Department of Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin.
Department of Surgery, Oregon Health & Science University, Portland, Oregon.
Depress Anxiety. 2019 Feb;36(2):170-178. doi: 10.1002/da.22873. Epub 2018 Dec 30.
The posttraumatic stress disorder (PTSD) Checklist for DSM-5 (PCL-5) is among few validated measures of PTSD severity in line with the DSM-5. Validation efforts among veteran samples have recommended cut scores of 33 and 38 to indicate PTSD; cut scores vary across populations depending on factors such as trauma type. The purpose of this study was to evaluate the diagnostic utility of and identify optimal cut scores for the PCL-5 in relation to the gold standard Clinician-Administered PTSD Scale for DSM-5 (CAPS-5) among traumatically injured individuals 6 months after discharge from a level I trauma center.
A total of 251 participants completed the PCL-5 and CAPS-5 6 months after discharge from a level I trauma center following traumatic injury. Receiver operating characteristic curve analyses detailed diagnostic accuracy of the PCL-5 and identified the optimal cut score via Youden's J index. Cut scores were also broken down by intentional versus nonintentional injury.
The PCL-5 produces satisfactory diagnostic accuracy, with adequate sensitivity and specificity, in a traumatically injured population. Estimates indicate the optimal cut score as >30; the optimal cut score for intentional injuries was >34 and >22 for nonintentional injuries.
This investigation provides support for the PCL-5 in detection of PTSD among injured individuals 6 months after discharge from a level I trauma center. PCL-5 specificity and sensitivity suggest clinicians working with this population can feel confident in using this measure over more onerous structured interviews (e.g., CAPS-5). This study signifies a move toward ensuring those experiencing mental health difficulties after traumatic injury are identified and connected to resources.
创伤后应激障碍（PTSD）检查表 DSM-5（PCL-5）是少数符合 DSM-5 的 PTSD 严重程度的验证措施之一。退伍军人样本的验证工作建议使用 33 和 38 的分界值来表示 PTSD；分界值因创伤类型等因素而异。本研究旨在评估 PCL-5 在与 DSM-5 临床医生管理 PTSD 量表（CAPS-5）相比，在创伤后 6 个月从一级创伤中心出院的创伤患者中的诊断效用，并确定最佳分界值。
共有 251 名参与者在创伤后 6 个月从一级创伤中心出院后完成了 PCL-5 和 CAPS-5。通过 Youden 的 J 指数，详细描述了 PCL-5 的诊断准确性，并确定了最佳分界值。分界值也按故意和非故意损伤进行了细分。
PCL-5 在创伤人群中产生了令人满意的诊断准确性，具有足够的敏感性和特异性。估计表明最佳分界值为>30；故意损伤的最佳分界值为>34，非故意损伤的最佳分界值为>22。
这项研究为 PCL-5 在从一级创伤中心出院后 6 个月的创伤患者中检测 PTSD 提供了支持。PCL-5 的特异性和敏感性表明，与更繁琐的结构性访谈（如 CAPS-5）相比，临床医生在使用该测量方法时可以有信心。这项研究标志着确保创伤后经历心理健康困难的人得到识别并与资源联系起来的努力。
