Validation of embedded PCL-5 symptom validity indices in active-duty military population

PTSD is among the most commonly diagnosed mental health conditions in the military and veteran populations. Shura et al. (2023) and Schroeder and Bieu (2024) developed three symptom validity indices for the PTSD Checklist for the DSM-5 (PCL-5) examining overreported PTSD symptomatology in veteran populations. The current study aimed to cross-validate these SVTs in an active-duty United States military sample.

The sample consisted of multiple criterion groups comprised active-duty service members (N = 165). Criterion for valid or invalid responses were based on Personality Assessment Inventory symptom validity scales. The three PCL-5 symptom validity indices included PCL-5 Symptom Severity (PSS), PCL-5 Extreme Symptom (PES), and PCL-5 Rare Items (PRI).

Areas under the curve ranged from .73 to .76 for valid full sample group versus invalid group, which met classification accuracy goals. Optimal cutoff scores were identified for each scale (PES ≥ 16, PSS ≥ 59, PRI ≥ 3) with corresponding sensitivities of PSS = 0.50, PES = 0.40, and PRI = 0.20 with specificity ≥0.90.

These findings provide support for the cross-validation of all three embedded symptom validity indices at the identified cutoff scores as PCL-5 over-report measures within an active-duty sample. The PSS and PES demonstrated superior classification statistics, as the PRI was hampered by lower sensitivity.