title: Comparing screening instruments to predict posttraumatic stress disorder.
abstract: BACKGROUND
  Following 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.
  
  
  OBJECTIVE
  This 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%.
  
  
  METHODS
  Injury 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.
  
  
  RESULTS
  Areas 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.
  
  
  CONCLUSIONS
  The 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.
authors.affiliation: Department of Psychiatry, Centre for Anxiety Disorders, Research Group Psychotrauma, Academic Medical Centre, Amsterdam, The Netherlands.
authors.forename: Joanne
authors.initials: J
authors.lastname: Mouthaan
authors.affiliation: Clinical Psychology, VU University, Amsterdam, The Netherlands; EMGO Institute for Health and Care Research, Amsterdam, The Netherlands.
authors.forename: Marit
authors.initials: M
authors.lastname: Sijbrandij
authors.affiliation: Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Centre, Amsterdam, The Netherlands; Julius Centre for Health Sciences and Primary Care, University Medical Centre, Utrecht, The Netherlands.
authors.forename: Johannes B
authors.initials: JB
authors.lastname: Reitsma
authors.affiliation: Department of Psychiatry, Centre for Anxiety Disorders, Research Group Psychotrauma, Academic Medical Centre, Amsterdam, The Netherlands; Arq Psychotrauma Expert Group, Diemen, The Netherlands.
authors.forename: Berthold P R
authors.initials: BP
authors.lastname: Gersons
authors.affiliation: Department of Psychiatry, Centre for Anxiety Disorders, Research Group Psychotrauma, Academic Medical Centre, Amsterdam, The Netherlands; Arq Psychotrauma Expert Group, Diemen, The Netherlands.
authors.forename: Miranda
authors.initials: M
authors.lastname: Olff
mesh_terms: D000328:Adult; D019540:Area Under Curve; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D009426:Netherlands; D011237:Predictive Value of Tests; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis* / Q000453:epidemiology*; D011795:Surveys and Questionnaires