Turkish UCLA PTSD-RI-5: Validation and the Role of Symptom Severity in Functional Impairment

This study translated the UCLA PTSD Reaction Index for DSM-5 into Turkish (PTSD-RI-5-TR), evaluated its psychometric properties, and examined whether PTSD symptom severity predicts functional impairment in Turkish adolescents aged 11-17.

A total of 157 trauma-exposed adolescents from a tertiary Child and Adolescent Psychiatry Clinic participated. Internal consistency and test-retest reliability were evaluated. Construct validity was examined via confirmatory factor analysis (CFA) of a five-factor model. Convergent, divergent, criterion, and known-groups validity were tested. ROC analysis assessed diagnostic accuracy. Binary logistic regression was used to evaluate the impact of scores on four functional domains.

PTSD-RI-5-TR showed good internal consistency and test-retest reliability (acceptable for Category C). CFA indicated excellent fit (CMIN/DF, CFI, TLI, RMSEA) and good fit (GFI, NFI). Scores correlated strongly with NSESSS-PTSD and moderately with DES-B. PTSD diagnoses were associated with significantly higher scores. ROC analysis yielded an AUC = 0.909, sensitivity = 86.4%, specificity = 84.1% with an optimal cutoff score of 49.5. In total score models, each one-point increase predicted impairment in developmental progression (OR = 1.097), home (OR = 1.084), peer (OR = 1.071), and school functioning (OR = 1.063). In symptom cluster models, negative mood/cognition (D) most strongly predicted peer (OR = 1.205) and developmental impairment (OR = 1.155); avoidance (C) predicted home impairment (OR = 1.250); arousal/reactivity (E) predicted home (OR = 1.144) and school impairment (OR = 1.131); intrusion (B) showed no independent effect.

PTSD-RI-5-TR is a reliable, valid tool for assessing PTSD in Turkish adolescents. Higher total PTSD scores and higher scores in the C, D, and E symptom clusters may indicate a greater likelihood of functional impairment.

This study was prospectively registered at ClinicalTrials.gov (Identifier: NCT06077474 {2023-10-05}).