Adapting the Primary Care PTSD Screener for firefighters

Area of Science:

• Psychiatry
• Occupational Health
• Psychological Assessment

Background:

• First responders are at elevated risk for post-traumatic stress disorder (PTSD) due to the nature of their demanding work.
• Early identification of PTSD in first responders is crucial for timely access to mental health services.
• Validated screening instruments are essential for efficient assessment in this high-risk population.

Purpose of the Study:

• To evaluate the diagnostic accuracy of the Primary Care PTSD for DSM-5 (PC-PTSD-5) scale in a firefighter population.
• To explore the utility of an adapted PC-PTSD-5 utilizing a five-point Likert scale.
• To determine the sensitivity and specificity of the adapted PC-PTSD-5 for identifying probable PTSD among firefighters.

Main Methods:

• A pooled analysis of firefighters (N=92) from treatment-seeking and general population samples was conducted.
• Participants completed an adapted PC-PTSD-5 and the Post-Traumatic Stress Disorder Checklist for DSM-5 (PCL-5).
• Receiver operating characteristic (ROC) curve analyses were performed using PCL-5 scores as the reference standard.

Main Results:

• The PC-PTSD-5 demonstrated strong overall operating characteristics for PTSD screening in firefighters.
• An optimal threshold of 3 was identified for the original PC-PTSD-5 proxy (0-5 scale).
• A threshold score of 9 was determined for the adapted PC-PTSD-5 with a wider response range (0-20).

Conclusions:

• The PC-PTSD-5 shows potential as a brief and effective screening tool for PTSD in firefighters.
• Preliminary findings suggest specific cut-off scores for both original and adapted versions.
• Further research with larger, diverse samples is recommended to validate these findings and expand clinical application.