TY - JOUR
T1 - The validity of military screening for mental health problems
T2 - Diagnostic accuracy of the PCL, K10 and AUDIT scales in an entire military population
AU - Searle, Amelia K.
AU - Van Hooff, Miranda
AU - Mcfarlane, Alexander C.
AU - Davies, Christopher E.
AU - Fairweather-Schmidt, A. Kate
AU - Hodson, Stephanie E.
AU - Benassi, Helen
AU - Steele, Nicole
N1 - Publisher Copyright:
© 2014 John Wiley & Sons, Ltd.
PY - 2015/3/1
Y1 - 2015/3/1
N2 - Depression, alcohol use disorders and post-traumatic stress disorder (PTSD) are serious issues among military personnel due to their impact on operational capability and individual well-being. Several military forces screen for these disorders using scales including the Kessler Psychological Distress Scale (K10), Alcohol Use Disorders Identification Test (AUDIT), and Post-traumatic Stress Disorder Checklist (PCL). However, it is unknown whether established cutoffs apply to military populations. This study is the first to test the diagnostic accuracy of these three scales in a population-based military cohort. A large sample of currently-serving Australian Defence Force (ADF) Navy, Army and Air Force personnel (n=24,481) completed the K10, AUDIT and PCL-C (civilian version). Then, a stratified sub-sample (n=1798) completed a structured diagnostic interview detecting 30-day disorder. Data were weighted to represent the ADF population (n=50,049). Receiver operating characteristic (ROC) analyses suggested all three scales had acceptable sensitivity and specificity, with areas under the curve from 0.75 to 0.93. AUDIT and K10 screening cutoffs closely paralleled established cutoffs, whereas the PCL-C screening cutoff resembled that recommended for US military personnel. These self-report scales represent a cost-effective and clinically-useful means of screening personnel for disorder. Military populations may need lower cutoffs than civilians to screen for PTSD.
AB - Depression, alcohol use disorders and post-traumatic stress disorder (PTSD) are serious issues among military personnel due to their impact on operational capability and individual well-being. Several military forces screen for these disorders using scales including the Kessler Psychological Distress Scale (K10), Alcohol Use Disorders Identification Test (AUDIT), and Post-traumatic Stress Disorder Checklist (PCL). However, it is unknown whether established cutoffs apply to military populations. This study is the first to test the diagnostic accuracy of these three scales in a population-based military cohort. A large sample of currently-serving Australian Defence Force (ADF) Navy, Army and Air Force personnel (n=24,481) completed the K10, AUDIT and PCL-C (civilian version). Then, a stratified sub-sample (n=1798) completed a structured diagnostic interview detecting 30-day disorder. Data were weighted to represent the ADF population (n=50,049). Receiver operating characteristic (ROC) analyses suggested all three scales had acceptable sensitivity and specificity, with areas under the curve from 0.75 to 0.93. AUDIT and K10 screening cutoffs closely paralleled established cutoffs, whereas the PCL-C screening cutoff resembled that recommended for US military personnel. These self-report scales represent a cost-effective and clinically-useful means of screening personnel for disorder. Military populations may need lower cutoffs than civilians to screen for PTSD.
KW - AUDIT
KW - K10
KW - Military
KW - PCL
KW - Sensitivity and specificity
UR - http://www.scopus.com/inward/record.url?scp=84923556149&partnerID=8YFLogxK
U2 - 10.1002/mpr.1460
DO - 10.1002/mpr.1460
M3 - Article
C2 - 25511518
AN - SCOPUS:84923556149
SN - 1049-8931
VL - 24
SP - 32
EP - 45
JO - International Journal of Methods in Psychiatric Research
JF - International Journal of Methods in Psychiatric Research
IS - 1
ER -