Early prognostic screening for posttraumatic stress disorder with the Davidson Trauma Scale and the SPAN.
BACKGROUND
This study examined the accuracy of the 17-item Dutch version of the Davidson Trauma Scale (DTS) and the four-item SPAN (Startle, Physiological Arousal, Anger and Numbness) to detect survivors at risk for posttraumatic stress disorder (PTSD) within the first 2 weeks after the trauma.


METHODS
203 civilian survivors of recent trauma with relatively mild symptoms completed the DTS a mean of 8.7 days after experiencing trauma. SPAN scores were computed from the DTS. At a mean of 64.6 days posttrauma, 160 respondents were assessed for diagnosis of PTSD with the Structured Interview for PTSD.


RESULTS
Receiver operating characteristic curves showed that the DTS showed good overall screening accuracy (84%). At a cut-off value of 64, the DTS demonstrated a sensitivity of 0.86, a specificity of 0.70, a positive predictive value (PPV) of 0.12, and a negative predictive value (NPV) of 0.98. Overall accuracy of the SPAN was good (89%). At a cut-off of 10 the SPAN showed a sensitivity of 0.86, a specificity of 0.86, a PPV of 0.22, and a NPV of 0.98. The low PPVs were possibly due to the low of prevalence of PTSD in our sample (4.4%).


CONCLUSIONS
This study shows that both the DTS and the SPAN are comparably accurate in screening early trauma survivors at risk for developing PTSD. The very brief four-item SPAN may be preferred over the longer 17-item DTS especially in settings in which time and resources are limited. Future studies should aim to cross-validate these results in random samples.
Sijbrandij
Marit
M
Department of Psychiatry, Centre for Psychological Trauma, Academic Medical Centre of the University of Amsterdam, Amsterdam, The Netherlands. e.m.sijbrandij@amc.uva.nl
Olff
Miranda
M
Opmeer
Brent C
BC
Carlier
Ingrid V E
IV
Gersons
Berthold P R
BP
D000059:Accidents / Q000523:psychology; D000328:Adult; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D008016:Life Change Events; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data*; D008875:Middle Aged; D009426:Netherlands; D010555:Personality Inventory / Q000706:statistics & numerical data*; D011379:Prognosis; D011594:Psychometrics / Q000706:statistics & numerical data; D015203:Reproducibility of Results; D012307:Risk Factors; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D014754:Violence