Trauma Symptom Inventory (TSI)

 

COPYRIGHT: Psychological Assessment Resources

TYPE OF POPULATION: Adults

The TSI is used in the evaluation of acute and chronic posttraumatic symptomatology, including the effects of rape, spouse abuse, physical assault, combat experiences, major accidents, and natural disasters, as well as the lasting sequelae of childhood abuse and other early traumatic events. The various scales of the TSI assess a wide range of psychological impacts. These include not only symptoms typically associated with posttraumatic stress disorder (PTSD) or acute stress disorder (ASD), but also those intra- and interpersonal difficulties often associated with more chronic psychological trauma.

MEASURE CONTENT: The 100 items of the TSI are contained in a reusable test booklet. Respondents complete a separate answer sheet that facilitates rapid scoring. Each symptom item is rated according to its frequency of occurrence over the prior six months, using a four point scale ranging from 0 ("never") to 3 ("often"). The TSI does not generate DSM-IV diagnoses; instead, it is intended to evaluates the relative level of various forms of posttraumatic distress. The TSI requires approximately 20 minutes to complete for all but the most traumatized or clinically impaired individuals, and can be scored and profiled in approximately 10 minutes.

This measure has three validity scales and ten clinical scales, all of which yield sex- and age-normed T scores. There are 12 critical items.

The validity scales of the TSI are:  

  • Response Level (RL) (measuring a tendency toward defensiveness, a general under-endorsement response set, or a need to appear unusually symptom-free);
  • Atypical Response (ATR) (measuring psychosis or extreme distress, a general over-endorsement response set, or an attempt to appear especially disturbed or dysfunctional); and
  • Inconsistent Response (INC) (measuring inconsistent responses to TSI items, potentially due to random item endorsement, attention or concentration problems, or reading/language difficulties).

The clinical scales are:

  • Anxious Arousal (AA) (symptoms of anxiety, including those associated with posttraumatic hyperarousal);
  • Depression (D) (depressive symptomatology, both in terms of mood state and depressive cognitive distortions);
  • Anger/Irritability (AI) (angry or irritable affect, as well as associated angry cognitions and behavior);
  • Intrusive Experiences (IE) (intrusive symptoms associated with posttraumatic stress, such as flashbacks, nightmares, and intrusive thoughts);
  • Defensive Avoidance (DA) (posttraumatic avoidance, both cognitive and behavioral);
  • Dissociation (DIS) (dissociative symptomatology, such as depersonalization, out-of-body experiences, and psychic numbing);
  • Sexual Concerns (SC) (sexual distress, such as sexual dissatisfaction, sexual dysfunction, and unwanted sexual thoughts or feelings);
  • Dysfunctional Sexual Behavior (DSB) (sexual behavior that is in some way dysfunctional, either because of its indiscriminate quality, its potential for self-harm, or its inappropriate use to accomplish non-sexual goals);
  • Impaired Self-reference (ISR) (problems in the "self" domain, such as identity confusion, self-other disturbance, and a relative lack of self-support); and
  • Tension Reduction Behavior (TRB) (the respondent's tendency to turn to external methods of reducing internal tension or distress, such as self-mutilation, angry outbursts, and suicide threats).

There is a 86-item Alternate version of the TSI (the TSI-A) that does not contain the Sexual Concerns or Dysfunctional Sexual behavior scales (only 5 sexual items remain), for use in circumstances where sexual item content is not desired.



EQUIPMENT NEEDED: Test manual, item booklet, answer sheet, profile/scoring sheet, computer scoring program (optional).

