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莫桑比克创伤后应激障碍(PTSD)筛查:《精神疾病诊断与统计手册》第五版初级保健创伤后应激障碍筛查量表(PC-PTSD-5)的验证

Screening for posttraumatic stress disorder (PTSD) in Mozambique: Validation of the Primary Care Posttraumatic Stress Disorder Screen for Diagnostic and Statistical Manual fifth edition (PC-PTSD-5).

作者信息

Massinga Luciana J, Greene M Claire, Duarte Cristiane S, Mandlate Flávio, Santos Palmira F, Gouveia Lídia, Oquendo Maria A, Mello Marcelo Feijo, Wainberg Milton L

机构信息

Department of Mental Health, Ministry of Health of Mozambique.

Heilbronn Department of Population and Family Health, Program on Forced Migration and Health, Columbia University, Mailman School of Public Health.

出版信息

Psychol Trauma. 2025 Jan;17(1):88-96. doi: 10.1037/tra0001806. Epub 2024 Oct 24.

Abstract

OBJECTIVE

The confluence of conflict-, climate-, and public health-related emergencies in Mozambique increases the risk of posttraumatic stress disorder (PTSD). Few brief screening tools for PTSD have been validated in low- and middle-income countries. We aimed to validate the five-item Primary Care PTSD Screen for the (5th ed.; ), the PC-PTSD-5 in Mozambique.

METHOD

This study recruited 957 participants who completed the Mini-International Neuropsychiatric Interview-Plus (MINI-Plus) and PC-PTSD-5, a convenience sample from primary and tertiary care settings in Maputo, Mozambique. Participants were administered a diagnostic interview for psychiatric disorders and the PC-PTSD-5 screening tool. We evaluated the criterion validity of the PC-PTSD-5 concerning the MINI-Plus diagnosis of PTSD, the internal construct validity and reliability using confirmatory factor analysis and Kuder-Richardson 20 (KR-20), discriminant validity of the PC-PTSD-5 in comparison to other common mental disorder and suicide risk screening tools, and measurement invariance of selected cutoffs by age, sex, and comorbidity.

RESULTS

Internal consistency of the PC-PTSD-5 was high (KR-20 = 0.837), and confirmatory factor analysis suggested that a single PTSD factor fits the data well. PC-PTSD-5 items were moderately correlated with other psychiatric symptoms. Criterion validity analyses revealed that a cutoff score of 3 provided high specificity (0.833) and moderate sensitivity (0.673). This cutoff score performed optimally across age and gender; however, a cutoff score of 2 was preferred if the participant had no psychiatric comorbidities.

CONCLUSION

Screening with the PC-PTSD-5 may facilitate case detection and linkages to appropriate treatment for individuals affected by potentially traumatic events in Mozambique. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

摘要

目的

莫桑比克冲突、气候和公共卫生相关紧急情况的交汇增加了创伤后应激障碍(PTSD)的风险。在低收入和中等收入国家,很少有PTSD简短筛查工具得到验证。我们旨在验证用于《精神疾病诊断与统计手册》(第5版)的五项初级保健PTSD筛查量表(PC-PTSD-5)在莫桑比克的有效性。

方法

本研究招募了957名参与者,他们完成了简易国际神经精神访谈升级版(MINI-Plus)和PC-PTSD-5,这是来自莫桑比克马普托初级和三级医疗机构的便利样本。参与者接受了精神疾病诊断访谈和PC-PTSD-5筛查工具。我们评估了PC-PTSD-5关于MINI-Plus诊断PTSD的标准效度、使用验证性因素分析和库德-理查森20(KR-20)的内部结构效度和信度、PC-PTSD-5与其他常见精神障碍和自杀风险筛查工具相比的区分效度,以及按年龄、性别和共病情况选定截断值的测量不变性。

结果

PC-PTSD-5的内部一致性较高(KR-20 = 0.837),验证性因素分析表明单一的PTSD因素与数据拟合良好。PC-PTSD-5项目与其他精神症状呈中度相关。标准效度分析显示,截断分数为3时具有较高的特异性(0.833)和中等的敏感性(0.673)。该截断分数在年龄和性别上表现最佳;然而,如果参与者没有精神共病,截断分数为2更可取。

结论

使用PC-PTSD-5进行筛查可能有助于在莫桑比克对受潜在创伤事件影响的个体进行病例检测并与适当治疗建立联系。(PsycInfo数据库记录(c)2025美国心理学会,保留所有权利)

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