Searle Amelia K, Van Hooff Miranda, McFarlane Alexander C, Davies Christopher E, Fairweather-Schmidt A Kate, Hodson Stephanie E, Benassi Helen, Steele Nicole
Centre for Traumatic Stress Studies, The University of Adelaide, Adelaide, SA, Australia.
Int J Methods Psychiatr Res. 2015 Mar;24(1):32-45. doi: 10.1002/mpr.1460. Epub 2014 Dec 16.
Depression, alcohol use disorders and post-traumatic stress disorder (PTSD) are serious issues among military personnel due to their impact on operational capability and individual well-being. Several military forces screen for these disorders using scales including the Kessler Psychological Distress Scale (K10), Alcohol Use Disorders Identification Test (AUDIT), and Post-traumatic Stress Disorder Checklist (PCL). However, it is unknown whether established cutoffs apply to military populations. This study is the first to test the diagnostic accuracy of these three scales in a population-based military cohort. A large sample of currently-serving Australian Defence Force (ADF) Navy, Army and Air Force personnel (n = 24,481) completed the K10, AUDIT and PCL-C (civilian version). Then, a stratified sub-sample (n = 1798) completed a structured diagnostic interview detecting 30-day disorder. Data were weighted to represent the ADF population (n = 50,049). Receiver operating characteristic (ROC) analyses suggested all three scales had acceptable sensitivity and specificity, with areas under the curve from 0.75 to 0.93. AUDIT and K10 screening cutoffs closely paralleled established cutoffs, whereas the PCL-C screening cutoff resembled that recommended for US military personnel. These self-report scales represent a cost-effective and clinically-useful means of screening personnel for disorder. Military populations may need lower cutoffs than civilians to screen for PTSD.
抑郁症、酒精使用障碍和创伤后应激障碍（PTSD）是军事人员面临的严重问题，因为它们会影响作战能力和个人福祉。一些军事力量使用包括凯斯勒心理困扰量表（K10）、酒精使用障碍识别测试（AUDIT）和创伤后应激障碍检查表（PCL）在内的量表来筛查这些障碍。然而，尚不清楚既定的临界值是否适用于军事人群。本研究首次在基于人群的军事队列中测试这三种量表的诊断准确性。大量现役澳大利亚国防军（ADF）海军、陆军和空军人员（n = 24481）完成了K10、AUDIT和PCL-C（民用版）。然后，一个分层子样本（n = 1798）完成了一次结构化诊断访谈，以检测30天内的障碍。对数据进行加权以代表ADF人群（n = 50049）。受试者工作特征（ROC）分析表明，所有三种量表都具有可接受的敏感性和特异性，曲线下面积在0.75至0.93之间。AUDIT和K10的筛查临界值与既定临界值非常相似，而PCL-C的筛查临界值与推荐给美国军事人员的临界值相似。这些自我报告量表是筛查人员是否患有障碍的一种经济有效且临床上有用的方法。军事人群筛查PTSD可能需要比平民更低的临界值。
