An Examination of the Diagnostic Efficiency of Post-Deployment Mental Health Screens

Autor:	James Maxwell, Robert D. Swanson, Nancy A. Skopp, Mark A. Reger, Lily Trofimovich, Michael B. First, Gregory A. Gahm, David D. Luxton
Rok vydání:	2012
Předmět:	medicine.medical_specialty business.industry Human factors and ergonomics Poison control Alcohol abuse medicine.disease behavioral disciplines and activities Mental health Suicide prevention Occupational safety and health Clinical Psychology Arts and Humanities (miscellaneous) Injury prevention Medicine Major depressive disorder business Psychiatry
Zdroj:	Journal of Clinical Psychology. 68:1253-1265
ISSN:	0021-9762
DOI:	10.1002/jclp.21887
Popis:	Objective To conduct a blinded study to examine the diagnostic efficiency of the Department of Defense (DoD) Post-Deployment Health Reassessment (PDHRA) screens for major depressive disorder (MDD), posttraumatic stress disorder (PTSD), and alcohol abuse. Method Participants were 148 post-deployed soldiers who were completing the PDHRA protocol. Soldiers’ mean age was 27.7 (standard deviation = 6.6) years, and 89.0% were male. Mental health professionals blinded to the PDHRA screening results administered the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition directly after the PDHRA assessment protocol. Results All screens exhibited excellent negative predictive power. Sensitivity metrics were lower, consistent with the relatively low base rates observed for MDD (10.1%), PTSD (8.8%), and alcohol abuse (5.4%). Metrics obtained for the PTSD screen were consistent with previous research with a similar base rate. A two-item screen containing PTSD reexperiencing and hyperarousal symptom items revealed excellent psychometric properties (sensitivity = .92; specificity = .79). The alcohol abuse screen yielded high sensitivity (.86), but very poor precision; these metrics were somewhat improved when the screen was reduced to a single item. Conclusions The PDHRA MDD, PTSD, and alcohol abuse screens appear to be functioning well in accurately ruling out these diagnoses, consistent with a population-level screening program. Cross validation of the current results is indicated. Additional refinement may yield more sensitive screening measures within constraints imposed by the low base rates in a typically healthy population.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_________::e924bc3f32c3d362a44fa313fc78c85e https://doi.org/10.1002/jclp.21887 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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