Mississippi Scale for Combat-Related Posttraumatic Stress Disorder: Three studies in reliability and validity.

The Mississippi Scale for Combat-Related Posttraumatic Stress Disorder is a 35-item self-report scale derived from Diagnostic and Statistical Manual of Mental Disorders (DSM-III) criteria for the disorder. This article describes a series of three studies designed to explore the psychometric properties of the scale. Study 1 used 362 Vietnam veterans seeking help at Vet Centers (Operation Outreach) to confirm the internal consistency of the instrument and provide an assessment of its factor structure. Study 2 demonstrated the high test–retest reliability of the instrument over a period of 1 week. Study 3 indicated that the test's sensitivity was .93, specificity was .89, and overall hit rate was .90 when it was used to differentiate between a posttraumatic stress disorder (PTSD) group and two non-PTSD comparison groups. The utility of the test when it is administered within the context of a multiaxial approach to assess military-related PTSD is discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Acute stress disorder scale: A self-report measure of acute stress disorder.

The Acute Stress Disorder Scale (ASDS) is a self-report inventory that (a) indexes acute stress disorder (ASD) and (b) predicts posttraumatic stress disorder (PTSD). The ASDS is a 19-item, inventory that is based on Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV, American Psychiatric Association, 1994) criteria. The ASDS possessed good sensitivity (95%) and specificity (83%) for identifying ASD against the ASD Interview on 99 civilian trauma survivors. Test-retest reliability of the ASDS scores between 2 and 7 days was strong (r? =? .94). The ASDS predicted 91% of bushfire survivors who developed PTSD and 93% of those who did not; one third of those identified by the ASDS as being at risk did not develop PTSD, however. The ASDS shows promise as a screening instrument to identify acutely traumatized individuals who warrant more thorough assessment for risk of PTSD. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Penn Inventory for Posttraumatic Stress Disorder: Psychometric properties.

Reports a 3-phase study to develop and validate the Penn Inventory for Posttraumatic Stress Disorder (PTSD), a 26-item self-report measure of the severity of PTSD. In Phase 1, using a sample (n?=?83) selected in 4 different groups, the inventory showed high internal consistency, test–retest reliability, and validity in relation to a structured clinical PTSD diagnosis, measures of combat exposure, and measures of PTSD symptom dimensions. Phase 2 cross-validated the initial findings on a 2nd sample (n?=?98), yielding results comparable to those of Phase 1, including measures of sensitivity and specificity. Phase 3, using a new sample (n?=?76), extended the findings to general veteran psychiatric admissions and civilian survivors of the Piper Alpha oil rig disaster, and used as criterion measures the Mississippi Scale for Combat-Related PTSD among the veteran groups and the Impact of Event Scale in the civilian group. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Faking on the Mississippi Scale for Combat-Related Posttraumatic Stress Disorder.

The Mississippi Scale for Combat-Related Posttraumatic Stress Disorder is a 35-item inventory developed for the differential diagnosis of posttraumatic stress disorder (PTSD). Thirty Veterans Administration Medical Center patients receiving vocational counseling were asked to fake PTSD on this scale. These volunteers were age and gender cohorts of Vietnam combat veterans and had primary diagnoses of substance abuse or anxiety disorder. None had been in combat or in Vietnam, nor had any lived with a Vietnam veteran. The feigning group obtained significantly lower scores than did a group of 30 inpatients in a PTSD treatment program, but 77% successfully faked PTSD by scoring higher than the suggested cutoff of 107. The Mississippi Scale is a unique and useful instrument for the evaluation and diagnosis of PTSD, but feigning must be ruled out by other methods. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Reliability and validity of Mississippi Scale for Combat-Related Posttraumatic Stress Disorder.

