Diagnostic accuracy of three scoring methods for the Davidson Trauma Scale among U.S. military veterans

Scott D McDonald; NiVonne L Thompson; Kelcey J Stratton; VA Mid-Atlantic Mental Illness Research, Education, Clinical Center (MIRECC) Workgroup; Patrick S Calhoun

doi:10.1016/j.janxdis.2013.09.004

Diagnostic accuracy of three scoring methods for the Davidson Trauma Scale among U.S. military veterans

J Anxiety Disord. 2014 Mar;28(2):160-8. doi: 10.1016/j.janxdis.2013.09.004. Epub 2013 Sep 25.

Authors

Scott D McDonald¹, NiVonne L Thompson², Kelcey J Stratton³; VA Mid-Atlantic Mental Illness Research, Education, Clinical Center (MIRECC) Workgroup; Patrick S Calhoun⁴

Collaborators

VA Mid-Atlantic Mental Illness Research, Education, Clinical Center (MIRECC) Workgroup:
Jean C Beckham, Mira Brancu, Eric B Elbogen, John A Fairbank, Jeffrey M Hoerle, Harold Kudler, Christine E Marx, Scott D Moore, Rajendra Morey, Kristy K Straits-Tröster, Larry A Tupler, Richard D Weiner, H Ryan Wagner, Marinell Miller-Mumford, Antony Fernandez, Treven C Pickett, Robin A Hurley, Katherine H Taber, Ruth E Yoash-Gantz, Gregory McCarthy

Affiliations

¹ Hunter Holmes McGuire, Richmond VA Medical Center (116-B), 1201 Broad Rock Boulevard, Richmond, VA 23249, USA; Department of Psychology, Virginia Commonwealth University, 806 West Franklin Street, PO Box 842018, Richmond, VA 23284, USA; Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, 122 E. Marshall Street, 4th Floor, Box 980677, Richmond, VA 23298, USA. Electronic address: Scott.McDonald@va.gov.
² Hunter Holmes McGuire, Richmond VA Medical Center (116-B), 1201 Broad Rock Boulevard, Richmond, VA 23249, USA; Department of Psychology, Virginia Commonwealth University, 806 West Franklin Street, PO Box 842018, Richmond, VA 23284, USA.
³ Hunter Holmes McGuire, Richmond VA Medical Center (116-B), 1201 Broad Rock Boulevard, Richmond, VA 23249, USA; Department of Psychology, Virginia Commonwealth University, 806 West Franklin Street, PO Box 842018, Richmond, VA 23284, USA; Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, 800 East Leigh Street, Suite 101, Richmond, VA 23219, USA.
⁴ VA Mid-Atlantic Region Mental Illness Research, Education and Clinical Center (MIRECC), 508 Fulton Street, Durham, NC 27705, USA; VA Center for Health Services Research in Primary Care, Durham NC 508 Fulton Street, Durham, NC 27705, USA; Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, 2301 Erwin Road, Durham, NC 27710, USA.

PMID: 24216181
DOI: 10.1016/j.janxdis.2013.09.004

Abstract

Self-report questionnaires are frequently used to identify PTSD among U.S. military personnel and Veterans. Two common scoring methods used to classify PTSD include: (1) a cut score threshold and (2) endorsement of PTSD symptoms meeting DSM-IV-TR symptom cluster criteria (SCM). A third method requiring a cut score in addition to SCM has been proposed, but has received little study. The current study examined the diagnostic accuracy of three scoring methods for the Davidson Trauma Scale (DTS) among 804 Afghanistan and Iraq war-era military Service Members and Veterans. Data were weighted to approximate the prevalence of PTSD and other Axis I disorders in VA primary care. As expected, adding a cut score criterion to SCM improved specificity and positive predictive power. However, a cut score of 68-72 provided optimal diagnostic accuracy. The utility of the DTS, the role of baseline prevalence, and recommendations for future research are discussed.

Keywords: Diagnostic efficiency; Differential diagnosis; Military Veterans; Posttraumatic Stress Disorder; Sensitivity and specificity; Test validity.

Published by Elsevier Ltd.

Publication types

Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

Adult
Afghan Campaign 2001-
Aged
Diagnostic and Statistical Manual of Mental Disorders
Female
Humans
Iraq War, 2003-2011
Male
Mental Disorders / diagnosis
Mental Disorders / epidemiology
Middle Aged
Primary Health Care
Psychiatric Status Rating Scales*
Reproducibility of Results
Stress Disorders, Post-Traumatic / diagnosis*
Stress Disorders, Post-Traumatic / epidemiology
United States / epidemiology
United States Department of Veterans Affairs
Veterans / psychology*
Veterans / statistics & numerical data
Veterans Health / statistics & numerical data*
Young Adult