5 - 7 However, there are notable differences between instruments. 4 This 20-item instrument has demonstrated excellent psychometric properties. Concurrent with changes in diagnostic criteria, the PCL for DSM-5 (PCL-5) was created to align with the new PTSD criteria. Based on DSM-IV/DSM-IV-TR criteria, the PTSD Checklist (PCL) was the most commonly used instrument of the 3 versions, PCL–Specific, PCL–Military, and PCL-Civilian (PCL-C), the PCL-C has been used most frequently.
These changes created challenges for longitudinal research and in medical settings, where it is important to maintain consistency in assessment of PTSD and retain the ability to monitor changes over time.Īlthough the Clinician-Administered PTSD Scale is considered the criterion standard for diagnosing PTSD, 3 owing to the time and skill required for administration, researchers and clinicians often rely on validated self-reported measures. 1 Compared with the previous version, DSM-IV- TR, 2 the DSM-5 made a number of notable revisions to the posttraumatic stress disorder (PTSD) diagnostic criteria, including adding new symptoms, modifying existing symptoms, and dividing the avoidance cluster into avoidance and negative alterations in cognitions and mood. The American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition ( DSM-5), released in 2013, provided updated criteria for mental disorders. The PCL-C and PCL-5 had nearly identical associations with comorbid conditions.Ĭonclusions and Relevance The findings of this diagnostic study suggest that PTSD can be successfully assessed and compared over time with either PCL instrument in veteran and military populations. Appending 2 additional PCL-C items to the PCL-5 did not significantly alter estimates. Of the 17 corresponding items between the 2 instruments, 16 had substantial agreement. Using an established crosswalk, PCL-5 sum scores estimated with the PCL-C were similar to observed PCL-5 scores. Estimated PTSD sum scores showed excellent agreement with observed scores. There was substantial agreement between PCLs for probable PTSD based on DSM-IV criteria (295 with PCL-C 316 with PCL-5 κ = 0.80) and DSM-5 criteria (286 with PCL-5 258 with PCL-C κ = 0.77). Results Among the 1921 participants (mean age, 50.1 years), 1358 (70.7%) were men, 1638 (85.3%) were non-Hispanic White individuals, 1440 (75.0%) were married, and 1190 (61.9%) had at least a bachelor’s degree 295 (15.4%) had probable PTSD according to DSM-IV criteria with PCL-C compared with 286 (14.9%) using DSM-5 criteria with PCL-5 (κ = 0.77). Demographic and military characteristics included age, sex, race/ethnicity, marital status, education, service branch, pay grade, enrollment panel, and military service status. Main Outcomes and Measures Survey data were used to assess PTSD (using the PCL-C and PCL-5), major depressive disorder (using the Patient Health Questionnaire), generalized anxiety (using the Generalized Anxiety Disorder scale), and problem drinking (using the Patient Health Questionnaire). PCL instruments were counterbalanced to control for order effects. The population for the present study was restricted to a subset of initial web responders of the 2019 survey cycle, randomly assigned to 1 of 4 survey groups.Įxposures Each group received the DSM-IV and DSM-5 PCL (PCL–Civilian version and PCL for DSM-5 ). Objective To evaluate the ability to compare and assess PTSD, based on DSM-IV and DSM-5 criteria, using PTSD Checklists (PCLs).ĭesign, Setting, and Participants This diagnostic study was conducted with survey data collected in October 2019, from the Millennium Cohort Study, a population-based US military cohort study. Importance The definition of posttraumatic stress disorder (PTSD) changed markedly between the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) and DSM-5, creating challenges for studies and in medical settings spanning this transition. Shared Decision Making and Communication.Scientific Discovery and the Future of Medicine.Health Care Economics, Insurance, Payment.Clinical Implications of Basic Neuroscience.Challenges in Clinical Electrocardiography.