This study examined the reliability and validity of the Mississippi Scale for Combat-Related Posttraumatic Stress Disorder (M-PTSD) in a sample of Vietnam combat veterans with PTSD (n?=?101) and substance-abusing patients without combat-related PTSD (n?=?102). The M-PTSD was found to have high internal consistency, and a principle-components analysis indicated that its items measure three dimensions: intrusive reexperiencing/numbing-avoidance, anger/lability, and social alienation. Discriminant validity of the M-PTSD was supported by its high sensitivity in identifying PTSD patients (93%) and specificity in discriminating them from substance-abusing control subjects (88.2%). Finally, convergent validity of the M-PTSD was substantiated by significant correlations of the instrument with measures of combat exposure and interview and psychometric measures of PTSD symptomatology. The M-PTSD was shown to be a highly reliable and valid measure of the spectrum of PTSD symptoms in Vietnam combat veterans. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychometric properties of the Accident Fear Questionnaire: An analysis based on motor vehicle accident survivors in a rehabilitation setting.

ABSTRACT. Objective: To evaluate the reliability and validity of the Accident Fear Questionnaire (AFQ; K. Kuch, B. J. Cox, & D. M. Direnfeld, 1995), a self-rated instrument developed for efficient screening of posttraumatic stress disorder (PTSD) and phobic avoidance after involvement in a motor vehicle accident (MVA). Participants: One hundred thirteen individuals receiving rehabilitation after an MVA. Setting: Tertiary rehabilitation center. Main Measures: The AFQ, comprising a 10-item accident profile and a 10-item phobic avoidance (PA) subscale; a structured clinical interview; and other self-report measures of psychopathology, personality and pain. Results: Correlations between the AFQ-PA total score and measures of psychopathology and personality indicated adequate convergent and discriminant validity. Patients diagnosed with PTSD or accident phobia scored higher on the AFQ-PA subscale and 6 of its 10 items than did those with neither diagnosis. An AFQ-PA cutoff score of 15 appears suitable for screening of patients in a rehabilitation setting. Hierarchical logistic regression indicated that the AFQ-PA was the only self-report measure that possessed incremental power over and above general negative affectivity in predicting group membership… (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Predictive validity of the Chinese version of the Adult Suicidal Ideation Questionnaire: Psychometric properties and its short version.

The success of screening for individuals at suicidal risk among the general population relies heavily on the availability of a reliable and validated instrument. However, there remains a lack of a well-validated screening tool for suicidal risk in Chinese, despite the fact that about a quarter of the world's suicides takes place in China. In view of the severity of the suicide problem among the Chinese population, there is a crucial need to develop robust screening tools locally. This study investigates the psychometric properties related to the Chinese version of the Adult Suicidal Ideation Questionnaire (ASIQ) with a 2-wave, population-based panel study in the Hong Kong Special Administrative Region, People's Republic of China. Two-thousand sixteen Chinese people were interviewed for their suicidality, psychological well-being, and ASIQ scores. The Chinese ASIQ was shown to have strong internal reliability, convergent validity, and factorial validity. This study also demonstrated its predictive validity by examining sensitivity and specificity in identifying subsequent suicidality. A 4-item short version of ASIQ was also developed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The validation of a self-report measure of posttraumatic stress disorder: The Posttraumatic Diagnostic Scale.

The present article reports on the development and validation of a self-report measure of posttraumatic stress disorder (PTSD), the Posttraumatic Diagnostic Scale (PTDS), that yields both a PTSD diagnosis according to Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994 DSM-IV) criteria and a measure of PTSD symptom severity. Two-hundred forty-eight participants who had experienced a wide variety of traumas (e.g., accident, fire, natural disaster, assault, combat) were administered the PTSD module of the Structured Clinical Interview (SCID; Spitzer, Williams, Gibbons, & First, 1990), the PTDS, and scales measuring trauma-related psychopathology. The PTDS demonstrated high internal consistency and test-retest reliability, high diagnostic agreement with SCID, and good sensitivity and specificity. The satisfactory validity of the PTDS was further supported by its high correlations with other measures of trauma-related psychopathology. Therefore, the PTDS appears to be a useful tool for screening and assessing current PTSD in clinical and research settings. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Absorption of lycopene from single or daily portions of raw and processed tomato

