Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Feb;36(2):170-178.
doi: 10.1002/da.22873. Epub 2018 Dec 30.

Detecting PTSD in a traumatically injured population: The diagnostic utility of the PTSD Checklist for DSM-5

Timothy J Geier  1 , Joshua C Hunt  1 , Lindsay D Nelson  1 , Karen J Brasel  2 , Terri A deRoon-Cassini  1
Affiliations

Detecting PTSD in a traumatically injured population: The diagnostic utility of the PTSD Checklist for DSM-5

Timothy J Geier et al. Depress Anxiety. 2019 Feb.

Abstract

Background: The posttraumatic stress disorder (PTSD) Checklist for DSM-5 (PCL-5) is among few validated measures of PTSD severity in line with the DSM-5. Validation efforts among veteran samples have recommended cut scores of 33 and 38 to indicate PTSD; cut scores vary across populations depending on factors such as trauma type. The purpose of this study was to evaluate the diagnostic utility of and identify optimal cut scores for the PCL-5 in relation to the gold standard Clinician-Administered PTSD Scale for DSM-5 (CAPS-5) among traumatically injured individuals 6 months after discharge from a level I trauma center.

Methods: A total of 251 participants completed the PCL-5 and CAPS-5 6 months after discharge from a level I trauma center following traumatic injury. Receiver operating characteristic curve analyses detailed diagnostic accuracy of the PCL-5 and identified the optimal cut score via Youden's J index. Cut scores were also broken down by intentional versus nonintentional injury.

Results: The PCL-5 produces satisfactory diagnostic accuracy, with adequate sensitivity and specificity, in a traumatically injured population. Estimates indicate the optimal cut score as >30; the optimal cut score for intentional injuries was >34 and >22 for nonintentional injuries.

Conclusions: This investigation provides support for the PCL-5 in detection of PTSD among injured individuals 6 months after discharge from a level I trauma center. PCL-5 specificity and sensitivity suggest clinicians working with this population can feel confident in using this measure over more onerous structured interviews (e.g., CAPS-5). This study signifies a move toward ensuring those experiencing mental health difficulties after traumatic injury are identified and connected to resources.

Keywords: PTSD/posttraumatic stress disorder; assessment/diagnosis; health services; measurement/psychometrics; trauma.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
ROC curve for the PCL-5 compared to the CAPS-5 PTSD diagnosis, among full analytic sample (n=251).
Figure 2.
Figure 2.
ROC curve for the PCL-5 compared to the CAPS-5 PTSD diagnosis, among those with intentional mechanism of injury (n=72).
Figure 3.
Figure 3.
ROC curve for the PCL-5 compared to the CAPS-5 PTSD diagnosis, among those with nonintentional mechanism of injury (n=179).
See this image and copyright information in PMC

References

    1. Alarcon LH, Germain A, Clontz AS, Roach E, Nicholas DH, Zenati MS, … Sperry JL (2012). Predictors of acute posttraumatic stress disorder symptoms following civilian trauma: highest incidence and severity of symptoms after assault. Journal of Trauma and Acute Care Surgery, 72(3), 629–637. - PubMed
    1. Blanchard EB, Jones-Alexander J, Buckley TC, & Forneris CA (1996). Psychometric properties of the PTSD Checklist (PCL). Behaviour research and therapy, 34(8), 669–673. - PubMed
    1. Blevins CA, Weathers FW, Davis MT, Witte TK, & Domino JL (2015). The posttraumatic stress disorder checklist for DSM‐5 (PCL‐5): Development and initial psychometric evaluation. Journal of Traumatic Stress, 28(6), 489–498. - PubMed
    1. Bovin MJ, Marx BP, Weathers FW, Gallagher MW, Rodriguez P, Schnurr PP, & Keane TM (2016). Psychometric properties of the PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders–Fifth Edition (PCL-5) in veterans. Psychological assessment, 28(11), 1379. - PubMed
    1. Bryant RA, & Harvey AG (1998). Relationship between acute stress disorder and posttraumatic stress disorder following mild traumatic brain injury. American Journal of Psychiatry, 155(5), 625–629. - PubMed

Publication types