PubMed · 15973901
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Sylvie Augy, Philppe Dejardin. [Memory consultation].. https://pubmed.ncbi.nlm.nih.gov/15973901/
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There are few available data on how to accurately screen for and assess posttraumatic stress disorder (PTSD) among severely mentally ill adults, a group with high rates of unrecognized trauma and PTSD symptoms. We examined the diagnostic utility of a widely used screening instrument, the PTSD Checklist (PCL), for diagnosing PTSD among 44 traumatized, adult, public-sector mental health patients recruited through a community mental health program. Participants completed the PCL and the Clinician-Administered PTSD Scale (CAPS), which is considered the "gold standard" for determining PTSD diagnoses. Data provide preliminary support for the use of the PCL as a screening instrument in public psychiatric settings, indicating that the optimal cut-point for adults with severe mental illness is about 54 (with slightly higher or lower recommended cut-points depending on the clinical context and purpose of the PCL). Such data are critical to ensuring that public-sector mental health patients with trauma-related difficulties are identified and referred for appropriate services.
Once considered to be a disorder associated with minimal impairment, the link between generalized anxiety disorder (GAD) and impairment across a broad constellation of domains is now well established. However, less is known about how comorbidity affects these relationships or how GAD impacts one's perceived life satisfaction or quality of life. To investigate these questions, data from 52 treatment-seeking individuals with GAD (33 with comorbid Axis I diagnoses) were compared to data from 55 nonanxious controls. Individuals with GAD reported more impairment at work and in their social functioning than they did with home and family responsibilities. They also reported lower quality of life than nonanxious controls, particularly in regard to self-esteem, goals and values, money, work, play, learning, creativity, friends, and relatives. Trait worry was positively correlated with impairment and inversely related to life satisfaction within the clinical sample. Individuals with GAD, with and without comorbid Axis I diagnoses, showed few differences on measures of impairment (differing only on impairment in social functioning). However, individuals with GAD and comorbid disorders perceived their lives as less satisfying than did individuals with GAD without comorbid diagnoses.
The Mini-Social Phobia Inventory (Mini-SPIN) is a 3-item, self-rated screening instrument to assess social anxiety disorder, but its psychometric properties have not yet been examined in a sample seeking treatment for psychiatric disorders. We analyzed responses from 291 adults who telephoned the Adult Anxiety Clinic of Temple (AACT) seeking treatment for social anxiety or generalized anxiety and worry. The Mini-SPIN demonstrated strong internal consistency. Support for the convergent validity of the Mini-SPIN was provided by moderate correlations with several self-report measures and a clinician-administered measure of social anxiety completed by the subsample of callers who later came to the AACT for evaluation. Furthermore, the Mini-SPIN correlated significantly with two of three measures of functional disability, but not with a measure of life satisfaction. Correlations with measures of other constructs were nonsignificant, providing support for the discriminant validity of the Mini-SPIN. In addition, a cutoff score of 6 on the Mini-SPIN yielded strong sensitivity and diagnostic efficiency in the subsample of treatment seekers that later completed pretreatment evaluation, although the specificity of this cutoff score was not optimal in this sample. Overall, the Mini-SPIN demonstrated sound psychometric properties in this treatment-seeking sample.