Peritraumatic Distress Inventory

The Peritraumatic Distress Inventory (PDI) is a validated clinical tool designed to capture the acute emotional and physiological distress individuals…

Questions: 13
Duration: 5 min
Original title: PDI — Peritraumatic Distress Inventory
Adaptation: Peritraumatic Distress Inventory
Authors: Brunet, A., Weiss, D. S., Metzler, T. J., Best, S. R., Neylan, T. C., Rogers, C., Fagan, J., & Marmar, C. R.
Created: 2001

The Peritraumatic Distress Inventory (PDI) is a validated clinical tool designed to capture the acute emotional and physiological distress individuals experience in the immediate aftermath of a traumatic event. Historically developed to assess the A2 criterion of the DSM-IV, the PDI remains a highly valuable measure for predicting long-term trauma outcomes and helping clinicians recognize PTSD risk early on.

By capturing subjective distress before memories consolidate, the PDI provides clinicians with a standardized way to gauge the severity of the peritraumatic response. It allows practitioners to identify highly impacted individuals, guiding early psychoeducation before utilizing a full PTSD checklist in later stages of care. Administered shortly after the event or retrospectively during intake, it forms a reliable baseline for understanding the patient’s initial traumatic imprint.

Example result

Fictitious result, computed from a sample set of answers.

Overall score

23/ 52

A 13-item self-report questionnaire assessing the intensity of emotional and physiological distress experienced during and immediately after a potentially traumatic event. The instrument operationalizes the DSM-IV PTSD Criterion A2 (intense fear, helplessness, horror) and helps identify individuals at risk of developing post-traumatic stress disorder. It is structured into two dimensions: negative (dysphoric) emotions and perceived life threat. Used in adult psychotrauma consultations.

généralemixed · community sample · healthcare workers, COVID-19 pandemic · Italy · n = 265 · 2021 · Carmassi et al. (2021)

052

M = 9.19 ± 7.94

généralemixed · community sample · below the IES-R cutoff · Italy · 2021 · Carmassi et al. (2021)

052

M = 6.47 ± 5.25

cliniquemixed · pathology: Psychological trauma · France · n = 127 · 2005 · Jehel et al. (2005)

052

M = 25.78 ± 11.59

cliniquefemales · pathology: Psychological trauma · females · France · n = 83 · 2005 · Jehel et al. (2005)

052

M = 28.5 ± 9.9

cliniquemales · pathology: Psychological trauma · males · France · n = 41 · 2005 · Jehel et al. (2005)

052

M = 20.6 ± 9.9

cliniquemixed · pathology: Probable PTSD · above the IES-R cutoff · Italy · 2021 · Carmassi et al. (2021)

052

M = 19.11 ± 8.29

cliniquemixed · pathology: Road traffic accident · France · n = 192 · 2013 · Guardia et al. (2013)

052

M = 15.68 ± 8.71

For information

Cut-off≥ 14Significant peritraumatic distress

Optimal cutoff for predicting a trauma-related disorder at 6 weeks following a road accident.

Guardia et al. (2013)View the study ↗

Cut-off> 28Very high risk of post-traumatic disorder

90% of victims above this score developed full or partial PTSD at follow-up.

Guardia et al. (2013)View the study ↗

Cut-off< 7Low risk of post-traumatic disorder

90% of victims below this score did not develop PTSD at follow-up.

Guardia et al. (2013)View the study ↗

Scoring

Sum of items (total score and subscale scores), total score ranging from 0 to 52, each item is scored on a 5-point scale (from 0 to 4).

Perceived life threat

13/ 24

Perceived threat to one's own life or that of others, accompanied by bodily alarm reactions.

items 4, 7, 9, 10, 11, 13

024

Negative (dysphoric) emotions

10/ 28

Dysphoric emotions experienced during the event: sadness, anger, guilt, shame, loss of control.

items 1, 2, 3, 5, 6, 8, 12

028

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What the test measures

The PDI measures the severity of acute distress experienced during and in the immediate hours following a traumatic incident. It evaluates the peritraumatic response across a range of affective and physiological dimensions:

Negative emotions: The presence of sadness, guilt, frustration, and helplessness in the face of the event.
Perceived life threat: The subjective fear for one's own safety and the safety of others.
Loss of emotional control: Feelings of shame regarding one's reactions and the fear of being overwhelmed by distress.
Autonomic arousal: Acute physical reactions such as palpitations, sweating, and tremors that reflect the activation of the autonomic nervous system.
Horror and panic: The subjective experience of being terrified by the event or feeling that death is imminent.

