Validation of the PTSD checklist in an HMO sample of women. Psychometric Properties of the PTSD Checklist—Civilian Version Sensitivity and Specificity of the PTSD Checklist in Detecting PTSD in Female Veterans in Primary Care Posttraumatic stress disorder among mothers of pediatric cancer survivors: diagnosis, comorbidity, and utility of the PTSD checklist as a screening instrument. Validity of the Patient Health Questionnaire‐9 in Assessing Depression Following Traumatic Brain Injury Randomized trial of cognitive-behavioral therapy for chronic posttraumatic stress disorder in adult female survivors of childhood sexual abuse. Predictive Validity of the Psychopathy Checklist: Screening Version for Intramural Behaviour in Violent Offenders—A Prospective Study at a Secure Psychiatric Hospital in Germany Psychopathy Checklist Score Predicts Negative Events during the Sentences of Prisoners with Hare Psychopathy: A Prospective Study at a German Prison Improvement in cerebral function with treatment of posttraumatic stress disorder. CAM and energy psychology techniques remediate PTSD symptoms in veterans and spouses. Effect of Group vs Individual Cognitive Processing Therapy in Active-Duty Military Seeking Treatment for Posttraumatic Stress Disorder: A Randomized Clinical Trial A Randomized Clinical Trial of Primary Care Brief Mindfulness Training for Veterans with PTSD. Delivery of self training and education for stressful situations (DESTRESS-PC): a randomized trial of nurse assisted online self-management for PTSD in primary care. Treatment of post traumatic stress disorder symptoms in emotionally distressed individuals Randomized Controlled Comparison of Cognitive Behavior Therapy with Rogerian Supportive Therapy in Chronic Post-Traumatic Stress Disorder: A 2-Year Follow-Up Cognitive processing therapy for veterans with military-related posttraumatic stress disorder. Reliability and validity of the PDS and PSS-I among participants with PTSD and alcohol dependence.
Although Post-traumatic Stress Disorder ( PTSD ) is common among patients seeking care at medical clinics , little is known about the performance of screening instruments for this disorder in these setting s. Previous studies of acute trauma population s using the  PTSD Checklist ( PCL )  have suggested that scores of 45 - 50 provide the best discrimination between cases and noncases . We gave the PCL  to 1,225 r and omly selected women enrolled in an HMO . After interviewing a sample of 261 of these women using a structured , clinician-administered PTSD interview , we compared the results of the PCL to the clinician interviews over a range of possible cut scores using Receiver Operating Characteristic analysis . The optimum balance of sensitivity and specificity for this population was a score of 30 , yielding a sensitivity of.82 and specificity of.76 . The positive and negative likelihood ratios for this cut score were 3.40 and 0.24 , respectively . By comparison , the use of 45 as a cut score would result in very low sensitivity ( .36 ) in this setting . The lower cut score found in this study may indicate that the use of previously published cut scores of 45 - 50 may not optimize the function of the PCL as a screening tool outside of acute trauma setting s due to an unacceptably high number of false negative cases We examined the psychometric properties of the  PTSD Checklist ( PCL ) , a self-report instrument design ed to assess symptoms of posttraumatic stress disorder . Three hundred ninety-two participants recruited in a university setting completed the PCL in addition to several well-established self-report instruments design ed to assess various forms of psychopathology ( e.g. , depression , general anxiety , PTSD ) . Ninety participants returned for readministration of selected measures . Findings provided support for psychometric properties of the PCL  , including internal consistency , test – retest reliability , convergent validity , and discriminant validity . Additional strengths of the PCL are discussed PTSD affects a substantial number of women in medical setting s and is associated with significant distress and impairment . There are effective methods of treating trauma-related distress , but a minority seek such care . Thus , primary care is an important setting in which to identify individuals with PTSD . We sent question naires , including the  PTSD Checklist — Civilian Version ( PCL-C )  , to 419 female veterans who were seen in our primary care clinic in 1998 ; 56 % ( N = 221 ) returned the measures . A r and om subset ( n = 49 ) was interviewed to establish psychiatric diagnoses . The results provide qualified support for the use of the PCL-C total score with a lowered cutoff score as a screening measure for PTSD in female veterans in primary care OBJECTIVE To examine posttraumatic stress disorder ( PTSD ) in mothers of survivors of childhood cancer . Comorbidity of anxiety and depressive disorders , prevalence of sub clinical PTSD , and the utility of a self-report measure as a screening instrument for PTSD were also investigated . METHOD Mothers ( n = 65 ) completed a question naire self-report PTSD checklist ( PCL-C ) .  