Assessing the utility of the Primary Care PTSD Screen for DSM‐5 (PC‐PTSD‐5) as a screening tool among caregivers of hematopoietic stem cell transplantation survivors

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Abstract
Background: Hematopoietic stem cell transplantation (HCT) is an intensive and invasive procedure used in cancer treatment that depends heavily on the involvement of caregivers and places them at high risk for posttraumatic stress disorder (PTSD) symptoms. These symptoms are frequently overlooked in oncology and general health care settings. The suitability and utility of the Primary Care PTSD Screen for DSM ‐ 5 (PC‐PTSD‐5) within cancer caregivers remains uncertain. This study sought to evaluate its performance as a brief (five‐item) case finding screening alternative to the longer (20‐item) PTSD Checklist for DSM‐5 (PCL‐5) in caregivers of survivors who received an HCT 1–5 years ago. Method: A total of 106 caregivers completed the PC‐PTSD‐5 and PCL‐5 during recruitment for a randomized clinical trial. Optimal cut scores for identifying probable PTSD and item performance were determined using indices correcting for chance and item response theory analyses. Results: Of the caregivers evaluated, 33% screened as positive for probable DSM‐5 PTSD using the PCL‐5. The PC‐PTSD‐5 exhibited acceptable internal consistency and significant associations with PCL‐5 scores (total, r = 0.79; items r [range] [0.60–0.69]). A cutoff score of 3 provided optimal sensitivity for screening (κ[Se] = 1). Item response theory analyses indicated the need for the complete PC‐PTSD‐5 items to provide the greatest information across varying levels of PTSD. Conclusion: Although not an instrument validation study, these findings provide preliminary support for using the PC‐PTSD‐5 as a succinct, effective screening tool among cancer caregivers in a clinical context.

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