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Forkus SR, Raudales AM, Rafiuddin HS, Weiss NH, Messman BA, Contractor AA. The Posttraumatic Stress Disorder (PTSD) Checklist for DSM-5: A Systematic Review of Existing Psychometric Evidence. CLINICAL PSYCHOLOGY-SCIENCE AND PRACTICE 2023; 30:110-121. [PMID: 37378352 PMCID: PMC10292741 DOI: 10.1037/cps0000111] [Citation(s) in RCA: 28] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/27/2023]
Abstract
The PTSD Checklist for DSM-5 (PCL-5) is a widely used self-rated measure of DSM-5 PTSD symptoms. The goal of this systematic review was to synthesize research on the psychometric properties of the PCL-5 to guide clinical and research applications. We focused on reliability, validity, factor structure, optimal cutoff scores, and sensitivity to clinical change indices. A systematic review of the literature following PRISMA guidelines was conducted using PubMed, PsycINFO, CINAHL, and PTSDpubs with search terms capturing selected psychometric indices of the PCL-5. The inclusion criteria were: peer-reviewed publication in English; primary focus on the PCL-5 psychometrics; empirical study; and study with adult samples. The search yielded 265 studies; 56 papers (amounting to 64 studies) met inclusion criteria and were reviewed. Findings generally indicated evidence for: acceptable internal consistency and test-retest reliability; construct validity; a 7-factor Hybrid Model; recommended cutoff scores between 31-33; and ability to index sensitivity to clinical change. To further advance knowledge and applications of the PCL-5, we need more research on abbreviated versions of the PCL-5, bifactor modeling as applied to the PCL-5, as well as on PCL-5 item difficulty estimates, discrimination parameters, and clinical change score estimates.
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Affiliation(s)
| | | | | | - Nicole H. Weiss
- Department of Psychology, University of Rhode Island, RI, USA
| | - Brett A. Messman
- Department of Psychology, University of North Texas, Denton, TX, USA
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Kagee A, Bantjes J, Saal W, Sterley A. Predicting Posttraumatic Stress Disorder Caseness Using the PTSD Checklist for DSM-5 Among Patients Receiving Care for HIV. J Trauma Stress 2022; 35:13-21. [PMID: 33533528 DOI: 10.1002/jts.22654] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 01/05/2021] [Accepted: 01/09/2021] [Indexed: 01/30/2023]
Abstract
This study assessed the ability of the Posttraumatic Stress Disorder (PTSD) Checklist for the DSM-5 (PCL-5) to distinguish between caseness and noncaseness for PTSD among South Africans receiving care for HIV. The PCL-5 and the Structured Clinical Interview for DSM-5-Research Version (SCID-RV) module for PTSD were administered to 688 patients receiving antiretroviral therapy (ART) at two HIV care clinics in the greater Cape Town (South Africa) area. In total, nearly half of the sample (n = 324, 47.1%) reported experiencing an index traumatic event, and 101 participants (14.74%, 95% CI [12.17%, 17.62%]) met the diagnostic criteria for PTSD as measured using the SCID-RV. An ROC curve analysis suggested that a PCL-5 cutoff score of 32 yielded optimal sensitivity (0.88) and specificity (0.88), indicating that the measure was successful in determining caseness for PTSD 88% of the time and noncaseness 88% of the time. The AUC was 94.3%, 95% CI [92.6% to 96.1%], indicating high accuracy. The positive predictive value and negative predictive values were 56.3% and 97.7%, respectively, which suggests that the PCL-5 is an effective screening instrument to determine the presence of PTSD among South African ART users. Undetected and, thus, untreated PTSD may reduce quality of life, impede optimal adherence to ART, and increase the likelihood of risk behaviors among individuals living with HIV, contributing to further infections. The PCL-5 may be used for detection, referral, and treatment of PTSD as a way to enhance its management among individuals receiving HIV care.
