Diagnostic accuracy of three scoring methods for the Davidson Trauma Scale among U.S. military Veterans

•Three scoring methods for the Davidson Trauma Scale were compared.•Subjects were 804 Afghanistan and Iraq war-era military Service Members and Veterans.•Adding a cut score to the symptom cluster method generally improved specificity.•Cut score in the range of 68–72 provided optimal diagnostic accuracy.

Self-report questionnaires are frequently used to identify PTSD among U.S. military personnel and Veterans. Two common scoring methods used to classify PTSD include: (1) a cut score threshold and (2) endorsement of PTSD symptoms meeting DSM-IV-TR symptom cluster criteria (SCM). A third method requiring a cut score in addition to SCM has been proposed, but has received little study. The current study examined the diagnostic accuracy of three scoring methods for the Davidson Trauma Scale (DTS) among 804 Afghanistan and Iraq war-era military Service Members and Veterans. Data were weighted to approximate the prevalence of PTSD and other Axis I disorders in VA primary care. As expected, adding a cut score criterion to SCM improved specificity and positive predictive power. However, a cut score of 68–72 provided optimal diagnostic accuracy. The utility of the DTS, the role of baseline prevalence, and recommendations for future research are discussed.