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The Responses to Script-Driven Imagery Scale (RSDI): Assessment of State Posttraumatic Symptoms for Psychobiological and Treatment Research

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Abstract

Studies of PTSD employing symptom provocation have seldom included self-report measures of the symptoms provoked. Doing so could benefit psychobiological research by improving diagnostic discrimination and capturing the heterogeneity of responses to script-driven imagery, and treatment research by complementing existing outcome measures. This paper describes the initial development and psychometric properties of the Responses to Script-Driven Imagery Scale (RSDI), a brief self-report measure of state PTSD and dissociative symptoms evoked by script-driven imagery, a widely used symptom provocation method in PTSD research. Across three samples and three variants of the script-driven imagery paradigm, confirmatory factor analysis fit a hypothesized and sample-invariant three-factor structure for the RSDI, composed of reexperiencing, avoidance, and dissociative symptoms. Subscales exhibited acceptable to high internal consistency reliabilities, and construct validity evidence was strong and consistent with predictions. The RSDI shows promise as a tool for psychobiological and treatment outcome research on PTSD.

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Acknowledgment

This research was supported by National Institute of Mental Health Grant MH-58363, a grant from Pfizer Incorporated for an investigator-initiated proposal, and Canadian Institutes of Health Research Grant MOP 49543.

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Authors and Affiliations

  1. Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA

    James W. Hopper & Bessel A. van der Kolk

  2. The Trauma Center, Boston, MA, USA

    James W. Hopper & Bessel A. van der Kolk

  3. Department of Psychology, University of Western Ontario, London, ON, Canada

    Paul A. Frewen

  4. Department of Psychosomatic Medicine, Hannover Medical School, Hannover, Germany

    Martin Sack

  5. Department of Psychiatry, University of Western Ontario, London, ON, Canada

    Ruth A. Lanius

  6. Behavioral Psychopharmacology Research Laboratory, Department of Psychiatry, McLean Hospital and Harvard Medical School, 115 Mill Street, Belmont, MA, 02478, USA

    James W. Hopper

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  1. James W. Hopper
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  2. Paul A. Frewen
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  3. Martin Sack
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  4. Ruth A. Lanius
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  5. Bessel A. van der Kolk
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Corresponding author

Correspondence to James W. Hopper.

Appendix

Appendix

Responses to Script-Driven Imagery Scale

Notes on Administration

This scale can be administered as an interview or a questionnaire, and can be used immediately after the entire script-driven imagery protocol (e.g., before removing electrodes, etc.), or immediately after the post-imaging rest period for each script. For the interview version, print the Likert scale on a separate page and give it to the subject at that point in the directions.

Directions for Participant

“You will be asked to describe the extent to which you have had particular experiences, during the script and the imagining periods between the script and the rest period.”

“You will be asked to give ratings on this scale:

“If you have difficulty remembering and/or estimating the extent of your experience for a particular item, just make the best estimation you can of your experience based on your memory now.”

1. Did you feel as though the event was reoccurring, like you were reliving it?

2. Were you distressed?

3. Were you emotionally upset?

4. Did you have physical reactions in your body (for example, sweaty, racing heart, trembling, short of breath)?

5. Did you avoid experiencing images, sounds, or smells connected to the event?

6. Did you avoid thoughts about the event?

7. Did you avoid feelings about the event?

8. Did what you were experiencing seem unreal to you, like you were in a dream or watching a movie or play?

9. Did you feel like you were a spectator watching what was happening to you, like an observer or outsider?

10. Did you feel disconnected from your body?

11. Did you feel like you were in a fog?

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Hopper, J.W., Frewen, P.A., Sack, M. et al. The Responses to Script-Driven Imagery Scale (RSDI): Assessment of State Posttraumatic Symptoms for Psychobiological and Treatment Research. J Psychopathol Behav Assess 29, 249–268 (2007). https://doi.org/10.1007/s10862-007-9046-0

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