McDonald SD, Beckham JC, Morey RA, Calhoun PS. The validity and diagnostic efficiency of the Davidson Trauma Scale in military veterans who have served since September 11th, 2001. J Anxiety Disord 23: 247-255

VA Mid-Atlantic Region Mental Illness Research, Education and Clinical Center, Durham, North Carolina, United States.
Journal of anxiety disorders (Impact Factor: 2.68). 09/2008; 23(2):247-55. DOI: 10.1016/j.janxdis.2008.07.007
Source: PubMed


The present study examined the psychometric properties and diagnostic efficiency of the Davidson Trauma Scale (DTS), a self-report measure of posttraumatic stress disorder (PTSD) symptoms. Participants included 158 U.S. military veterans who have served since September 11, 2001 (post-9/11). Results support the DTS as a valid self-report measure of PTSD symptoms. The DTS demonstrated good internal consistency, concurrent validity, and convergent and divergent validity. Diagnostic efficiency was excellent when discriminating between veterans with PTSD and veterans with no Axis I diagnosis. However, although satisfactory by conventional standards, efficiency was substantially attenuated when discriminating between PTSD and other Axis I diagnoses. Thus, results illustrate that potency of the DTS as a diagnostic aid was highly dependent on the comparison group used for analyses. Results are discussed in terms of applications to clinical practice and research.