PSYCHOMETRIC SUMMARY: The TSI has been standardized on a random sample of men and women from the general population (N=828), age 18 or older, and includes separate norms for male and female Navy recruits (N=3,659). Because separate norms are available for different combinations of sex and age (18-54, 55 or older), the TSI is appropriate for all adult sex by age combinations. TSI scores vary slightly as a function of race (accounting for 2-3% of the variance in most scales), and slight adjustments for validity scale cutoffs are suggested for certain racial groups. Results of readability analyses indicate that a 5th to 7th grade reading ability is required to complete the TSI. The ten clinical scales of the TSI are internally consistent (mean alphas of .86, .87, .84, and .84 in standardization, clinical, university, and military samples, respectively), and exhibit reasonable convergent, predictive, and incremental validity. Validity scales covary as expected with similar scales from other measures. In a standardization subsample (n=449), TSI scales predicted PTSD "positive" or "negative" status, based upon Astin, Lawrence, and Foy's (1993) joint scoring of the IES and LASC, in over 90% of cases. Similarly, in a psychiatric inpatient sample, TSI scales identified 89% of those independently diagnosed with borderline personality disorder. Studies indicate that specific TSI scale elevations are associated with a wide variety of traumatic experiences, including adult interpersonal violence, adult natural disaster, childhood interpersonal violence, childhood natural disaster, involvement in prostitution, and professionals' exposure to trauma.

GENERAL COMMENTS: Common TSI scale profiles/configurations are presented in the professional manual, with brief interpretive suggestions based on clinical experience, normative information, and the results of scale-level factor analyses (exploratory and confirmatory). There is also a scoring program available (Briere & PAR staff, 1995) which scores and profiles TSI validity and clinical scales, controls for race on validity scales (if requested), and yields three summary scores based on confirmatory factor analysis: Trauma, Self, and Dysphoria.


INSTRUMENT CONTACT NAME: Psychological Assessment Resources, Inc.
Address: P.O. Box 998, Odessa, FL, 33556
Phone: 1-800-331-TEST


PUBLISHED ARTICLES/CHAPTERS/BOOKS USING OR DESCRIBING THE TSI:

Banyard, V.L., & Williams, L.M. (2007). Women's voices on recovery: a multi-method study of the complexity of recovery from child sexual abuse. Child Abuse and Neglect, 31, 275-290.

Banyard, V.L, Williams, L.M., & Siegel, J.A. (2001). Understanding links among childhood trauma, dissociation, and women's mental health. American Journal of Orthopsychiatry, 71, 311-321.

Banyard, V.L., Williams, L.M., & Siegel, J.A. (2001).  The long-term mental health consequences of child sexual abuse: an exploratory study of the impact of multiple traumas in a sample of women. Journal of Traumatic Stress, 14, 697-715.

Banyard, V.L., Williams, L.M., & Siegel, J.A. (2003).  The impact of complex trauma and depression on parenting: an exploration of mediating risk and protective factors.  Child Maltreatment, 8, 334-349.

Banyard, V.L., Williams, L.M., & Siegel, J.A (2004). Childhood sexual abuse: a gender perspective on context and consequences. Child Maltreatment, 9, 223-238. 

Berah, E. (1997). Test review: The Trauma Symptom Inventory. Psychiatry, Psychology, and Law, 4, 93-94.

Berg, S.H. (2006). Everyday sexism and posttraumatic stress disorder in women: a correlational study. Violence Against Women, 12, 970-988.

Blinder, B.J., Cumella, E.J., & Sanathara, V.A. (2006). Psychiatric comorbidities of female inpatients with eating disorders. Psychosomatic Medicine, 68, 454-462.

Blumenthal, D.R., Neemann, J., & Murphy, C.M. (1998). Lifetime exposure to interparental physical and verbal aggression and symptom expression in college students. Victims and Violence, 13, 175-196.

Boccaccini, M.T., & Brodsky, S.L. (1999). Diagnostic test usage by forensic psychologists in emotional injury cases. Professional Psychology: Research and Practice, 30, 253-259.

Bradley, R.G. & Follingstad, D.R. (2003).  Group therapy for incarcerated women who experienced interpersonal violence: a pilot study.  Journal of Traumatic Stress, 16, 337-340. 

