The Aberdeen Trauma Screening Index: an instrument to predict post-accident psychopathology

Susan Klein, David Alan Alexander, James Douglas Hutchison, J. A. Simpson, J. M. Simpson, J.s. Bell

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Background. A key challenge in trauma care is the prevention of psychopathology. However, no definitive method of identifying individuals at risk of developing psychopathology exists. The Aberdeen Trauma Screening Index (ATSI) is a brief screening tool developed for use in a clinical setting by non-mental health professionals to facilitate the early identification of individuals most at risk of psychopathology 3-months post-accident.

Methods. The ATSI derived from a prospective study of a 150 out of an initial pool of 213 consecutive admissions to the Orthopaedic Trauma Unit and the Accident and Emergency Department of Aberdeen Royal Infirmary. Potential predictors were identified by a comprehensive assessment conducted within 1-week post-accident. Outcome at 3-months post-accident was measured using 'caseness' according to the General Health Questionnaire (GHQ-28).

Results. The ATSI is based on a final model comprising only seven variables with a sensitivity of 79% and specificity of 65%. A predictive index score (0-100) was produced to ensure the practical utility of the ATSI in a clinical setting. A ROC curve was constructed to illustrate the relationship between sensitivity and the specificity values with their corresponding threshold scores. On the basis of a prevalence rate of 55% 'caseness', as identified in the present study, a cut-off point of 45 provides the optimal outcome with a sensitivity value of 70% and a specificity value of 71%.

Conclusions. The ATSI can accurately identify those most at risk of developing psychopathology 3-months post-accident in a sample of accidentally injured adult subjects recruited as consecutive admissions to an urban hospital in the North East of Scotland. However, to establish the generalizability of these findings, it is important that the ATSI be validated in both similar and diverse populations.

Original languageEnglish
Pages (from-to)863-871
Number of pages8
JournalPsychological Medicine
Volume32
Issue number5
DOIs
Publication statusPublished - 2002

Keywords

  • POSTTRAUMATIC-STRESS-DISORDER
  • MOTOR-VEHICLE ACCIDENTS
  • GENERAL HEALTH QUESTIONNAIRE
  • PSYCHOLOGICAL TRAUMA
  • EVENT SCALE
  • INJURY
  • PTSD
  • SURVIVORS
  • DISASTER
  • IMPACT

Cite this

Klein, S., Alexander, D. A., Hutchison, J. D., Simpson, J. A., Simpson, J. M., & Bell, J. S. (2002). The Aberdeen Trauma Screening Index: an instrument to predict post-accident psychopathology. Psychological Medicine, 32(5), 863-871. https://doi.org/10.1017/S0033291702005809

The Aberdeen Trauma Screening Index: an instrument to predict post-accident psychopathology. / Klein, Susan; Alexander, David Alan; Hutchison, James Douglas; Simpson, J. A.; Simpson, J. M.; Bell, J.s.

In: Psychological Medicine, Vol. 32, No. 5, 2002, p. 863-871.

Research output: Contribution to journalArticle

Klein, S, Alexander, DA, Hutchison, JD, Simpson, JA, Simpson, JM & Bell, JS 2002, 'The Aberdeen Trauma Screening Index: an instrument to predict post-accident psychopathology', Psychological Medicine, vol. 32, no. 5, pp. 863-871. https://doi.org/10.1017/S0033291702005809
Klein, Susan ; Alexander, David Alan ; Hutchison, James Douglas ; Simpson, J. A. ; Simpson, J. M. ; Bell, J.s. / The Aberdeen Trauma Screening Index: an instrument to predict post-accident psychopathology. In: Psychological Medicine. 2002 ; Vol. 32, No. 5. pp. 863-871.
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abstract = "Background. A key challenge in trauma care is the prevention of psychopathology. However, no definitive method of identifying individuals at risk of developing psychopathology exists. The Aberdeen Trauma Screening Index (ATSI) is a brief screening tool developed for use in a clinical setting by non-mental health professionals to facilitate the early identification of individuals most at risk of psychopathology 3-months post-accident.Methods. The ATSI derived from a prospective study of a 150 out of an initial pool of 213 consecutive admissions to the Orthopaedic Trauma Unit and the Accident and Emergency Department of Aberdeen Royal Infirmary. Potential predictors were identified by a comprehensive assessment conducted within 1-week post-accident. Outcome at 3-months post-accident was measured using 'caseness' according to the General Health Questionnaire (GHQ-28).Results. The ATSI is based on a final model comprising only seven variables with a sensitivity of 79{\%} and specificity of 65{\%}. A predictive index score (0-100) was produced to ensure the practical utility of the ATSI in a clinical setting. A ROC curve was constructed to illustrate the relationship between sensitivity and the specificity values with their corresponding threshold scores. On the basis of a prevalence rate of 55{\%} 'caseness', as identified in the present study, a cut-off point of 45 provides the optimal outcome with a sensitivity value of 70{\%} and a specificity value of 71{\%}.Conclusions. The ATSI can accurately identify those most at risk of developing psychopathology 3-months post-accident in a sample of accidentally injured adult subjects recruited as consecutive admissions to an urban hospital in the North East of Scotland. However, to establish the generalizability of these findings, it is important that the ATSI be validated in both similar and diverse populations.",
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AU - Alexander, David Alan