The present study examined the association of childhood risk factors with exposure to traumas and posttraumatic stress disorder (PTSD). PTSD is a unique symptom configuration after exposure to an unusual, extreme event. Data come from the US National Comorbidity Study of 5,877 respondents aged 15-54 years conducted between September 1990 and February 1992. The risk factors examined were preexposure affective, anxiety, and substance use disorders; parental mental and substance use disorders; parental aggression toward the respondent and toward the other parent; and a nonconfiding relationship with the mother during childhood. Analyses were stratified by gender and adjusted for demographic variables and traumatic experiences prior to the index trauma. The occurrence of trauma was associated with many risk factors in women but few in men. Similarly, more risk factors predicted PTSD in women than in men. Overall, when respondents were grouped into broad trauma categories, an increase in the number of risk factors was associated with higher rates of PTSD. However, in analyses of the trauma subsample that adjusted for individual type of trauma (e.g., rape, physical attack), only one risk factor (history of affective disorder) predicted PTSD in women, and two (history of anxiety disorder and parental mental disorder) predicted PTSD in men. The results thus indicate that although these risk factors have an important association with PTSD, they operate largely by predicting trauma exposure rather than by predicting the onset of disorder after exposure.     

Norms and screening utility of the Dutch version of the Children's Depression Inventory in clinical and nonclinical youths.

This study aimed to (a) assess relationships between the Children's Depression Inventory (CDI) and DSM-oriented depression and anxiety scales of the Youth Self Report, (b) develop reliable norms for the CDI, and (c) determine CDI cutoff scores for selecting youngsters at risk for depression and anxiety. A total of 3,073 nonclinical and 511 clinically referred children and adolescents from The Netherlands and Belgium were included. Results showed that CDI scores were significantly related to DSM-oriented symptoms of both depression and anxiety. CDI scores correlated highly with depression symptoms and moderately with anxiety symptoms. Norms for the CDI were determined by means of multiple regression analysis and depended on sex, age, and country. CDI cutoff scores for selecting individuals at risk for depression and anxiety as measured by the DSM-oriented depression and anxiety scales of the Youth Self Report were determined by means of multiple regression analysis and receiver operating characteristic analysis. A CDI score of 16 was found to have the most optimal balance between sensitivity and specificity for depression, whereas a score of 21 provided the best sensitivity and specificity for anxiety in a subsample of children. We conclude that the CDI is an effective instrument for screening depression and to a lesser extent anxiety in primary and secondary care centers, before applying further assessment of high-risk individuals. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Screening for depressive disorders using the Mood and Anxiety Symptoms Questionnaire Anhedonic Depression Scale: A receiver-operating characteristic analysis.

The present study examined the utility of the anhedonic depression scale from the Mood and Anxiety Symptoms Questionnaire (MASQ–AD scale) as a way to screen for depressive disorders. Using receiver-operating characteristic analysis, we examined the sensitivity and specificity of the full 22-item MASQ–AD scale, as well as the 8- and 14-item subscales, in relation to both current and lifetime Diagnostic and Statistical Manual of Mental Disorders (4th ed.) depressive disorder diagnoses in two nonpatient samples. As a means of comparison, the sensitivity and specificity of a measure of a relevant personality dimension, Neuroticism, was also examined. Results from both samples support the clinical utility of the MASQ–AD scale as a means of screening for depressive disorders. Findings were strongest for the MASQ–AD 8-item subscale and when predicting current depression status. Furthermore, the MASQ–AD 8-item subscale outperformed the Neuroticism measure under certain conditions. The overall usefulness of the MASQ–AD scale as a screening device is discussed, as are possible cutoff scores for use in research. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Screening for posttraumatic stress disorder in a general psychiatric outpatient setting.