Briere, J. (1997). Psychological assessment of adult posttraumatic states. Washington, DC: American Psychological Association.

Briere, J. (1995). Trauma Symptom Inventory professional manual. Odessa, FL: Psychological Assessment Resources.

Briere, J., & Elliott, D.M. (2000). Prevalence, characteristics, and long-term sequelae of natural disaster exposure in the general population.  Journal of Traumatic Stress, 13,  661-679.

Briere, J., & Elliott, D.M. (1998). Clinical utility of the Impact of Event Scale: Psychometrics in the general population. Assessment, 5, 171-180.

Briere, J., & Elliott, D.M. (2003).  Prevalence and psychological sequelae of self-reported childhood physical and sexual abuse in a general population sample of men and women.  Child Abuse & Neglect, 27, 1205-1222.

Briere, J., Elliott, D.M., Harris, K., & Cotman, A. (1995). Trauma Symptom Inventory: Psychometrics and association with childhood and adult trauma in clinical samples. Journal of Interpersonal Violence, 10, 387-401.

Briere, J., & Gil, E. (1998). Self-mutilation in clinical and general population samples: Prevalence, correlates, and functions. American Journal of Orthopsychiatry, 68, 609-620.

Briere, J., Kaltman, S., & Green, B.L. (in press). Accumulated childhood trauma and symptom complexity. Journal of Traumatic Stress.

Briere, J., & PAR staff (1995). Computer scoring system for the Trauma Symptom Inventory (TSI). Computer program. Odessa, FL: Psychological Assessment Resources.

Briere, J., Weathers, F.W., & Runtz, M.G. (2005).  Is dissociation a multidimensional construct?: data from the Multiscale Dissociation Inventory.  Journal of Traumatic Stress, 18, 221-231.

Broach, J.L., & Petretic, P.A. (2006). Beyond traditional definitions of assault: expanding our focus to include sexually coercive experiences. Journal of Family Violence, 21, 477-486.

Brock, K.J., Pearlman, L.A., & Varra, E.M. (2006).  Child maltreatment, self capacities, and trauma symptoms: psychometric properties of the Inner Experience Questionnaire. Journal of Emotional Abuse, 6, 103-125.

Brown, J.R., Hill, H.M., & Lambert, S.F. (2005). Traumatic stress symptoms in women exposed to community and partner violence. Journal of Interpersonal Violence, 20, 1478-1494.

Browne, C., & Winkelman, C. (2007). The effect of childhood trauma on later psychological adjustment. Journal of Interpersonal Violence, 22, 684-697.

Carmody, D.P., & Crossman, A.M. (2005). Youth deception: malingering traumatic stress.
Journal of Forensic Psychiatry and Psychology, 16, 477-493.

Castelda, B.A, Levis, D.J., Rourke, P.A., & Coleman, S.L. (2007). Extension of the Sexual Abuse Questionnaire to other abuse categories: the initial psychometric validation of the Binghamton Childhood Abuse Screen. Journal of Child Sexual Abuse, 16, 107-125.

Cicione, R.M., Fontaine, L.A., Williams, C.N. (2002). Trauma Relief Unlimited: an outcome study of a new treatment method. Trauma and Loss: Research and Interventions, 2, 25-33.

Clarke, S.B., Rizvi, S.L., & Resick, P.A. (2008). Borderline personality characteristics and treatment outcome in cognitive-behavioral treatments for PTSD in female rape victims  Behavior Therapy, 39, 72-78.

Cole, K.L., Sarlund-Heinrich, P., & Brown, L.S. (2007). Developing and assessing effectiveness of a time-limited therapy group for incarcerated women survivors of childhood sexual abuse. Journal of Trauma and Dissociation, 8, 97-121.

Davis, J.L., Petretic-Jackson, P.A., Ting, L. (2001). Intimacy dysfunction and trauma symptomatology: long-term correlates of different types of child abuse. Journal of Traumatic Stress, 14, 63-79.

