Clinical utility of the Primary Care--PTSD Screen among U.S. veterans who served since September 11, 2001.

Published

Journal Article

Posttraumatic stress disorder (PTSD) is a prevalent anxiety disorder that is often undetected among primary care patients. The Department of Veterans Affairs has implemented the Primary Care-PTSD Screen (PC-PTSD) to screen for PTSD; however, minimal research has examined its utility. This study was designed to assess the diagnostic accuracy of the PC-PTSD among veterans who had served since 9/11/2001, including operations in Afghanistan (Operation Enduring Freedom) and Iraq (Operation Iraqi Freedom). Signal detection analyses were used to evaluate the performance of the PC-PTSD and two other screens, the Davidson Trauma Scale (DTS) and the SPAN, in a sample of 220 veterans with military service since 9/11/2001. The reference standard for PTSD was Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) diagnosis based upon structured clinical interview. The impact of demographic variables on test performance was examined. A cutting score of 3 on the PC-PTSD maximized efficiency (85%; sensitivity=0.83; and specificity=0.85). Although analyses supported the utility of the PC-PTSD (area under the curve (AUC)=0.875), the measure was outperformed by both the DTS (AUC=0.944) and the SPAN (AUC=0.931). Results suggest that the PC-PTSD is an acceptable screen for PTSD among veterans. Within primary care settings, the PC-PTSD may be most advantageously employed in the context of staged screening, given the measure's relative susceptibility to false positives.

Full Text

Duke Authors

Cited Authors

  • Calhoun, PS; McDonald, SD; Guerra, VS; Eggleston, AM; Beckham, JC; Straits-Troster, K; VA Mid-Atlantic MIRECC OEF/OIF Registry Workgroup,

Published Date

  • July 2010

Published In

Volume / Issue

  • 178 / 2

Start / End Page

  • 330 - 335

PubMed ID

  • 20483463

Pubmed Central ID

  • 20483463

Electronic International Standard Serial Number (EISSN)

  • 1872-7123

International Standard Serial Number (ISSN)

  • 0165-1781

Digital Object Identifier (DOI)

  • 10.1016/j.psychres.2009.11.009

Language

  • eng