Detecting PTSD in a traumatically injured population: The diagnostic utility of the PTSD Checklist for DSM-5
Detecting PTSD in a traumatically injured population: The diagnostic utility of the PTSD Checklist for DSM-5
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DOI：
10.1002/da.22873
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发表时间：
2019-02-01
影响因子：
7.4
通讯作者：
deRoon-Cassini, Terri A.
中科院分区：
文献类型：
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作者：
Geier, Timothy J.;Hunt, Joshua C.;deRoon-Cassini, Terri A.
背景 DSM-5 的创伤后应激障碍 (PTSD) 检查表 (PCL-5) 是符合 DSM-5 的少数经过验证的 PTSD 严重程度衡量标准之一。对退伍军人样本进行的验证工作建议将 33 和 38 分作为 PTSD 的削减分数；根据创伤类型等因素，不同人群的削减分数有所不同。本研究的目的是评估从一级创伤中心出院后 6 个月的创伤性损伤个体中 PCL-5 相对于黄金标准临床医生管理的 DSM-5 PTSD 量表 (CAPS-5) 的诊断效用并确定最佳评分。方法 共有 251 名参与者在创伤性损伤后从一级创伤中心出院 6 个月后完成了 PCL-5 和 CAPS-5。受试者工作特征曲线分析了 PCL-5 的详细诊断准确性，并通过 Youden's J 指数确定了最佳切分分数。削减分数还按故意伤害和非故意伤害进行了细分。结果 PCL-5 在外伤人群中产生令人满意的诊断准确性，具有足够的敏感性和特异性。估计表明最佳切割分数为 >30；故意伤害的最佳削减分数> 34，非故意伤害的最佳削减分数> 22。结论 这项调查为 PCL-5 在一级创伤中心出院后 6 个月的受伤人员中检测 PTSD 提供了支持。 PCL-5 的特异性和敏感性表明，与该人群合作的临床医生可以放心地使用这种方法，而不是更繁重的结构化访谈（例如 CAPS-5）。这项研究标志着一项举措，旨在确保那些在创伤性伤害后经历心理健康困难的人能够被识别出来并获得资源。
Background The posttraumatic stress disorder (PTSD) Checklist for DSM-5 (PCL-5) is among few validated measures of PTSD severity in line with the DSM-5. Validation efforts among veteran samples have recommended cut scores of 33 and 38 to indicate PTSD; cut scores vary across populations depending on factors such as trauma type. The purpose of this study was to evaluate the diagnostic utility of and identify optimal cut scores for the PCL-5 in relation to the gold standard Clinician-Administered PTSD Scale for DSM-5 (CAPS-5) among traumatically injured individuals 6 months after discharge from a level I trauma center. Methods A total of 251 participants completed the PCL-5 and CAPS-5 6 months after discharge from a level I trauma center following traumatic injury. Receiver operating characteristic curve analyses detailed diagnostic accuracy of the PCL-5 and identified the optimal cut score via Youden's J index. Cut scores were also broken down by intentional versus nonintentional injury. Results The PCL-5 produces satisfactory diagnostic accuracy, with adequate sensitivity and specificity, in a traumatically injured population. Estimates indicate the optimal cut score as >30; the optimal cut score for intentional injuries was >34 and >22 for nonintentional injuries. Conclusions This investigation provides support for the PCL-5 in detection of PTSD among injured individuals 6 months after discharge from a level I trauma center. PCL-5 specificity and sensitivity suggest clinicians working with this population can feel confident in using this measure over more onerous structured interviews (e.g., CAPS-5). This study signifies a move toward ensuring those experiencing mental health difficulties after traumatic injury are identified and connected to resources.