Cynthia A LeardMann1,2, Hope Seib McMaster1,2, Steven Warner1,2, Alejandro P Esquivel1,2, Ben Porter1,2,3, Teresa M Powell1,2, Xin M Tu1,4, William W Lee1,2, Rudolph P Rull1, Charles W Hoge5,6. 1. Deployment Health Research Department, Naval Health Research Center, San Diego, California. 2. Leidos, San Diego, California. 3. Social Science Research Center, Mississippi State University, Starkville. 4. Division of Biostatistics and Bioinformatics, Department of Family Medicine and Public Health, University of California, San Diego, La Jolla. 5. Center for Psychiatry and Neuroscience, Walter Reed Army Institute of Research, Silver Spring, Maryland. 6. Office of the Army Surgeon General, Falls Church, Virginia.
Abstract
Importance: The definition of posttraumatic stress disorder (PTSD) changed markedly between the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) and DSM-5, creating challenges for studies and in medical settings spanning this transition. Objective: To evaluate the ability to compare and assess PTSD, based on DSM-IV and DSM-5 criteria, using PTSD Checklists (PCLs). Design, Setting, and Participants: This diagnostic study was conducted with survey data collected in October 2019, from the Millennium Cohort Study, a population-based US military cohort study. The population for the present study was restricted to a subset of initial web responders of the 2019 survey cycle, randomly assigned to 1 of 4 survey groups. Exposures: Each group received the DSM-IV and DSM-5 PCL (PCL-Civilian [PCL-C] version and PCL for DSM-5 [PCL-5]). PCL instruments were counterbalanced to control for order effects. Main Outcomes and Measures: Survey data were used to assess PTSD (using the PCL-C and PCL-5), major depressive disorder (using the Patient Health Questionnaire), generalized anxiety (using the Generalized Anxiety Disorder scale), and problem drinking (using the Patient Health Questionnaire). Demographic and military characteristics included age, sex, race/ethnicity, marital status, education, service branch, pay grade, enrollment panel, and military service status. Results: Among the 1921 participants (mean [SD] age, 50.1 [12.5] years), 1358 (70.7%) were men, 1638 (85.3%) were non-Hispanic White individuals, 1440 (75.0%) were married, and 1190 (61.9%) had at least a bachelor's degree; 295 (15.4%) had probable PTSD according to DSM-IV criteria with PCL-C compared with 286 (14.9%) using DSM-5 criteria with PCL-5 (κ = 0.77). There was substantial agreement between PCLs for probable PTSD based on DSM-IV criteria (295 [15.4%] with PCL-C; 316 [16.4%] with PCL-5; κ = 0.80) and DSM-5 criteria (286 [14.9%] with PCL-5; 258 [13.4%] with PCL-C; κ = 0.77). Estimated PTSD sum scores showed excellent agreement with observed scores. Using an established crosswalk, PCL-5 sum scores estimated with the PCL-C were similar to observed PCL-5 scores. Of the 17 corresponding items between the 2 instruments, 16 had substantial agreement. Appending 2 additional PCL-C items to the PCL-5 did not significantly alter estimates. The PCL-C and PCL-5 had nearly identical associations with comorbid conditions. Conclusions and Relevance: The findings of this diagnostic study suggest that PTSD can be successfully assessed and compared over time with either PCL instrument in veteran and military populations.
Importance: The definition of posttraumatic stress disorder (PTSD) changed markedly between the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) and DSM-5, creating challenges for studies and in medical settings spanning this transition. Objective: To evaluate the ability to compare and assess PTSD, based on DSM-IV and DSM-5 criteria, using PTSD Checklists (PCLs). Design, Setting, and Participants: This diagnostic study was conducted with survey data collected in October 2019, from the Millennium Cohort Study, a population-based US military cohort study. The population for the present study was restricted to a subset of initial web responders of the 2019 survey cycle, randomly assigned to 1 of 4 survey groups. Exposures: Each group received the DSM-IV and DSM-5 PCL (PCL-Civilian [PCL-C] version and PCL for DSM-5 [PCL-5]). PCL instruments were counterbalanced to control for order effects. Main Outcomes and Measures: Survey data were used to assess PTSD (using the PCL-C and PCL-5), major depressive disorder (using the Patient Health Questionnaire), generalized anxiety (using the Generalized Anxiety Disorder scale), and problem drinking (using the Patient Health Questionnaire). Demographic and military characteristics included age, sex, race/ethnicity, marital status, education, service branch, pay grade, enrollment panel, and military service status. Results: Among the 1921 participants (mean [SD] age, 50.1 [12.5] years), 1358 (70.7%) were men, 1638 (85.3%) were non-Hispanic White individuals, 1440 (75.0%) were married, and 1190 (61.9%) had at least a bachelor's degree; 295 (15.4%) had probable PTSD according to DSM-IV criteria with PCL-C compared with 286 (14.9%) using DSM-5 criteria with PCL-5 (κ = 0.77). There was substantial agreement between PCLs for probable PTSD based on DSM-IV criteria (295 [15.4%] with PCL-C; 316 [16.4%] with PCL-5; κ = 0.80) and DSM-5 criteria (286 [14.9%] with PCL-5; 258 [13.4%] with PCL-C; κ = 0.77). Estimated PTSD sum scores showed excellent agreement with observed scores. Using an established crosswalk, PCL-5 sum scores estimated with the PCL-C were similar to observed PCL-5 scores. Of the 17 corresponding items between the 2 instruments, 16 had substantial agreement. Appending 2 additional PCL-C items to the PCL-5 did not significantly alter estimates. The PCL-C and PCL-5 had nearly identical associations with comorbid conditions. Conclusions and Relevance: The findings of this diagnostic study suggest that PTSD can be successfully assessed and compared over time with either PCL instrument in veteran and military populations.
Authors: Sara L Kornfield; Rachel L Johnson; Liisa V Hantsoo; Rachel B Kaminsky; Rebecca Waller; Mary Sammel; C Neill Epperson Journal: Front Psychiatry Date: 2022-06-15 Impact factor: 5.435
Authors: Claire Kolaja; Sheila F Castañeda; Susan I Woodruff; Rudolph P Rull; Richard F Armenta Journal: PLoS One Date: 2022-09-29 Impact factor: 3.752
Authors: Lilian Calderón-Garcidueñas; Ravi Philip Rajkumar; Elijah W Stommel; Randy Kulesza; Yusra Mansour; Adriana Rico-Villanueva; Jorge Orlando Flores-Vázquez; Rafael Brito-Aguilar; Silvia Ramírez-Sánchez; Griselda García-Alonso; Diana A Chávez-Franco; Samuel C Luévano-Castro; Edgar García-Rojas; Paula Revueltas-Ficachi; Rodolfo Villarreal-Ríos; Partha S Mukherjee Journal: Int J Environ Res Public Health Date: 2021-06-22 Impact factor: 3.390