‘If I am Reminded of my Trauma, I will …’: Assessing Threat Expectancies for Being Confronted with Trauma Reminders

TL;DR

This study introduces a new scale to measure how people with PTSD predict negative outcomes when reminded of trauma, aiming to improve treatment.

Contribution

The novel contribution is the development and validation of the Threat Appraisal in PTSD Scale (TAPS) for assessing dysfunctional threat expectancies.

Findings

The TAPS demonstrated strong internal consistency and reliability in both non-clinical and clinical samples.

The TAPS showed incremental validity in predicting PTSD symptoms in a combined sample but not in patients alone.

Three factors were identified: 'losing control', 'externalizing reactions', and 'physical reactions', with patients most concerned about losing control.

Abstract

Dysfunctional threat appraisal plays a key role in both the development and treatment of PTSD. It is unclear how these appraisals can best be measured. This study aimed to explore the specific negative outcome predictions held by patients with PTSD and to develop and validate the Threat Appraisal in PTSD Scale (TAPS).

We used data from a non-clinical (N = 309) and clinical sample (N = 125) to assess the psychometric properties of the TAPS.

The TAPS had excellent internal consistency and test-retest reliability, and convergent and discriminative validity were adequate. The TAPS showed to be sensitive to change following treatment. The TAPS demonstrated incremental validity beyond general cognitions in predicting PTSD symptoms in the combined sample, but not in the patient sample. An exploratory factor analysis suggested three factors: ‘losing control’, ‘externalizing reactions’, and ‘physical reactions’, and patients seemed most concerned about outcomes related to ‘losing control’.

These findings imply that the TAPS could be clinically beneficial, enabling patients and therapists to recognize dysfunctional expectancies and tailor therapeutic interventions accordingly.

The online version contains supplementary material available at 10.1007/s10608-025-10582-5.