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A Primer on Using the Clinician Administered PTSD Scale (CAPS)

A Primer on Using the Clinician Administered PTSD Scale (CAPS). Dudley Blake, Ph.D. & Pat VanWyk , Ph.D. CAPS Features. Symptom-Based Interview for Assessing and Diagnosing PTSD Standardized Administration Week or Month Time Frame

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A Primer on Using the Clinician Administered PTSD Scale (CAPS)

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  1. A Primer on Using the Clinician Administered PTSD Scale (CAPS) Dudley Blake, Ph.D. & Pat VanWyk, Ph.D

  2. CAPS Features Symptom-Based Interview for Assessing and Diagnosing PTSD Standardized Administration Week or Month Time Frame Ratings made for Frequency/Duration and Intensity of Symptom and Disorder Rating Continua with Anchor Descriptors Well Validated

  3. Advantages of CAPS Interview Provides fine-grained, multi-dimensional data on PTSD symptom status Serves as a clinical assessment tool

  4. General CAPS Interview Conventions Establish positive interview tone Explain interview purpose (i.e., assess possible problems in past week/month) Predict and normalize arousal or temporary symptom increase Describe interview structure, e.g., will ask two sets of questions about 20 or so problems Encourage interviewee to give specific (brief) answers to specific questions

  5. Assessing Traumatic Stress Exposure Orient the interviewee to trauma assessment Administer the LEC Ask trauma questions » Objective features of the trauma » Subjective response to trauma

  6. DSM-IV PTSD Stressor Criterion (Criterion A) To be considered a trauma, a stressor must involve… Actual or threatened death or injury to oneself or to others, and The person must have responded with intense fear, helplessness, or horror

  7. CAPS Life Events Checklist (LEC) Procedure for Assessing Traumatic Events

  8. Life Events Checklist Sixteen event categories and one “other” category Three Types of Exposure: Happened to me Witnessed it Learned about it

  9. General CAPS interview Item Conventions Always ask standard prompt question (or, in some cases, an equivalent) Rephrase or elaborate on prompt questions, as needed Offer two (2) rating options, if needed Frequently repeat ratings back to interviewee

  10. CAPS Rating Conventions forFrequency/Duration: Has interviewee ever had the problem? If yes, has interviewee had the problem in the past month (or past week)? How often or how much of the time in the past month has the interviewee had the problem?

  11. Frequency rating prompts for distressing dreams (B-2) Have you ever had unpleasant dreams about (EVENT)? Describe a typical dream. (What happens in them?) How often have you had these dreams in the past month?

  12. Frequency rating continua for distressing dreams (B-2) Never Once or twice Once or twice a week Several times a week Daily or almost every day

  13. Frequency/duration rating prompts for feelings of detachment or estrangement from others (C-5) Have you felt distant or cut off from other people? What was that like? How much of the time in the past month have you felt that way?

  14. Frequency rating continua for feelings of detachment (C-5) None of the time Very little of the time (less than 10%) Some of the time (approx 20-30%) Much of the time (approx 50-60%) Most or all of the time (more than 80%)

  15. CAPS Rating ConventionsIntensity: Questions assessing degree of impact that the symptom has had on the interviewee’s life Behavioral referents of impact that are unique to the symptom (in both prompt questions and rating anchors)

  16. Intensity rating prompts for feelings of detachment or estrangement (C-5) How strong were your feelings of being distant or cut off from others? (Who do you feel closest to? How many people do you feel comfortable talking with about personal things?)

  17. Intensity rating continua for estrangement or detachment (B-2) No feelings of detachment or estrangement Mild, may feel “out of synch” with others Moderate, feelings of detachment clearly present, but still feels some interpersonal connection Severe, marked feelings of detachment or estrangement from most people, may feel close to only one or two people Extreme, feels completely detached or estranged from others, not close with anyone

  18. Challenges in PTSD Assessment Co-Morbid Disorders Symptom Overlap Multiple Traumas Culture and Language (Ethnic, Gender) Symptom Over-reporting

  19. CAPS Interview Prerequisites • Exposure to PTSD population(s) • Working knowledge of DSM-IV criteria for PTSD • Careful reading of CAPS Administration Manual • Practice, Practice, Practice (first with non-patients, then with patients)

  20. CAPS Training Resources National Center for PTSD’s website that includes: CAPS and CAPS-C training manuals CAPS training DVD ordering information Information about obtaining CAPS training in the VA http://www.ptsd.va.gov/professional/pages/assessments/caps-training.asp

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