Development and Validation of a Computerized-Adaptive Test for PTSD (P-CAT)
Abstract
Objective:
Methods:
Results:
Conclusions:
Methods
Overview
Participants
Calibration sample.
Sample for field test validation.
Calibration Measures
Traumatic exposure screen.
PTSD item bank.
Validation Measures
Procedures
Item calibration.
Field test item validation.
Data Analysis
P-CAT Development and Psychometric Properties
Validation
Results
Sample Characteristics
Characteristic | Calibration sample (N=1,085) | Validation sample (N=203) | ||
---|---|---|---|---|
N | % | N | % | |
Age | ||||
18–30 | 109 | 10 | 29 | 14 |
31–45 | 386 | 36 | 44 | 22 |
45–60 | 246 | 23 | 72 | 35 |
≥61 | 344 | 32 | 58 | 29 |
Gender | ||||
Male | 851 | 78 | 161 | 79 |
Female | 234 | 22 | 42 | 21 |
Racea | ||||
White | 821 | 76 | 147 | 72 |
African American | 91 | 8 | 37 | 18 |
Other nonwhite | 88 | 8 | 11 | 5 |
Latino ethnicity | 78 | 7 | 15 | 7 |
Education | ||||
Less than high school | 35 | 3 | 0 | — |
High school or GED | 213 | 20 | 31 | 15 |
Some college | 501 | 46 | 114 | 56 |
Bachelor’s degree or higher | 335 | 31 | 58 | 29 |
Employmenta | ||||
Employed | 573 | 53 | 69 | 34 |
Student | 63 | 6 | 24 | 12 |
Homemaker | 46 | 4 | 5 | 2 |
Unemployed or disabled | 233 | 21 | 97 | 48 |
Retired | 305 | 28 | 52 | 26 |
Self-reported diagnosisa | ||||
PTSD | 237 | 22 | 103 | 51 |
Other mental health conditionb | 404 | 37 | 135 | 67 |
No mental health condition | 646 | 60 | 51 | 25 |
Factor Analysis and Item Calibration
P-CAT Scoring and CAT Simulations
Concurrent and Discriminant Validity
P-CAT total and domain | PTSD (N=91) | Other mental health condition (N=60) | No mental health condition (N=52) | Fb | |||
---|---|---|---|---|---|---|---|
M | SD | M | SD | M | SD | ||
Total | 62.98 | 4.41 | 57.17 | 7.39 | 52.93 | 7.82 | 43.75 |
Reexperiencing | 63.29 | 4.79 | 57.09 | 7.70 | 52.78 | 8.11 | 43.73 |
Avoidance | 62.19 | 4.13 | 57.44 | 6.68 | 53.85 | 7.83 | 33.07 |
Negative mood-cognitions | 62.49 | 4.47 | 56.99 | 7.54 | 52.09 | 7.65 | 45.64 |
Arousal | 62.71 | 4.24 | 56.55 | 7.36 | 52.58 | 8.19 | 44.41 |
P-CAT total and domain | PTSD diagnosis | PTSD screen | ||||||||
---|---|---|---|---|---|---|---|---|---|---|
Yes (N=129) | No (N=71) | Fb,c | Positive (N=140) | Negative (N=63) | Fb,d | |||||
M | SD | M | SD | M | SD | M | SD | |||
Total | 62.18 | 5.10 | 52.04 | 6.97 | 138.5 | 62.35 | 4.86 | 50.55 | 6.07 | 218.1 |
Reexperiencing | 62.26 | 5.67 | 52.09 | 7.31 | 119.5 | 62.54 | 5.28 | 50.38 | 6.37 | 202.3 |
Avoidance | 61.55 | 4.70 | 53.17 | 7.16 | 99.0 | 61.65 | 4.40 | 51.98 | 6.97 | 143.0 |
Negative mood-cognitions | 61.77 | 5.24 | 51.39 | 6.76 | 145.4 | 61.85 | 5.04 | 50.09 | 6.09 | 206.9 |
Arousal | 61.80 | 5.15 | 51.58 | 7.06 | 137.7 | 61.98 | 4.93 | 50.10 | 6.19 | 214.1 |
Sensitivity and Specificity
Example of P-CAT Administration
Respondent and item | Domain | Response | Scorea | SE |
---|---|---|---|---|
Low symptom severity | ||||
I felt upset when I was reminded of the trauma | Reexperiencing | Never | 45.3 | .66 |
I had sleep problems | Arousal | Sometimes | 46.9 | .52 |
I avoided situations that might remind me of something terrible that happened to me | Avoidance | Never | 46.1 | .48 |
I felt distant or cut off from people | Negative mood-cognitions | Never | 44.9 | .44 |
I found myself remembering bad things that happened to me | Reexperiencing | Rarely | 45.9 | .36 |
I lost interest in social activities | Negative mood-cognitions | Never | 47.0 | .36 |
I felt jumpy or easily startled | Arousal | Rarely | 47.0 | .31 |
I had bad dreams or nightmares about the trauma | Reexperiencing | Never | 46.9 | .30 |
I felt that if someone pushed me too far, I would become angry | Arousal | Rarely | 47.1 | .28 |
I had flashbacks (sudden, vivid, distracting memories) of the trauma | Reexperiencing | Never | 47.0 | .28 |
I had trouble concentrating | Arousal | Rarely | 47.4 | .26 |
I felt that I had no future | Negative mood-cognitions | Never | 47.3 | .26 |
High symptom severity | ||||
I felt upset when I was reminded of the trauma | Reexperiencing | Often | 62.5 | .50 |
I had sleep problems | Arousal | Often | 62.1 | .45 |
I tried to avoid activities, people, or places that reminded me of the traumatic event | Avoidance | Often | 62.7 | .37 |
I lost interest in social activities | Negative mood-cognitions | Sometimes | 61.9 | .33 |
I had flashbacks (sudden, vivid, distracting memories) of the trauma | Reexperiencing | Sometimes | 61.7 | .31 |
I felt emotionally numb | Negative mood-cognitions | Often | 62.5 | .30 |
Memories of the trauma kept entering my mind | Reexperiencing | Sometimes | 62.3 | .29 |
I felt distant or cut off from people | Negative mood-cognitions | Often | 62.5 | .28 |
I had bad dreams about terrible things that have happened to me | Reexperiencing | Sometimes | 62.4 | .28 |
I felt jumpy or easily startled | Arousal | Often | 63.0 | .25 |
Any reminder brought back feelings about the trauma | Reexperiencing | sometimes | 63.4 | .24 |
I felt that I had no future | Negative mood-cognitions | Rarely | 63.3 | .24 |
Discussion
Conclusions
Acknowledgments
Footnote
References
Information & Authors
Information
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Authors
Funding Information
Metrics & Citations
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Citations
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