A Validation Study of the Korean Version of SPAN

Abstract

PurposeThe SPAN, which is acronym standing for its four components: Startle, Physiological arousal, Anger, and Numbness, is a short post-traumatic stress disorder (PTSD) screening scale. This study sought to develop and validate a Korean version of the SPAN (SPAN-K).Materials and MethodsNinety-three PTSD patients (PTSD group), 73 patients with non-psychotic psychiatric disorders (psychiatric control group), and 88 healthy participants (normal control group) were recruited for this study. Participants completed a variety of psychiatric assessments including the SPAN-K, the Davidson Trauma Scale (DTS), the Clinician-Administered PTSD Scale (CAPS), and the State-Trait Anxiety Inventory (STAI).ResultsCronbach's α and test-retest reliability values for the SPAN-K were both 0.80. Mean SPAN-K scores were 10.06 for the PTSD group, 4.94 for the psychiatric control group, and 1.42 for the normal control group. With respect to concurrent validity, correlation coefficients were 0.87 for SPAN-K vs. CAPS total scores (p<0.001) and 0.86 for SPAN-K vs. DTS scores (p<0.001). Additionally, correlation coefficients were 0.31 and 0.42 for SPAN-K vs. STAI-S and STAI-T, respectively. Receiver operating characteristic analysis of SPAN-K showed good diagnostic accuracy with an area under the curve (AUC) of 0.87. The SPAN-K showed the highest efficiency at a cutoff score of 7, with a sensitivity of 0.83, a specificity of 0.81, positive predictive value (PPV) of 0.88, and negative predictive value (NPV) of 0.73.ConclusionThese results suggest that the SPAN-K had good psychometric properties and may be a useful instrument for rapid screening of PTSD patients.

Comparing Screening Instruments to Predict Posttraumatic Stress Disorder

“…Specificity results are often lower in replication studies as compared to the original validation studies, in which the items of the instruments are selected based on the performance in that particular population [29] , [41] – [43] . Our proposed cut-offs of 4 for SPAN, 5 for TSQ and 23 for IES-R, best corresponding to 80% sensitivity, slightly differ from the cut-offs previously published [10] , [11] , [24] – [26] , [28] – [35] . Our cut-off of 4 for the SPAN is much lower than found in a previous study administering the SPAN at 10 days after the trauma [24] .…”

“…Missing items were replaced with the mean item response (1 case with 1 missing item). Previous studies found sensitivity varying between 0.79–0.84 and specificity varying between 0.80–0.91 in relation to a concurrent PTSD diagnosis [10] , [25] , [26] . The only prospective study of the SPAN found a cut-off of 10 at 1 week post-trauma to be predictive of 2 month PTSD with a sensitivity and specificity of 0.86 [24] .…”

Validation of the Davidson Trauma Scale in its original and a new shorter version in people exposed to the F-27 earthquake in Chile

“…Although there is another short version called SPAN (named for its four items Startle, Physiological arousal, Anger and Numbness; Meltzer-Brody, Churchill, & Davidson, 1999), we did not find any validation study with EFA and/or CFA (Chen, Shen, Tan, Chou, & Lu, 2003; Seo et al, 2011; Yeager, Magruder, Knapp, Nicholas, & Frueh, 2007), which makes us doubt its construct validity. This represents an opportunity, as it is possible to apply a shorter version of DTS as valid as the original and with the same factor structure.…”

Measuring mental health burden in humanitarian settings: a critical review of assessment tools

“…• Chilean people exposed to F-27 earthquake [69] • Military veterans served after 9/11 [70] • Korean [71] • Chinese [72] • Spanish [73] IES-R…”