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Abstract

[Indexed for MEDLINE] 16. BMC Psychol. 2024 Aug 28;12(1):456. doi: 10.1186/s40359-024-01951-y. Validation of the PCL-5 in Dutch trauma-exposed adults. Hoeboer CM(1)(2), Karaban I(3), Karchoud JF(3)(4), Olff M(3)(4)(5), van Zuiden M(3)(6). Author information: (1)Department of Psychiatry, Amsterdam UMC location University of Amsterdam, Meibergdreef 5, Amsterdam, 1005 AZ, The Netherlands. c.m.hoeboer@amsterdamumc.nl. (2)Amsterdam Public Health, Mental Health, Amsterdam, The Netherlands. c.m.hoeboer@amsterdamumc.nl. (3)Department of Psychiatry, Amsterdam UMC location University of Amsterdam, Meibergdreef 5, Amsterdam, 1005 AZ, The Netherlands. (4)Amsterdam Public Health, Mental Health, Amsterdam, The Netherlands. (5)ARQ National Psychotrauma Centre, Diemen, The Netherlands. (6)Department of Clinical Psychology, Utrecht University, Utrecht, the Netherlands. BACKGROUND: The PTSD Checklist for DSM-5 (PCL-5) is an internationally widely used self-report questionnaire that can be used to screen for probable diagnosis of posttraumatic stress disorder (PTSD). Information on the psychometric properties of the Dutch PCL-5 is currently lacking. OBJECTIVE: We aimed to validate the Dutch PCL-5 in a sample of Dutch adults with prior (suspected) serious injury and establish the optimal cut-off for probable PTSD diagnosis herein. METHODS: Data for the current study were collected as part of a long-term follow-up measurement of the TraumaTIPS cohort, where adults admitted to an emergency department following (suspected) serious injury completed a follow-up measurement 12-15 years post-trauma. Of N = 333 eligible participants, n = 192 (57.7%) consented and completed the PCL-5 alongside self-report instruments measuring depression (QIDS), PTSD (IES-R), and quality of life (WHO-QOL and EQ-6D). In total, n = 185 participants also completed a clinician administered interview for PTSD (CAPS-5). Most participants were men (66%) and on average 54 years old (SD = 12.41). We evaluated the diagnostic utility of the PCL-5 using Youden index and tested reliability and convergent validity. RESULTS: The PCL-5 demonstrated excellent diagnostic accuracy with a cut-off point of 16 resulting in an optimal Youden index (0.90) for screening purposes with a high sensitivity (1.00) and specificity (0.90). A cut-off of 22 yielded a slightly lower Youden index (0.84) but better positive predictive value (0.50 instead of 0.33) than the cut-off of 16. A cut-off of 29 resulted in the most accurate prevalence estimates. The PCL-5 showed a high internal consistency (Cronbach's α = 0.94), excellent inter-item and item-total correlations and good convergent validity (r > .5 for CAPS-5, IES-R and QIDS). CONCLUSIONS: The PCL-5 is a reliable and valid measurement for PTSD symptoms and probable diagnosis and shows excellent screening abilities in Dutch adults with prior (suspected) serious injury, with a lower optimal cut-off compared to previously found in clinical populations. We recommend a cut-off of 22 for screening purposes and a cut-off of 29 for prevalence estimates in Dutch trauma-exposed adults. © 2024. The Author(s). DOI: 10.1186/s40359-024-01951-y PMCID: PMC11351185