Screening for posttraumatic stress disorder (PTSD) in Mozambique: Validation of the Primary Care Posttraumatic Stress
Luciana J Massinga1, M Claire Greene2, Cristiane S Duarte3
1Department of Mental Health, Ministry of Health of Mozambique.
Objective:
The confluence of conflict-, climate-, and public health-related emergencies in Mozambique increases the risk of posttraumatic stress disorder (PTSD). Few brief screening tools for PTSD have been validated in low- and middle-income countries. We aimed to validate the five-item Primary Care PTSD Screen for the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5), the PC-PTSD-5 in Mozambique.
Method:
This study recruited 957 participants who completed the Mini-International Neuropsychiatric Interview-Plus (MINI-Plus) and PC-PTSD-5, a convenience sample from primary and tertiary care settings in Maputo, Mozambique. Participants were administered a diagnostic interview for psychiatric disorders and the PC-PTSD-5 screening tool. We evaluated the criterion validity of the PC-PTSD-5 concerning the MINI-Plus diagnosis of PTSD, the internal construct validity and reliability using confirmatory factor analysis and Kuder-Richardson 20 (KR-20), discriminant validity of the PC-PTSD-5 in comparison to other common mental disorder and suicide risk screening tools, and measurement invariance of selected cutoffs by age, sex, and comorbidity.
Results:
Internal consistency of the PC-PTSD-5 was high (KR-20 = 0.837), and confirmatory factor analysis suggested that a single PTSD factor fits the data well. PC-PTSD-5 items were moderately correlated with other psychiatric symptoms. Criterion validity analyses revealed that a cutoff score of 3 provided high specificity (0.833) and moderate sensitivity (0.673). This cutoff score performed optimally across age and gender; however, a cutoff score of 2 was preferred if the participant had no psychiatric comorbidities.
Conclusion:
Screening with the PC-PTSD-5 may facilitate case detection and linkages to appropriate treatment for individuals affected by potentially traumatic events in Mozambique. (PsycInfo Database Record (c) 2025 APA, all rights reserved).
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