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Affiliation(s)
- Ashraf Kagee
- Department of Psychology, Stellenbosch University, Stellenbosch, South Africa
| | - Jason Bantjes
- Department of Psychology, Stellenbosch University, Stellenbosch, South Africa
| | - Wylene Saal
- Department of Psychology, Stellenbosch University, Stellenbosch, South Africa
| | - Adelle Sterley
- Department of Psychology, Stellenbosch University, Stellenbosch, South Africa.,Helderberg Hospital, Cape Town, South Africa
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Molebatsi K, Ng LC, Chiliza B. A culturally adapted brief intervention for post-traumatic stress disorder in people with severe mental illness in Botswana: protocol for a randomised feasibility trial. Pilot Feasibility Stud 2021; 7:170. [PMID: 34479640 PMCID: PMC8414703 DOI: 10.1186/s40814-021-00904-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 08/20/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Research consistently reports elevated rates of exposure to traumatic events and post-traumatic stress disorder (PTSD) in people with severe mental illness (SMI). PTSD may be adequately managed with psychotherapy; however, there is a gap when it comes to management in culturally diverse settings like Botswana. This paper describes a study protocol whose aim is to culturally adapt the BREATHE intervention, a brief psychological intervention for people living with comorbid PTSD and SMI that was developed and tested in the USA; assess the feasibility and acceptability of the adapted BREATHE intervention and explore its efficacy. METHODS The study will be conducted in three phases using a mixed methods approach. The first phase will identify and describe the most common traumatic experiences and responses to traumatic experiences, amongst patients with SMI, and patients' and mental health care providers' perceptions about suitable PTSD interventions for Botswana. The second phase will entail cultural adaption of the intervention using findings from phase 1, and the third phase will be a pilot trial to assess the feasibility and acceptability of the culturally adapted intervention and explore its efficacy. Quantitative and qualitative data will be analysed using basic descriptive statistics and thematic analysis, respectively. DISCUSSION Literature highlights cultural variations in the expression and management of mental illness suggesting the need for culturally adapted interventions. The findings of this feasibility study will be used to inform the design of a larger trial to assess the efficacy of an adapted brief intervention for PTSD in patients with SMI in Botswana. TRIAL REGISTRATION Clinicaltrials.gov registration: NCT04426448 . Date of registration: June 7, 2020.
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Affiliation(s)
- Keneilwe Molebatsi
- Department of Psychiatry, Nelson R. Mandela School of Clinical Medicine, University of KwaZulu-Natal, Durban, South Africa.
- Department of Psychiatry, Faculty of Medicine, University of Botswana, Private Bag, 00713, Gaborone, Botswana.
| | - Lauren C Ng
- Department of Psychology, University of California Los Angeles, Los Angeles, CA, USA
| | - Bonginkosi Chiliza
- Department of Psychiatry, Nelson R. Mandela School of Clinical Medicine, University of KwaZulu-Natal, Durban, South Africa
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Joubert J, Guse T, Maree D. The prevalence of hope, subjective well-being, and psychopathology among trauma survivors at community-based clinics in Gauteng. SOUTH AFRICAN JOURNAL OF PSYCHOLOGY 2021. [DOI: 10.1177/00812463211040380] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study examined the prevalence of hope and subjective well-being as well as symptoms of depression and post-traumatic stress disorder among trauma survivors at community-based clinics in Gauteng. We further explored traumatic events and help-seeking behaviour in this context. Using a cross-sectional survey design, we collected demographic information and administered questionnaires measuring hope, well-being, depression, and post-traumatic stress. The sample comprised 120 adults, of whom the majority were Black females. Results showed that participants experienced low levels of hope, positive affect, and life satisfaction as well as high levels of negative affect, depression, and post-traumatic stress. In addition, the majority of participants experienced multiple traumatic events in the past 5 years, which had a negative impact on their well-being. However, receiving professional help and being able to cope in the aftermath of trauma may contribute towards higher levels of well-being and fewer psychopathological symptoms. Our findings thus highlighted the need for effective therapeutic interventions among trauma survivors.
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Affiliation(s)
- Jolize Joubert
- Pholosong Hospital, Gauteng Department of Health, South Africa
- Department of Psychology, University of Pretoria, South Africa
| | - Tharina Guse
- Department of Psychology, University of Pretoria, South Africa
| | - David Maree
- Department of Psychology, University of Pretoria, South Africa
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Guidetti G, Grandi A, Converso D, Bosco N, Fantinelli S, Zito M, Colombo L. Funeral and Mortuary Operators: The Role of Stigma, Incivility, Work Meaningfulness and Work-Family Relation to Explain Occupational Burnout. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18136691. [PMID: 34206238 PMCID: PMC8297114 DOI: 10.3390/ijerph18136691] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 06/15/2021] [Accepted: 06/15/2021] [Indexed: 11/16/2022]
Abstract
The funeral and mortuary sector, including funeral homes, cemeteries and crematoria, is a largely neglected sector in regard to the study of occupational factors that can affect the quality of working life. The present study aimed at overcoming this gap by investigating job demands and resources that may affect burnout levels. Data were collected through a self-report questionnaire involving funeral industry employees (N = 229) from cemetery, morgues, crematoria and funeral agencies in a Northern Italian region. The survey was cross-sectional and non-randomized. Results reveal that among job demands, stigma consciousness, supervisor incivility and work-to-family negative spillover significantly affect levels of burnout, whereas meaningfulness of work and family-to-work positive spillover may represent relevant resources to counter the onset of burnout. The results of this study contribute to new insights into the psychosocial working conditions that affect occupational wellbeing among the funeral industry sector by also giving insight into how to promote resources to prevent burnout.
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Affiliation(s)
- Gloria Guidetti
- Department of Psychological, Health and Territorial Sciences, University G. d’Annunzio of Chieti-Pescara, Via dei Vestini 31, 66100 Chieti, Italy; (G.G.); (S.F.)
| | - Annalisa Grandi
- Department of Psychology, University of Turin, Via Verdi 10, 10124 Turin, Italy; (D.C.); (L.C.)
