How Do Mental Health Professionals Measure Recovery and Dysfunction After Trauma?

What you need to know

• A new assessment tool called the Dispositional Recovery and Dysfunction Inventory (DRDI) measures both positive recovery progress and lingering dysfunction after trauma
• The tool can help clinicians track therapy progress and identify areas where patients may be stuck
• The assessment is reliable across different groups and correlates well with other measures of mental health and resilience

Understanding Trauma Recovery

Most people experience some type of trauma during their lifetime - from natural disasters to accidents to assault. While many people recover naturally, others may develop conditions like post-traumatic stress disorder (PTSD). Even among those who develop PTSD or other difficulties, recovery is possible either naturally or through therapy.

Until now, most assessment tools focused only on measuring either positive aspects like resilience or negative symptoms like PTSD. However, recovery from trauma isn’t just about reducing symptoms - it also involves building strength and positive coping. This new tool aims to track both sides of the recovery journey.

What the DRDI Measures

The DRDI is a 14-item questionnaire that measures two main areas:

1. Recovery mindset - How much someone feels they can bounce back and grow from adversity
2. Dysfunctional thoughts - Negative beliefs about oneself that may persist after trauma

Questions assess things like:

• Feeling restored after facing difficulties
• Believing in ability to improve
• Feeling broken or damaged
• Experiencing shame
• Sense of personal growth
• Feeling detached

How It Was Developed

Mental health experts who treat trauma and PTSD helped develop the questions based on what they commonly hear from patients. The researchers tested the tool in two groups:

1. University students (401 people)
2. A mixed group including people with and without PTSD symptoms (249 people)

The testing showed the tool was reliable and measured what it was intended to measure. Importantly, it worked equally well across different groups:

• Men and women
• People with and without PTSD
• Different age groups

What the Research Found

The study revealed several important findings about trauma recovery:

Recovery Mindset

• People who scored higher on recovery mindset tended to be more psychologically hardy
• They had lower levels of anxiety and depression
• However, having a recovery mindset wasn’t necessarily related to PTSD symptoms, suggesting recovery is complex

Dysfunction

• Higher dysfunction scores were linked to:
  • More PTSD symptoms
  • Greater stress, anxiety and depression
  • More thoughts of suicide
  • Lower psychological hardiness
  • More difficulty tolerating uncertainty
  • Poorer social functioning

Importantly, recovery and dysfunction were only weakly related to each other. This suggests they are separate processes - someone could be building recovery strengths while still experiencing some dysfunction.

How Clinicians Can Use It

The DRDI can be helpful in several ways:

1. Track therapy progress by measuring both gains in recovery and reductions in dysfunction
2. Identify specific areas where patients may be stuck
3. Start conversations about both struggles and strengths
4. Guide treatment planning by showing what areas need more focus

For example, if a patient scores high on dysfunction but low on recovery, the therapist might focus more on building positive coping skills. If dysfunction scores remain high while recovery improves, they may need to address specific negative beliefs more directly.

Conclusions

• Recovery from trauma involves both reducing negative symptoms and building positive strengths
• The DRDI is a reliable tool for measuring both aspects of recovery
• Recovery and dysfunction are separate processes that may improve at different rates
• The tool can help clinicians better track progress and guide treatment

While more research is still needed, especially in diverse populations and over longer time periods, the DRDI shows promise as a practical tool for both clinicians and researchers studying trauma recovery.