Posttraumatic stress disorder (PTSD) may affect survivors of a number of accidents and illnesses, in addition to violence victims and combat veterans. Prior research suggests that PTSD may be underdiagnosed when trauma is not the presenting problem. Thus, a PTSD screening scale might have utility in routine clinical settings. The authors evaluated the screening performance of the Posttraumatic Diagnostic Scale (PDS) in a general psychiatric setting. Results indicated that the PDS performed as well in this setting as it did in the original trauma-focused validation studies, independent of PTSD status as a primary, versus secondary, reason for presenting. A simple cutoff score was adequate for case identification. There were no gender effects, and the scale performed equally well among patients with, versus without, a depressive diagnosis. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Ten questions about alcohol as identifier of addiction problems. Psychometric tests at an emergency psychiatric department

It is important to develop and evaluate methods of identifying alcohol dependent patients and patients at risk of alcohol problems. The World Health Organisation recommends a 10-item questionnaire, AUDIT (Alcohol Use Disorders Identification Test), which assesses hazardous alcohol use, dependence symptoms, and harmful alcohol use. The article describes a Swedish version of AUDIT that has been psychometrically tested on a sample of patients admitted to a psychiatric emergency ward. Both internal consistency, reliability and validity were found to be satisfactory in terms of sensitivity and specificity in predicting DSM alcoholism diagnoses.     

Violence and risk of PTSD, major depression, substance abuse/dependence, and comorbidity: Results from the National Survey of Adolescents.

With a national household probability sample of 4,023 telephone-interviewed adolescents ages 12-17, this study provides prevalence, comorbidity, and risk-factor data for posttraumatic stress disorder (PTSD), major depressive episode (MDE), and substance abuse/dependence (SA/D). Roughly 16% of boys and 19% of girls met criteria for at least 1 diagnosis. Six-month PTSD prevalence was 3.7% for boys and 6.3% for girls, 6-month MDE prevalence was 7.4% for boys and 13.9% for girls. and 12-month SAM prevalence was 8.2% for boys and 6.2% for girls. PTSD was more likely to be comorbid than were MDE and SA/D. Results generally support the hypothesis that exposure to interpersonal violence (i.e., physical assault, sexual assault, or witnessed violence) increases the risk of these disorders and of diagnostic comorbidity. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Postdeployment traumatic brain injury screening questions: Sensitivity, specificity, and predictive values in returning soldiers.

Objective: To evaluate the sensitivity, specificity, and predictive values of Post-Deployment Health Assessment traumatic brain injury (TBI) screening questions employed by the Department of Defense (DOD). Participants: Complete data was obtained from 3,072 soldiers upon return from a 15-month deployment to Iraq. Method: Comparisons were made between responses to the DOD four-item screener and a brief structured clinical interview for likely deployment-related TBI history. The interview process was facilitated using responses to the Warrior Administered Retrospective Casualty Assessment Tool (WARCAT). Results: The sensitivity and specificity of the DOD screening tool (positive response to all four items) in comparison to the clinician-confirmed diagnosis was 60% and 96%, respectively. The sensitivity increased to 80%, with a slight decrease in specificity to 93%, for positive TBI screening when affirmative responses to questions 1 and 2 only were included. Conclusions: Affirmative responses to questions 1 and 2 of the DOD TBI screening tool demonstrated higher sensitivity for clinician-diagnosed deployment-related TBI. These two items perform better than positive responses to all four questions; the criteria presently being used for documentation and referral of a deployment-related TBI. These findings support further exploration of TBI screening and assessment procedures. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Hearing loss in community-dwelling older persons: national prevalence data and identification using simple questions

