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Diagnostic performance of the PTSD checklist and the Vietnam Era Twin Registry PTSD scale

Published online by Cambridge University Press:  06 June 2014

K. Magruder*
Affiliation:
Mental Health Service, Ralph H. Johnson VA Medical Center, Charleston, South Carolina, USA Department of Psychiatry, Medical University of South Carolina, Charleston, South Carolina, USA
D. Yeager
Affiliation:
Mental Health Service, Ralph H. Johnson VA Medical Center, Charleston, South Carolina, USA Department of Psychiatry, Medical University of South Carolina, Charleston, South Carolina, USA
J. Goldberg
Affiliation:
Seattle Epidemiologic Research and Information Center, VA Puget Sound Health Care System, Seattle, Washington, USA Department of Epidemiology, University of Washington, Seattle, Washington, USA
C. Forsberg
Affiliation:
Seattle Epidemiologic Research and Information Center, VA Puget Sound Health Care System, Seattle, Washington, USA
B. Litz
Affiliation:
Massachusetts Epidemiology Research and Information Center, VA Boston Healthcare System, Boston, Massachusetts, USA Boston University School of Medicine, Boston, Massachusetts, USA
V. Vaccarino
Affiliation:
Departments of Epidemiology and Medicine, Emory University, Atlanta, Georgia, USA
M. Friedman
Affiliation:
Department of Veterans Affairs, National Center for Posttraumatic Stress Disorder, White River Junction, Vermont, USA Departments of Psychiatry and Pharmacology & Toxicology, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA
T. Gleason
Affiliation:
Cooperative Studies Program, Clinical Science Research and Development, VA Office of Research and Development, Washington, DC, USA
G. Huang
Affiliation:
Cooperative Studies Program, Clinical Science Research and Development, VA Office of Research and Development, Washington, DC, USA
N. Smith
Affiliation:
Seattle Epidemiologic Research and Information Center, VA Puget Sound Health Care System, Seattle, Washington, USA Department of Epidemiology, University of Washington, Seattle, Washington, USA
*
*Address for correspondence: Dr K. M. Magruder, Mental Health Service, Ralph H. Johnson VA Medical Center, 109 Bee Street, Charleston, SC 29401, USA. (Email: [email protected])

Abstract

Aims.

Self-report questionnaires are frequently used in clinical and epidemiologic studies to assess post-traumatic stress disorder (PTSD). A number of studies have evaluated these scales relative to clinician administered structured interviews; however, there has been no formal evaluation of their performance relative to non-clinician administered epidemiologic assessments such as the Composite International Diagnostic Interview (CIDI). We examined the diagnostic performance of two self-report PTSD scales, the PTSD checklist (PCL) and the Vietnam Era Twin Registry (VET-R) PTSD scale, compared to the CIDI.

Methods.

Data were derived from a large epidemiologic follow-up study of PTSD in 5141 Vietnam Era Veterans. Measures included the PCL, VET-R PTSD scale and CIDI. For both the PCL and VET-R PTSD scale, ROC curves, areas under the curve (AUC), sensitivity, specificity, % correctly classified, likelihood ratios, predictive values and quality estimates were generated based on the CIDI PTSD diagnosis.

Results.

For the PCL and VET-R PTSD scale the AUCs were 89.0 and 87.7%, respectively. Optimal PCL cutpoints varied from the 31–33 range (when considering sensitivity and specificity) to the 36–56 range (when considering quality estimates). Similar variations were found for the VET-R PTSD, ranging from 31 (when considering sensitivity and specificity) to the 37–42 range (when considering quality estimates).

Conclusions.

The PCL and VET-R PTSD scale performed similarly using a CIDI PTSD diagnosis as the criterion. There was a range of acceptable cutpoints, depending on the metric used, but most metrics suggested a lower PCL cutpoint than in previous studies in Veteran populations.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2014 

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