Abstract
The study aimed at examining the diagnostic utility of the Impact of Event Scale-Revised (IES-R) as a screening tool for post-traumatic stress disorder (PTSD) in survivors of war. The IES-R was completed by two independent samples that had survived the war in the Balkans: a sample of randomly selected people who had stayed in the area of former conflict (n = 3,313) and a sample of refugees to Western European countries (n = 854). PTSD was diagnosed using the MINI International Neuropsychiatric Interview. Prevalence of PTSD was 20.1% in the Balkan sample and 33.1% in the refugee sample. Results revealed that when considering a minimum value of specificity of 0.80, the optimally sensitive cut-off score for screening for PTSD in the Balkan sample was 34. In both the Balkan sample and the refugee sample, this cut-off score provided good values on sensitivity (0.86 and 0.89, respectively) and overall efficiency (0.81 and 0.79, respectively). Further, the kappa coefficients for sensitivity for the cut-off of 34 were 0.80 in both samples. Findings of this study support the clinical utility of the IES-R as a screening tool for PTSD in large-scale research studies and intervention studies if structured diagnostic interviews are regarded as too labor-intensive and too costly.
Highlights
Post-traumatic stress disorder (PTSD) is a common and disabling disorder with onset after traumatic experiences [1]
The findings of this study in two independent samples suggest that the Impact of Event Scale-Revised (IES-R) can be effectively used as a screening instrument for PTSD
A cut-off score of 34 showed excellent sensitivity (0.89 and 0.86) as well as kappa coefficients used as quality indices sensitivity in both samples, whereas specificity was somewhat lower in the refugees than in the Balkan sample (0.74 vs. 0.80)
Summary
Post-traumatic stress disorder (PTSD) is a common and disabling disorder with onset after traumatic experiences [1]. Post-traumatic symptoms must be present for more than one month and include intrusive recollections of the traumatic event (Criterion B; at least 1 symptom), avoidant symptoms (Criterion C; at least 3 symptoms), and hyperarousal symptoms (Criterion D; at least 2 symptoms) [2]. DSM-IV Criterion A2 (i.e., and a reaction to that event that involves fear, helplessness, or horror) has been deleted, due to its low utility in predicting the development of PTSD. In both editions of the DSM, symptoms of PTSD must persist for more than one month and must cause clinically significant distress or impairment in functioning
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