What Does the PCL-5 Measure? A Conjoint Hierarchical Analysis Using the MMPI-3

Area of Science:

• Psychology
• Psychiatry
• Clinical Assessment

Background:

• The PTSD Checklist for DSM-5 (PCL-5) is a common tool for screening posttraumatic stress disorder (PTSD) symptoms.
• Debate exists regarding whether the PCL-5 measures PTSD-specific symptoms or broader psychological distress.
• The Minnesota Multiphasic Personality Inventory-3 (MMPI-3) is a comprehensive assessment for psychological difficulties.

Purpose of the Study:

• To clarify the underlying factors measured by the PCL-5.
• To examine the relationship between PCL-5 items and MMPI-3 scales in a veteran sample.
• To differentiate PTSD-specific symptoms from general distress using conjoint factor analysis.

Main Methods:

• Conjoint exploratory factor analyses were performed on PCL-5 items and MMPI-3 scales.
• A sample of 386 United States veterans and their partners was utilized.
• Statistical analyses examined the factor structure and cross-loadings between the two instruments.

Main Results:

• PCL-5 items were explained by three factors: affect/cognitions, traumatic intrusion/avoidance, and hyperarousal.
• The affect/cognition factor on the PCL-5 was associated with general demoralization/distress from the MMPI-3.
• The hyperarousal factor cross-loaded with MMPI-3 somatic and cognitive scales, while intrusions/avoidance showed minimal overlap.

Conclusions:

• The PCL-5 may capture transdiagnostic factors like demoralization alongside PTSD symptoms.
• Analyzing individual PCL-5 symptom clusters can provide more specific insights into posttraumatic symptomatology.
• Findings support a multidimensional view of PTSD assessment and treatment.