The primary care PTSD screen (PC–PTSD): development and operating characteristics

TLDR

PTSD is a frequently unrecognized anxiety disorder in primary care settings. The study aimed to develop and evaluate a brief 4‑item PTSD screen (PC‑PTSD) for primary care. The screen was administered to 188 VA primary‑care patients alongside the PCL and CAPS to assess its performance. The PC‑PTSD identified a 24.5% PTSD prevalence, with an optimal cutoff of 3 for efficiency and 2 for sensitivity, outperforming the PCL in sensitivity, specificity, and overall quality, and demonstrating psychometric soundness comparable to other mental‑disorder screens.

Abstract

Posttraumatic stress disorder (PTSD) is a frequently unrecognized anxiety disorder in primary care settings. This study reports on the development and operating characteristics of a brief 4-item screen for PTSD in primary care (PC-PTSD). 188 VA primary care patients completed the PC-PTSD, the PTSD Symptom Checklist (PCL) and the Clinician Administered Scale for PTSD (CAPS). The prevalence of PTSD was 24.5%. Signal detection analyses showed that with this base rate, the PC-PTSD had an optimally efficient cutoff score of 3 for both male and female patients. A cutoff score of 2 is recommended when sensitivity rather than efficiency is optimized. The PC-PTSD outperformed the PCL in terms of overall quality, sensitivity, specificity, efficiency, and quality of efficiency. The PC-PTSD appears to be a psychometrically sound screen for PTSD with comparable operating characteristtics to other screens for mental disorders.