Adapting the Primary Care PTSD Screener for firefighters

摘要

Background By the nature of their work, first responders are at risk for post-traumatic stress disorder (PTSD). Efficient screening instruments are useful to identify at-risk first responders and connect them to services. Aims The current study aimed to (i) evaluate the diagnostic properties of the Primary Care PTSD for DSM-5 (PC-PTSD-5) scale among firefighters, (ii) explore the use of an adapted PC-PTSD-5 on a five-point Likert-type scale and (iii) examine sensitivity and specificity of the adapted instrument in this population. Methods Pooled data were analysed among firefighters (N = 92) from a treatment-seeking sample (n = 36) and a population health screening sample (n = 56). Participants completed an adapted version of the PC-PTSD-5 and the Post-Traumatic Stress Disorder Checklist for DSM-5 (PCL-5). Receiver operating characteristic curve analyses were performed, referencing PCL-5 cut-off/probable diagnostic threshold scores. Results The PC-PTSD-5 demonstrated excellent operating characteristics overall. A threshold of 3 was optimal for discriminating probable PTSD using a proxy for the original PC-PTSD-5 (range: 0-5), whereas a score of 9 was identified for the PC-PTSD-5 permutation that allowed for more response variability (range: 0-20). Conclusions Our preliminary data suggest the PC-PTSD-5 may be a useful tool for brief firefighter screening, with suggested cut-offs that require further replication and expanded investigation. Firefighters are exposed to repeated risk and chronic stressors by nature of their professional duties. In turn, post-traumatic stress disorder (PTSD) rates are elevated. Yet, efficient means to identify PTSD in this occupational group remains an undeveloped area of medicine. This study tested an adapted Primary Care PTSD for DSM-5 (PC-PTSD-5) screening questionnaire with treatment-seeking firefighters. Results inform guidelines to interpret firefighter PC-PTSD-5 scores, which represents a practical screening instrument for providers in the context of brief medical visits or other screening settings.