Agile Post-Crash Anxiety and Agile Depression Screen for PTSD

A screen for PTSD will help determine the level of brain injury in a patient.

Screen for PTSD Overview

The Agile Post-Crash Anxiety Screen (APCAS) together with the Agile Depression Screen (ADS) is a battery of commonly used evidence-based screens that compiles self-reported symptoms consistent with the Diagnostic and Statistical Manual V (DSM-V) related to anxiety, stress, phobia, and depression.

These screens are used to help identify motor vehicle crash survivors who are experiencing symptoms that put them at risk for developing, or indicate they could have developed anxiety, stress, or depressive-related disorder. The tool does not provide a diagnosis, but it does provide direction on whether a survivor could benefit from further assessment or intervention to support recovery based on the American Psychiatric Association practice guidelines ¹.

The primary strength of this battery of screens is in the algorithm that compiles the results of all the screens in one comprehensive report. The benefits of these tools include:

• Saves on the cost to score, compile, and compare multiple screens
• Instantaneous calculation of results and provision of reports
• Provides comprehensive reports that include a list of symptoms reported by the client based on the DSM 5 (Diagnostic and Statistical Manual of Mental Health Disorders Edition 5) categories.

Screen for PTSD Measures Used

The professionals involved in the development of this tool included experts in psychology, counseling, medicine, and software development. Following is a brief description of each screen for PTSD included in the battery:

Acute Stress Disorder Checklist
The Acute Stress Disorder Scale was developed in 2000 by a team of researchers from the University of New South Wales led by Dr. Richard Bryant ². It is a widely used self-report inventory that identifies those suffering immediate severe reactions to trauma and can benefit from early intervention. It is also used to identify those who are at risk for developing PTSD. It is only used for clients whose injury happened within 1 month before the screening.

PCL-5

The PCL-5 is a commonly used 20-item self-report measure that identifies the 20 DSM-5 (Diagnostic and Statistical Manual of Mental Health Disorders Edition 5) symptoms of post-traumatic stress disorder (PTSD). The PCL-5 has a good internal consistency (.96), test-retest reliability (r .84), and convergent and discriminant validity³. It has a variety of purposes, including to:

• Quantify and monitor symptoms over time
• Each individual will receive a screen for PTSD
• Make a provisional or temporary diagnosis of PTSD

The PCL-5 is an update published in 2013 to the PTSD checklist developed in 1993 by Dr. FW Weathers which was presented at the Proceedings of the Annual Conference of the International Society for Traumatic Stress Studies, October 25, 1993.

Accident Fear Questionnaire

The Accident Fear Questionnaire (AFQ) is a self-rated screen for PTSD tool developed by Dr. Klaus Kuch (University of Toronto) for identifying symptoms of PTSD and phobic avoidance related to traveling in a motor vehicle for post-crash survivors. It is a two-part questionnaire with the first consisting of a 10-item accident profile and a 10-item phobic avoidance scale. The AFQ has good internal consistency and sensitivity with adequate convergent and discriminate validity⁴.

Zung Self-Rating Anxiety Scale

The Zung Self-Rating Anxiety Scale is a commonly used 20-item rating instrument to measure the levels of anxiety symptoms developed by Dr. William W. K. Zung of Duke University in 1971 and has good psychometric properties⁵.

Anxiety/PTSD Predisposition Questions

The predisposition questions ask about symptoms that research has shown put a person at an increased risk for developing anxiety or stress-related disorder following a trauma. If yes to any of the predisposition questions, then there is no change in score, but risk factors are listed on the report.

Center for Epidemiologic Studies Depression Scale Revised (CESD-R)

The CESD-R is a commonly used, accurate, and valid self-rated measure for symptoms consistent with depression. It has good psychometric properties, including high internal consistency, strong factor loadings, and theoretically consistent convergent and divergent validity with anxiety, schizophyte, and positive and negative affect⁶.

Screen for PTSD Report

The comprehensive report for each screen for PTSD Includes:

• List of client-reported symptoms based on the DSM-5
• Level of symptoms (mild, moderate, severe) for each of the screens: anxiety, stress-related, phobia, and depression
• Recommendations specific to the level of the client’s reported symptomology and risk factors based on the guidelines set out by the American Psychiatric Association practice guidelines⁷g., clients with moderate or severe symptoms are recommended to have further evaluation.

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