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The PREPARED Center for Emergency Response Research
The PREPARED Center for Emergency Response Research

The Continuous Traumatic Stress Response (CTSR) scale

Current diagnostic criteria for posttraumatic stress disorder (PTSD) do not include symptoms resulting from exposure to continuous or ongoing traumatic stress. Thus existing assessment tools do not fully capture stress symptoms associated with exposure to threats that extend over months or years. To address this void, we enumerated the symptoms associated with ongoing exposure to stress including those that are distinct from existing PTSD diagnostic criteria.

The study's process comprised a mixed-method approach combining qualitative and quantitative methods. Thematic analysis yielded three main themes:

  • PTSD in its current definition does not capture the whole “traumatic picture” observed in ongoing exposure to threat
  • Some DSM-5 criteria are not applicable in ongoing exposure to threat
  • There is a need for a new tool or modifications to commonly used assessment tools.

Following these results supporting the need for a new tool specifically designed for assessing traumatic stress in these situations, we developed the Continuous Traumatic Stress Response Scale (CTSR).

The tool was based on data collected from a representative sample of 313 adults exposed (n=138,44.1%) and unexposed 175 (55.9%) to ongoing security threat. Exposed respondents lived in communities bordering the Gaza Strip in southern Israel (mean distance from the Gaza border = 7.73 km, SD = 4.29 km) where they are exposed to frequent rocket attacks, requiring they locate and find shelter in 15-30 seconds, unexposed participants had up to 90 seconds to find shelter (mean distance from Gaza = 66.58 km, SD = 17.65 km).

This study is the first to systematically measure the effects of ongoing traumatic stress, based on cutting-edge research and statistical analysis. The CTSR scale is a unique, valid tool offering translational ‎science research for a better understanding and management of traumatic stress ‎symptoms, which in turn, further fosters community resilience in the face of trauma.

The CTSR scale is currently being translated, validated and used as a valid assessment tool in various research projects and languages including Hebrew, Ukrainian, Lithuanian and German among others.

In the wake of the October 7th horrific events in Israel, the ongoing war in Ukraine, and the hostile atmosphere and violence directed at civilian populations in various regions of the world, the need for such a diagnostic tool is clear and Salient.

We recommend incorporating the CTSR scale when assessing traumatic stress in prolonged exposure to allow an efficient diagnosis and alleviate unnecessary suffering.  

Any questions may be addressed to Dr. Aviva Goral at: g.aviva7@gmail.com

 

Link to the CTSR Scale abstract

 

CTSR Scale
CTSR Scale