Exploring false negatives in self-reported trauma exposure status.

Abstract

Introduction: Trauma exposure is often assessed using checklists such as the Life Events Checklist for DSM-5 (LEC-5; Weathers et al., 2013b). When participants endorse multiple events, respondents are asked to identify a single, worst event (i.e., index event). Recent work indicates that the "worst event" method leads to a concerning number of false negatives. The purpose of the current study was to replicate previous findings of false negatives and extend them by examining characteristics associated with false negatives, such as trauma type, means of exposure, recency of trauma, and posttraumatic stress disorder (PTSD) symptom severity.

Method: Adults (n = 476) provided data on trauma history assessed using a revised version of the LEC-5 that asked participants to provide follow-up information for each traumatic event endorsed. Participants also provided demographic data and completed the PTSD Checklist for DSM-5. Results: Two hundred thirty-four participants (49.16%) reported a worst event that met the DSM-5 definition of Criterion A trauma ("primary Criterion A" group). However, of the 242 participants who did not, 138 participants (57.02%, or 28.99% of the total sample) reported a secondary event that did meet Criterion A ("secondary Criterion A" group). The secondary Criterion A group most commonly reported serious life-threatening illnesses/injuries and "other" stressful life experiences as their index trauma that did not fulfill Criterion A. Participants in the primary and secondary Criterion A groups reported similar levels of PTSD symptoms. No differences were observed in means of exposure and recency of index trauma between the Criterion A groups.

Discussion: Findings raise questions regarding the efficiency and accuracy of the worst event method to determine trauma exposure status via self-report. Researchers should consider alternative methods for assessing trauma exposure rather than relying on the worst event scoring method. (PsycInfo Database Record (c) 2024 APA, all rights reserved).