Optimize PTSD Diagnostic Criteria

Provides tools for analyzing and optimizing PTSD (Post-Traumatic Stress Disorder) diagnostic criteria using PCL-5 (PTSD Checklist for DSM-5) and CAPS-5 (Clinician-Administered PTSD Scale for DSM-5) data. Functions identify optimal subsets of PCL-5 items that maintain diagnostic accuracy while reducing assessment burden. Includes tools for both hierarchical (cluster-based) and non-hierarchical symptom combinations, calculation of diagnostic metrics, and comparison with standard DSM-5 criteria. Redundancy analysis quantifies how many item subsets perform equivalently, through plateau sizes and bootstrap stability, and reports item selection against the chance baseline of the searched candidate space. A transport layer allows a site to evaluate subsets derived elsewhere and return only aggregate summaries, supporting multi-site validation without sharing individual-level data. Model validation is conducted using holdout and cross-validation methods to assess robustness and generalizability of the results. For more details see Weidmann et al. (2025) .

PTSDdiag

Getting Started Comparing Criteria Reference Publication

Description

PTSDdiag is a comprehensive R package for analyzing and simplifying PTSD diagnostic criteria using PCL-5 (PTSD Checklist for DSM-5) data. It provides tools to identify optimal subsets of six PCL-5 items that maintain diagnostic accuracy while reducing assessment burden.

Key Features

Data preparation and standardization for PCL-5 scores
Implementation of DSM-5 diagnostic criteria
Calculation of diagnostic metrics and summary statistics
Simplification of diagnostic criteria through:
- Hierarchical (cluster-based) approach
- Non-hierarchical approach
Comparison of different diagnostic approaches
Model validation using:
- Holdout Validation
- Cross-Validation

Installation

You can install the released version of PTSDdiag from CRAN:

install.packages("PTSDdiag")

Or install the development version from GitHub:

# install.packages("devtools")
devtools::install_github("TobiasRSpiller/PTSDdiag")

Getting Started

The vignettes demonstrate how to prepare PCL-5 data, find the optimal minimal symptom combinations for PTSD diagnosis, compare different diagnostic approaches (including ICD-11 and the clinician-administered CAPS-5), and validate the resulting definitions within and across cohorts.

Bugs, Contributions

If you have any suggestions or if you find a bug, please report them using GitHub issue tracker.
Contributions are welcome! Please feel free to submit a Pull Request.