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A Journal on Psychiatry, Psychology and Psychopharmacology
Official Journal of the Italian Society of Social Psychiatry
Indexed/Abstracted in: EMBASE, e-psyche, PsycINFO, Scopus, Emerging Sources Citation Index
ADVANCES IN PSYCHIATRY IN 2012
Minerva Psichiatrica 2012 March;53(1):47-59
Predicting future PTSD using a modified New York Risk Score: implications for patient screening and management
Boscarino J. A. 1, 2, 3, 4, Lester Kirchner H. 1, 5, Hoffman S. N. 6, Sartorius J. 1, Adams R. E. 7, Figley C. R. 8
1 Center for Health Research, Geisinger Clinic, Danville, PA, USA;
2 Department of Medicine, Mount Sinai School of Medicine,New York, NY, USA;
3 Department of Pediatrics, Mount Sinai School of Medicine, New York, NY, USA;
4 Department of Psychiatry, Temple University School of Medicine, Philadelphia, PA, USA;
5 Department of Medicine, Temple University School of Medicine, Philadelphia, PA, USA;
6 Department of Neurology, Geisinger Clinic, Danville, PA, USA;
7 Department of Sociology, Kent State University, Kent, OH, USA;
8 Graduate School of Social Work, Tulane University, New Orleans, LA, USA
Aim. We previously developed a posttraumatic stress disorder (PTSD) screening instrument – the New York PTSD Risk Score – that was effective in predicting PTSD. In the present study, we assessed a 12-month prospective version of this risk score, which is important for patient management, follow-up, and for emergency medicine.
Methods. Using data collected in a study of New York City adults after the World Trade Center Disaster (WTCD), we developed a new PTSD prediction tool. Using diagnostic test methods, including receiver operating curve (ROC) and bootstrap procedures, we examined different prediction variables to assess PTSD status 12 months after initial assessment among 1,681 trauma-exposed adults.
Results. While our original PTSD screener worked well in the short term, it was not specifically developed to predict long-term PTSD. In the current study, we found that the Primary Care PTSD Screener, when combined with psychosocial predictors from the original NY Risk Score, including depression, trauma exposure, sleep disturbance, and healthcare access, increased the area under the ROC curve (AUC) from 0.707 to 0.774, a significant improvement (P<0.0001). When additional risk-factor variables were added, including negative life events, handedness, self-esteem, and pain status, the AUC increased to 0.819, also a significant improvement (P=0.001). Adding Latino and foreign status to the model further increased the AUC to 0.839 (P=0.007).
Conclusion. A prospective version of the New York PTSD Risk Score appears to be effective in predicting PTSD status 12 months after initial assessment among trauma-exposed adults. Further research is advised to further validate and expand these findings.