AU - Hutchison, James Douglas

AU - Simpson, J. A.

AU - Simpson, J. M.

AU - Bell, J.s.

PY - 2002

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N2 - Background. A key challenge in trauma care is the prevention of psychopathology. However, no definitive method of identifying individuals at risk of developing psychopathology exists. The Aberdeen Trauma Screening Index (ATSI) is a brief screening tool developed for use in a clinical setting by non-mental health professionals to facilitate the early identification of individuals most at risk of psychopathology 3-months post-accident.Methods. The ATSI derived from a prospective study of a 150 out of an initial pool of 213 consecutive admissions to the Orthopaedic Trauma Unit and the Accident and Emergency Department of Aberdeen Royal Infirmary. Potential predictors were identified by a comprehensive assessment conducted within 1-week post-accident. Outcome at 3-months post-accident was measured using 'caseness' according to the General Health Questionnaire (GHQ-28).Results. The ATSI is based on a final model comprising only seven variables with a sensitivity of 79% and specificity of 65%. A predictive index score (0-100) was produced to ensure the practical utility of the ATSI in a clinical setting. A ROC curve was constructed to illustrate the relationship between sensitivity and the specificity values with their corresponding threshold scores. On the basis of a prevalence rate of 55% 'caseness', as identified in the present study, a cut-off point of 45 provides the optimal outcome with a sensitivity value of 70% and a specificity value of 71%.Conclusions. The ATSI can accurately identify those most at risk of developing psychopathology 3-months post-accident in a sample of accidentally injured adult subjects recruited as consecutive admissions to an urban hospital in the North East of Scotland. However, to establish the generalizability of these findings, it is important that the ATSI be validated in both similar and diverse populations.

AB - Background. A key challenge in trauma care is the prevention of psychopathology. However, no definitive method of identifying individuals at risk of developing psychopathology exists. The Aberdeen Trauma Screening Index (ATSI) is a brief screening tool developed for use in a clinical setting by non-mental health professionals to facilitate the early identification of individuals most at risk of psychopathology 3-months post-accident.Methods. The ATSI derived from a prospective study of a 150 out of an initial pool of 213 consecutive admissions to the Orthopaedic Trauma Unit and the Accident and Emergency Department of Aberdeen Royal Infirmary. Potential predictors were identified by a comprehensive assessment conducted within 1-week post-accident. Outcome at 3-months post-accident was measured using 'caseness' according to the General Health Questionnaire (GHQ-28).Results. The ATSI is based on a final model comprising only seven variables with a sensitivity of 79% and specificity of 65%. A predictive index score (0-100) was produced to ensure the practical utility of the ATSI in a clinical setting. A ROC curve was constructed to illustrate the relationship between sensitivity and the specificity values with their corresponding threshold scores. On the basis of a prevalence rate of 55% 'caseness', as identified in the present study, a cut-off point of 45 provides the optimal outcome with a sensitivity value of 70% and a specificity value of 71%.Conclusions. The ATSI can accurately identify those most at risk of developing psychopathology 3-months post-accident in a sample of accidentally injured adult subjects recruited as consecutive admissions to an urban hospital in the North East of Scotland. However, to establish the generalizability of these findings, it is important that the ATSI be validated in both similar and diverse populations.

KW - POSTTRAUMATIC-STRESS-DISORDER

KW - MOTOR-VEHICLE ACCIDENTS

KW - GENERAL HEALTH QUESTIONNAIRE

KW - PSYCHOLOGICAL TRAUMA

KW - EVENT SCALE

KW - INJURY

KW - PTSD

KW - SURVIVORS

KW - DISASTER

KW - IMPACT

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DO - 10.1017/S0033291702005809

M3 - Article

VL - 32

SP - 863

EP - 871

JO - Psychological Medicine

JF - Psychological Medicine

SN - 0033-2917

IS - 5

ER -