Mothers were administered several modules of the SCID : nonpatient edition by telephone , including the PTSD , Generalized Anxiety , and Major Depressive Disorder modules . RESULTS We diagnosed 6.2 % of the sample with current PTSD . An additional 20 % had sub clinical PTSD . One of four mothers with PTSD diagnoses had a comorbid diagnosis of an anxiety and depressive disorder . The PCL-C evidence d diagnostic utility as a screening instrument . However , a moderate number of false-positives would result if the recommended cut-off on the instrument was used . CONCLUSIONS The PCL-C had diagnostic utility in screening mothers of childhood cancer survivors . The presence of comorbid diagnoses such as anxiety and depression should be examined Objective To test the validity and reliability of the Patient Health Question naire-9 ( PHQ-9 ) for diagnosing major depressive disorder ( MDD ) among persons with traumatic brain injury ( TBI ) . Design Prospect i ve cohort study . Setting Level I trauma center . Participants 135 adults within 1 year of complicated mild , moderate , or severe TBI . Main Outcome Measures  PHQ-9 Depression Scale , Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders , Fourth Edition ( SCID ) . Results Using a screening criterion of at least 5 PHQ-9 symptoms present at least several days over the last 2 weeks ( with one being depressed mood or anhedonia ) maximizes sensitivity ( 0.93 ) and specificity ( 0.89 ) while providing a positive predictive value of 0.63 and a negative predictive value of 0.99 when compared to SCID diagnosis of MDD . Pearson 's correlation between the PHQ-9 scores and other depression measures was 0.90 with the Hopkins Symptom Checklist depression subscale and 0.78 with the Hamilton Rating Scale for Depression . Test-retest reliability of the PHQ-9  was r = 0.76 and κ = 0.46 when using the optimal screening method . Conclusions The PHQ-9 is a valid and reliable screening tool for detecting MDD in persons with TBI The authors conducted a r and omized clinical trial of individual psychotherapy for women with posttraumatic stress disorder ( PTSD ) related to childhood sexual abuse ( n = 74 ) , comparing cognitive-behavioral therapy ( CBT ) with a problem-solving therapy ( present-centered therapy ; PCT ) and to a wait-list ( WL ) . The authors hypothesized that CBT would be more effective than PCT and WL in decreasing PTSD and related symptoms . CBT participants were significantly more likely than PCT participants to no longer meet criteria for a PTSD diagnosis at follow-up assessment s. CBT and PCT were superior to WL in decreasing PTSD symptoms and secondary measures . CBT had a significantly greater dropout rate than PCT and WL . Both CBT and PCT were associated with sustained symptom reduction in this sample Objective : To consider the extent to which the presence of psychopathy , as indicated by the psychopathy checklist : screening version ( PCL : SV ) , can predict intramural behaviour in offenders with mental disorders serving compulsory treatment at a German forensic psychiatric hospital . Method : The PCL : SV was used with 48 offenders detained at a forensic psychiatric hospital in Germany . In a prospect i ve design , objective and subjective measures of behaviour were compared for those identified as high and low scorers on the PCL : SV . Data were obtained from hospital records of disciplinary incidents ( objective ) and from interviews with case managers and therapists ( subjective ) , according to predefined criteria and in st and ardized forms . Results : The hospital records of the high scorers indicated they had been involved in significantly more disciplinary incidents than low scorers . Their behaviour was also rated significantly more negative by therapists than the low scorers . Conclusion : Numeorus studies found the  psychopathy checklist ( PCL ) score to be a reliable predictor of recidivism in offenders after release . The present study has demonstrated that the  PCL score has also predictive validity for intramural behaviour problems in individuals serving compulsory treatment at a forensic psychiatric hospital . As a result , we recommend the routine use of the PCL with offenders starting a period of compulsory detention to identify those at increased risk for problem behaviour Objective : This study examined the predictive validity of the German translation of the Psychopathy Checklist-Screening Version ( PCL-SV ) for negative events during the course of the prison sentence of German prisoners . Method : Using the PCL-SV , we investigated 145 offenders in a German prison at the start of their sentences . We then compared the extreme groups identified by the PCL-SV — the high and low scorers — using a prospect i ve design with respect to negative events and factors during the course of the sentences . This involved the st and ardized collection of data on