Day, A., Davey, L., Wanganeen, R., Casey, S., Howells, K., Nakata, M. (2008). Symptoms of trauma, perceptions of discrimination, and anger: a comparison between Australian indigenous and nonindigenous prisoners.  Journal of Interpersonal Violence, 23, 245-258.

Ebert, L., & Fairbank, J.A. (1996). The Trauma Symptom Inventory: Assessing the spectrum of symptoms associated with traumatic stress. American Psychology - Law Society News (Division 41 of the American Psychological Association), Fall, 21-23.

Edens, J. F., Otto, R. K., & Dwyer, T. J. (1998). Susceptibility of the Trauma Symptom Inventory to malingering. Journal of Personality Assessment, 71, 379-392.

Edens, J.F., Guy, L.S., Otto, R.K., Buffington, J.K., Tomicic, T.L., & Poythres, N.G. (2001).  Factors differentiating successful versus unsuccessful malingerers.  Journal of Personality Assessment, 77, 333-338.

Edwards, C., Dunham, D.N., Ries, A., & Barnett, J. (2006). Symptoms of traumatic stress and substance use in a non-clinical sample of young adults. Addictive Behaviors, 31, 2094-2104.

Elhai, J.D., Butcher, J.J., Reeves, A.N., Baugher, S.N., Gray, M.J., Jacobs, G.A., Fricker-Elhai, A.E., North, T.C., & Arbisi, P.A. (2007). Varying cautionary instructions, monetary incentives, and comorbid diagnostic training in malingered psychopathology research. Journal of Personality Assessment, 88, 328-337.

Elhai, J.D., Gray, M.J., Kashdan, T.B., & Franklin, C.L. (2005). Which instruments are most commonly used to assess traumatic event exposure and posttraumatic effects?: a survey of traumatic stress professionals. Journal of Traumatic Stress, 18, 541-545.

Elhai, J.D., Gray, M.J., Naifeh, J.A., Butcher, J.J., Davis, J.L., Falsetti, S.A., & Best, C.L. (2005. Utility of the Trauma Symptom Inventory's atypical response scale in detecting malingered post-traumatic stress disorder. Assessment, 12, 210-219.

Elhai, J.D., Kashdan, T.B., Snyder, J.J., North, T.C., Heaney, C.J., & Frueh, B.C. (2007). Symptom severity and lifetime and prospective health service use among military veterans evaluated for PTSD. Depression and Anxiety, 24, 178-184.
Elliott, D.M., & Briere, J. (1995). Posttraumatic stress associated with delayed recall of sexual abuse: A general population study. Journal of Traumatic Stress, 8, 629-647.

Elliott, D.M. & Briere, J. (1996).  Appendix I: Trauma Symptom Inventory scores as a function of sexual abuse status in male and female psychiatric inpatients and outpatients. In J. Briere, Therapy for Adults Molested as Children: Beyond Survival, Second Edition. New York: Springer Publishing Co.

Elliott, D.M., Mok, D.S., & Briere, J. (2004).  Adult sexual assault: prevalence, symptomatology, and sex differences in the general population.  Journal of Traumatic Stress, 17, 203-211.

Feerick, M.M, & Haugaard, J.J. (1999). Long-term effects of witnessing marital violence for women: the contribution of childhood physical and sexual abuse. Journal of Family Violence, 14, 377-398.

Feiring, C., Miller-Johnson, S., & Cleland, C.M. (2007). Potential pathways from stigmatization and internalizing symptoms to delinquency in sexually abused youth. Child Maltreatment, 12, 220-232.

Feiring, C., & Taska, L.S. (2005). The persistence of shame following sexual abuse: a longitudinal look at risk and recovery. Child Maltreatment, 10, 337-349.

Fitzgerald, L.F., Buchanan, N.T., Collinsworth, L.L., Magley V.J., & Ramos, A.M. (1999). Junk logic: the abuse defense in sexual harassment litigation. Psychology, Public Policy, and Law, 5, 730-759.

