Outcome Measure
Impact of Event Scale-Revised
What it measures?
- The Impact of Event Scale-Revised (IES-R) is a tool designed to gauge the presence and severity of symptoms associated with post-traumatic stress disorder (PTSD). Consisting of 22 self-reported items, each directly corresponding to PTSD symptoms outlined in the DSM-IV, it offers insights into an individual's subjective response to a traumatic event. While it doesn't provide a formal diagnosis, it effectively assesses various dimensions of trauma response in older adults, notably intrusion (such as intrusive thoughts and nightmares), avoidance (including numbing of feelings and avoidance behaviours), and hyperarousal (manifesting as anger, hypervigilance, etc.) as well as a total subjective stress score.
Who is it for?
The IES-R is suitable for use with both healthy older adults and those who may be more vulnerable due to frailty, following exposure to specific traumatic events. Its utility extends to repeated assessments overtime, facilitating the monitoring of progress (McCabe, 2019).
Instrument Quality
- The IES-R is a well-established tool for assessing traumatic stress, offering a robust measure of post-trauma phenomena that complements other assessment approaches in clinical settings (Creamer et al., 2003; Beck et al., 2008). Validation studies have consistently demonstrated high levels of internal consistency and test-retest reliability (Creamer et al., 2003; Weiss, 2007). Research also supports its concurrent and discriminative validity along with the absence of social desirability effects (Beck et al., 2009).
Structure
- 22 items
- 5-point Likert scale
- Respondents indicate how distressing each item (e.g. “I had trouble staying asleep”) has been for them in the past 7 days (0 = “Not at all”; 4 = “Extremely”)
Scoring instructions
Sum item responses to derive full-scale and subscale scores.
| Subscale | Item number |
|---|---|
Intrusion (IES-R) |
1,2,3,6,9,14,16,20 |
Avoidance (IES-R) |
5,7,8,11,12,13,17,22 |
Full-scale (IES-R) |
1,2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22 |
Hyperarousal (IES-R) |
4,10,15,18,19,21 |
Score Interpretation
What higher scores mean?
- Higher scores on the IES-R indicate a greater likelihood of PTSD and the associated impacts on an individual's health and well-being (McCabe, 2019).
How to assess symptom severity & change?
| Description | Score Range | |
|---|---|---|
| Below normative mean | 0 | |
| Normative mean | 10.4 | |
| 1 SD above normative mean | 17.2 | |
| 2 SD above normative mean | 24 | |
| Maximum | 32 |
| Description | Score Range | |
|---|---|---|
| Below normative mean | 0 | |
| Normative mean | 11.4 | |
| 1 SD above normative mean | 17.5 | |
| 2 SD above normative mean | 23.6 | |
| Maximum | 32 |
Severity ranges
Normative mean and standard deviation are based on an Indonesian-speaking adults’ sample (N = 992) of healthy adults during the Covid-19 pandemic as a probable ongoing collective traumatic event (Wijovi et al., 2021).
Reliable change and clinically significant improvement
Wampold et al (2001) conducted a meta-analysis of psychotherapy outcome studies and noted that the average improvement was reflected in an effect size (ES) of .80. Because a change of 1 SD corresponds to an ES of 1.0, and .80 is considered to be a large ES, Wise (2004) concludes that a change of 1 SD is a defensible indicator of clinically significant change.
Mean
| Sample | Mean | Comments |
|---|---|---|
| Clinical | 19.7 | Based on a sample 109 adults’ survivors of motor vehicle crash injury and PTSD in Sydney, Australia (Guest et al., 2018). |
| Normative | 11.4 | Normative mean and standard deviation are based on an Indonesian-speaking adults’ sample (N = 992) of healthy adults during the Covid-19 pandemic as a probable ongoing collective traumatic event (Wijovi et al., 2021). |
Standard Deviation
| Sample | Mean | Comments |
|---|---|---|
| Clinical | 7.1 | Based on a sample 109 adults’ survivors of motor vehicle crash injury and PTSD in Sydney, Australia (Guest et al., 2018). |
| Normative | 6.1 | Normative mean and standard deviation are based on an Indonesian-speaking adults’ sample (N = 992) of healthy adults during the Covid-19 pandemic as a probable ongoing collective traumatic event (Wijovi et al., 2021). |
| Description | Score Range | |
|---|---|---|
| Normal | 0 | |
| Mild Psychological Impact | 24 | |
| Post-Traumatic Stress Disorder (PTSD) | >=33 | Provisional Diagnosis |
| Moderate Psychological Impact | 33 | |
| Severe Psychological Impact | 39 | |
| Maximum | 88 |
Severity ranges
Normative mean and standard deviation are based on an Indonesian-speaking adults’ sample (N = 992) of healthy adults during the Covid-19 pandemic as a probable ongoing collective traumatic event (Wijovi et al., 2021).
