The revised Impact of Event Scale (IES-R) is a self-report questionnaire developed by Dr Daniel Weiss and Dr Charles Marmar and is designed to reflect the DSM-IV criteria for post-traumatic stress disorder (PTSD). The original Impact of Events Scale (IES) predated the adoption of PTSD as a ‘legitimate’ diagnosis in the DSM-III and measured two of the four DSM-IV criteria for PTSD specifically, ‘re-experiencing / intrusion’ and ‘avoidance / numbing’. This IES-R version includes hyperarousal, another of the DSM criteria for PTSD. Other criteria include exposure to a traumatic event, duration of symptoms and impairment due to symptoms. The hyperarousal scale help measure hyperarousal symptoms e.g. anger and irritability, heightened startle response, difficulty concentrating and hypervigilance. The IES-R report was developed by Dr Gary C. Townsend of Skillworx Africa (Pty) Ltd.
Why measure the impact of traumatic events
The IES-R is a broadly applicable self-report measure designed to assess current subjective distress for any specific life event (PTSD). It is an instrument that can be used for repeated measurement over a period of time. Its sensitivity to change renders it useful for monitoring the client’s progress in therapy. The main strengths of this revised measure for the individual are that it is short, quick, and easy to administer and score and may be used repeatedly to assess progress. It is intended to be used as a screening tool, not a diagnostic test.
Participants undertaking the IES-R assessment receive a detailed report containing the three IES-R scales containing 22 items, divided into sub-scales of 8 intrusive, 8 avoidance, and 6 hyper-arousal items with similar content namely:
INTRUSIVE SYMPTOMS: intrusive thoughts, nightmares, intrusive feelings and imagery
AVOIDANCE SYMPTOMS: numbing of responsiveness, avoidance of feelings, situations, ideas
HYPER-AROUSAL SYMPTOMS: anger and irritability, heightened startle response, difficulty concentrating and hyper-vigilance
Benefits for the individual
The insights gained from the IES-R assessment will provide an objective idea of a person’s vulnerability to distress after a traumatic event. The IES-R is typically used in conjunction with corroborating information when assessing for the presence or absence of PTSD symptoms. High scores on the IES-R are symptomatic of high levels of distress in the individual and assists the clinician and individual being assessed with supplementary information regarding the decision to further explore the condition with a formal clinical interview. Similarly, low scores on the IES-R should not be seen as a substitute for not pursuing a comprehensive clinical interview should there be other corroborating information suggesting so.
In addition, retesting may also offer insight into scales that are fluctuating while others are staying relatively high over time. This may further assist with flagging the presence of a co-existing disorders or some life event or problem which may need immediate treatment.
IES-R Personal Report
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