Franklin, C.L., & Thompson, K.E. (2005).  Response style and posttraumatic stress disorder (PTSD): a review. Journal of Trauma and Dissociation, 6, 105-123.

Goodman, L.A., Corcoran, C., Turner, K., Yuan, N., & Green, B.L. (1998). Assessing traumatic event exposure: General issues and preliminary findings for the Stressful Life Events Screening Questionnaire. Journal of Traumatic Stress, 11, 521-542.

Gorde, M.W., Helfrich, C.A., & Finlayson, M.L. (2004).  Trauma symptoms and life skill needs of domestic violence victims. Journal of Interpersonal Violence, 19, 691-708.

Green, B.L., Goodman, L.A., Krupnick, J.L., Corcoran, C.B., Petty, R.M., Stockton, P., & Stern, N.M. (2000). Outcome of single versus multiple trauma exposure in a screening sample. Journal of Traumatic Stress, 13, 271-286.

Green, B.L., Krupnick, J.L., Stockton, P., Goodman, L.A., Corcoran, C.B., & Petty, R.M. (2005). Effects of adolescent trauma exposure on risky behavior in college women.
Psychiatry, 68, 363-378.

Higgins, A.B., & Follette, V.M.  Frequency and impact of interpersonal trauma in older women. Journal of Clinical Geropsychology, 8, 215-226.

Kaltman, S.I., Krupnick, J.L., Stockton, P., Hooper, L., & Green, B.L. (2005). Psychological impact of types of sexual trauma among college women. Journal of Traumatic Stress, 18, 547-555.

Kamsner, S., & McCabe, M.P. (2000). The relationship between adult psychological adjustment and childhood sexual abuse, childhood physical abuse, and family-of-origin characteristics. Journal of Interpersonal Violence, 15, 1243-1261.

Kaplan, M.J., Klinetob, N.A. (2000). Childhood emotional trauma and chronic posttraumatic stress disorder in adult outpatients with treatment-resistant depression. Journal of Nervous and Mental Disease, 188, 596-601.

Kaysen, D.L., Dillworth, T.M., Simpson, T.L., Waldrop, A.E., Larimer, M.E., & Resick, P.A. (2007). Domestic violence and alcohol use: trauma-related symptoms and motives for drinking. Addictive Behaviors, 32, 1272-1283.

Kessler, B.L., & Bieschke, K.J. (1999). A retrospective analysis of shame, dissociation, and adult victimization in survivors of childhood sexual abuse. Journal of Counseling Psychology, 46, 335-341.

Larson, G.E., Booth-Kewley, S., Merrill, L.L., & Stander, V.A. (2001). Physical symptoms as indicators of depression and anxiety. Military Medicine, 166, 796-799.

Leahy, T., Pretty, G., & Tenenbaum, G. (2004).  Perpetrator methodology as a predictor of traumatic symptomatology in adult survivors of childhood sexual abuse.  Journal of Interpersonal Violence, 19, 521-540.

Luterek, J.A., Orsillo, S.M., & Marx, B.P. (2005). An experimental examination of emotional experience, expression, and disclosure in women reporting a history of childhood sexual abuse. Journal of Traumatic Stress, 18, 237-244, June 2005.

Lysaker, P.H., Davis, L.W., Gatton, M.J., & Herman, S.M. (2005). Associations of anxiety-related symptoms with reported history of childhood sexual abuse in schizophrenia spectrum disorders. Journal of Clinical Psychiatry, 66, 1279-1284.
McDevitts-Murphy, M.E., Weathers, F.W., & Adkins, J.W. (2005).  Use of the Trauma Symptom Inventory in the assessment of PTSD symptoms.  Journal of Traumatic Stress, 18, 63-67.

McGruder, J.A.K, Davidson, E.S., Gleaves, D.H, Stock, W., & Finch, J.F. (2000). Interpersonal violence and posttraumatic symptomatology: the effects of ethnicity, gender, and exposure to violent events. Journal of Interpersonal Violence, 15, 205-221.

