BACKGROUND Previous work has indicated that post-traumatic stress disorder (PTSD) symptoms, measured by the Clinician-Administered PTSD Scale (CAPS) within 60 days of trauma exposure, can reliably produce likelihood estimates of chronic PTSD among trauma survivors admitted to acute care centers. Administering the CAPS is burdensome, requires skilled professionals, and relies on symptoms that are not fully expressed upon acute care admission. Predicting chronic PTSD from peritraumatic responses, which are obtainable upon acute care admission, has yielded conflicting results, hence the rationale for a stepwise screening-and-prediction practice. This work explores the ability of peritraumatic responses to produce risk likelihood estimates of early CAPS-based PTSD symptoms indicative of chronic PTSD risk. It specifically evaluates the Peritraumatic Dissociative Experiences Questionnaire (PDEQ) as a risk-likelihood estimator. METHODS We used individual participant data (IPD) from five acute care studies that used both the PDEQ and the CAPS (n = 647). Logistic regression calculated the probability of having CAPS scores ≥ 40 between 30 and 60 days after trauma exposure across the range of initial PDEQ scores, and evaluated the added contribution of age, sex, trauma type, and prior trauma exposure. Brier scores, area under the receiver-operating characteristic curve (AUC), and the mean slope of the calibration line evaluated the accuracy and precision of the predicted probabilities. RESULTS Twenty percent of the sample had CAPS ≥ 40. PDEQ severity significantly predicted having CAPS ≥ 40 symptoms (p < 0.001). Incremental PDEQ scores produced a reliable estimator of CAPS ≥ 40 likelihood. An individual risk estimation tool incorporating PDEQ and other significant risk indicators is provided. CONCLUSION Peritraumatic reactions, measured here by the PDEQ, can reliably quantify the likelihood of acute PTSD symptoms predictive of chronic PTSD and requiring clinical attention. Using them as a screener in a stepwise chronic PTSD prediction strategy may reduce the burden of later CAPS-based assessments. Other peritraumatic metrics may perform similarly and their use requires similar validation. TRIAL REGISTRATION Jerusalem Trauma Outreach and Prevention Study (J-TOPS): NCT00146900.

中文翻译：

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使用紧急护理信息评估筛查仪以量化 PTSD 风险：概念验证研究。


背景 先前的工作表明，在创伤暴露后 60 天内通过临床医生管理的 PTSD 量表 (CAPS) 测量的创伤后应激障碍 (PTSD) 症状，可以可靠地对入住急症护理中心的创伤幸存者进行慢性 PTSD 的可能性估计。实施 CAPS 是一项繁重的工作，需要熟练的专业人员，并且依赖于入院时未完全表达的症状。从急性护理入院时获得的创伤周围反应来预测慢性创伤后应激障碍（PTSD）已经产生了相互矛盾的结果，因此是逐步筛查和预测实践的理由。这项工作探讨了创伤周围反应对基于 CAPS 的早期 PTSD 症状（指示慢性 PTSD 风险）进行风险可能性估计的能力。它专门评估创伤周围解离经历问卷（PDEQ）作为风险可能性估计器。方法 我们使用了来自五项急性护理研究的个体参与者数据 (IPD)，这些研究同时使用了 PDEQ 和 CAPS (n = 647)。 Logistic 回归计算了在初始 PDEQ 评分范围内创伤暴露后 30 至 60 天内 CAPS 评分≥ 40 的概率，并评估了年龄、性别、创伤类型和既往创伤暴露的附加贡献。 Brier 评分、受试者工作特征曲线下面积 (AUC) 和校准线的平均斜率评估了预测概率的准确性和精密度。结果 20% 的样本有 CAPS ≥ 40。PDEQ 严重程度显着预测有 CAPS ≥ 40 症状 (p < 0.001)。增量 PDEQ 分数产生了 CAPS ≥ 40 可能性的可靠估计。 提供了包含 PDEQ 和其他重要风险指标的个人风险评估工具。结论 通过 PDEQ 测量的创伤周围反应可以可靠地量化急性 PTSD 症状的可能性，从而预测慢性 PTSD 并需要临床关注。使用它们作为逐步慢性 PTSD 预测策略的筛选器可能会减轻以后基于 CAPS 的评估的负担。其他创伤周围指标可能表现类似，并且它们的使用需要类似的验证。试用注册耶路撒冷创伤外展和预防研究 (J-TOPS)：NCT00146900。