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Home > Clinical Resources > Adult Trauma Assessments > Posttraumatic Expectations Scale

Posttraumatic Expectations Scale

Overview

The Posttraumatic Expectations Scale (PTES) is an 81-item self-report measure that assesses dysfunctional expectations in posttraumatic stress disorder (PTSD). It can be used to assess both disorder-specific expectations and treatment expectations in clinical samples of adult patients with PTSD.

The full scale takes 10-15 minutes to administer. The original scale was developed and validated in German (Herzog et al., 2023) and is available in German here. A shortened 13-item brief screening version of the PTSD may significant reduce the administration time and burden for patients and clinicians and is available in German here. English versions are also available upon request to Dr. Herzog; the English versions have yet to be validated. 

Author/Publisher Details   

Herzog et al., 2023. Assessment.

Citation

Herzog P, Kaiser T, Rief W, Brakemeier EL, Kube T. Assessing Dysfunctional Expectations in Posttraumatic Stress Disorder: Development and Validation of the Posttraumatic Expectations Scale (PTES). Assessment. 2023 Jun;30(4):1285-1301. doi: 10.1177/10731911221089038

Corresponding Author

Philipp Herzog, Ph.D., Department of Psychology, University of Kaiserslautern-Landau (RPTU),
Ostbahnstraße 10
76829 Landau in der Pfalz
Germany
philipp.herzog@rptu.de
ORCID iD: https://orcid.org/0000-0002-8267-2083

Date   

2023

Description   

In recent years, it has become increasingly evident that dysfunctional expectations are core to various mental disorders, and contribute significantly to their development and maintenance. In posttraumatic stress disorder (PTSD), dysfunctional expectations have only rarely been investigated systematically; in part this was related to the fact that there was no well-validated assessment tool to measure dysfunctional expectations in PTSD.

Thus, we developed and validated a new self-report questionnaire that allows assessing both disorder-specific expectations in PTSD and expectations relating to the (cognitive-behavioral) treatment of PTSD – the Posttraumatic Expectations Scale (PTES). The PTES is an 81-item self-report questionnaire that assesses dysfunctional disorder-specific expectations and treatment expectations in clinical samples of adult patients with PTSD.

The results of our validation study indicate that the PTES is a highly reliable assessment tool that incrementally explains variance of PTSD symptom severity, beyond and above the well-established Posttraumatic Cognition Inventory (PTCI). By applying a novel statistical procedure (best items scales that are cross validated, unit weighted, informative and transparent - BISCUIT; Elleman et al., 2020) to build short scales, we finally built a short version of the scale in order to facilitate its use in clinical practice. 

Main features/uses:

  • To enable researchers to systematically assess dysfunctional expectations in PTSD, which offers the opportunity to gain novel insights into the psychopathology of PTSD, as future research may examine how dysfunctional expectations are related to the course of PTSD symptoms.
  • To assess relevant expectations of their patients prior to treatment (and address them, if required, accordingly).
  • Items from the PTES may provide the basis for the conduction of cognitive-behavioral interventions, such as behavioral experiments, with the aim of testing the validity of patients’ expectations. 

Scoring

Respondents rate each item on a 5-point Likert scale from 1 ("I don't agree at all") to 5 ("I totally agree") to indicate the degree to which they hold specific expectation about possible events and experiences within the next four weeks. The full scale has 9 theory-driven subscales with a total of 81 items targeting:
  • General treatment-specific expectations (subscale A)
  • Expectations towards the exposure to the traumatic event during psychotherapy (subscale B)
  • Talking about the traumatic event in psychotherapy (subscale C)
  • Reexperiencing symptoms (subscale D)
  • Emotion regulation (subscale E)
  • Openness to other people (subscale F)
  • Encounters with strangers (subscale G)
  • Avoidance behavior (subscale H)
  • General disorder-specific expectations (subscale I) 
A total score (range 81-405) can be obtained by summing the scores for each of the 81 items. Subscale scores scan be obtained by summing the scores for the items within a given subscale:
  • Subscale A: Items 1-5
  • Subscale B: Items 6-15
  • Subscale C: Items 16-25
  • Subscale D: Items 26-34
  • Subscale E: Items 35-42
  • Subscale F: Items 43-54
  • Subscale G: Items 55-60
  • Subscale H: Items 61-65
  • Subscale I: Items 66-81
Lower sum scores indicate fewer dysfunctional expectations. As we aimed to balance negative expectations with positive expectations, about half of the items need to be inversely scored. On the item-level, the PTES enables practitioners to assess their individual patients' disorder-specific expectations and treatment expectations. Subsequently, the most relevant expectations (e.g., those items with extremely high scores) can empirically be tested in expectation-focused psychology interventions (e.g., behavioral experiements) to precisely target expectation violation as a mechanism of change. 

Access


The PTES is an open-access instrument. Researchers and clinicians can freely access and use the German version of the PTES (here) and its short scale (here). English versions are available upon request to Dr. Herzog; the English versions have yet to be validated. 

Of note, this resource should be used in an ethical and responsible manner and only for the purpose(s) for which it has demonstratable validity. Please reference it appropriately:
Herzog P, Kaiser T, Rief W, Brakemeier EL, Kube T. Assessing Dysfunctional Expectations in Posttraumatic Stress Disorder: Development and Validation of the Posttraumatic Expectations Scale (PTES). Assessment. 2023 Jun;30(4):1285-1301. doi: 10.1177/10731911221089038.

Researchers who are interested to validate the English version of the PTES can contact directly the corresponding author Dr. Herzog, (philipp.herzog@rptu.de).

Key/Core References   

Herzog, P., Kaiser, T., Rief, W., Brakemeier, E.-L., & Kube, T. (2023). Assessing Dysfunctional Expectations in Posttraumatic Stress Disorder: Development and Validation of the Posttraumatic Expectations Scale (PTES). Assessment, 30(4), 10731911221089038. https://doi.org/10.1177/10731911221089038
 
Kube, T., Elssner, A. C., & Herzog, P. (2023). The relationship between multiple traumatic events and the severity of posttraumatic stress disorder symptoms – evidence for a cognitive link. European Journal of Psychotraumatology14(1), 2165025. https://doi.org/10.1080/20008066.2023.2165025

Further Information

Further information can be obtained from the key reference (Herzog et al., 2023) and the corresponding author Dr. Herzog (philipp.herzog@rptu.de).