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Available from: Jean C Beckham, Jan 08, 2014
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    • "Davidson et al. (1997) proposed a scale composed of 17 items, each one related to DSM-IV symptoms. Regardless of the participants and their cultural characteristics, the DTS scale has both construct (generally in terms of three or four factors) and convergent validity (with other PTSD measurements), and very good internal consistency and test–retest reliability (Bobes et al., 2000; Chen, Lin, Tang, Shen, & Lu, 2001; Davidson et al., 1997; McDonald, Beckham, Morey, & Calhoun, 2009; Villafañe, Milanesio, Marcellino, & Amodei, 2003). For example, Villafañe and his collaborators (2003) indicate that DTS has very high reliability (α=0.890) and a structure composed of four factors very consistent with the original structure and other previous validity studies. "
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    ABSTRACT: On February 27, 2010 (F-27), an earthquake and tsunami occurred having a significant impact on the mental health of the Chilean population, leading to an increase in cases of post-traumatic stress disorder (PTSD). Within this context, validated for the first time in Chile was the Davidson Trauma Scale (DTS) using three samples (each one consisting of 200 participants), two of them random from the Chilean population. Reliability analyses (i.e., α=0.933), concurrent validity (63% of the items are significantly correlated with the criteria variable "degree of damage to home") and construct validity (i.e., CMIN = 3.754, RMSEA = 0.118, NFI = 0.808, CFI = 0.850 and PNFI = 0.689) indicate validity between regular and good for DTS. However, a new short version of the scale (DTS-SF) created using the items with heavier factor weights, presented better fits (CMIN = 2.170, RMSEA = 0.077, NFI = 0.935, CFI = 0.963, PNFI = 0.697). Finally, the usefulness of DTS and DTS-SF is discussed, the latter being briefer, valid and having better psychometric characteristics.
    Full-text · Article · Aug 2013 · European Journal of Psychotraumatology
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    • "While there are specific aspects of this model that are clearly relevant to PTSD, particularly understanding cognitive-emotional interactions, the model does not adequately comprehend the effect of traumatic events and trauma-related information as distinct from emotional (trauma-unrelated) information. Moreover, this comparatively narrow treatment of cognitive-emotional processing does not encompass major symptom clusters of PTSD such as re-experiencing (frequent memories and thoughts of the trauma, reliving the trauma), hyperarousal (being frequently on guard, hyperalert, suddenly startled), and avoidance of persons and places that trigger reminders of the trauma (reviewed in Davidson et al., 1997; McDonald et al., 2008, 2009; Hayes et al., 2012). A traumatic experience is classified as Citerion-A of DSM-IV but is not a required diagnostic feature of depression, which makes it unique to PTSD (First et al., 1997). "
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    ABSTRACT: Individuals with posttraumatic stress disorder (PTSD) show altered cognition when trauma-related material is present. PTSD may lead to enhanced processing of trauma-related material, or it may cause impaired processing of trauma-unrelated information. However, other forms of emotional information may also alter cognition in PTSD. In this review, we discuss the behavioral and neural effects of emotion processing on cognition in PTSD, with a focus on neuroimaging results. We propose a model of emotion-cognition interaction based on evidence of two network models of altered brain activation in PTSD. The first is a trauma-disrupted network made up of ventrolateral PFC, dorsal anterior cingulate cortex (ACC), hippocampus, insula, and dorsomedial PFC that are differentially modulated by trauma content relative to emotional trauma-unrelated information. The trauma-disrupted network forms a subnetwork of regions within a larger, widely recognized network organized into ventral and dorsal streams for processing emotional and cognitive information that converge in the medial PFC and cingulate cortex. Models of fear learning, while not a cognitive process in the conventional sense, provide important insights into the maintenance of the core symptom clusters of PTSD such as re-experiencing and hypervigilance. Fear processing takes place within the limbic corticostriatal loop composed of threat-alerting and threat-assessing components. Understanding the disruptions in these two networks, and their effect on individuals with PTSD, will lead to an improved knowledge of the etiopathogenesis of PTSD and potential targets for both psychotherapeutic and pharmacotherapeutic interventions.
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    • "The Davidson Trauma Scale (DTS) was administered just prior to scanning to assess PTSD symptom severity (Davidson et al. 1997). Lacking a diagnostic interview in these subjects, a DTS cutoff score of 32, previously shown by us to have high diagnostic efficiency (0.94) in the post-9/11 military cohort [59], was used to divide the participants into a PTSD group with mean DTS (SD) = 74.4 (18.8) and Control group with mean DTS = 10.2 (8.8). "
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    ABSTRACT: Serotonergic system dysfunction has been implicated in posttraumatic stress disorder (PTSD). Genetic polymorphisms associated with serotonin signaling may predict differences in brain circuitry involved in emotion processing and deficits associated with PTSD. In healthy individuals, common functional polymorphisms in the serotonin transporter gene (SLC6A4) have been shown to modulate amygdala and prefrontal cortex (PFC) activity in response to salient emotional stimuli. Similar patterns of differential neural responses to emotional stimuli have been demonstrated in PTSD but genetic factors influencing these activations have yet to be examined. We investigated whether SLC6A4 promoter polymorphisms (5-HTTLPR, rs25531) and several downstream single nucleotide polymorphisms (SNPs) modulated activity of brain regions involved in the cognitive control of emotion in post-9/11 veterans with PTSD. We used functional MRI to examine neural activity in a PTSD group (n = 22) and a trauma-exposed control group (n = 20) in response to trauma-related images presented as task-irrelevant distractors during the active maintenance period of a delayed-response working memory task. Regions of interest were derived by contrasting activation for the most distracting and least distracting conditions across participants. In patients with PTSD, when compared to trauma-exposed controls, rs16965628 (associated with serotonin transporter gene expression) modulated task-related ventrolateral PFC activation and 5-HTTLPR tended to modulate left amygdala activation. Subsequent to combat-related trauma, these SLC6A4 polymorphisms may bias serotonin signaling and the neural circuitry mediating cognitive control of emotion in patients with PTSD. The SLC6A4 SNP rs16965628 and 5-HTTLPR are associated with a bias in neural responses to traumatic reminders and cognitive control of emotions in patients with PTSD. Functional MRI may help identify intermediate phenotypes and dimensions of PTSD that clarify the functional link between genes and disease phenotype, and also highlight features of PTSD that show more proximal influence of susceptibility genes compared to current clinical categorizations.
    Full-text · Article · May 2011 · BMC Psychiatry
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