both objective records of disciplinary incidents and subjective impressions from prison staff on the basis of operationalized criteria . Results : The high scorers were involved in significantly more disciplinary incidents and were also rated significantly less favourably by prison staff than the low scorers . Conclusion : Until now , the PCL has only been shown to predict recidivism following release from prison . The results of our study show that the PCL also has predictive validity for problems during the course of the sentence . It is therefore recommended that the PCL be used routinely at the start of the prison sentence to estimate the likelihood of subsequent difficulties Posttraumatic stress disorder ( PTSD ) and mild traumatic brain injury ( mTBI ) are signature illnesses of the Iraq and Afghanistan wars , but current diagnostic and therapeutic measures for these conditions are suboptimal . In our study , functional magnetic resonance imaging ( fMRI ) is used to try to differentiate military service members with : PTSD and mTBI , PTSD alone , mTBI alone , and neither PTSD nor mTBI . Those with PTSD are then r and omized to virtual reality exposure therapy or imaginal exposure . fMRI is repeated after treatment and along with the Clinician-Administered PTSD Scale ( CAPS ) and Clinical Global Impression ( CGI ) scores to compare with baseline . Twenty subjects have completed baseline fMRI scans , including four controls and one  mTBI  only ; of 15 treated for PTSD , eight completed posttreatment scans . Most subjects have been male ( 93 % ) and Caucasian ( 83 % ) , with a mean age of 34 . Significant improvements are evident on fMRI scans , and corroborated by CGI scores , but CAPS scores improvements are modest . In conclusion , CGI scores and fMRI scans indicate significant improvement in PTSD in both treatment arms , though CAPS score improvements are less robust Male veterans and their spouses ( N = 218 ) attending one of six-week-long retreats were assessed for  posttraumatic stress disorder ( PTSD ) symptoms pre- and postintervention . Participants were evaluated using the PTSD checklist ( PCL ) , on which , a score of > 49 indicates clinical symptom levels . The mean pretest score was 61.1 ( SD ± 12.5 ) for veterans and 42.6 ( SD ± 16.5 ) for spouses ; 83 % of veterans and 29 % of spouses met clinical criteria . The multimodal intervention used Emotional Freedom Techniques and other energy psychology ( EP ) methods to address PTSD symptoms and a variety of complementary and alternative medicine ( CAM ) modalities for stress reduction and re source building . Interventions were delivered in group format as well as individual counseling sessions . Data were analyzed for each retreat , as well as for the six retreats as a whole . Mean post-test PCL scores decreased to 41.8 ( SE ± 1.2 ; p < .001 ) for veterans , with 28 % still clinical . Spouses demonstrated substantial symptom reductions ( M = 28.7 , SE ± 1.0 ; p < .001 ) , with 4 % still clinical . A follow-up assessment ( n = 63 ) found PTSD symptom levels dropping even further for spouses ( p < .003 ) , whereas gains were maintained for veterans . The significant reduction in PTSD symptoms is consistent with other published reports of EP treatment , though counter to the usual long-term course of the condition . The results indicate that a multimodal CAM intervention incorporating EP may offer benefits to family members as well as veterans suffering from PTSD symptoms . Recommendations are made for further research to answer the questions posed by this study Importance Cognitive processing therapy ( CPT ) , an evidence -based treatment for posttraumatic stress disorder ( PTSD ) , has not been tested as an individual treatment among active-duty military .  Group CPT may be an efficient way to deliver treatment . Objective To determine the effects of CPT on PTSD and co-occurring symptoms and whether they differ when administered in an individual or a group format . Design , Setting , and Participants In this r and omized clinical trial , 268 active-duty servicemembers consented to assessment at an army medical center from March 8 , 2012 , to September 23 , 2014 , and were r and omized to group or individual CPT . Inclusion criteria were PTSD after military deployment and stable medication therapy . Exclusion criteria consisted of suicidal or homicidal intent or psychosis . Data collection was completed on June 15 , 2015 . Analysis was based on intention to treat . Interventions Participants received CPT ( the version excluding written accounts ) in 90-minute group sessions of 8 to 10 participants ( 15 cohorts total ; 133 participants ) or 60-minute individual sessions ( 135 participants ) twice weekly for 6 weeks . The 12 group and individual sessions were conducted concurrently . Main Outcomes and Measures Primary measures were scores on the Posttraumatic Symptom Scale – Interview Version ( PSS-I ) and the stressor-specific Posttraumatic Stress Disorder Checklist ( PCL-S ) ; secondary measures were