Provisional diagnosis
Reliable change and clinically significant improvement
Wampold et al (2001) conducted a meta-analysis of psychotherapy outcome studies and noted that the average improvement was reflected in an effect size (ES) of .80. Because a change of 1 SD corresponds to an ES of 1.0, and .80 is considered to be a large ES, Wise (2004) concludes that a change of 1 SD is a defensible indicator of clinically significant change.
Mean
| Sample | Mean | Comments |
|---|---|---|
| Clinical | 63.33 | Based on a sample 109 adults’ survivors of motor vehicle crash injury and PTSD in Sydney, Australia (Guest et al., 2018). |
| Normative | 29.7 | Based on an Indonesian-speaking adults’ sample (N = 992) of healthy adults during the Covid-19 pandemic as a probable ongoing collective traumatic event (Wijovi et al., 2021). |
Standard Deviation
| Sample | Mean | Comments |
|---|---|---|
| Clinical | 17.7 | Based on a sample 109 adults’ survivors of motor vehicle crash injury and PTSD in Sydney, Australia (Guest et al., 2018). |
| Normative | 16.3 | Based on an Indonesian-speaking adults’ sample (N = 992) of healthy adults during the Covid-19 pandemic as a probable ongoing collective traumatic event (Wijovi et al., 2021). |
Reliability
| Value | Comments |
|---|---|
| 0.95 | Based on an American sample (N = 124) of substance-dependent individuals who all had a history of a DSM-IV criterion A traumatic event (Rash et al., 2008). |
| Description | Score Range | |
|---|---|---|
| Below normative mean | 0 | |
| Normal | 7.9 | |
| 1 SD above normative mean | 12.6 | |
| 2 SD above normative mean | 17.3 | |
| Maximum | 24 |
Severity ranges
Normative mean and standard deviation are based on an Indonesian-speaking adults’ sample (N = 992) of healthy adults during the Covid-19 pandemic as a probable ongoing collective traumatic event (Wijovi et al., 2021).
Reliable change and clinically significant improvement
Wampold et al (2001) conducted a meta-analysis of psychotherapy outcome studies and noted that the average improvement was reflected in an effect size (ES) of .80. Because a change of 1 SD corresponds to an ES of 1.0, and .80 is considered to be a large ES, Wise (2004) concludes that a change of 1 SD is a defensible indicator of clinically significant change.
Mean
| Sample | Mean | Comments |
|---|---|---|
| Clinical | 18.5 | Based on a sample 109 adults’ survivors of motor vehicle crash injury and PTSD in Sydney, Australia (Guest et al., 2018). |
| Normative | 7.9 | Normative mean and standard deviation are based on an Indonesian-speaking adults’ sample (N = 992) of healthy adults during the Covid-19 pandemic as a probable ongoing collective traumatic event (Wijovi et al., 2021). |
Standard Deviation
| Sample | Mean | Comments |
|---|---|---|
| Clinical | 5 | Based on a sample 109 adults’ survivors of motor vehicle crash injury and PTSD in Sydney, Australia (Guest et al., 2018). |
| Normative | 4.7 | Normative mean and standard deviation are based on an Indonesian-speaking adults’ sample (N = 992) of healthy adults during the Covid-19 pandemic as a probable ongoing collective traumatic event (Wijovi et al., 2021). |
Instrument developers
- Weiss, D. S. (2007). The impact of event scale: revised. In Cross-cultural assessment of psychological trauma and PTSD (pp. 219-238). Boston, MA: Springer US.
Refrences
* Beck, J. G., Grant, D. M., Read, J. P., Clapp, J. D., Coffey, S. F., Miller, L. M., & Palyo, S. A. (2008). The impact of event scale-revised: psychometric properties in a sample of motor vehicle accident survivors. Journal of anxiety disorders, 22(2), 187-198. *Creamer, M., Bell, R., & Failla, S. (2003). Psychometric properties of the impact of event scale—revised. Behaviour research and therapy, 41(12), 1489-1496. McCabe, D. (2019). The impact of event scale-Revised (IES-R). New York University *Rory Meyers College of Nursing, 19 Weiss, D. S. (2007). The impact of event scale: revised. In Cross-cultural assessment of psychological trauma and PTSD (pp. 219-238). Boston, MA: Springer US.
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Severity ranges
Normative mean and standard deviation are based on an Indonesian-speaking adults’ sample (N = 992) of healthy adults during the Covid-19 pandemic as a probable ongoing collective traumatic event (Wijovi et al., 2021).
Reliable change and clinically significant improvement
Wampold et al (2001) conducted a meta-analysis of psychotherapy outcome studies and noted that the average improvement was reflected in an effect size (ES) of .80. Because a change of 1 SD corresponds to an ES of 1.0, and .80 is considered to be a large ES, Wise (2004) concludes that a change of 1 SD is a defensible indicator of clinically significant change.
Mean
Standard Deviation