Research utility of a CAPS‐IV and CAPS‐5 hybrid interview: Posttraumatic stress symptom and diagnostic concordance in recent‐era U.S. veterans

Abstract

The Clinician-Administered PTSD Scale (CAPS) is used to measure posttraumatic stress symptoms (PTSS) and diagnose posttraumatic stress disorder (PTSD). However, its use, particularly in settings involving longitudinal assessment, has been complicated by changes in the diagnostic criteria between the fourth and fifth editions of the Diagnostic and Statistical Manual of Mental Disorders (i.e., DSM-IV and DSM-5, respectively). The current sample included trauma-exposed U.S. veterans who were deployed in support of military operations following the September 11, 2001, terrorist attacks (N = 371) and were enrolled in a longitudinal study focused on deployment-related stress and traumatic brain injury. A hybrid clinical interview using item wording from the CAPS for DSM-IV (CAPS-IV) with the addition of items unique to the CAPS for DSM-5 (CAPS-5) was used to assess both DSM-IV and DSM-5 PTSD diagnostic criteria, allowing for the calculation of separate total scores and diagnoses. Diagnostic agreement, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and interrater reliability between CAPS-IV and CAPS-5 were evaluated for the entire sample and stratified by gender.We found high diagnostic agreement (92.9%-95.4%), sensitivity (94.4%-98.2%), specificity (91.7%-92.8%), PPV (89.5%-93.0%), NPV (95.7%-98.1%), and interrater reliability,κ = 0.86-0.91,) for both men and women. The current study supports the use of a hybrid PTSD diagnostic interview assessing both DSM-IV and DSM-5 diagnostic criteria, particularly in situations such as longitudinal studies that may require a feasible method of incorporating changes in diagnostic criteria from the DSM-IV to the DSM-5.

Longitudinal volumetric evaluation of hippocampus and amygdala subregions in recent trauma survivors

“…In order to maintain continuity with decades of PTSD research based on DSM-IV de nitions, and given the ndings of nonoverlapping samples per de nitional criteria used 31,32 , we administered a combined clinical interview assessing both CAPS-IV 33 and CAPS-5 34 items at the same time. The usage of such hybrid PTSD diagnostic interviews is supported, particularly in longitudinal studies 35 , and is in line with the recommendation to use broader cross-template de nitions of PTSD for empirical research 36 . Here, a positive PTSD diagnosis was given to individuals who met either DSM-IV or DSM-5 diagnostic criteria or, in line with previous recommendations 37 endorsed CAPS-IV total score of ≥ 40.…”

Associations among posttraumatic stress disorder symptoms, suicidal ideation, suicide attempts, and reward discounting

“…Similarly, due to the remote nature of the study, the PTSD groups are based on provisional diagnoses rather than clinician interview. However, the PCL-5 and the CAPS-5, the gold-standard clinical interview for diagnosing PTSD, are highly correlated (ρ = 0.83; Jackson et al, 2022). Rates of lifetime psychopathology were also higher than expected in the general population, though they are consistent with other research utilising crowd sourced data collection methods (e.g., van Stolk-Cooke et al, 2018;Wastler et al, 2022).…”

Sexual and gender minority status predicts additional variance in posttraumatic stress disorder after accounting for conventional trauma exposure.

“…This is notable for two primary reasons: (a) there is a difference in symptom clusters between the DSM-IV and DSM-5 and (b) the definitions of a Criterion A trauma. With respect to the former, total symptom severity scores between the CAPS-IV and CAPS-V have been shown to be highly correlated (r = .83), suggesting good backward compatibility between the CAPS-V and CAPS-IV (Jackson et al, 2022;Weathers et al, 2018). With respect to the latter, what constituted a Criterion A event became narrower in the DSM-5.…”