Assessment Of Cognitions

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An extensive review of potential measurements to use to assess cognitions is beyond the scope of this chapter. However, a few measures deserve mention for those readers who are seeking appropriate assessment instruments that are sensitive to changes in cognition anticipated over the course of treatment. Among the commonly used measures of cognition are the Trauma and Attachment Belief Scale (TABS; Pearlman, 2003), the Personal Beliefs and Reactions Scale (PBRS; Mechanic & Resick, 1993), the World Assump tions Scale (WAS; Janoff-Bulman, 1989), and the Posttraumatic Cognitions Inventory (PTCI; Foa, Ehlers, Clark, Tolin, & Orsillo, 1999b).

The TABS is an 84-item measure that identifies disruption in several dimensions that impact interpersonal relationships, including Safety, Trust, Esteem, Intimacy, and Control. Similarly, the PBRS is a 55-item measure developed for use with sexual assault survivors to assess eight dimensions of Safety, Trust, Power, Esteem, Intimacy, Negative Rape Beliefs, Self-Blame, and Undoing (i.e., trying to deny or alter the event as a method of assimilation). Three subscales of the PBRS are predictive of intrusive symptoms of PTSD (Self-Blame, Undoing, and Safety), whereas four scales were predictive of avoidant symptoms of PTSD (Trust, Self-Blame, Undoing, Intimacy), and two scales were predictive of arousal symptoms (Power, Safety; Mechanic & Resick, 1993). The WAS is a 32-item measure that evaluates eight categories of personal beliefs, including Benevolence of the World, Benevolence of People, Justice, Controllability of Life Events, Randomness of Life Events, Self-Worth, Self-Control, and Personal Luck. Three of these subscales appear to discriminate between trauma survivors and nontrauma survivors (Self-Worth, Randomness of Life Events, and Benevolence of the World; Janoff-Bulman, 1989). Finally, the PTCI is a 36-item measure that assesses three cognitive factors: Negative Cognitions about Self, Negative Cognitions about the World, and Self-Blame. This measure has also demonstrated an ability to discriminate between clients with and without PTSD (Foa et al., 1999b). Thus there are ample measures available to assess the trauma-related cognitions that are frequently targeted by cognitive interventions.

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