scores on the Beck Depression Inventory – II ( BDI-II ) and the Beck Scale for Suicidal Ideation ( BSSI ) . Assessment s were completed by independent evaluators masked to treatment condition at baseline and 2 weeks and 6 months after treatment . Results Among the 268 participants ( 244 men [ 91.0 % ] ; 24 women [ 9.0 % ] ; mean [ SD ] age , 33.2 [ 7.4 ] years ) , improvement in PTSD severity at posttreatment was greater when CPT was administered individually compared with the group format ( mean [ SE ] difference on the PSS-I , −3.7 [ 1.4 ] ; Cohen d = 0.6 ; P = .006 ) . Significant improvements were maintained with the individual ( mean [ SE ] PSS-I , −7.8 [ 1.0 ] ; Cohen d = 1.3 ; mean [ SE ] PCL-S , −12.6 [ 1.4 ] ; Cohen d = 1.2 ) and group ( mean [ SE ] PSS-I , −4.0 [ 0.97 ] ; Cohen d = 0.7 ; mean [ SE ] PCL-S , −6.3 [ 1.4 ] ; Cohen d = 0.6 ) formats , with no differences in remission or severity of PTSD at the 6-month follow-up . Symptoms of depression and suicidal ideation did not differ significantly between formats . Conclusions and Relevance Individual treatment result ed in greater improvement in PTSD severity than group treatment .  Depression and suicidal ideation improved equally with both formats . However , even among those receiving individual CPT , approximately 50 % still had PTSD and clinical ly significant symptoms . In the military population , improving existing treatments such as CPT or developing new treatments is needed . Trial Registration clinical trials.gov identifier : OBJECTIVES Primary care ( PC ) patients typically do not receive adequate posttraumatic stress disorder ( PTSD ) treatment . This study tested if a brief mindfulness training ( BMT ) offered in PC can decrease PTSD severity . METHOD VA PC patients with PTSD ( N = 62 ) were recruited for a r and omized clinical trial comparing PCBMT with PC treatment as usual . PCBMT is a 4-session program adapted from mindfulness-based stress reduction . RESULTS PTSD severity decreased in both conditions , although PCBMT completers reported significantly larger decreases in PTSD and depression from pre- to posttreatment and maintained gains at the 8-week follow-up compared with the control group . Exploratory analyses revealed that the describing , nonjudging , and acting with awareness facets of mindfulness may account for decreases in PTSD . CONCLUSION Our data support preliminary efficacy of BMT for Veterans with PTSD . Whether PCBMT facilitates engagement into , or improves outcomes of , full-length empirically supported treatment for PTSD remains to be evaluated OBJECTIVE This r and omized controlled trial examined the effectiveness of a nurse assisted online cognitive-behavioral self-management intervention for war-related posttraumatic stress disorder ( PTSD ) , compared to optimized usual primary care PTSD Treatment ( OUC ) to reduce PTSD symptoms . METHOD Participants were 80 veterans of recent military conflicts with PTSD as assessed by the PTSD Checklist ( PCL ) seeking primary care treatment at one of three Veterans Affairs ( VA ) and four Army clinics .  DESTRESS-PC consisted of logins to a secure website three times per week for 6 weeks with monitoring by a study nurse . All participants received nurse care management in the form of phone check-ins every two weeks and feedback to their primary care providers . Blinded raters assessed outcomes 6 , 12 , and 18 weeks post-r and omization . RESULTS DESTRESS-PC was associated with a significantly greater decrease in PTSD symptoms compared to OUC ( F(3 , 186)=3.72 , p=.012 ) . The effect was largest at the 12-week assessment ( ∆PCL=12.6±16.6 versus 5.7±12.5 , p<0.05 ) with the treatment effect disappearing by the 18-week follow-up . Notably , there was a dose effect ; number of logins correlated significantly with PTSD outcomes , with more logins associated with greater PTSD symptom improvement . None of the secondary outcomes ( depression , anxiety , somatic symptoms , and functional status ) showed statistically significant improvement ; however , the treatment effect on depression approached significance ( F(3 , 186)=2.17 , p=.093 ) . CONCLUSIONS DESTRESS-PC shows promise as a means of delivering effective , early PTSD treatment in primary care . Larger trials are needed Older individuals with emotional distress and a history of psychologic trauma are at risk for post traumatic stress disorder ( PTSD ) and major depression . This study was an exploratory , secondary analysis of data from the study " Prevention of Depression in Older African Americans " . It examined whether Problem Solving Therapy- Primary Care ( PST-PC ) would lead to improvement in PTSD symptoms in patients with subsyndromal depression and a history of psychologic trauma . The control condition was dietary education ( DIET ) .  