Sijbrandij Marit, Olff Miranda, Opmeer Brent C, Carlier Ingrid V E, Gersons Berthold P R
Department of Psychiatry, Centre for Psychological Trauma, Academic Medical Centre of the University of Amsterdam, Amsterdam, The Netherlands.
Depress Anxiety. 2008;25(12):1038-45. doi: 10.1002/da.20441.
This study examined the accuracy of the 17-item Dutch version of the Davidson Trauma Scale (DTS) and the four-item SPAN (Startle, Physiological Arousal, Anger and Numbness) to detect survivors at risk for posttraumatic stress disorder (PTSD) within the first 2 weeks after the trauma.
203 civilian survivors of recent trauma with relatively mild symptoms completed the DTS a mean of 8.7 days after experiencing trauma. SPAN scores were computed from the DTS. At a mean of 64.6 days posttrauma, 160 respondents were assessed for diagnosis of PTSD with the Structured Interview for PTSD.
Receiver operating characteristic curves showed that the DTS showed good overall screening accuracy (84%). At a cut-off value of 64, the DTS demonstrated a sensitivity of 0.86, a specificity of 0.70, a positive predictive value (PPV) of 0.12, and a negative predictive value (NPV) of 0.98. Overall accuracy of the SPAN was good (89%). At a cut-off of 10 the SPAN showed a sensitivity of 0.86, a specificity of 0.86, a PPV of 0.22, and a NPV of 0.98. The low PPVs were possibly due to the low of prevalence of PTSD in our sample (4.4%).
This study shows that both the DTS and the SPAN are comparably accurate in screening early trauma survivors at risk for developing PTSD. The very brief four-item SPAN may be preferred over the longer 17-item DTS especially in settings in which time and resources are limited. Future studies should aim to cross-validate these results in random samples.
本研究检验了17项荷兰版戴维森创伤量表（DTS）和四项简版量表SPAN（惊吓、生理唤醒、愤怒和麻木）在创伤后前两周内检测创伤后应激障碍（PTSD）风险幸存者的准确性。
203名近期遭受创伤且症状相对较轻的平民幸存者在经历创伤后平均8.7天完成了DTS量表测试。SPAN分数由DTS量表计算得出。在创伤后平均64.6天时，对160名受访者进行了PTSD结构化访谈以评估PTSD诊断情况。
受试者工作特征曲线显示，DTS量表总体筛查准确性良好（84%）。在临界值为64时，DTS量表的灵敏度为0.86，特异度为0.70，阳性预测值（PPV）为0.12，阴性预测值（NPV）为0.98。SPAN量表的总体准确性良好（89%）。在临界值为10时，SPAN量表的灵敏度为0.86，特异度为0.86，PPV为0.22，NPV为0.98。较低的PPV可能是由于我们样本中PTSD的患病率较低（4.4%）。
本研究表明，DTS量表和SPAN量表在筛查早期有患PTSD风险的创伤幸存者方面具有相当的准确性。特别是在时间和资源有限的情况下，非常简短的四项简版量表SPAN可能比更长的17项DTS量表更受青睐。未来的研究应旨在对随机样本中的这些结果进行交叉验证。