OBJECTIVE: To estimate the prevalence of hearing loss among community-dwelling older persons according to clinical criteria and to develop a brief self-report screening instrument to detect hearing loss. DESIGN: Survey. SETTING: National probability sample of noninstitutionalized older persons. PARTICIPANTS: A total of 2506 persons aged 55 to 74 who participated in the National Health and Nutrition Examination Survey. MAIN OUTCOME MEASURES: Hearing loss as defined by Ventry and Weinstein (VW) criteria and by the High Frequency Pure-Tone Average (HFPTA) scale. RESULTS: Hearing loss by VW criteria was present in 14.2% and by HFPTA criteria in 35.1% of those surveyed. The prevalence increased with advancing age and was higher among men and those with less education. A logistic regression model identified six independent factors for hearing loss by VW criteria: age > or = 70 years (adjusted odds-ratio (AOR) 2.7, 95% confidence interval (95% CI) 1.6, 4.4), male gender (AOR 3.0, 95% CI 1.9, 4.8), < or = 12th grade education (AOR 3.8, 95% CI 1.8, 7.7), having seen a doctor for deafness or hearing loss (AOR 8.9, 95% CI 5.3, 14.9), unable to hear a whisper across a room (AOR 3.2, 95% CI 2.0, 5.1), and unable to hear a normal voice across a room (AOR 6.2, 95% CI 2.6, 14.9). A clinical scale based on the logistic model had 80% sensitivity and 80% specificity in predicting hearing loss using VW criteria and 59% sensitivity and 88% specificity in predicting hearing loss using HFPTA criteria. CONCLUSIONS: Hearing loss, as defined by two clinical criteria, is common and can be screened for accurately using simple questions that assess sociodemographic and hearing-related characteristics.     

Maladaptive self-appraisals before trauma exposure predict posttraumatic stress disorder.

This study tested the proposal that negative appraisals represent a risk factor for developing posttraumatic stress disorder (PTSD) after trauma. Trainee firefighters (N = 68) were assessed during training (before trauma exposure) for PTSD, history of traumatic events, and tendency to engage in negative appraisals. Firefighters were reassessed 4 years later (N = 52), after commencing firefighter duty (after trauma exposure), for PTSD and depression using the Posttraumatic Stress Disorder Scale (E. B. Foa, L. Cashman, L. Jaycox, & K. Perry, 1997) and the Beck Depression Inventory (Version 2; A. T. Beck, R. A. Steer, & G. K. Brown, 1996). At follow-up, 12% met criteria for PTSD. Pretrauma negative appraisals about oneself accounted for 20% of variance in PTSD severity at follow-up. These data provide the first evidence that preexisting negative appraisals are a risk factor for PTSD. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Prediction of posttraumatic stress disorder by immediate reactions to trauma: a prospective study in road traffic accident victims

Road traffic accidents often cause serious physical and psychological sequelae. Specialists of various medical faculties are involved in the treatment of accident victims. Little is known about the factors which might predict psychiatric disorders, e.g. Posttraumatic Stress Disorder (PTSD) after accidents and how psychological problems influence physical treatment. In a prospective study 179 unselected, consecutively admitted road traffic accident victims were assessed a few days after the accident for psychiatric diagnoses, severity of injury and psychopathology. All were inpatients and had to be treated for bone fractures. At 6-months follow-up assessment 152 (85%) of the patients were interviewed again. Of the patients, 18.4% fulfilled the criteria for Posttraumatic Stress Disorder (DSM-III-R) within 6 months after the accident. Patients who developed PTSD were injured more severely and showed more symptoms of anxiety, depression and PTSD a few days after the accident than patients with no psychiatric diagnosis. Patients with PTSD stayed significantly longer in the hospital than the other patients. Multiple regression analysis revealed that the length of hospitalization was due mainly to a diversity of factors such as severity of injury, severity of accident, premorbid personality and psychopathology. Posttraumatic stress disorder is common after road traffic accidents. Patients with PTSD at follow-up can be identified by findings from early assessment. Untreated psychological sequelae such as PTSD cause longer hospitalization and therefore more costs than in non-PTSD patients.     

Risk Factors for Partner Violence Among a National Sample of Combat Veterans.

In this study, the authors identified potential risk factors for partner violence perpetration among a subsample (n=109) of men who participated in a national study of Vietnam veterans. Partner violent (PV) men with posttraumatic stress disorder (PTSD) were compared with PV men without PTSD and nonviolent men with PTSD on family-of-origin variables, psychiatric problems, relationship problems, and war-zone factors. PV men with PTSD were the highest of the 3 groups on every risk factor other than childhood abuse. Group contrasts and a classification tree analysis suggest some potential markers and mechanisms for the association between PTSD and partner violence among military veterans and highlight the need for theory development in this area of inquiry. (PsycINFO Database Record (c) 2010 APA, all rights reserved)