Validation of a Brief PTSD Screener for Underserved Patients in Federally Qualified Health Centers

Published in: General Hospital Psychiatry, v. 38, Jan.-Feb. 2016, p.84-88

Posted on on January 15, 2016

by Bing Han, Eunice C. Wong, Zhimin Mao, Lisa S. Meredith, Andrea Cassells, Jonathan N. Tobin

Read More

Access further information on this document at General Hospital Psychiatry

This article was published outside of RAND. The full text of the article can be found at the link above.

OBJECTIVE: To validate the reliability and efficiency of alternative cutoff values on the abbreviated six-item Posttraumatic Stress Disorder (PTSD) Checklist (PCL-6) [1] for underserved, largely minority patients in primary care settings of Federally Qualified Health Centers (FQHCs). METHOD: Using a sample of 760 patients recruited from six FQHCs in the New York City and New Jersey metropolitan area from June 2010 to April 2013, we compared the PCL-6 with the Clinician Administered PTSD Scale (CAPS) for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. We used reliability statistics for single cutoff values on PCL-6 scores. We examined the relationship between probabilities of meeting CAPS diagnostic criteria and PCL-6 scores by nonparametric regression. RESULTS: PCL-6 scores range between 6 and 30. Reliability and efficiency statistics for cutoff between 12 and 26 were reported. There is a strong monotonic relationship between PCL-6 scores and the probability of meeting CAPS diagnostic criteria. CONCLUSION: No single cutoff on PCL-6 scores has acceptable reliability on both false positive and false negative simultaneously. An ordinal decision rule (low risk: 12 or less, medium risk: 13 to 16, high risk: 17 to 25 and very high risk: 26 and above) can differentiate the risk of PTSD. A single cutoff (17 or higher as positive) may be suitable for identifying those with the greatest need for care given limited mental health capacity in FQHC settings.

This report is part of the RAND Corporation External publication series. Many RAND studies are published in peer-reviewed scholarly journals, as chapters in commercial books, or as documents published by other organizations.

Our mission to help improve policy and decisionmaking through research and analysis is enabled through our core values of quality and objectivity and our unwavering commitment to the highest level of integrity and ethical behavior. To help ensure our research and analysis are rigorous, objective, and nonpartisan, we subject our research publications to a robust and exacting quality-assurance process; avoid both the appearance and reality of financial and other conflicts of interest through staff training, project screening, and a policy of mandatory disclosure; and pursue transparency in our research engagements through our commitment to the open publication of our research findings and recommendations, disclosure of the source of funding of published research, and policies to ensure intellectual independence. For more information, visit

The RAND Corporation is a nonprofit institution that helps improve policy and decisionmaking through research and analysis. RAND's publications do not necessarily reflect the opinions of its research clients and sponsors.