Participants ( n=60 ) were age 50 or older with scores on the Center for Epidemiologic Studies -Depression scale of 11 or greater and history of psychologic trauma . Exclusions stipulated no major depression and substance dependence within a year . Participants were r and omized to 6 - 8 sessions of either PST-PC or DIET and followed 2 years with booster sessions every 6 months ; 29 participants were in the PST-PC group and 31 were in the DIET group . Mixed effects models showed that improvement of PTSD Check List scores was significantly greater in the DIET group over two years than in the PST-PC group ( based on a group time interaction ) . We observed no intervention⁎time interactions in Beck Depression Inventory or Brief Symptom Inventory-Anxiety subscale scores Background : To date , there have been no studies comparing cognitive behavior therapy ( CBT ) with Rogerian therapy in post-traumatic stress disorder . Method : Sixty out patients with DSM-IV chronic post-traumatic stress disorder were r and omized into two groups for 16 weekly individual sessions of CBT or Rogerian supportive therapy ( ST ) at two centers . No medication was prescribed . Measures included the Post-Traumatic Stress Disorder Checklist Scale ( PCLS ) , the Hamilton Anxiety Scale , Beck Depression Inventory , and Quality of Life . The general criterion of improvement ( GCI ) was a score of less than 44 on the PCLS . Results : Forty-two patients were evaluated at post-test , 38 at week 52 and 25 at week 104 . At post-test , the rate of patients leaving the trial due to worsening or lack of effectiveness was significantly higher in the ST group ( p = 0.004 ) . At this point , no between-group difference was found on the GCI and any of the rating scales . Intent-to-treat analysis found no difference for the GCI , but patients in the CBT group showed greater improvement on the PCLS and Hamilton Anxiety Scale . Naturalistic follow-up showed sustained improvement without between-group differences at weeks 52 and 104 . Conclusions : CBT retained significantly more patients in treatment than ST , but its effects were equivalent to those of ST in the completers . CBT was better in the dimensional intent-to-treat analysis at post-test Sixty veterans ( 54 men , 6 women ) with chronic military-related posttraumatic stress disorder ( PTSD ) participated in a wait-list controlled trial of cognitive processing therapy ( CPT ) . The overall dropout rate was 16.6 % ( 20 % from CPT , 13 % from waiting list ) . R and om regression analyses of the intention-to-treat sample revealed significant improvements in PTSD and comorbid symptoms in the CPT condition compared with the wait-list condition . Forty percent of the intention-to-treat sample receiving CPT did not meet criteria for a PTSD diagnosis , and 50 % had a reliable change in their PTSD symptoms at posttreatment assessment . There was no relationship between PTSD disability status and outcomes . This trial provides some of the most encouraging results of PTSD treatment for veterans with chronic PTSD and supports increased use of cognitive- behavioral treatments in this population The prevalence of alcohol use disorder ( e.g. , alcohol dependence ; AD ) among individuals with posttraumatic stress disorder ( PTSD ) is quite high , with estimates of 52 % for men and 30 % for women ( Kessler , Sonnega , Bromet , Hughes , & Nelson , 1995 ) . There are several interviews and self-report measures of PTSD with good published psychometric properties , and they are routinely used with comorbid AD and PTSD . However , none of these instruments was vali date d with this population . The current study fills this gap by examining the psychometric properties of the  PTSD Symptom Scale-Interview ( PSS-I )  and  the self-report PTSD Diagnostic Scale ( PDS )  in individuals diagnosed with current PTSD and AD . Both scales comprised of 17 items provide diagnostic and symptom severity information according to DSM-IV-TR criteria . Participants were 167 individuals who were diagnosed with AD and chronic PTSD and were enrolled in a r and omized controlled treatment study . Results revealed excellent internal consistency of both the PSS-I and the PDS , good test-retest reliability over a 1-month period , and good convergent validity with the SCID . The specificity of the PSS-I diagnosis of PTSD was better than the PDS diagnosis , the latter exhibiting a greater percentage of false positives . In sum , the results showed that the PSS-I and PDS performed well in this population and can be used with confidence to assess PTSD diagnosis and symptom severity
Findings indicated that although studies generally met st and ards in several quality areas , there is still room for improvement .
Areas for improvement include establishing representativeness , adequately describing clinical and demographic characteristics of the sample , and presenting better descriptions of important aspects of test and reference st and ard execution .
In addition , study quality has not appreciably improved since the publication of the STARD Statement in 2003 .
Despite the popularity of the PTSD Checklist ( PCL ) as a clinical screening test , there has been no comprehensive quality review of studies evaluating its diagnostic accuracy .