RESUMEN
Background: Identifying high-risk groups for posttraumatic stress disorder (PTSD) during evacuation situations requires a valid short screening tool. The re-experiencing symptoms of PTSD are considered helpful for distinguishing those with PTSD from those without, as they are thought to be specific to PTSD, have less ambiguity for respondents, and are representative of all PTSD symptoms. Objective: To develop a new short version of the Posttraumatic Diagnostic Scale (PDS) comprising only re-experiencing symptom items. Method: We used existing data (N = 169) from our previous study on the Japanese version of the PDS and the Clinician-Administered PTSD Scale (CAPS). The sample included both clinical outpatients (n = 106) and university students (n = 63), all of whom reported one or more traumatic experiences. We created candidate 2- and 3-item versions of the PDS and compared their psychometric characteristics against the CAPS. Results: The best candidate (comprising items for 'intrusive images', 'nightmares', and 'physiological reactions when reminded of the trauma') demonstrated an area under the curve of .95, 94.8% sensitivity, 86.1% specificity for the best cut-off score of three. The candidate scale also showed a strong correlation with CAPS-evaluated severity score and internal consistency. Conclusions: The brief re-experiencing PDS had good psychometric properties among Japanese adults with and without PTSD.
RESUMEN
The Posttraumatic Diagnostic Scale (PDS) is a brief, self-report questionnaire developed for the diagnostic screening and assessment of the severity of posttraumatic stress disorder (PTSD); the PDS is based on the criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (4th edition; DSM-IV). We investigated the validity and reliability of the Japanese version of the PDS in a clinical (n=109) and a non-clinical (n=116) sample, recruited from an outpatient psychiatric facility and a university student population, respectively. The Japanese versions of the PDS and the Clinician-Administered PTSD Scale (CAPS/DSM-IV) were administered to the participants. The Japanese PDS's diagnostic sensitivity and specificity exceeded 90%. The correlation between the severity scores assessed by the Japanese PDS and the CAPS was also high (r=0.92). The findings suggest that the Japanese version of the PDS is useful for diagnostically screening PTSD and assessing symptom severity.
Asunto(s)
Escalas de Valoración Psiquiátrica/normas , Psicometría/instrumentación , Trastornos por Estrés Postraumático/diagnóstico , Adolescente , Adulto , Femenino , Humanos , Japón , Masculino , Persona de Mediana Edad , Reproducibilidad de los Resultados , Autoinforme , Sensibilidad y Especificidad , Adulto JovenRESUMEN
UNLABELLED: To clarify the clinical characteristics of mental disorders in sexual assault victims, we investigated the victims focusing on PTSD, depression, physical symptoms, and their relationships. SUBJECTS: Participants were 46 treatment-seeking female victims of sexual assault who consulted four hospitals, one clinic and one psychological services center, between February 2000 and April 2001. The mean +/- SD age of the participants was 28.0 +/- 8.9 years, the mean +/- SD period from the traumatic event was 94.5 +/- 88.0 months. PTSD was diagnosed and evaluated using a structured interview (Clinician-Administered PTSD Scale for DSM-IV: CAPS). Depressive symptoms were assessed using Self-rating Depression Scales (SDS). Physical symptoms were assessed using the Physical symptom scale developed by the authors. RESULTS: Thirty-two participants (69.6%) met the criteria for PTSD in their current diagnosis, and 41 (89.1%) had the disorder at some point during their lives. SDS score and Physical symptom scale score of the PTSD group were significantly higher than those scores of the non-PTSD group. The SDS score correlated with the Avoidant-numbing score. The Physical symptoms scale score correlated with the Intrusion score and Hyperarousal score. We think that the PTSD group had the co-existing depression secondary to PTSD. Although previous studies have discussed the relationship between physical symptoms and Hyperarousal symptoms, this study suggested that physical symptoms were related to Intrusion symptoms as much as Hyperarousal symptoms. We found 2 patterns when PTSD patients reported physical symptoms related to Intrusion symptoms. The patterns were caused (1) by physiological reactivity on exposure to internal or external cues that symbolize an aspect of the traumatic event, and caused (2) by somatic reenactment symptoms. CONCLUSION: We discuss the importance for clinicians to distinguish Intrusion symptoms from physical symptoms as well as Avoidant-numbing symptoms from depressive symptoms on PTSD diagnosis. Because sexual assault victims have difficulty in talking about the traumatic experience, clinicians should pay attention to these findings in developing therapeutic plans for the victims.