PTSD Screening Tool?

[foreverbull]

I know we have a lot of VA folk and PTSD experts here--does anyone know of a free, relatively brief, and psychometrically sound PTSD measure to be used as a screening tool?

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[cara susanna]

PCL-5, definitely. There are even studies about suggested cutoffs in Primary Care settings etc. The only thing is they need to specify the index event, but I imagine that'd be true for any PTSD measure. I suggest combining it with the LEC or at least using the version with the extended criterion A question.

 

[futureapppsy2]

PCL-5, definitely

Was just coming in here to recommend that!

 

[WisNeuro]

Yeah, PCL-5, but definitely just as a screener. You'd be surprised how many people endorse items, such as flashbacks, but when you follow up with questions, it's clear that they are interpreting flashbacks as bad memories or reminders of the event. I used earlier versions, as well as structured clinical interviews in masters and dissertation projects.

 

[Therapist4Chnge]

PCL-5 to screen, but as WisNeuro mentioned....a solid interview is the best option to confirm. In my Psychiatric Functioning section I will go through each criteria and document each one. It's an easy structure to use and insert examples and quotes from the patient. Often a patient's understanding of PTSD isn't very accurate, so it's important to go through each criteria and clarify answers provided.

 

[Justanothergrad]

I really hate most of them. Not because of the instruments themselves but the broader issues with assuming symptom screeners are valid on their own. PCL-5 I guess, at least it aligns to criteria

 

[AbnormalPsych]

Yep PCL-5, read up on the CAPS to see how to do a thorough structured interview ('gold standard').

 

[cara susanna]

Yes, CAPS-5 is definitely gold standard for actually diagnosing and not just screening. Another option is the "PCL-5 interview," that was part of the PE pretreatment protocol they taught us in the VA, but it's not as rigorous as the CAPS IMO.

 

[foreverbull]

Excellent suggestions & feedback--thanks everyone!

 

[mdwpsyd]

I suggest combining it with the LEC or at least using the version with the extended criterion A question.

Excellent advice!

I highly recommend reading PTSD Checklist for DSM-5 (PCL-5) on the National Center for PTSD website. It is concise and informative. That site is also where you can download:

• PCL-5 with LEC-5 and Criterion A (PDF)
  
  
• Using the PTSD Checklist for DSM-5 (PCL-5) (PDF)

Over the last 10 years my primary specialty has been VA C&P exams for PTSD and other mental disorders. I and other C&P examiners (psychologists and psychiatrists) frequently review previous exams where a veteran was diagnosed with PTSD based only on a PCL score and an unstructured interview.

Sometimes there are reliable records documenting a history of PTSD, in which case the PCL might be appropriate. (I would still use the CAPS and other evidence-based assessment measures, but reasonable minds can disagree.)

Very often, unfortunately, the evidence for a PTSD diagnosis is sparse—and there may be contradictory evidence—but the examiner nonetheless diagnoses PTSD.

~ Mark

P.S. Re: "evidence-based assessment" here are some helpful articles and book chapters:

Bornstein, Robert F. “Evidence-Based Psychological Assessment.” Journal of Personality Assessment 99, no. 4 (July 4, 2017): 435–45. doi:10.1080/00223891.2016.1236343

Hunsley, John, and Eric J. Mash. “Evidence-Based Assessment.” Annual Review of Clinical Psychology 3, no. 1 (April 2007): 29–51. doi:10.1146/annurev.clinpsy.3.022806.091419

Bornstein, Robert F., and Christopher J. Hopwood. "Introduction to Multimethod Clinical Assessment." In Multimethod Clinical Assessment, edited by Christopher J. Hopwood and Robert J. Bornstein, 1–20. New York: Guilford, 2014.

Burchett, Danielle, and R. Michael Bagby. “Multimethod Assessment of Distortion: Integrating Data from Interviews, Collateral Records, and Standardized Assessment Tools.” In Multimethod Clinical Assessment, edited by Christopher J. Hopwood and Robert J. Bornstein, 345–78. New York: Guilford, 2014.