Psychometric analysis of the PTSD Checklist-5 (PCL-5) among treatment-seeking military service members.

TLDR

The Posttraumatic Stress Disorder Checklist (PCL‑5) was recently revised to align with DSM‑5 diagnostic criteria for PTSD. The study examined the psychometric properties of PCL‑5 scores in a large cohort of 912 military service members seeking PTSD treatment. Researchers evaluated internal consistency, convergent and discriminant validity, DSM‑5 factor structure, sensitivity to clinical change relative to the PSS‑I, and diagnostic utility of PCL‑5 scores for predicting PTSD diagnosis. PCL‑5 scores demonstrated high internal consistency, strong convergent validity, a superior 7‑factor hybrid structure, sensitivity to change comparable to the PSS‑I, and cut scores that reliably predict PTSD diagnosis, confirming it as a psychometrically sound tool for assessing and monitoring PTSD in treatment‑seeking service members. PsycINFO database record.

Abstract

The Posttraumatic Stress Disorder Checklist (PCL-5; Weathers et al., 2013) was recently revised to reflect the changed diagnostic criteria for posttraumatic stress disorder (PTSD) in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5; American Psychiatric Association, 2013). We investigated the psychometric properties of PCL-5 scores in a large cohort (N = 912) of military service members seeking PTSD treatment while stationed in garrison. We examined the internal consistency, convergent and discriminant validity, and DSM-5 factor structure of PCL-5 scores, their sensitivity to clinical change relative to PTSD Symptom Scale-Interview (PSS-I; Foa, Riggs, Dancu, & Rothbaum, 1993) scores, and their diagnostic utility for predicting a PTSD diagnosis based on various measures and scoring rules. PCL-5 scores exhibited high internal consistency. There was strong agreement between the order of hypothesized and observed correlations among PCL-5 and criterion measure scores. The best-fitting structural model was a 7-factor hybrid model (Armour et al., 2015), which demonstrated closer fit than all other models evaluated, including the DSM-5 model. The PCL-5's sensitivity to clinical change, pre- to posttreatment, was comparable with that of the PSS-I. Optimally efficient cut scores for predicting PTSD diagnosis were consistent with prior research with service members (Hoge, Riviere, Wilk, Herrell, & Weathers, 2014). The results indicate that the PCL-5 is a psychometrically sound measure of DSM-5 PTSD symptoms that is useful for identifying provisional PTSD diagnostic status, quantifying PTSD symptom severity, and detecting clinical change over time in PTSD symptoms among service members seeking treatment. (PsycINFO Database Record