article · European journal of psychotraumatology
Psychological safety is crucial for recovery, rest, and building social connections, but trauma often leads individuals to perceive elevated levels of danger. Persistent feelings of threat and diminished safety are linked to post-traumatic stress disorder. To measure these perceptions, the neuroception of psychological safety scale assesses three dimensions rooted in polyvagal theory: social engagement, compassion, and bodily sensations. Testing the tool on an adult community group of over two thousand participants confirmed its three-factor structure and demonstrated robust internal consistency alongside good test-retest reliability. Scores consistently correlated with measures of wellbeing, burnout, body awareness, team psychological safety, and post-traumatic stress. The validated metric offers a dependable means of examining psychological safety, with potential uses in health and social care settings, trauma-informed care initiatives, and the assessment of trauma treatments.
A persistent sense of threat and a lack of psychological safety are key features of post-traumatic stress disorder. Having a validated assessment tool helps practitioners and researchers accurately gauge an individual's sense of bodily and social safety. This supports more precise evaluations of trauma interventions, improving how health and social care providers recognise and respond to trauma recovery.
The validated assessment scale is applied and tested, functioning as a practical measurement tool ready for adoption by clinicians, researchers, and healthcare organisations. It could be integrated into diagnostic platforms, workplace wellbeing programmes, and health and social care toolkits to evaluate trauma treatments and monitor trauma-informed care environments.
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<b>Background:</b> Psychological safety plays a vital role in rest, recovery, and fostering social connections. However, a history of trauma can predispose individuals to perceive heightened levels of threat and danger. Research suggests that a lack of psychological safety may be a defining biopsychosocial characteristic of posttraumatic stress disorder (PTSD). Persistent feelings of threat and danger are associated with a lack of psychological safety and may be predictive of PTSD. Our pioneering work reported on the development of the neuroception of psychological safety (NPSS), rooted in polyvagal theory, and consists of social engagement, compassion, and body sensations dimensions. Understanding more about the dimensionality of the NPSS and further establishing its psychometric properties was our priority.<b>Objective:</b> Our current research aimed to validate and test the reliability and dimensionality of the NPSS, using a large community sample (<i>n</i> = 2035) of adult residents in the UK<b>Method</b>: We examined the internal and test-retest reliability, convergent, discriminant, and concurrent validity as well as dimensionality of the NPSS.<b>Results:</b> The 3-factor structure of the NPSS was replicated with regard to the absolute fit indices. Internal consistencies ranged from acceptable to excellent across the NPSS's subscales. Providing support for the validity of the NPSS, scores were predictably related to team psychological safety, wellbeing, post-traumatic stress, burnout, body awareness, and personality, with effect sizes typically in the high to medium range. Scores on the NPSS were found to show good test-retest reliability.<b>Conclusions:</b> This study demonstrates the validity, reliability and dimensionality of the NPSS with an adult sample. Further work is underway to support and enhance understandings of psychological safety with diverse clinical populations impacted by trauma. The NPSS has applicability across a range of health and social care contexts, such as shaping new approaches to evaluating trauma treatments and enhancing trauma informed care.
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DOI: 10.1080/20008066.2025.2490329
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