What is the ITQ used for?

The International Trauma Questionnaire is used to screen for and support the diagnosis of ICD-11 post-traumatic stress disorder and complex PTSD. Clinicians use its 18 items to identify core trauma symptoms, gauge functional impact, distinguish the two conditions, and monitor how symptoms change across a course of treatment.

How many items are on the ITQ and how is it scored?

The ITQ has 18 items: 12 symptom items and 6 functional impairment items, each rated from 0 (Not at all) to 4 (Extremely). Rather than a single total-score cutoff, it uses a diagnostic algorithm in which a symptom counts as present when it is rated 2 or higher.

What is the difference between PTSD and complex PTSD on the ITQ?

Both share the three PTSD clusters: re-experiencing, avoidance, and a sense of current threat. Complex PTSD adds three disturbances in self-organization: affective dysregulation, negative self-concept, and disturbances in relationships. A person meets criteria for either PTSD or complex PTSD, not both, based on which clusters are endorsed with impairment.

Is the ITQ free to use?

Yes. The ITQ is in the public domain and freely available to clinicians and researchers, so practices can adopt it without licensing fees. Because it aligns with the World Health Organization's ICD-11 criteria, it offers a standardized, no-cost option for trauma screening across a range of clinical settings.

How often should the ITQ be repeated?

There is no fixed interval, but the ITQ is well suited to repeated use because it detects reliable, clinically significant change during treatment. Many clinicians re-administer it at regular review points, such as every few weeks or at the start and end of an episode of care, to track progress.

Can the ITQ diagnose PTSD on its own?

No. The ITQ supports clinical decision-making but is not a standalone diagnostic tool. A positive result prompts follow-up, and a qualified clinician should confirm the diagnosis through a full evaluation that considers history, context, and functional impact. Consider further assessment whenever screening suggests PTSD or complex PTSD.

International Trauma Questionnaire (ITQ) | Template & auto-scoring

The International Trauma Questionnaire (ITQ) is a free, 18-item self-report measure that screens for post-traumatic stress disorder (PTSD) and complex PTSD as defined by the World Health Organization's ICD-11. It captures core trauma symptoms and functional impact, giving mental health clinicians a brief, standardized way to support diagnosis and monitor change over time.

Why healthcare providers use the ITQ

ICD-11 aligned. It maps directly to the World Health Organization criteria for PTSD and complex PTSD, so screening reflects the current international diagnostic framework.
Brief and self-administered. Patients typically finish the 18 items in a few minutes, which keeps screening feasible in busy clinics.
Distinguishes PTSD from complex PTSD. Separate symptom and self-organization clusters help clarify which presentation fits a patient, guiding clinical decision-making.
Tracks treatment change. Repeated administration shows whether symptoms improve over a course of care, supporting outcome monitoring.
Freely available. The measure sits in the public domain, so practices can adopt it without licensing fees.

Which settings use the ITQ?

Community mental health. Clinicians use it to screen and monitor trauma-related presentations across outpatient caseloads.
Trauma and PTSD specialty services. Programs focused on post-traumatic stress apply it to characterize PTSD versus complex PTSD.
Primary care and integrated behavioral health. Teams use it as a brief screen when trauma is suspected during a broader assessment.
Research and outcome programs. Investigators rely on its ICD-11 alignment for consistent measurement across studies.

What does the ITQ measure?

The ITQ measures the symptoms that define ICD-11 PTSD alongside the broader disturbances in self-organization that distinguish complex PTSD. Twelve items cover six symptom clusters, and six additional items rate the functional impact of those symptoms on daily life, relationships, and work.

PTSD symptom clusters. Re-experiencing in the here and now, avoidance, and a sense of current threat.
Disturbances in self-organization. Affective dysregulation, negative self-concept, and disturbances in relationships.
Functional impairment. Separate items rate how the PTSD and self-organization symptoms affect functioning.

Scoring the ITQ

Number of items: 18 total, comprising 12 symptom items and 6 functional impairment items.
Per-item scale: each item is rated 0 to 4 (Not at all, A little bit, Moderately, Quite a bit, Extremely).
Total score range: the 12 symptom items yield a symptom score from 0 to 48, with the PTSD and self-organization subscales each ranging 0 to 24.
Score direction: higher scores reflect greater symptom endorsement and impact.

The ITQ is designed to be interpreted with a diagnostic algorithm rather than a single total-score cutoff, and the developers specifically advise against using sum-score thresholds to determine caseness. Scores guide clinical decision-making and should not replace a full evaluation by a qualified clinician.

For diagnostic use, a symptom is counted as present when it is rated 2 (Moderately) or higher. A PTSD diagnosis requires at least one endorsed symptom in each of the three PTSD clusters plus related functional impairment. Complex PTSD additionally requires at least one endorsed symptom in each of the three self-organization clusters plus impairment, and a person meets criteria for either PTSD or complex PTSD, not both.

Best practices for administration

Confirm a trauma history. The measure assumes exposure to a stressful event, so anchor responses to the patient's identified experience.
Use the standard timeframe. Ask patients to rate symptoms over the past month to match the validated instructions.
Provide a private setting. Trauma content can be distressing, so let patients complete it somewhere comfortable and unhurried.
Apply the diagnostic algorithm. Score with the cluster-based algorithm rather than an invented cutoff to preserve accuracy.
Re-administer to track change. Repeat at intervals to monitor the symptom trajectory across care.
Pair with clinical interview. Use results to guide follow-up questions, not as a standalone diagnosis.

How Zentake helps with the ITQ

Automatic scoring. Totals are calculated on submit, so there is no hand-tallying.
Longitudinal tracking. Re-send the ITQ on a schedule and view change over time.
Before the visit. Patients at mental health practices complete it from home on any device, so the clinician starts informed.
HIPAA compliant. Data is encrypted, with a signed BAA on every plan.

References

Cloitre, M., Shevlin, M., Brewin, C. R., Bisson, J. I., Roberts, N. P., Maercker, A., Karatzias, T., and Hyland, P. (2018). The International Trauma Questionnaire: development of a self-report measure of ICD-11 PTSD and complex PTSD. Acta Psychiatrica Scandinavica, 138(6), 536-546.

The ITQ is freely available in the public domain. Its developers advise that caseness should be determined with the diagnostic algorithm rather than sum-score cutoffs, and the response scale and cluster structure are documented by the International Trauma Consortium and reproduced by clinical resources such as NovoPsych and NHS trauma services.

Last updated: August 2026

International Trauma Questionnaire (ITQ)