The TALS – reduced form: An inventory for assessing the heroin post-traumatic stress disorder spectrum (H/PTSD-S)

Background: Using the TALS questionnaire, in many papers, we stressed the importance of including the PTSD spec- trum symptomatology as an integral part of the psychopathology of addiction. Unfortunately, we duly noted the difficulty our patients experienced in filling in the questionnaire, with negative consequences on recruitment data. So, in this study, we propose a shorter TALS-SR form. Methods: The main aim of this study was to select items from TALS to obtain a reduced form for HUD patients, so making it possible to differentiate patients with and without a PTSD spectrum com- parable with the one developed by the survivors of the L’Aquila (Italy) 2009 earthquake (H/PTSD-S). The secondary aim was to start the validation of our H/PTSD-S inventory by testing the items regarding its discriminatory effect, and its reliability in treating HUD patients. Results: Out of the 26 items included initially in Domain II (Grief Reactions), we retained only seven. Out of the 18 items initially assigned to Domain IV (Reaction to losses or upsetting events), we kept five. Out of the 9 items that belonged to Domain V (Re-experiencing), we retained five. Out of the 12 items in the first version of Domain VI (Avoidance & Numbing), we retained five. Out of 8 items once in Domain VII (Maladaptive Coping), we maintained three. Out of 5 items originally in Domain VIII (Arousal), we saved three. Out of 6 items in the longer version of Domain IX (Personal Characteristics/Risk Factors), we discarded four, leaving only two. The cut-off value determined with the ROC analysis was 11. All the items demonstrated adequate variability. The internal consist- ency (reliability) estimated using Cronbach’s alpha was optimal (0.88). Conclusions: The proposed H/PTSD-S inventory, which is founded on the principle of achieving a satisfactory level of internal consistency, measures the stress reactivity construct. It seems set to evolve into an easily accessible, practical tool for evaluating the stress reactivity that occurs in heroin use disorder patients, whether outside or inside a treatment setting.