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创伤后应激障碍检查表在军事初级保健环境中的操作特征。

Operating characteristics of the PTSD checklist in a military primary care setting.

机构信息

DoD Deployment Health Clinical Center, Walter Reed National Military Medical Center.

出版信息

Psychol Assess. 2013 Sep;25(3):1032-6. doi: 10.1037/a0033325.

Abstract

The Department of Defense (DoD) is implementing universal behavioral health screening for all DoD health-care beneficiaries presenting to military primary care clinics. The PTSD Checklist-Civilian Version (PCL-C; Weathers, Litz, Herman, Huska, & Keane, 1993) is used for the identification of posttraumatic stress disorder (PTSD); however, the operating characteristics of the PCL-C remain unstudied in this population. This study examined the operating characteristics of the PCL-C in a sample of 213 patients from 3 Washington, D.C., area military primary care clinics. Blinded raters independently assessed PTSD using the PTSD Symptom Scale Interview (Foa, Riggs, Dancu, & Rothbaum, 1993) as the diagnostic criterion standard. The receiver operating characteristic curve revealed that PCL-C scores accounted for 92% of the area under the curve. A PCL-C score of 31 optimized sensitivity (0.93) and specificity (0.90), and the multilevel likelihood ratio was 5.50 (95% confidence interval [2.26, 13.37]). Internal consistency (0.97) and test-retest reliability (0.87 after a median 13 days) were strong. Results suggest that a PCL-C score of 31 is the optimal cutoff score for use in a military primary care setting serving active duty service members, dependents, and retirees. These findings offer military primary care providers preliminary data to interpret PCL-C scores and to inform treatment decisions as part of routine clinical practice.

摘要

国防部正在为所有前往军事初级保健诊所的国防部保健福利享受者实施通用行为健康筛查。创伤后应激障碍检查表-平民版(PCL-C;Weathers、Litz、Herman、Huska 和 Keane,1993)用于识别创伤后应激障碍(PTSD);然而,该量表在该人群中的操作特征仍未得到研究。本研究在来自华盛顿特区 3 个军事初级保健诊所的 213 名患者样本中检查了 PCL-C 的操作特征。盲法评估者使用创伤后应激障碍症状量表访谈(Foa、Riggs、Dancu 和 Rothbaum,1993)作为诊断标准独立评估 PTSD。受试者工作特征曲线显示 PCL-C 得分占曲线下面积的 92%。PCL-C 得分为 31 时,灵敏度(0.93)和特异性(0.90)最佳,多级似然比为 5.50(95%置信区间[2.26, 13.37])。内部一致性(0.97)和测试-重测可靠性(中位数 13 天后为 0.87)很强。结果表明,PCL-C 得分为 31 是在为现役军人、家属和退休人员服务的军事初级保健环境中使用的最佳截断分数。这些发现为军事初级保健提供者提供了初步数据,以解释 PCL-C 分数,并为常规临床实践中的治疗决策提供信息。

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