The PDI is appropriate for adults and adolescents who have been exposed to a potentially traumatic event, including accidents, violence, natural disasters, or critical illness.

When and why to use it

Clinicians use the PDI during the acute phase following a trauma or during a post-traumatic assessment to clarify the initial impact of the event. It supports several clinical objectives:

Intake baseline: To reconstruct the acute traumatic response when patients present with chronic trauma symptoms, providing vital context for a cognitive case formulation.
Psychoeducation support: To validate the patient's acute physical and emotional experiences by naming these as common reactions to trauma.
Critical incident follow-up: To evaluate the initial psychological impact on medical survivors, helping to anticipate and manage critical care and PTSD trajectories.
Risk screening: To quantify the initial distress level and flag individuals who may require closer monitoring or early intervention.

Using a validated measure like the PDI provides a quantified picture of peritraumatic distress, helping clinicians move beyond generalized trauma narratives to target specific maintaining factors.

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The questions

Please indicate the extent to which each of the following statements describes your thoughts, feelings, and reactions during the traumatic event and immediately after. Choose the response that best describes your experience.
1. I felt totally unable to do anything.
Assesses the patient's sense of powerlessness and inability to alter the outcome during the event.
- Not at all true
- A little true
- Somewhat true
- Very true
- Extremely true
2. I felt sadness and grief.
Evaluates the immediate emotional pain and sorrow experienced as the trauma unfolded.
- Not at all true
- A little true
- Somewhat true
- Very true
- Extremely true
3. I felt frustrated and angry because there was nothing more I could do.
Probes the presence of acute anger or frustration tied to a perceived inability to act effectively.
- Not at all true
- A little true
- Somewhat true
- Very true
- Extremely true
4. I was afraid for my own safety.
Measures the subjective perception of an immediate threat to the patient's own life or physical integrity.
- Not at all true
- A little true
- Somewhat true
- Very true
- Extremely true
5. I felt guilty.
Explores early feelings of self-blame or guilt regarding actions taken or omitted during the crisis.
- Not at all true
- A little true
- Somewhat true
- Very true
- Extremely true
6. I was ashamed of my emotional reactions.
Identifies peritraumatic shame regarding the patient's inability to maintain emotional composure.
- Not at all true
- A little true
- Somewhat true
- Very true
- Extremely true
7. I was worried about the safety of others.
Captures the distress derived from witnessing others in danger or being unable to ensure their safety.
- Not at all true
- A little true
- Somewhat true
- Very true
- Extremely true
8. I felt like I was losing control of my emotions.
Assesses the fear of psychological collapse and the subjective loss of emotional regulation.
- Not at all true
- A little true
- Somewhat true
- Very true
- Extremely true
9. I felt the urge to urinate or have a bowel movement.
Probes for extreme physiological stress responses involving a loss of sphincter control.
- Not at all true
- A little true
- Somewhat true
- Very true
- Extremely true
10. I was horrified by what I saw.
Evaluates the sheer intensity of horror or shock induced by the visual aspects of the trauma.
- Not at all true
- A little true
- Somewhat true
- Very true
- Extremely true
11. I had physical reactions like sweating, shaking, and heart palpitations.
Measures the degree of acute sympathetic nervous system activation during the event.
- Not at all true
- A little true
- Somewhat true
- Very true
- Extremely true
12. I felt like I was about to faint.
Assesses signs of acute vasovagal response or impending dissociation during the incident.
- Not at all true
- A little true
- Somewhat true
- Very true
- Extremely true
13. I thought I was going to die.
Captures the ultimate cognitive appraisal of vital threat and imminent mortality.
- Not at all true
- A little true
- Somewhat true
- Very true
- Extremely true