Transcript Posttraumatic Stress Disorder Checklist (PCL)

POSTTRAUMATIC
STRESS DISORDER
CHECKLIST (PCL)
JOCELYN WILLIAMS
WAKE FOREST UNIVERSITY
BACKGROUND
One of the most commonly used self-report measurements for
PTSD
First introduced in 1993 by the National Center for PTSD
• 3 versions for the DSM-IV
• Civilian (PCL-C) – “stressful experiences”
• Military (PCL-M) – “stressful military experiences”
• Specific (PCL-S) – anchored to a specific, identified
traumatic event
Current version – PCL-5 for DSM-5
Translated into Chinese, Spanish, and Bosnian
PTSD Explanation:
https://www.youtube.com/watch?v=tqxiEe0RH-Y
PURPOSE
Screening individuals for PTSD
Aiding in the diagnostic assessment of PTSD
• Gold standard for diagnosing PTSD is a structured clinical
interview, such as the Clinician-Administered PTSD Scale
(CAPS-5)
• Can be used for provisional diagnosis
Monitoring change in PTSD symptoms
• Evidence for the PCL for DSM-IV suggests that a 5-10 point
change represents reliable change (not due to chance); 10-20
point change is clinically significant
(U.S. Department of Veteran Affairs, 2014)
DESCRIPTION
PCL for DSM-IV (PCL-C, PCL-M, PCL-S)
• 17 questions; DSM-IV
• Likert scale rating how bothered client has been by the symptom in the
past month
• 1 – not at all, 5 – extremely
PCL-5 for DSM-5
• 20 questions; DSM-5
• Likert scale: 0 – 4
• 3 formats:
• without Criterion A
• with Criterion A
• with the Life Events Checklist for DSM-5 (LEC-5) and extended Criterion A
component
• Scores not compatible with PCL for DSM-IV scores and cannot be
used interchangeably (U.S. Department of Veteran Affairs, 2014)
ADMINISTRATION/
SCORING (PCL-5)
Completion time: 5-10 minutes
Sum item scores for a “Total Symptom Severity Score” (0-80)
• Symptom cluster severity score
Each item rated 2 or higher is an endorsed symptom
• Diagnostic rule: 1 B item (questions 1-5), 1 C item (6-7), 2 D
items (8-14), 2 E items (15-20)
Cut off of 38 appears to be reasonable (U.S. Department of
Veteran Affairs, 2014)
PSYCHOMETRICS
PCL-S
• Test-retest
•
•
•
Immediate – 0.92
One week – 0.87-0.88
2 weeks – 0.66-0.68
• Internal consistency
•
Cronbach’s Alpha = 0.85-0.95
• Convergent validity
•
•
PCL-S correlated significantly more highly with measures of PTSD than with
measures assessing depression, other domains of psychopathology, or physical pain
Overall correlation between total PCL-S and CAPS scores – 0.93 (Norris & Hamblen,
2004)
• Discriminant validity
•
PCL-S correlated significantly more highly with the CAPS than PTSD measures that
were not anchored to DSM-IV PTSD symptom criteria
• Structural validity
•
Support for a 4 factor model of re-experiencing, avoidance, hyperarousal, and
dysphoria/numbing vs current 3 factor model
• Cut point
•
44 showed sensitivity of 0.94-0.97, a specificity of 0.86-0.87, and an overall diagnostic
efficacy of 0.90-0.94 (Norris & Hamblen, 2004) with individuals in France who had
experienced a variety of events.
(Wilkins, Lang, & Norman, 2011)
STRENGTHS
• Can be used as an outcome instrument to help measure
symptom change
• Useful as a guide for diagnostic assessment
• Easy to administer and score
• Only takes 5-10 minutes to complete
• In the public domain - easy to obtain
• M and S versions correlate highly with clinicianadministered measures
• PCL-5 has option to assess for Criterion A
LIMITATIONS
• Limited to no research available on current version’s
(PCL-5) psychometrics
• No definitive cut off
• Dependent on the prevalence of PTSD in that population
and the needs of a given setting
• Published cutpoints should be used with caution as many
were derived from samples with high prevalence rates of
current PTSD. May not be appropriate for samples with
lower rates (Norris & Hamblen, 2011).
• Reading level – 10 – 13.2 years of schooling (Wilkins, Lang
& Norman, 2011)
SELECTED
REFERENCES
U.S. Department of Veteran Affairs. (2014, May 2). PTSD Checklist for DSM-5
(PCL-5). Retrieved November 13, 2014, from U.S. Department of Veteran
Affairs: National Center for PTSD website:
http://www.ptsd.va.gov/professional/assessment/adult-sr/ptsd-checklist.asp
Norris, F. H., & Hamblen, J. L. (2004). Standardized self-report measures of
civilian trauma and PTSD. In J. P. Wilson & T. M. Keane (Eds.), Assessing
Psychological Trauma and PTSD: A Practitioner's Handbook (2nd ed.). New
York, NY: The Guilford Press.
Wilkins, K. C., Lang, A. J., & Norman, S. B. (2011). Synthesis of the
psychometric properties of the PTSD Checklist (PCL) military, civilian, and
specific versions. Depression and Anxiety, 28, 596-606.
Posttraumatic Stress Disorder Checklist (PCL). (n.d.). Retrieved November
13, 2014, from International Society for Traumatic Stress Studies website:
http://www.istss.org/PosttraumaticStressDisorderChecklist.htm