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Validity of the posttraumatic stress disorders (PTSD) checklist in pregnant women

BACKGROUND: The PTSD Checklist-civilian (PCL-C) is one of the most commonly used self-report measures of PTSD symptoms, however, little is known about its validity when used in pregnancy. This study aims to evaluate the reliability and validity of the PCL-C as a screen for detecting PTSD symptoms am...

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Autores principales: Gelaye, Bizu, Zheng, Yinnan, Medina-Mora, Maria Elena, Rondon, Marta B., Sánchez, Sixto E., Williams, Michelle A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5427611/
https://www.ncbi.nlm.nih.gov/pubmed/28494804
http://dx.doi.org/10.1186/s12888-017-1304-4
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author Gelaye, Bizu
Zheng, Yinnan
Medina-Mora, Maria Elena
Rondon, Marta B.
Sánchez, Sixto E.
Williams, Michelle A.
author_facet Gelaye, Bizu
Zheng, Yinnan
Medina-Mora, Maria Elena
Rondon, Marta B.
Sánchez, Sixto E.
Williams, Michelle A.
author_sort Gelaye, Bizu
collection PubMed
description BACKGROUND: The PTSD Checklist-civilian (PCL-C) is one of the most commonly used self-report measures of PTSD symptoms, however, little is known about its validity when used in pregnancy. This study aims to evaluate the reliability and validity of the PCL-C as a screen for detecting PTSD symptoms among pregnant women. METHODS: A total of 3372 pregnant women who attended their first prenatal care visit in Lima, Peru participated in the study. We assessed the reliability of the PCL-C items using Cronbach’s alpha. Criterion validity and performance characteristics of PCL-C were assessed against an independent, blinded Clinician-Administered PTSD Scale (CAPS) interview using measures of sensitivity, specificity and receiver operating characteristics (ROC) curves. We tested construct validity using exploratory and confirmatory factor analytic approaches. RESULTS: The reliability of the PCL-C was excellent (Cronbach’s alpha =0.90). ROC analysis showed that a cut-off score of 26 offered optimal discriminatory power, with a sensitivity of 0.86 (95% CI: 0.78–0.92) and a specificity of 0.63 (95% CI: 0.62–0.65). The area under the ROC curve was 0.75 (95% CI: 0.71–0.78). A three-factor solution was extracted using exploratory factor analysis and was further complemented with three other models using confirmatory factor analysis (CFA). In a CFA, a three-factor model based on DSM-IV symptom structure had reasonable fit statistics with comparative fit index of 0.86 and root mean square error of approximation of 0.09. CONCLUSION: The Spanish-language version of the PCL-C may be used as a screening tool for pregnant women. The PCL-C has good reliability, criterion validity and factorial validity. The optimal cut-off score obtained by maximizing the sensitivity and specificity should be considered cautiously; women who screened positive may require further investigation to confirm PTSD diagnosis. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12888-017-1304-4) contains supplementary material, which is available to authorized users.
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spelling pubmed-54276112017-05-15 Validity of the posttraumatic stress disorders (PTSD) checklist in pregnant women Gelaye, Bizu Zheng, Yinnan Medina-Mora, Maria Elena Rondon, Marta B. Sánchez, Sixto E. Williams, Michelle A. BMC Psychiatry Research Article BACKGROUND: The PTSD Checklist-civilian (PCL-C) is one of the most commonly used self-report measures of PTSD symptoms, however, little is known about its validity when used in pregnancy. This study aims to evaluate the reliability and validity of the PCL-C as a screen for detecting PTSD symptoms among pregnant women. METHODS: A total of 3372 pregnant women who attended their first prenatal care visit in Lima, Peru participated in the study. We assessed the reliability of the PCL-C items using Cronbach’s alpha. Criterion validity and performance characteristics of PCL-C were assessed against an independent, blinded Clinician-Administered PTSD Scale (CAPS) interview using measures of sensitivity, specificity and receiver operating characteristics (ROC) curves. We tested construct validity using exploratory and confirmatory factor analytic approaches. RESULTS: The reliability of the PCL-C was excellent (Cronbach’s alpha =0.90). ROC analysis showed that a cut-off score of 26 offered optimal discriminatory power, with a sensitivity of 0.86 (95% CI: 0.78–0.92) and a specificity of 0.63 (95% CI: 0.62–0.65). The area under the ROC curve was 0.75 (95% CI: 0.71–0.78). A three-factor solution was extracted using exploratory factor analysis and was further complemented with three other models using confirmatory factor analysis (CFA). In a CFA, a three-factor model based on DSM-IV symptom structure had reasonable fit statistics with comparative fit index of 0.86 and root mean square error of approximation of 0.09. CONCLUSION: The Spanish-language version of the PCL-C may be used as a screening tool for pregnant women. The PCL-C has good reliability, criterion validity and factorial validity. The optimal cut-off score obtained by maximizing the sensitivity and specificity should be considered cautiously; women who screened positive may require further investigation to confirm PTSD diagnosis. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12888-017-1304-4) contains supplementary material, which is available to authorized users. BioMed Central 2017-05-12 /pmc/articles/PMC5427611/ /pubmed/28494804 http://dx.doi.org/10.1186/s12888-017-1304-4 Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Gelaye, Bizu
Zheng, Yinnan
Medina-Mora, Maria Elena
Rondon, Marta B.
Sánchez, Sixto E.
Williams, Michelle A.
Validity of the posttraumatic stress disorders (PTSD) checklist in pregnant women
title Validity of the posttraumatic stress disorders (PTSD) checklist in pregnant women
title_full Validity of the posttraumatic stress disorders (PTSD) checklist in pregnant women
title_fullStr Validity of the posttraumatic stress disorders (PTSD) checklist in pregnant women
title_full_unstemmed Validity of the posttraumatic stress disorders (PTSD) checklist in pregnant women
title_short Validity of the posttraumatic stress disorders (PTSD) checklist in pregnant women
title_sort validity of the posttraumatic stress disorders (ptsd) checklist in pregnant women
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5427611/
https://www.ncbi.nlm.nih.gov/pubmed/28494804
http://dx.doi.org/10.1186/s12888-017-1304-4
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