- Correspondence:
| | - Daniela Converso
- Department of Psychology, University of Turin, Via Verdi 10, 10124 Turin, Italy; (D.C.); (L.C.)
| | - Nicoletta Bosco
- Department of Cultures, Politics and Society, University of Turin, Lungo Dora Siena 100/A, 10124 Turin, Italy;
| | - Stefania Fantinelli
- Department of Psychological, Health and Territorial Sciences, University G. d’Annunzio of Chieti-Pescara, Via dei Vestini 31, 66100 Chieti, Italy; (G.G.); (S.F.)
| | - Margherita Zito
- Department of Business, Law, Economics and Consumer Behaviour “Carlo A. Ricciardi”, Università IULM, Via Carlo Bo 1, 20143 Milan, Italy;
| | - Lara Colombo
- Department of Psychology, University of Turin, Via Verdi 10, 10124 Turin, Italy; (D.C.); (L.C.)
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Roberts NP, Kitchiner NJ, Lewis CE, Downes AJ, Bisson JI. Psychometric properties of the PTSD Checklist for DSM-5 in a sample of trauma exposed mental health service users. Eur J Psychotraumatol 2021; 12:1863578. [PMID: 34992744 PMCID: PMC8725778 DOI: 10.1080/20008198.2020.1863578] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 11/09/2020] [Indexed: 11/25/2022] Open
Abstract
Background: PTSD self-report measures are frequently used in mental health services but very few have been evaluated in clinical samples that include civilians. The PCL-5 was developed to assess for DSM-5 PTSD. Objective: The aim of this study was to evaluate the psychometric properties of the PCL-5 in a sample of trauma-exposed mental health service users who were evidencing symptoms of PTSD. Method: Reliability and validity of the PCL-5 were investigated in a sample of 273 participants who reported past diagnosis for PTSD or who had screened positively for traumatic stress symptoms. Diagnostic utility was evaluated in comparison to the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5). Results: The PCL-5 demonstrated high internal consistency, good convergent and divergent validity, acceptable stability and good diagnostic utility. However, operating characteristics differed from those found in other samples. Scores of 43-44 provided optimal efficiency for diagnosing PTSD. A post hoc regression analysis showed that depression explained more of the variance in PCL-5 total score than the CAPS-5. Conclusion: Whilst the PCL-5 is psychometrically sound it appears to have difficulty differentiating self-reported depression and anxiety symptoms from PTSD in trauma-exposed mental health service users and clinicians should take care to assess full symptomatology when individuals screen positively on the PCL-5. Clinicians and researchers should also take care not to assume that operating characteristics of self-report PTSD measures are valid for mental health service users, when these have been established in other populations.
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Affiliation(s)
- Neil P. Roberts
- Psychology and Psychological Therapies Directorate, Cardiff & Vale University Health Board, Cardiff, UK
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - Neil J. Kitchiner
- Psychology and Psychological Therapies Directorate, Cardiff & Vale University Health Board, Cardiff, UK
- Veterans’ NHS Wales, Cardiff & Vale University Health Board, Cardiff, UK
| | - Catrin E. Lewis
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - Anthony J. Downes
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - Jonathan I. Bisson
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
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Fresno A, Arias V, Núñez D, Spencer R, Ramos N, Espinoza C, Bravo P, Arriagada J, Brunet A. Using Exploratory Structural Equation Modeling (ESEM) to Examine the Internal Structure of Posttraumatic Stress Disorder Symptoms. THE SPANISH JOURNAL OF PSYCHOLOGY 2020; 23:e48. [PMID: 33176894 DOI: 10.1017/sjp.2020.46] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Several studies have reported the factor structure of posttraumatic stress disorder (PTSD) using confirmatory factor analysis (CFA). The results show models with different number of factors, high correlations between factors, and symptoms that belong to different factors in different models without affecting the fit index. These elements could suppose the existence of considerable item cross-loading, the overlap of different factors or even the presence of a general factor that explains the items common source of variance. The aim is to provide new evidence regarding the factor structure of PTSD using CFA and exploratory structural equation modeling (ESEM). In a sample of 1,372 undergraduate students, we tested six different models using CFA and two models using ESEM and ESEM bifactor analysis. Trauma event and past-month PTSD symptoms were assessed with Life Events Checklist for DSM-5 (LEC-5) and PTSD Checklist for DSM-5 (PCL-5). All six tested CFA models showed good fit indexes (RMSEA = .051-.056, CFI = .969-.977, TLI = .965-.970), with high correlations between factors (M = .77, SD = .09 to M = .80, SD = .09). The ESEM models showed good fit indexes (RMSEA = .027-.036, CFI = .991-.996, TLI = .985-.992). These models confirmed the presence of cross-loadings on several items as well as loads on a general factor that explained 76.3% of the common variance. The results showed that most of the items do not meet the assumption of dimensional exclusivity, showing the need to expand the analysis strategies to study the symptomatic organization of PTSD.
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