Page Last Updated: May 16, 2026

DSM5 Severity Acute Stress or PTSD🔗

National Stressful Events Survey- PTSD Short Scale/Acute Stress Disorder

Table Namepex_bm_str__ptsd
ConstructPTSD/Acute Stress Disorder Symptom Severity
Study VisitsV01, V02, V03
Administration Child-specific: No
Respondent: Pregnant Participant, Birth Parent, or Primary Caregiver<
Method: Self-administered in-person or remotely (3 min estimated duration)
Quality Control
  • Checks for missing data based on counts for items completed by each participant
  • Verification of scoring accuracy
  • Summary statistics to examine item-level frequencies and total scores
  • Review of response distributions for potential outliers
Data Warning â–¸

Consideration of Mental Health Symptoms Experienced During Pregnancy
The co-occurrence of psychiatric symptoms and substance use during pregnancy is well-documented (Massey et al., 2011, Massey et al., 2012). Phenotypic risk in birthing parents may affect offspring neurodevelopment through both prenatal and postnatal mechanisms, beyond direct exposure alone (Estabrook et al., 2016, Massey et al., 2016, Massey et al., 2018). These factors may confound associations between exposures and neuroimaging or neurodevelopmental outcomes, but they also represent malleable targets for prevention and early intervention. When possible, incorporating parental mental health symptoms as covariates offers a robust strategy to account for these confounding influences.

Please review the Known Issues & Pending Updates page for updates that may affect data use.

Instrument Details🔗

This measure is a combination of two measures:

  • Severity of Posttraumatic Stress Symptoms-National Stressful Events Survey PTSD Short scale (NSESSS-PTSD)
  • Severity of Acute Stress Symptoms—Adult National Stressful Events Survey Acute Stress Disorder Short Scale (NSESSS-Acute stress)

The NSESSS-acute stress is a 7-item scale, 6 of which are from the NSESSS-PTSD short scale, with one additional question. As such, the measures were combined into one administration. Publications should note the combined administration.

Thus, the scales are as follows:

  • Total Raw Score PTSD (Total of Questions 1, 2, 3, 4, 5, 6, 7, 8, 9)
  • Total Raw Score Acute Stress (Total of Questions 1, 2, 3, 7, 8, 9, 10)

Questionnaire prompt/instructions:

People sometimes have problems after extremely stressful events or experiences. How much have you been bothered during the PAST SEVEN (7) DAYS by each of the following problems that occurred or became worse after an extremely stressful event/experience?

HBCD Modification Details â–¸

In the HBCD study, a ‘Decline to answer’ option was added to all items. A ‘Don’t know’ option was also available early in data collection, but was later removed.

Scoring Procedures â–¸

Please see documentation linked above for scoring.

NSESS-PTSD
Total of Questions 1, 2, 3, 4, 5, 6, 7, 8, 9. This 9-item measure assesses the severity of PTSD following an extremely stressful event or experience. Each item asks about severity of the PTSD over the past 7 days, and is measured on a 5-point scale (0-4). Total score ranges from 0 to 36, with higher scores indicating greater severity of PTSD.

Scoring Rules:

  • If 3 or more items on a scale are left unanswered, a total score is not computed.
  • If 1-2 items are left unanswered, a prorated total score is calculated using the formula:

    • \[ \text{Prorated Score} = \frac{\text{Raw sum} \times {9}}{\text{Number of items that were actually answered}} \]

The result is rounded to the nearest whole number and noted with an NA in the summary column and the new score in the pro-rated column.


NSESS-Acute stress
Total of Questions 1, 2, 3, 7, 8, 9, 10. This 7-item measure assesses the severity symptoms of acute stress disorder following an extremely stressful event or experience. Each item asks about severity of the acute stress disorder over the past 7 days, and is measured on a 5-point scale (0-4). Total score ranges from 0 to 28, with higher scores indicating greater severity of acute stress disorder.

Scoring Rules:

  • If 2 or more items on a scale are left unanswered, a total score is not computed.
  • If 1 item is left unanswered, a prorated total score is calculated using the formula:

\[ \text{Prorated Score} = \frac{\text{Raw sum} \times {7}}{\text{Number of items that were actually answered}} \]

The result is rounded to the nearest whole number and noted with an NA in the summary column and the new score in the pro-rated column.

References🔗

Estabrook, R., Massey, S. H., Clark, C. A. C., Burns, J. L., Mustanski, B. S., Cook, E. H., O’Brien, T. C., Makowski, B., Espy, K. A., & Wakschlag, L. S. (2016). Separating family-level and direct exposure effects of smoking during pregnancy on offspring externalizing symptoms: Bridging the behavior genetic and behavior teratologic divide. Behavior Genetics, 46(3), 389–402. https://doi.org/10.1007/s10519-015-9762-2

Massey, S. H., Lieberman, D. Z., Reiss, D., Leve, L. D., Shaw, D. S., & Neiderhiser, J. M. (2011). Association of clinical characteristics and cessation of tobacco, alcohol, and illicit drug use during pregnancy. The American Journal on Addictions. https://doi.org/10.1111/j.1521-0391.2010.00110.x

Massey, S. H., Mroczek, D. K., Burns, J. L., Clark, C. A. C., Espy, K. A., & Wakschlag, L. S. (2018). Positive parenting behaviors in women who spontaneously quit smoking during pregnancy: Clues to putative targets for preventive interventions. Neurotoxicology and Teratology, 67, 18–24.https://doi.org/10.1016/j.ntt.2018.02.003

Massey, S. H., Neiderhiser, J. M., Shaw, D. S., Leve, L. D., Ganiban, J. M., & Reiss, D. (2012). Maternal self concept as a provider and cessation of substance use during pregnancy. Addictive Behaviors, 37(8), 956–961. https://doi.org/10.1016/j.addbeh.2012.04.002

Massey, S. H., Reiss, D., Neiderhiser, J. M., Leve, L. D., Shaw, D. S., & Ganiban, J. M. (2016). Maternal personality traits associated with patterns of prenatal smoking and exposure: Implications for etiologic and prevention research. Neurotoxicology and Teratology, 53, 48–54. https://doi.org/10.1016/j.ntt.2015.11.010