PRISM (Pictorial Representation of Illness and Self Measure): A new method for the assessment of suffering after trauma


  • This study was supported by the Swiss National Science Foundation (3200B0-102204.03), Olga Mayenfisch Foundation, Hermann Klaus Foundation, and the Zurich University Jubiläumsspende.


This pilot study tested the validity of a 1-item visual assessment method originally developed to evaluate suffering in chronic illness that has been adapted for use with patients who have been exposed to traumatic events. The Pictorial Representation of Illness and Self Measure (PRISM) was administered 5 times during the course of a posttraumatic stress disorder (PTSD) treatment outcome study (N = 29). The PRISM scores declined significantly under trauma-focused psychotherapy and differentiated between participants with and without PTSD diagnoses. Test-retest reliability over a 6-month period was high (r = .85). PRISM showed significant correlations with measures of PTSD, depression, and psychopathology symptom load (r = −.38 to r = −.81; convergent validity). At the same time, PRISM was not significantly related to trauma history (discriminant validity). Illustrations of symptom time courses indicated that PRISM was more closely related to trauma-specific psychopathology than to nontrauma-specific psychopathology (discriminant validity) and sensitive to change. In summary, PRISM appears to be a valid tool for the assessment of trauma-related suffering and adds to multimethod approaches in trauma research.