘not intended togenerate a DSM IV PTSD diagnosis’. The TSI takes approximately 20 minutes tocomplete and around 15 minutes to score (Briere and Elliott, 1997).

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Reliability

Table 1 lists the scales along with their internalreliability correlation coefficient for the standardised sample (N = 836), andthe number of items for each scale (Briere, 1995).

Table 1. Clinical scales & Mean alpha coefficients& number of test items for each scale.

Scales

alpha

Items

Validity Scales:

Response level (RL)

Atypical Response (ATR)

Inconsistent Response (INC)

.80

.75

.51

10*

20*

Clinical Scales:

Anxious Arousal (AA)

Depression (D)

Anger/Irritability (AI)

Intrusive Experiences (IE)

Defensive Avoidance (DA)

Dissociation (DIS)

Sexual Concerns (SC)

Dysfunctional Sexual Behaviour (DSB)

Impaired Self-Reference (ISR)

Tension Reduction Behaviour (TRB)

.86

.91

.90

.89

.90

.82

.87

.85

.88

.74

(Source: Briere 1995) *RL = 5 independentitems & 5 combined *INC = 20 combined items

The Mean alpha correlation scores show a high reliability onall scales except for the INC validity scale.

Briere (1995), states that the mean intercorrelations of the10 clinical scales for the ‘TSI are internally consistent with Mean alphacoefficients’ of .86 for the standardised (N=836), .87 for the clinical(N=370), .84 for the university (N=279), and .85 for the military samples(N=3659).

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Runtz & Roche (1999), in their study of a group of 775‘previously victimized’ Canadian university women calculated internalconsistency reliabilities for the clinical scales of the TSI. They found thatthe TSI internal consistency is strong (alpha = .64) ‘as all reliabilitieswere above alpha = .80, except for TRB’. They cite other researchers who foundthat TRB scales have lower reliability with student samples. In their samplemore than 90% of those surveyed were aged under 25.

Criterion Validity: Discriminant function analysis, using the standardised clinical scales of the TSI to predict PTSD status were compared to the subscales on the Brief Symptom Inventory, (BSI), and the Impact of Events Scale (Norris & Raid, 1997 p.30). This comparison indicated, that all TSI scales were associated with PTSD (Briere, 1995 p.44). From a sample of 449 of the general population the TSI scales predicted 24 of the 26 true positive cases of PTSD (92%). The TSI predicted 91% of true negative cases of PTSD, identifying 385 of 423 PTSD negative cases. The TSI also predicted 89% of a clinical sample ‘independently diagnosed with Borderline Personality Disorder’ (Briere, 1995).

Runtz & Roche (1999), found in their study that bothchildhood sexual assault (CHA) as measured by an events checklist created by theresearchers, and childhood physical maltreatment as measured by a modifiedversion of the Physical Maltreatment scale (PHY), were linked to all 10 scalesof the TSI. However, other studies have not firmly established a link betweenchildhood physical abuse and the TSI scales.

Construct Validity: Discriminant function analysis was used to examine the relationship, in the normative sample, between TSI T scores and four types of traumatic experience – adult interpersonal violence, adult disaster, childhood interpersonal violence, and childhood disaster, and it was found that ‘all four trauma types were significantly associated with elevated TSI scores’ (Briere, 1995 p.38). Analysis also justified ‘conceptualising the scales in terms of three higher order constructs’, traumatic stress – IE, DA, DIS, and ISR, dysphoria – AI, D, and AA, and Self – ISR, SC, DSB, TRB, AI. However, these factors were ‘highly interrelated’, and ISR and AI in the Self construct scored low correlations which indicates that the Self construct would be more related to ‘sexual trauma and dysfunction’ (Briere, 1995; Norris and Raid, 1997).

Convergent & Discriminant Validity: The ATR and RL validity scales on the TSI correlated with other validity scales on the PAI and MMPI-2. The ATR correlated at .52 with the PAI Negative Impression Management (NIM) scale of the Personality Assessment Inventory and .50 with the MMPI-2 F scale. The TSI RL scale positively correlated with the PAI Positive Impression Management scale and at .46 on the MMPI-2 K scale. The TSI INC scale was uncorrelated with the PAI ICN scale (Briere, 1995).

The TSI clinical scales were compared to the scales on theBrief Symptom Inventory (BSI). ‘Reasonable convergent validity was observedbetween those scales expected to correlate positively’ ie: Anxiety vs AA at.75, Depression scales at .82, Hostility vs AI .77. The TSI clinical scales werealso compared with the IES and SCL scales with the IES Avoidance vs DA at .69,and SCL Avoidance vs DA at .68. IES Intrusion vs IE correlated at .67, and SCL.73. SCL Arousal scale vs AA correlated at .75. This again would suggestreasonable convergent validity but low reliability on discriminant validity (Briere,1995).

The standardisation sample Norms and T scores were derivedfrom the general population in a mail out of 836 American males and females 18years and over. The mean age of subjects 47.3 years (SD = 16.6%) range = 18-88).Of the sample 57.1% were married, 16.6% separated, 16.5% single, 50.8% males,77.5% Caucasian, 10.3% African American, 6.1% Hispanic, 2.9% Asian, and 2.3%Native American. Normative data for the TSI scales were derived from the rawscore data of the above standardisation sample. There are separate norms for asample of 3,659 male and female navy recruits (Briere, 1995). Analyses ofvariance revealed differences in age, sex and race. Based upon age and sexgroupings normative data were derived with Linear T scores having a mean of 50and a standard deviation of 10. Separate norms have been calculated for age 18– 55 and 55 and over for both male and females.

The Runtz & Roche (1999) study confirmed Briere’s(1995) observation that student samples report ‘greater difficulties on manyof the TSI scales’ than a survey of the general population. The overall meansfor the 10 TSI scales were higher than the standardisation sample of females 18to 54, compared to the student sample. They had an average of .42 SD (rangingfrom .15 to .81).

Briere, J. (1995). Trauma Symptom Inventory (TSI)Professional Manual, Psychological Assessment Resources, Inc.

Briere, J., & Elliott D.M. (1997) PsychologicalAssessment of Interpersonal Victimisation Effects in Adults and Children. Psychotherapy,34, 353 – 364.

Norris, F.H., & Raid, J.K. (1997). Standardisedself-report measures of civilian trauma and posttraumatic stress disorder. InJ.P. Wilson and T.M Keane (Eds.) Assessing psychological trauma and PTSD.The Guilford Press: New York.

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