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

• Type of Material: Article
• Authors: K. Magruder, Ralph H. Johnson VA Medical Center; D. Yeager, Ralph H. Johnson VA Medical Center; J. Goldberg, VA Puget Sound Health Care System; C. Forsberg, VA Puget Sound Health Care System; B. Litz, VA Boston Healthcare System; M. Friedman, National Center for Posttraumatic Stress Disorder; Viola Vaccarino, Emory University; T. Gleason, VA Office of Research and Development; G. Huang, VA Office of Research and Development; N. Smith, VA Puget Sound Health Care System
• Language: English
• Date: 2015-10-01
• Publisher: CAMBRIDGE UNIV PRESS
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © Cambridge University Press 2014
• Final Published Version (URL): http://dx.doi.org/10.1017/S2045796014000365
• Title of Journal or Parent Work: Epidemiology and Psychiatric Sciences
• Volume: 24
• Issue: 5
• Start Page: 415
• End Page: 422
• Grant/Funding Information: The Cooperative Studies Program (CSP) of the US Department of Veterans Affairs’ Office of Research and Development has provided financial support for Cooperative Study #569 and the development and maintenance of the Vietnam-Era Twin (VET) Registry. Dr Viola Vaccarino was supported in part by a National Institutes of Health award, K24 HL077506.
• Keywords: MORTALITY; Assessment; FEMALE VETERANS; Life Sciences & Biomedicine; TERRORIST ATTACKS; INTERVIEW; CIDI; Science & Technology; COMORBIDITY; POSTTRAUMATIC-STRESS-DISORDER; PTSD; CANCER; PRIMARY-CARE; PCL; SCREENING INSTRUMENT; PREVALENCE; Psychiatry
• Research Categories: Health Sciences, Epidemiology

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.