Merrill, L.L. (2001). Trauma symptomatology among female U.S. Navy recruits. Military Medicine, 166, 621-624.

Merrill, L.L., Thomsen, C.J., Sinclair, B.B., Gold, S.R., & Milner, J.S. (2001).  Predicting the impact of child sexual abuse on women: The role of abuse severity, parental support, and coping strategies.  Journal of Consulting and Clinical Psychology, 69, 992-1006.

Merrill, L.L., Crouch, J.L., Thomsen, C.J., & Guimond, J.M. (2004).  Risk for intimate partner violence and child physical abuse: psychosocial characteristics of multirisk male and female Navy recruits.  Child Maltreatment, 9, 18-29.

Messman-Moore, T.L., Brown, A.L., & Koelsch, L.E. (2005).  Posttraumatic symptoms and self-dysfunction as consequences and predictors of sexual revictimization. Journal of Traumatic Stress, 18, 253-261.

Nye, E.C., Qualls, C.R., & Katzman, J.W. (2006). The Trauma Symptom Inventory: factors associated with invalid profiles in a sample of combat veterans with post-traumatic stress disorder. Military Medicine, 171, 857-860.

Pederson, C.L., Maurer, S.H., Kaminski, P.L., Zander, K.A., Peters, C.M., Stokes-Crowe, L.A., & Osborn, R.E. (2004).  Hippocampal volume and memory performance in a community-based sample of women with posttraumatic stress disorder secondary to child abuse.  Journal of Traumatic Stress, 17, 37-40.

Phelps, L.F., Davies, W.H., McCart, M.R., Klein-Tasman, B.P., Melzer-Lange, M.D., Heuermann, W. (2006). Concerns and coping of African-American mothers after youth assault requiring emergency medical treatment.
Journal of Pediatric Psychology, 31, 388-396.

Pollock, P.H. (2000). Eye movement desensitization and reprocessing (EMDR) for post-traumatic stress disorder (PTSD) following homicide. Journal of Forensic Psychiatry, 11, 176-184.

Porter, Stephen; Peace, Kristine A (2007). The scars of memory: a prospective, longitudinal investigation of the consistency of traumatic and positive emotional memories in adulthood. Psychological Science, 18, 435-441.

Purves, D.G, & Erwin, P.R. (2004).  Post-traumatic stress and self-disclosure. Journal of Psychology, 138, 23-33.

Resick, P.A., Nishith, P., & Griffin, M.G. How well does cognitive-behavioral therapy treat symptoms of complex PTSD?: an examination of child sexual abuse survivors within a clinical trial. CNS Spectrums, 8, 340-342, 351-355.

Roche, D.N., Runtz, M.G., & Hunter, M.A. (1999). Adult attachment: A mediator between child sexual abuse and later psychological adjustment. Journal of Interpersonal Violence, 14, 184-207.

Roe-Sepowitz, D., Bedard, L.E., & Pate, K. (2007). The impact of child abuse on dissociative symptoms: a study of incarcerated women. Journal of Trauma and Dissociation, 8, 7-26.

 Rosenthal, B.S. (2000). Exposure to community violence in adolescence: Trauma symptoms. Adolescence, 35, 271-284.

Rosenthal, B.S. & Hutton, E.M. (2001). Exposure to community violence and trauma symptoms in late adolescence: Comparison of a college sample and a noncollege community sample. Psychological Reports, 88 , 367-374.

Rosenthal, B.S., & Wilson, W.C. (2003).  Impact of and exposure to community violence and psychological symptoms on college performance among students of color.  Adolescence, 38, 239-249.

Rosenthal, B.S., & Wilson, W.C. (2003).  The association of ecological variables and psychological distress with exposure to community violence among adolescents.  Adolescence, 38, 459-479.

