Schick Melissa R, Sullivan Tami P, Alfano Alexis R, Weiss Nicole H
Division of Prevention and Community Research, Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA.
Department of Psychology, University of Rhode Island, Kingston, Rhode Island, USA.
J Trauma Stress. 2024 Dec;37(6):998-1008. doi: 10.1002/jts.23087. Epub 2024 Jul 19.
Recent national estimates suggest that 1 in 2 women will experience intimate partner violence (IPV) in their lifetime. Given the high prevalence of posttraumatic stress disorder (PTSD) among women experiencing IPV, it is necessary to consider whether PTSD assessments function adequately for this population. Thus, the present study aimed to evaluate the psychometric properties of the past-month version of the PTSD Checklist for DSM-5 (PCL-5), one of the most widely used self-report measures of PTSD symptoms, in a sample of community women experiencing IPV. Participants were 158 women who had experienced IPV in the past 6 months (M = 40.14 years, 39.9% White). The PCL-5 demonstrated good internal consistency, Cronbach's α = .97, and scores were significantly positively correlated with theoretically related constructs (i.e., PTSD symptom count on the SCID-5, IPV severity, substance use, depression, anxiety, and emotion dysregulation); however, it demonstrated poor 30-day stability, r = .38, ICC = .55. The ability of the PCL-5 to discriminate with respect to a PTSD diagnosis was acceptable, AUC = .74. A cutoff score of 21 maximized sensitivity (82.5%) and specificity (55.4%); this is lower than typical cutoffs (i.e., 31-33). Although the PCL-5 has generally demonstrated adequate psychometric properties, findings suggest that it does not function optimally for women experiencing IPV relative to its functioning for other trauma-exposed populations. The lower-than-typical cutoff suggests that the PCL-5 may underestimate PTSD prevalence among women experiencing IPV.
近期全国性评估显示，每两名女性中就有一人在其一生中会经历亲密伴侣暴力（IPV）。鉴于经历IPV的女性中创伤后应激障碍（PTSD）的高患病率，有必要考虑PTSD评估对该人群是否足够有效。因此，本研究旨在评估《精神疾病诊断与统计手册》第5版PTSD检查表（PCL-5）过去一个月版本的心理测量特性，PCL-5是最广泛使用的PTSD症状自我报告测量工具之一，研究对象为经历IPV的社区女性样本。参与者为158名在过去6个月内经历过IPV的女性（平均年龄M = 40.14岁，39.9%为白人）。PCL-5显示出良好的内部一致性，克朗巴哈系数α = 0.97，得分与理论相关结构显著正相关（即SCID-5上的PTSD症状计数、IPV严重程度、物质使用、抑郁、焦虑和情绪失调）；然而，它显示出较差的30天稳定性，r = 0.38，组内相关系数ICC = 0.55。PCL-5在区分PTSD诊断方面的能力是可接受的，曲线下面积AUC = 0.74。临界值为21时，敏感性（82.5%）和特异性（55.4%）达到最大值；这低于典型临界值（即31 - 33）。尽管PCL-5总体上显示出足够的心理测量特性，但研究结果表明，相对于其他遭受创伤的人群，它在经历IPV的女性中并未发挥最佳作用。低于典型的临界值表明PCL-5可能低估了经历IPV的女性中PTSD的患病率。
