Citation

Bienvenu125 OJ, Williams1 JB, Yang6 A, Hopkins RO, Needham234 DM. Chest 2013; 144(1): 24-31.

Copyright

(Copyright © 2013, American College of Chest Physicians)

DOI

10.1378/chest.12-0908

PMID

23699588

Abstract

BACKGROUND: Survivors of acute lung injury (ALI) and other critical illnesses often experience substantial posttraumatic stress disorder (PTSD) symptoms. However, most questionnaires have not been validated against a PTSD diagnostic reference standard in this patient population. Hence, in the current study employing ALI survivors, we evaluated the Impact of Events Scale-Revised (IES-R), a questionnaire measure of PTSD symptoms, against the Clinician-Administered PTSD Scale (CAPS), the current state-of-the-art PTSD diagnostic reference standard, which also provides a quantitative assessment of PTSD symptoms. METHODS: We evaluated the IES-R questionnaire versus the CAPS diagnostic interview in 60 of 77 consecutively recruited ALI survivors from 2 prospective cohort studies of patients 1 to 5 years after ALI. RESULTS: The IES-R total score (range=0.0-3.2) and the CAPS total severity score (range=0-70) were strongly related (Pearson r=0.80, Spearman's rho=0.69). Using CAPS data, 8 of the 60 patients (13%) had PTSD at the time of assessment, and an additional 8 patients had partial PTSD (total prevalence=27%). In a receiver operating characteristics curve analysis with CAPS PTSD or partial PTSD as criterion variables, the area under the curve ranged from 95% (95% confidence interval, 88-100%) to 97% (95% CI, 92-100%). At an IES-R threshold of 1.6, with the same criterion variables, sensitivities ranged from 80-100%, specificities 85-91%, positive predictive values 50-75%, negative predictive values 93-100%, positive likelihood ratios 6.5-9.0, negative likelihood ratios 0.0-0.2, and efficiencies 87-90%. CONCLUSIONS: The IES-R appears to be an excellent brief PTSD symptom measure and screening tool in ALI survivors.

Language: en