The International Trauma Questionnaire (ITQ)

The International Trauma Questionnaire (ITQ) is a self-report diagnostic tool designed to assess the presence of Post-Traumatic Stress Disorder (PTSD) and Complex Post-Traumatic Stress Disorder (CPTSD). It was developed to align specifically with the diagnostic criteria established by the World Health Organization (WHO) in the 11th revision of the International Classification of Diseases (ICD-11).

What is the ITQ?

Unlike previous diagnostic systems that often conflated PTSD and CPTSD, the ICD-11 provides a clear distinction between the two. The ITQ serves as the primary instrument to measure this distinction. The questionnaire is brief, user-friendly, and intended for use in clinical, research, and population-based settings to identify individuals who meet the criteria for these trauma-related disorders.

The Two Components of Diagnosis

To accurately capture the complexity of trauma-related symptoms, the ITQ evaluates two distinct clusters of symptoms:

• PTSD Symptoms: These relate to the core symptoms of re-experiencing the trauma in the present, avoidance of trauma-related thoughts or situations, and a persistent sense of current threat.
• Disturbances in Self-Organization (DSO) Symptoms: These are specific to CPTSD and include affective dysregulation, negative self-concept, and disturbances in relationships.

A diagnosis of PTSD requires the presence of the core PTSD symptoms, while a diagnosis of CPTSD requires both the core PTSD symptoms and the DSO symptoms. It is important to note that a person cannot be diagnosed with both simultaneously; they are distinct classifications within the ICD-11 framework.

Structure of the Questionnaire

The ITQ is designed to be concise, typically consisting of 18 items. The items are rated on a 5-point Likert scale, ranging from "Not at all" to "Extremely." This structure allows clinicians and researchers to assess the severity of symptoms while ensuring the assessment process remains manageable for the respondent.

Clinical Significance

The development of the ITQ represents a significant advancement in trauma psychology. By facilitating the identification of CPTSD, the ITQ helps ensure that individuals receive appropriate treatment. While standard PTSD treatments focus on trauma-focused cognitive behavioral therapies, those with CPTSD may require additional interventions that address emotional regulation and interpersonal functioning.

Psychometric Properties

Extensive research has been conducted to validate the ITQ across various populations and cultures. Studies consistently show that the ITQ has high internal consistency, good test-retest reliability, and strong construct validity. Because it is brief and has been translated into numerous languages, it has become a global standard for trauma assessment in the post-ICD-11 era.

Ethical Considerations and Limitations

While the ITQ is an essential tool, it is not a substitute for a comprehensive clinical interview conducted by a qualified professional. Self-report measures can be subject to bias, and trauma symptoms often fluctuate over time. Furthermore, the ITQ should be used in conjunction with a full assessment of an individuals history and psychological needs. It is meant to assist in screening and clinical decision-making, rather than to serve as the sole basis for a lifelong diagnosis.

In summary, the ITQ is a vital instrument for modern mental health practice, providing a standardized, evidence-based method for identifying the distinct clinical profiles of PTSD and CPTSD as defined by the WHO.