Diagnostic accuracy of the trauma screening questionnaire after the 2005 London bombings

Brewin, Chris R.; Fuchkan, Nika; Huntley, Zoe; Scragg, Peter

doi:10.1002/jts.20529

Cited by 74 publications

(29 citation statements)

References 28 publications

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“…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].…”

Section: Discussionmentioning

confidence: 66%

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Comparing Screening Instruments to Predict Posttraumatic Stress Disorder

Mouthaan¹,

Sijbrandij

Reitsma

et al. 2014

PLoS ONE

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BackgroundFollowing traumatic exposure, a proportion of trauma victims develops posttraumatic stress disorder (PTSD). Early PTSD risk screening requires sensitive instruments to identify everyone at risk for developing PTSD in need of diagnostic follow-up.AimsThis study compares the accuracy of the 4-item SPAN, 10-item Trauma Screening Questionnaire (TSQ) and 22-item Impact of Event Scale-Revised (IES-R) in predicting chronic PTSD at a minimum sensitivity of 80%.MethodInjury patients admitted to a level-I trauma centre (N = 311) completed the instruments at a median of 23 days and were clinically assessed for PTSD at 6 months. Areas under the curve and specificities at 80% sensitivity were compared between instruments.ResultsAreas under the curve in all instruments were adequate (SPAN: 0.83; TSQ: 0.82; IES-R: 0.83) with no significant differences. At 80% sensitivity, specificities were 64% for SPAN, 59% for TSQ and 72% for IES-R.ConclusionThe SPAN, TSQ and IES-R show similar accuracy in early detection of individuals at risk for PTSD, despite differences in number of items. The modest specificities and low positive predictive values found for all instruments could lead to relatively many false positive cases, when applied in clinical practice.

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Section: Discussionmentioning

confidence: 66%

“…This could indicate a reluctance to screening or research participation among patients with a higher risk of later PTSD. This issue has also been raised previously [41] and limits the generalizability of the findings to samples with a higher PTSD prevalence.…”

Section: Discussionmentioning

confidence: 85%

Comparing Screening Instruments to Predict Posttraumatic Stress Disorder

Mouthaan¹,

Sijbrandij

Reitsma

et al. 2014

PLoS ONE

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“…Unfortunately, this method can be problematic because the specificity (minimization of false positives) and sensitivity (minimization of false negatives) of these instruments has rarely been assessed in disaster situations. After the 2005 London bombings, for example, the specificity of the screening instrument used to assess PTSD was dramatically lower than reported in the samples on which it had been developed, although it improved steadily over the following 2 years (Brewin, Fuchkan, Huntley, & Scragg, 2010). Because low specificity of screening instruments leads to an overestimation of the prevalence of a disorder, it is likely that many postdisaster studies have overestimated the prevalence of PTSD in the general population.…”

Section: Making Sense Of the Discrepanciesmentioning

confidence: 99%

Weighing the Costs of Disaster

Bonanno

Brewin

Kaniasty

et al. 2010

Psychol Sci Public Interest

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949

443

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SummaryDisasters typically strike quickly and cause great harm. Unfortunately, because of the spontaneous and chaotic nature of disasters, the psychological consequences have proved exceedingly difficult to assess. Published reports have often overestimated a disaster's psychological cost to survivors, suggesting, for example, that many if not most survivors will develop posttraumatic stress disorder (PTSD); at the same time, these reports have underestimated the scope of the disaster's broader impact in other domains. We argue that such ambiguities can be attributed to methodological limitations. When we focus on only the most scientifically sound research-studies that use prospective designs or include multivariate analyses of predictor and outcome measures-relatively clear conclusions about the psychological parameters of disasters emerge. We summarize the major aspects of these conclusions in five key points and close with a brief review of possible implications these points suggest for disaster intervention.1. Disasters cause serious psychological harm in a minority of exposed individuals. People exposed to disaster show myriad psychological problems, including PTSD, grief, depression, anxiety, stress-related health costs, substance abuse, and suicidal ideation. However, severe levels of these problems are typically observed only in a relatively small minority of exposed individuals. In adults, the proportion rarely exceeds 30% of most samples, and in the vast majority of methodologically sound studies, the level is usually considerably lower. Among youth, elevated symptoms are common in the first few months following a high-impact disaster, but again, chronic symptom elevations rarely exceed 30% of the youth sampled.2. Disasters produce multiple patterns of outcome, including psychological resilience. In addition to chronic dysfunction, other patterns of disaster outcome are typically observed. Some survivors recover their psychological equilibrium within a period ranging from several months to 1 or 2 years. A sizeable proportion, often more than half of those exposed, experience only transient distress and maintain a stable trajectory of healthy functioning or resilience. Resilient outcomes have been evidenced across different methodologies, including recent studies that identified patterns of outcome using relatively sophisticated data analytic approaches, such as latent growth mixture modeling.3. Disaster outcome depends on a combination of risk and resilience factors. As is true for most highly aversive events, individual differences in disaster outcomes are informed by a number of unique risk and resilience factors, including variables related to the context in which the disaster occurs, variables related to proximal exposure during the disaster, and variables related to distal exposure in the disaster's aftermath. Multivariate studies indicate that there is no one single dominant predictor of disaster outcomes. Rather, as with traumatic life events more generally, most predictor variables exert small...

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“…None of these screening tools have been given within days of an event and accurately differentiated between those who developed disorder and those who did not [21–25]. Screening tools have also been developed to identify those who currently have PTSD, but those are not designed to prospectively predict PTSD at a future time point [26, 27]. …”

Section: Introductionmentioning

confidence: 99%

Development and preliminary performance of a risk factor screen to predict posttraumatic psychological disorder after trauma exposure

Carlson

Palmieri

Spain

2017

General Hospital Psychiatry

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Objective We examined data from a prospective study of risk factors that increase vulnerability or resilience, exacerbate distress, or foster recovery to determine whether risk factors accurately predict which individuals will later have high posttraumatic (PT) symptom levels and whether brief measures of risk factors also accurately predict later symptom elevations. Method Using data from 129 adults exposed to traumatic injury of self or a loved one, we conducted receiver operating characteristic (ROC) analyses of 14 risk factors assessed by full-length measures, determined optimal cutoff scores and calculated predictive performance for the nine that were most predictive. For five risk factors, we identified sets of items that accounted for 90% of variance in total scores and calculated predictive performance for sets of brief risk measures. Results A set of nine risk factors assessed by full measures identified 89% of those who later had elevated PT symptoms (sensitivity) and 78% of those who did not (specificity). A set of four brief risk factor measures assessed soon after injury identified 86% of those who later had elevated PT symptoms and 72% of those who did not. Conclusions Use of sets of brief risk factor measures shows promise of accurate prediction of PT psychological disorder and probable PTSD or depression. Replication of predictive accuracy is needed in a new and larger sample.

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Diagnostic accuracy of the trauma screening questionnaire after the 2005 London bombings

Cited by 74 publications

References 28 publications

Comparing Screening Instruments to Predict Posttraumatic Stress Disorder

Comparing Screening Instruments to Predict Posttraumatic Stress Disorder

Weighing the Costs of Disaster

Development and preliminary performance of a risk factor screen to predict posttraumatic psychological disorder after trauma exposure

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