Rosenthal, M.Z., Hall, M.L.R., Palm, K.M., Batten, S.V. & Follette, V.M. (2005). Chronic avoidance helps explain the relationship between severity of childhood sexual abuse and psychological distress in adulthood. Journal of Child Sexual Abuse, 14, 25-41.

Runtz, M.G., & Roche, D.N. (1999). Validation of the Trauma Symptom Inventory (TSI) in a Canadian university sample. Child Maltreatment, 4, 69-80.

Sanders, B., & Moore, D.L. (1999). Childhood maltreatment and date rape. Journal of Interpersonal Violence, 14, 115-124.

Schaaf, K.K., & McCanne, T.R. (1998). Relationship of childhood sexual, physical, and combined sexual and physical abuse to adult victimization and posttraumatic stress disorder. Child Abuse & Neglect, 22, 1119-1133.

Schnurr, P.P., Friedman, M.J., Engel, C.C., Foa, E.B., Shea, M.T., Resick, P.A., James, K.E., & Chow, B.K. (2005). Issues in the design of multisite clinical trials of psychotherapy: VA Cooperative Study No. 494 as an example. Contemporary Clinical Trials, 26, 626-636.

Shapiro, B.L., & Schwartz, J.C. (1997). Date rape: Its relationship to trauma symptoms and sexual self-esteem. Journal of Interpersonal Violence, 12, 407-419.

Sigman, M.R., & Wilson, J.P. (1998). Traumatic bereavement: post traumatic stress disorder and prolonged grief in motherless daughters. Journal of Psychological Practice, 4, 34-50.

Simon, M.J. (2001).  A comparison between EMDR and exposure for treating PTSD: a single-subject analysis. Behavior Therapist, 23, 172-175.

Smith, D.W., Davis, J.L., & Fricker-Elhai, A.E. (2004).  How does trauma beget trauma?: cognitions about risk in women with abuse histories. Child Maltreatment, 9, 292-303.

Stander, V.A., Merrill, L.L. Thomsen, C.J., & Milner, J.S. (2007). Posttraumatic stress symptoms in Navy personnel: prevalence rates among recruits in basic training. Journal of Anxiety Disorders, 21, 860-870.

Taft, C.T., Vogt, D.S., Mechanic, M.B., & Resick, P.A.  (2007). Posttraumatic stress disorder and physical health symptoms among women seeking help for relationship aggression. Journal of Family Psychology, 21, 354-362.

Thanh, D.D., Wilson, J.P., & Slane, S. (2006). PTSD in Vietnamese veterans living in Vietnam. International Perspectives in Victimology, 2, 42-66.

Van Bruggen, L.K., Runtz, M.G., & Kadlec, H. (2006). Sexual revictimization: the role of sexual self-esteem and dysfunctional sexual behaviors. Child Maltreatment, 11, 131-145.

Wallis, D.A.N. (2002).  Reduction of trauma symptoms following group therapy. Australian and New Zealand Journal of Psychiatry, 36, 67-74.

Weller, L.A. (2005).  Group therapy to treat substance use and traumatic symptoms in female veterans.  Federal Practitioner, 22, 27-38.

Wilson, C.W., & Rosenthal, B.S. (2004).  Psychological effects of attacks on the World Trade Center: Analysis before and after.  Psychological Reports, 94, 587-606.

Wilson, W.C., Rosenthal, B.S., & Battle, W.S. (2007). Effects of gender, ethnicity and educational status on exposure to community violence and psychological distress in adolescence. Journal of Aggression, Maltreatment and Trauma, 15, 93-111.

Wolfe, D.A., Francis, K.J., & Straatman, A. (2006). Child abuse in religiously-affiliated institutions: long-term impact on men's mental health. Child Abuse and Neglect, 30, 205-212.

Wright, E., Borrill, J., Teers, R., & Cassidy, T. (2006). The mental health consequences of dealing with self-inflicted death in custody. Counselling Psychology Quarterly, 19, 165-180.