Portuguese version of the Posttraumatic Stress Disorder Checklist for DSM‐5 (PCL‐5): Comparison of latent models and other psychometric analyses

Abstract

Objective: This psychometric study explores the Portuguese version of the Posttraumatic Stress Disorder (PTSD) Checklist (PCL-5). It aims to clarify the best-fitting latent structure among competing PTSD models (Diagnostic and Statistical Manual of Mental Disorders-fifth edition [DSM-5], Dysphoria, Dysphoric Arousal, Anhedonia, Externalizing Behavior, And Hybrid models) and its implications for PTSD measurement. Method: Psychometric analyses were conducted in a sample from the general population of firefighters (N = 446), except the temporal stability, which was tested in a subsample of 100 participants. Results: The models presented significant differences in a global fit. The Hybrid model presented the best-fitting structure, but the DSM-5 model showed more favorable reliability and convergent validity in Confirmatory Factor Analyses. The DSM-5 model also proved to be internally consistency, temporally stable, and presented convergent validity. Conclusion: The Portuguese version of PCL-5 is reliable and valid. The findings suggest the appropriateness of the DSM-5 model to assess PTSD symptomatology, encouraging its use in clinical, and research settings. K E Y W O R D S firefighters, Portuguese version, Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5), Portuguese version, psychometric properties, PTSD model comparison

Using Exploratory Structural Equation Modeling (ESEM) to Examine the Internal Structure of Posttraumatic Stress Disorder Symptoms

“…The results also provide evidence of reliability and validity that allows the use of the PCL-5 as a symptomatic screening tool for PTSD in Chile in non-clinical undergraduate students' samples. The Cronbach's alpha of the subscales is adequate and similar to that of the English version and of the adaptations made in French, German, Portuguese, Turkish and Deuth (α = .75-.94) (Ashbaugh et al, 2016;Boysan et al, 2017;Carvalho et al, 2020;Krüger-Gottschalk et al, 2017;van Praag et al, 2020;Wortmann, et al, 2016). The internal structure validity agrees with the theoretical structure proposed by the DSM-5 using CFA, similar to the structure reported in studies carried out in other countries (Armour et al, 2015;Boysan et al, 2017;Lee et al, 2019;Liu et al, 2014;Makhubela, 2018;Tsai et al, 2015;van Praag et al, 2020;Wang et al, 2015), and with the use of ESEM.…”

“…This is the first study combining both CFA and ESEM to assess the internal structure of PTSD symptoms of DSM-5. The CFA models explored were similar to previous studies showing good fit indices, high correlation between their factors, and interchangeability of items between factors in different models (Armour et al, 2015;Ashbaugh et al, 2016;Blevins et al, 2015;Bovin et al, 2016;Boysan et al, 2017;Carvalho et al, 2020;Lee et al, 2019;Liu et al, 2014;Makhubela, 2018;Seligowski, & Orcutt, 2016;Tsai et al, 2015;van Praag et al, 2020;Wortmann et al, 2016;Wang et al, 2015). Specifically in this Chilean undergraduate sample, the six models tested presented good fit index similar to that reported in a high school student sample in China (Wang et al, 2015), a U.S. veterans sample (Armour et al, 2015), and a clinical sample in Turkey (Boysan et al, 2017).…”

“…A series of studies have reported the factor structure of Posttraumatic Stress Disorder (PTSD) proposed in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Structural analyzes have been performed using confirmatory factor analysis (CFA) in diverse samples (clinical and non-clinical population, veterans, civilians, high school or undergradate students) in different countries, with a probable PTSD prevalence ranging from 4.2% to 74.1% (Armour et al, 2015;Ashbaugh et al, 2016;Blevins et al, 2015;Bovin et al, 2016;Boysan et al, 2017;Carvalho et al, 2020;Krüger-Gottschalk et al, 2017;Lee et al, 2019;Liu et al, 2014;Makhubela, 2018;Seligowski & Orcutt, 2016;Tsai et al, 2015;van Praag et al, 2020;Wortmann et al, 2016;Wang et al, 2015) (see Table 1).…”

Future Perspectives From a Case Report of Transcranial Magnetic Stimulation, Cognitive Behavioral Therapy, and Psychopharmacological Treatment for Post-traumatic Stress Disorder

“…The State Trait Anxiety Inventory (STAI) (Spielberger et al, 1983 ; Silva and Campos, 1998 ) was collected at the same time points in order to measure self-reported anxiety symptoms that commonly co-occur with PTSD (Brady et al, 2000 ). In order to assess PTSD symptomatology, the self-rated PTSD Checklist for DSM-5 (PCL-5) (Blevins et al, 2015 ; Carvalho et al, 2020 ), was used. Finally, at baseline and at the end of acute and continuation treatment cycles, PTSD symptoms were also assessed using Clinician-Administered PTSD Scale for DSM-5 (CAPS-5) (Weathers et al, 2018 ; Oliveira-Watanabe et al, 2019 ).…”

Validation of the PTSD Checklist for DSM-5 (PCL-5) on Patients Injured in Car Accidents

“…The validations were mostly undertaken on US veterans, but some were on other clinical groups: HIV positive patients, addicted patients, recipients of bone marrow transplant, women with breast cancer, mothers of pediatric cancer survivors [2]. Noteworthy are validations of the Chinese version of PCL-5 on frontline healthcare workers in the outbreak of COVID-19 by Cheng et al [4], and of the Portuguese version on firefighters by Carvalho et al [5], and of the German version on a heterogenous sample of persons who experienced trauma in the form of physical assaults, or traffic accidents, other accidents, sexual assaults, combat, or natural disasters [6].…”