Diagnostic accuracy of Japanese posttraumatic stress measures after a complex disaster: The Fukushima Health Management Survey

Background: The Posttraumatic Stress Disorder (PTSD) Checklist (PCL) has been widely used among traumatized populations to screen people with PTSD; however, the Japanese version of the PCL has yet to be validated. We examined the diagnostic accuracy of the Japanese version PCL-Specific (PCL-S) and the abbreviated versions of the PCL-S among the evacuees of the Fukushima Daiichi Nuclear Power Plant accident.

Methods: Fifty-one participants were recruited from an evacuee and clinical sample. The PCL-S, Impact of Event Scale-Revised (IES-R), and World Health Organization Composite International Diagnostic Interview were administered. Screening properties of the PCL-S, IES-R, and abbreviated PCL-S against PTSD diagnosis, including sensitivity, specificity, and diagnostic efficiency, were calculated. Receiver operating characteristic curves were drawn, and optimal cutoff points were examined.

Results: The sensitivity, specificity, and diagnostic efficiency of the PCL-S were 66.7%, 84.9%, and 79.2%, respectively (at 52, the area under the curve was 0.83). The cutoff point method for the PCL-S performed better than did the symptom cluster method. The screening properties of the abbreviated versions were comparable with those of the full version.

Conclusions: The Japanese version of the PCL-S showed moderate diagnostic accuracy and improved performance over the IES-R for PTSD diagnosis based on the Diagnostic and Statistical Manual of Mental Disorders, fourth edition. The Japanese version of the PCL-S was a reliable and valid measure, and its diagnostic accuracy was reasonable for both full and abbreviated versions.