ITQ Scoring · International Trauma Questionnaire for ICD-11 PTSD and Complex PTSD

The ITQ (International Trauma Questionnaire) is a brief self-report questionnaire for post-traumatic stress disorder (PTSD) and complex PTSD (CPTSD) as defined in ICD-11. It has 12 symptom items and a simple diagnostic algorithm ¹.

What does the ITQ measure?

The ITQ measures the core features of ICD-11 PTSD (6B40) and complex PTSD (6B41). ICD-11 describes each disorder with a limited set of central symptoms rather than a long checklist, and the ITQ follows that design to maximize clinical utility and international applicability ¹.

Its 12 symptom items form six clusters of two items each ^{1 2}:

• PTSD: re-experiencing in the here and now, avoidance, and a sense of current threat.
• Disturbances in self-organization (DSO): affective dysregulation, negative self-concept and disturbances in relationships.

Complex PTSD is PTSD plus the three DSO clusters.

How do you give the ITQ?

• Who completes it. The client, about the experience that troubles them most. They briefly describe it and say when it happened ².
• PTSD items. Rated for how much each problem has bothered them in the past month ².
• DSO items. Rated for how true each statement typically is of them ².
• Response scale. Every item is rated 0 (not at all), 1 (a little bit), 2 (moderately), 3 (quite a bit) or 4 (extremely) ¹.
• Impairment. After each half, three items ask about functional impairment from those symptoms in social, occupational and other important areas of life ^{1 2}.
• Permissions. The developers state it is freely available in the public domain for all interested parties, without any change ². Use the published form; this page numbers the clusters and does not reproduce the items.

How do you score and interpret the ITQ?

1. Treat a rating of 2 (moderately) or more as an endorsed symptom ¹.
2. PTSD: at least one of the two items endorsed in each PTSD cluster (re-experiencing, avoidance, sense of threat), plus endorsed functional impairment associated with those symptoms ¹.
3. Complex PTSD: at least one of the two items endorsed in each of the six clusters, plus endorsed functional impairment associated with those symptoms ¹.
4. One result only. ICD-11 dictates that a person may receive a diagnosis of PTSD or complex PTSD, but not both ¹. When the complex PTSD criteria are met, the result is complex PTSD.

The ITQ is read as a cluster profile, not as one total against a cutoff, so this page has no score band table. Reviewing the six cluster scores shows which symptoms drive the result and which to track over treatment.

Psychometric properties

• Development. Item response theory was applied to a trauma-exposed community sample (n = 1,051) and a trauma-exposed clinical sample (n = 247) from the United Kingdom to choose the 12 best symptom items ¹.
• Structure. Confirmatory factor analysis of the 12-item version fitted the data from both samples extremely well, for first- and second-order models, and showed no evidence of differential item functioning between clinical and community groups ¹.
• Diagnostic rates. In the community sample, 5.3% met criteria for PTSD and 12.9% for complex PTSD. In the clinical sample, 14.6% met criteria for PTSD and 61.1% for complex PTSD ¹.

Limitations

• Self-report, not a clinical diagnosis. The algorithm mirrors ICD-11, but a diagnosis needs a clinical assessment.
• Samples. The community sample came from a nationally representative panel, but the trauma-exposed participants in it may not have been representative; the clinical sample came from trauma specialty clinics ¹.
• ICD-11, not DSM-5. It does not map onto the 20 DSM-5 PTSD symptoms; use the PCL-5 for DSM-5 PTSD.
• Further evaluation needed. The developers note that further evaluation and development of the measure is needed ¹.
• Use unchanged. The public domain terms apply to the ITQ without any change; altered wording is not the validated questionnaire ².