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Screening for posttraumatic stress disorder in ARDS survivors: validation of the Impact of Event Scale-6 (IES-6).
Crit Care. 2019 08 07; 23(1):276.CC

Abstract

BACKGROUND

Posttraumatic stress disorder (PTSD) symptoms are common in acute respiratory distress syndrome (ARDS) survivors. Brief screening instruments are needed for clinical and research purposes. We evaluated internal consistency, external construct, and criterion validity of the Impact of Event Scale-6 (IES-6; 6 items) compared to the original Impact of Event Scale-Revised (IES-R; 22 items) and to the Clinician Administered PTSD Scale (CAPS) reference standard evaluation in ARDS survivors.

METHODS

This study is a secondary analysis from two independent multi-site, prospective studies of ARDS survivors. Measures of internal consistency, and external construct and criterion validity were evaluated.

RESULTS

A total of 1001 ARDS survivors (51% female, 76% white, mean (SD) age 49 (14) years) were evaluated. The IES-6 demonstrated internal consistency over multiple time points up to 5 years after ARDS (Cronbach’s alpha = 0.86 to 0.91) and high correlation with the IES-R (0.96; 95% confidence interval (CI): 0.94 to 0.97). The IES-6 demonstrated stronger correlations with related constructs (e.g., anxiety and depression; |r| = 0.32 to 0.52) and weaker correlations with unrelated constructs (e.g., physical function and healthcare utilization measures (|r| = 0.02 to 0.27). Criterion validity evaluation with the CAPS diagnosis of PTSD in a subsample of 60 participants yielded an area under receiver operating characteristic curve (95% CI) of 0.93 (0.86, 1.00), with an IES-6 cutoff score of 1.75 yielding 0.88 sensitivity and 0.85 specificity.

CONCLUSIONS

The IES-6 is reliable and valid for screening for PTSD in ARDS survivors and may be useful in clinical and research settings.

Authors+Show Affiliations

Department of Physical Medicine and Rehabilitation, Johns Hopkins School of Medicine, Baltimore, MD, USA. Outcomes After Critical Illness and Surgery (OACIS) Group, Johns Hopkins School of Medicine, Baltimore, MD, USA.Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA.Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.Division of Pulmonary and Critical Care Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA. Outcomes After Critical Illness and Surgery (OACIS) Group, Johns Hopkins School of Medicine, Baltimore, MD, USA.Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA. Outcomes After Critical Illness and Surgery (OACIS) Group, Johns Hopkins School of Medicine, Baltimore, MD, USA.Division of Pulmonary and Critical Care Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA. Outcomes After Critical Illness and Surgery (OACIS) Group, Johns Hopkins School of Medicine, Baltimore, MD, USA.Department of Medicine, Pulmonary and Critical Care Division, Intermountain Medical Center, Murray, UT, USA. Center for Humanizing Critical Care, Intermountain Health Care, Murray, UT, USA. Neuroscience Center and Psychology Department, Psychology Department and Neuroscience Center, Brigham Young University, Provo, UT, USA.Department of Physical Medicine and Rehabilitation, Johns Hopkins School of Medicine, Baltimore, MD, USA. Dale.needham@jhmi.edu. Division of Pulmonary and Critical Care Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA. Dale.needham@jhmi.edu. Outcomes After Critical Illness and Surgery (OACIS) Group, Johns Hopkins School of Medicine, Baltimore, MD, USA. Dale.needham@jhmi.edu.Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA. Outcomes After Critical Illness and Surgery (OACIS) Group, Johns Hopkins School of Medicine, Baltimore, MD, USA.

