title: Preliminary analysis of posttraumatic stress disorder screening within specialty clinic setting for OIF/OEF veterans seeking care for neck or back pain.
abstract: Escalating prevalence estimates of posttraumatic stress disorder (PTSD) among recently returning Operation Iraqi Freedom/Operation Enduring Freedom (OIF/OEF) veterans highlight the need for early detection and management for reducing chronic mental illness and disability. Because PTSD and chronic pain are common comorbid conditions among veterans, PTSD screening within specialty clinic settings addressing musculoskeletal pain may be of value. This retrospective study evaluated measures of diagnostic value for the PTSD Checklist (PCL) for a sample (n = 79) of OIF/OEF veterans seeking care for neck or back pain within a Department of Veterans Affairs specialty clinic. Because published accounts of optimal PCL cutoff scores vary considerably, we used receiver operating characteristic curves to identify whether the optimal PCL cutoff score for the sample differed from a conventional cutoff score of 50. A clinical psychologist experienced in diagnosing and managing PTSD confirmed the diagnosis of PTSD for 37 veterans through a review of clinical records. The prevalence of diagnosed PTSD was 46.8%, with an optimal PCL cutoff score of 44. These findings may guide future research and influence clinical practice regarding PTSD screening for recently returning veterans with chronic pain.
authors.affiliation: Department of Veterans Affairs (VA) Western New York Healthcare System, Buffalo VA Medical Center, Buffalo, NY 14215, USA. Andrew.dunn@va.gov
authors.forename: Andrew S
authors.initials: AS
authors.lastname: Dunn
authors.forename: Terri
authors.initials: T
authors.lastname: Julian
authors.forename: Lance R
authors.initials: LR
authors.lastname: Formolo
authors.forename: Bart N
authors.initials: BN
authors.lastname: Green
authors.forename: David R
authors.initials: DR
authors.lastname: Chicoine
mesh_terms: D000328:Adult; D055826:Afghan Campaign 2001-; D001416:Back Pain / Q000150:complications*; D057189:Checklist; D002908:Chronic Disease; D005260:Female; D006801:Humans; D054542:Iraq War, 2003-2011; D008297:Male; D008403:Mass Screening; D019547:Neck Pain / Q000150:complications*; D018710:Pain Clinics; D015995:Prevalence; D012372:ROC Curve; D012189:Retrospective Studies; D013313:Stress Disorders, Post-Traumatic / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology; D014728:Veterans / Q000523:psychology*