Psychometric evaluation of the PCL-5: assessing validity, diagnostic utility, and bifactor structures

Area of Science:

• Psychiatry
• Clinical Psychology
• Psychometrics

Background:

• The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) revised diagnostic criteria for posttraumatic stress disorder (PTSD).
• This necessitated updating assessment tools, leading to the development of the Posttraumatic Checklist for DSM-5 (PCL-5).
• The PCL-5 is a widely used instrument for PTSD assessment.

Purpose of the Study:

• To evaluate the psychometric properties of the Romanian version of the PCL-5.
• To assess its diagnostic utility against the Structured Clinical Interview for DSM-5 (SCID-5).
• To investigate the latent structure of PTSD symptoms using various modeling techniques.

Main Methods:

• Psychometric testing of the PCL-5 on a sample of 727 participants.
• Diagnostic utility assessment using the SCID-5 on 101 participants.
• Confirmatory Factor Analyses (CFAs) and bifactor modeling to examine PTSD symptom structure.

Main Results:

• The Romanian PCL-5 demonstrated acceptable diagnostic accuracy compared to SCID-5 diagnoses, with an optimal cut-off score of >47.
• CFAs supported Anhedonia, Hybrid, and bifactor models for PTSD symptom structure.
• Limitations include retrospective self-report data and a high proportion of female participants.

Conclusions:

• The PCL-5 is a psychometrically sound instrument for provisional PTSD diagnoses in community samples.
• It can enhance trauma-informed practices.
• Further research may explore its utility in more diverse populations.