Self-reported outcome measures for adults with post-traumatic stress disorder: towards recommendations for clinical practice

The 2018 Phoenix Australia Clinical Practice Guidelines for Post-traumatic Stress Disorder (PTSD) recommended that practitioners use validated, user-friendly self-report measures for PTSD in their practice. However, selecting which measure to use can be difficult as there are currently no guidelines for selection. This research sought to evaluate self-report outcome measures for adults with PTSD and produce recommendations to guide clinicians. A systematic search was use qd to identify relevant articles and a comprehensive list of the existing measures of PTSD symptoms were extracted. A second search for validation papers for these measures was then conducted. Using these validation papers, measures were evaluated for their psychometric properties and utility for clinical practice via a purpose-built evaluation tool. Twenty-two self-report outcome measures for PTSD were extracted from 256 randomised controlled trials. For these measures, 110 validation papers were located. For nonspecific trauma exposure populations, the PCL-5 and SPRINT were found to be the most psychometrically valid measures, with the highest scoring clinical utility. The measures for 12 specific trauma exposure populations were examined and discussed. This paper has direct clinical relevance for working with individuals with PTSD and provides researchers and clinicians with justification for outcome measure selection. <b>KEY POINTS</b> <b>What is already known about this topic:</b>It is recommended that clinicians use validated, user-friendly self-report measures to support their assessments of treatment outcomes over time for post-traumatic stress disorder (PTSD).Clinicians may struggle to select which measure to use in their practice when faced with a plethora of choice regarding outcome measures for PTSD, especially given the impact of the DSM-5 update.The differences between measures which are utilised frequently (i.e. ‘common’ measures) and measures with good psychometric properties (i.e. validated measures) and those with good clinical utility (i.e. usability) can be difficult to understand It is recommended that clinicians use validated, user-friendly self-report measures to support their assessments of treatment outcomes over time for post-traumatic stress disorder (PTSD). Clinicians may struggle to select which measure to use in their practice when faced with a plethora of choice regarding outcome measures for PTSD, especially given the impact of the DSM-5 update. The differences between measures which are utilised frequently (i.e. ‘common’ measures) and measures with good psychometric properties (i.e. validated measures) and those with good clinical utility (i.e. usability) can be difficult to understand <b>What this topic adds:</b>This paper used systematic review methodology was used to identify &amp; evaluate a comprehensive list of self-report outcome measures for PTSD since the DSM-5 update in 2013 and the populations that they should be used with.For non-specific trauma exposure populations, the PCL-5 and SPRINT were found to be the most psychometrically valid measures, with the highest scoring clinical utility.The most psychometrically valid measures, with the highest scoring clinical utility for twelve specific trauma exposure populations are also presented. This paper used systematic review methodology was used to identify &amp; evaluate a comprehensive list of self-report outcome measures for PTSD since the DSM-5 update in 2013 and the populations that they should be used with. For non-specific trauma exposure populations, the PCL-5 and SPRINT were found to be the most psychometrically valid measures, with the highest scoring clinical utility. The most psychometrically valid measures, with the highest scoring clinical utility for twelve specific trauma exposure populations are also presented.

2018年澳大利亚凤凰城创伤后应激障碍（Post-traumatic Stress Disorder, PTSD）临床实践指南建议，临床从业者在工作中应采用经过验证、操作便捷的PTSD自评量表。但目前尚无统一的量表选择规范，临床医师常因可选量表繁多而难以抉择适配的测评工具。本研究旨在评估成人PTSD自评结局量表，并为临床工作者提供科学的选择指引。研究首先通过系统检索筛选相关文献，提取现有PTSD症状自评量表的完整目录；随后针对上述量表的验证类研究开展二次检索。依托这些验证文献，本研究采用专门构建的专用评估工具，对各量表的心理测量学属性与临床实用性进行系统评价。最终从256项随机对照试验（randomised controlled trial, RCT）中筛选出22项PTSD自评结局量表，对应110篇验证研究文献。针对非特异性创伤暴露人群，PCL-5与SPRINT被证实为心理测量学效度最优、临床实用性评分最高的量表。本研究还对适用于12种特定创伤暴露人群的量表进行了分析与讨论。本研究对PTSD患者的临床诊疗具有直接指导价值，同时为研究人员与临床医师选择结局测评量表提供了充分的科学依据。

<b>核心要点</b>
<b>已知研究背景：</b>
临床医师应采用经过验证、易于使用的自评量表，以长期评估创伤后应激障碍（PTSD）的治疗结局。面对海量可选的PTSD结局量表时，临床医师常难以抉择合适的测评工具，尤其是在《精神障碍诊断与统计手册（第五版）》（Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, DSM-5）更新后。高频使用的（即“常用”）量表、具备良好心理测量学属性的（即“经过验证的”）量表，以及具备良好临床实用性的（即“易用性”）量表之间的差异往往难以厘清。

<b>本研究新增贡献：</b>
本研究采用系统综述方法，梳理了2013年《精神障碍诊断与统计手册（第五版）》（DSM-5）更新后所有PTSD自评结局量表及其适用人群，并完成系统性评估。针对非特异性创伤暴露人群，PCL-5与SPRINT被证实为心理测量学效度最高、临床实用性评分最优的量表。本研究同时呈现了适用于12种特定创伤暴露人群的、兼具最优心理测量学效度与临床实用性的量表。