Psychology and Psychological Therapies Directorate, Cardiff & Vale University Health Board, Cardiff, UK.
Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK.
Eur J Psychotraumatol. 2021 Jan 26;12(1):1863578. doi: 10.1080/20008198.2020.1863578. eCollection 2021.
: PTSD self-report measures are frequently used in mental health services but very few have been evaluated in clinical samples that include civilians. The PCL-5 was developed to assess for DSM-5 PTSD. : The aim of this study was to evaluate the psychometric properties of the PCL-5 in a sample of trauma-exposed mental health service users who were evidencing symptoms of PTSD. : Reliability and validity of the PCL-5 were investigated in a sample of 273 participants who reported past diagnosis for PTSD or who had screened positively for traumatic stress symptoms. Diagnostic utility was evaluated in comparison to the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5). : The PCL-5 demonstrated high internal consistency, good convergent and divergent validity, acceptable stability and good diagnostic utility. However, operating characteristics differed from those found in other samples. Scores of 43-44 provided optimal efficiency for diagnosing PTSD. A post hoc regression analysis showed that depression explained more of the variance in PCL-5 total score than the CAPS-5. : Whilst the PCL-5 is psychometrically sound it appears to have difficulty differentiating self-reported depression and anxiety symptoms from PTSD in trauma-exposed mental health service users and clinicians should take care to assess full symptomatology when individuals screen positively on the PCL-5. Clinicians and researchers should also take care not to assume that operating characteristics of self-report PTSD measures are valid for mental health service users, when these have been established in other populations.
创伤后应激障碍自评量表常用于精神卫生服务领域,但在包括平民在内的临床样本中评估的量表却很少。PCL-5 是为评估 DSM-5 创伤后应激障碍而开发的。
本研究旨在评估 PCL-5 在一组有创伤后应激障碍症状的精神卫生服务使用者样本中的心理测量特性。该研究共纳入 273 名参与者,这些参与者报告有 PTSD 既往诊断或创伤性应激症状筛查阳性。与用于 DSM-5 的临床医生管理 PTSD 量表(CAPS-5)相比,评估了 PCL-5 的诊断效用。
PCL-5 表现出较高的内部一致性、良好的聚合和发散效度、可接受的稳定性和良好的诊断实用性。然而,其操作特征与其他样本中的特征不同。43-44 分的得分提供了诊断 PTSD 的最佳效率。事后回归分析显示,抑郁比 CAPS-5 更能解释 PCL-5 总分的方差。
虽然 PCL-5 在心理测量上是可靠的,但它似乎难以区分创伤后应激障碍患者中自我报告的抑郁和焦虑症状。当个体在 PCL-5 上筛查阳性时,临床医生应注意评估完整的症状。临床医生和研究人员还应注意,当在其他人群中建立了自我报告的 PTSD 测量的操作特征时,不要假设其在精神卫生服务使用者中是有效的。