TSQ: Trauma Screening Questionnaire

What this assessment is

The Trauma Screening Questionnaire, or TSQ, is a 10-item self-report screen for possible posttraumatic stress disorder.

It asks about reactions linked to a traumatic event. Five questions cover re-experiencing and five cover arousal.

Chris Brewin and colleagues introduced the TSQ in a 2002 study.

It is a brief screen. It is not a diagnostic interview or a trauma-severity scale.

Who it was designed for

The TSQ was designed for adult survivors of traumatic events. The original work involved people who survived a rail crash and people affected by crime.

Later studies tested it after assault, terrorism, injury, and other events.

This page covers the adult TSQ. Child trauma screens are separate measures.

Accuracy depends on the population, time since the event, and the interview used to confirm PTSD. A boundary that works in one group may create more false positives or false negatives in another.

How it is administered

The respondent answers yes or no for each of 10 reactions. A yes means that the reaction occurred at least twice during the past week.

Timing matters.

The VA TSQ guide reports the authors' recommendation to screen three to four weeks after the event. This allows common early reactions time to settle.

That timing is part of the original use. A questionnaire completed earlier answers a different question and should not be interpreted with the same confidence.

What it measures

The TSQ covers five re-experiencing reactions and five arousal reactions.

It does not assess avoidance. It also does not cover every negative change in thoughts and mood included in current DSM-5 PTSD criteria.

The PC-PTSD-5 is another brief adult PTSD screen with different content and a past-month timeframe. The PCL-5 provides a 20-symptom severity total.

The measures serve different roles.

Do not compare their raw scores.

How scoring works

Give one point for each yes response. Give zero points for no.

Count reactions.

Ten reactions. Yes or no. One count.

Add the 10 responses for a total from 0 to 10.

The original study treated a score of 6 or more as a positive screen. A score from 0 to 5 was a negative screen under that rule.

This is a count of recent reactions, not a graded symptom-severity scale. A yes does not distinguish a moderate reaction from an extreme one.

The same total can reflect very different combinations of re-experiencing and arousal, so review the endorsed reactions rather than the count alone.

Complete all 10 responses. Do not treat a missing answer as no.

How to interpret a TSQ score

A positive screen means that at least six of the listed reactions occurred twice or more during the past week. It supports a fuller PTSD assessment.

It does not confirm PTSD.

Screen, then assess.

The original study found good screening performance in its small rail-crash and crime samples. Later studies found different best boundaries in other settings.

Use 6 as the original rule, not as a universal diagnostic fact.

Review the result with event exposure, symptom duration, avoidance, mood and belief changes, functioning, safety, and other possible causes.

What the score cannot tell you

The TSQ cannot establish that the event meets DSM-5 Criterion A. It cannot determine the full PTSD symptom pattern, duration, or functional impairment.

It also cannot measure the intensity of each reaction because every answer is yes or no.

A negative screen can miss PTSD symptoms outside the two covered groups. A positive screen can reflect acute distress that does not become PTSD.

Both errors matter.

Do not diagnose or choose treatment from the count alone.

Evidence and limitations

The National Center for PTSD review summarizes the original structure, score-of-6 rule, and recommended timing.

A later assault study found that the TSQ could help predict later PTSD when used one to three weeks after assault. Its timing differed from the original general recommendation, which shows why setting matters.

The TSQ is short and easy to score. That strength also limits it. It samples two symptom groups, uses binary answers, and cannot replace a structured assessment.

Brief means limited.