Pub Type(s)

Journal Article
Multicenter Study

Language

eng

PubMed ID

31391069

Citation

Hosey, Megan M., et al. "Screening for Posttraumatic Stress Disorder in ARDS Survivors: Validation of the Impact of Event Scale-6 (IES-6)." Critical Care (London, England), vol. 23, no. 1, 2019, p. 276.
Hosey MM, Leoutsakos JS, Li X, et al. Screening for posttraumatic stress disorder in ARDS survivors: validation of the Impact of Event Scale-6 (IES-6). Crit Care. 2019;23(1):276.
Hosey, M. M., Leoutsakos, J. S., Li, X., Dinglas, V. D., Bienvenu, O. J., Parker, A. M., Hopkins, R. O., Needham, D. M., & Neufeld, K. J. (2019). Screening for posttraumatic stress disorder in ARDS survivors: validation of the Impact of Event Scale-6 (IES-6). Critical Care (London, England), 23(1), 276. https://doi.org/10.1186/s13054-019-2553-z
Hosey MM, et al. Screening for Posttraumatic Stress Disorder in ARDS Survivors: Validation of the Impact of Event Scale-6 (IES-6). Crit Care. 2019 08 7;23(1):276. PubMed PMID: 31391069.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Screening for posttraumatic stress disorder in ARDS survivors: validation of the Impact of Event Scale-6 (IES-6). AU - Hosey,Megan M, AU - Leoutsakos,Jeannie-Marie S, AU - Li,Ximin, AU - Dinglas,Victor D, AU - Bienvenu,O Joseph, AU - Parker,Ann M, AU - Hopkins,Ramona O, AU - Needham,Dale M, AU - Neufeld,Karin J, Y1 - 2019/08/07/ PY - 2019/04/18/received PY - 2019/07/23/accepted PY - 2019/8/9/entrez PY - 2019/8/9/pubmed PY - 2020/2/11/medline KW - Critical care KW - Mental health KW - Posttraumatic stress disorder KW - Psychometric KW - Survivorship KW - Validation studies SP - 276 EP - 276 JF - Critical care (London, England) JO - Crit Care VL - 23 IS - 1 N2 - BACKGROUND: Posttraumatic stress disorder (PTSD) symptoms are common in acute respiratory distress syndrome (ARDS) survivors. Brief screening instruments are needed for clinical and research purposes. We evaluated internal consistency, external construct, and criterion validity of the Impact of Event Scale-6 (IES-6; 6 items) compared to the original Impact of Event Scale-Revised (IES-R; 22 items) and to the Clinician Administered PTSD Scale (CAPS) reference standard evaluation in ARDS survivors. METHODS: This study is a secondary analysis from two independent multi-site, prospective studies of ARDS survivors. Measures of internal consistency, and external construct and criterion validity were evaluated. RESULTS: A total of 1001 ARDS survivors (51% female, 76% white, mean (SD) age 49 (14) years) were evaluated. The IES-6 demonstrated internal consistency over multiple time points up to 5 years after ARDS (Cronbach’s alpha = 0.86 to 0.91) and high correlation with the IES-R (0.96; 95% confidence interval (CI): 0.94 to 0.97). The IES-6 demonstrated stronger correlations with related constructs (e.g., anxiety and depression; |r| = 0.32 to 0.52) and weaker correlations with unrelated constructs (e.g., physical function and healthcare utilization measures (|r| = 0.02 to 0.27). Criterion validity evaluation with the CAPS diagnosis of PTSD in a subsample of 60 participants yielded an area under receiver operating characteristic curve (95% CI) of 0.93 (0.86, 1.00), with an IES-6 cutoff score of 1.75 yielding 0.88 sensitivity and 0.85 specificity. CONCLUSIONS: The IES-6 is reliable and valid for screening for PTSD in ARDS survivors and may be useful in clinical and research settings. SN - 1466-609X UR - https://www.unboundmedicine.com/medline/citation/31391069/Screening_for_posttraumatic_stress_disorder_in_ARDS_survivors:_validation_of_the_Impact_of_Event_Scale_6__IES_6__ L2 - https://ccforum.biomedcentral.com/articles/10.1186/s13054-019-2553-z DB - PRIME DP - Unbound Medicine ER -