The Posttraumatic Stress Disorder (PTSD) Checklist for the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM–5; PCL–5) is a widely used self-rated measure of DSM–5 PTSD symptoms. The goal of this systematic review was to synthesize research on the psychometric properties of the PCL–5 to guide clinical and research applications. We focused on reliability, validity, factor structure, optimal cutoff scores, and sensitivity to clinical change indices. A systematic review of the literature following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was conducted using PubMed, PsycINFO, CINAHL, and PTSDpubs with search terms capturing selected psychometric indices of the PCL–5. The inclusion criteria were: peer-reviewed publication in English; primary focus on the PCL–5 psychometrics; empirical study; and study with adult samples. The search yielded 265 studies; 56 articles (amounting to 64 studies) met inclusion criteria and were reviewed. Findings generally indicated evidence for: acceptable internal consistency and test–retest reliability; construct validity; a seven-factor Hybrid Model; recommended cutoff scores between 31 and 33; and ability to index sensitivity to clinical change. To further advance knowledge and applications of the PCL–5, we need more research on abbreviated versions of the PCL–5, bi-factor modeling as applied to the PCL–5, as well as on PCL–5 item difficulty estimates, discrimination parameters, and clinical change score estimates.

Topic. Limited research has examined trauma and posttraumatic stress disorder (PTSD) among Asian Indians in the U.S. Thus, we (1) synthesize literature on trauma, PTSD, disparities in treatment for PTSD, the burden of untreated PTSD, and culturally-adapted (CA) PTSD interventions; and (2) discuss recommendations for clinicians/researchers working with this population. Method. We searched two databases using keywords related to Asian Indians, PTSD, and interventions. Of 238 identified articles, we used content from 26 articles to inform our review. Findings. Asian Indians report traumatic experiences before, during, or after immigration to the U.S. and consequential PTSD symptoms. Further, Asian Indians in the U.S. are disproportionately impacted by socio-cultural and economic determinants of poor mental health (e.g., shame/stigma associated with seeking mental health services, few culturally-responsive services), which may contribute to the under-reporting of PTSD and (interpersonal) traumas and less willingness to seek treatment. Additionally, CA PTSD interventions tailored to Asian Indians in the U.S. have not been developed. Socio-cultural considerations that can inform CA PTSD interventions for Asian Indians include: causal conditions (e.g., culturally-rooted beliefs about trauma/PTSD), intervening conditions/barriers (e.g., emotional inhibition), and mitigating/coping strategies (e.g., religious/spiritual practices, cultural idioms of distress). These considerations influence clinician/treatment preferences (e.g., solution-oriented and structured therapy, less emotional exposure). Lastly, we outline recommendations for clinicians/researchers: (1) need for national studies on trauma, PTSD, treatment utilization, and the burden of untreated PTSD; (2) consideration of immigration-related experiences influencing PTSD; (3) consideration of socio-cultural elements for CA PTSD interventions; and (4) need for culturally-valid PTSD assessments.

Objective: Stressors and worries related to the COVID-19 pandemic have contributed to the onset and exacerbation of psychological symptoms such as posttraumatic stress disorder (PTSD). Using a microlongitudinal framework, we uniquely investigated bidirectional associations between daily-level PTSD symptoms and COVID-19 worries. Method: Data from 42 trauma-exposed university students (Mage = 22.67 ± 5.02, 86.7% female) were collected between March and August 2020. Participants completed daily surveys for 10 days to assess PTSD symptom severity and COVID-19 worries. Multilevel regression was conducted to examine both lagged and simultaneous models of daily person-centered mean PTSD symptom severity predicting COVID-19 worries, and vice-versa. Results: Days with greater COVID-19 worries were associated with greater same-day (b = .53, SE = .19, p = .006) and next-day (b = .65, SE = .21, p = .003) PTSD symptom severity. Additionally, days with greater PTSD symptom severity were associated with greater same-day COVID-19 worries (b = .06, SE = .02, p = .006). Conclusions: COVID-19 worries may influence same-day and next-day PTSD symptoms, and PTSD symptoms may influence same day COVID-19 worries. Findings substantiate the interplay between ongoing stress related to the COVID-19 pandemic and posttrauma symptoms and support therapeutically targeting COVID-19 stress in PTSD treatments to potentially impact posttrauma symptoms.

Introduction The COVID-19 pandemic has resulted in substantial changes in social interactions, work schedules, and socioeconomic factors that may negatively impact sleep onset, maintenance, and quality. The ongoing stress of the pandemic also may exacerbate existing racial/ethnic disparities in sleep health. In this study, we examined the effects of COVID-19 related distress on sleep-related impairment and sleep disturbances among trauma-exposed South Asian adults. Since a health advantage among foreign-born individuals has been previously noted in the literature (the “immigrant paradox”), we also assessed whether generational status (i.e., being born in the U.S. or not) moderated associations between COVID-19 related distress and sleep outcomes. Methods Participants were recruited through Amazon’s Mechanical Turk and completed online surveys on demographic information, the COVID-19 Stress Scale, The Life Events Checklist for DSM-5 (LEC-5), and PROMIS™ Sleep-Related Impairment and Sleep Disturbances Scale. The final sample included 316 South Asian adults residing in the U.S, who had been exposed to a traumatic event at some point in their lifetime. Most participants were male (55%) and U.S.-born citizens (64%), with an average age of 35.32 (SD = 9.52) years. Results Examination of t-scores for PROMIS™ sleep-related and sleep disturbances revealed that our sample endorsed slightly higher values than the general U.S. population. Greater COVID-19 distress was associated with more sleep disturbances (b = 0.09, p < .001, sr2 = .04) and sleep-related impairment (b = 0.20, p < .001, sr2 = .12). Generational status was not associated with sleep, nor did it modify associations between COVID-19 distress and sleep. Conclusion In our sample, we found that psychological distress triggered by the pandemic (e.g., fear of contamination, fear of the dangerousness of the virus, socioeconomic worries) was associated with greater sleep difficulties. Our findings highlight the importance of developing targeted interventions to cope with stress and sleep disturbances during the pandemic, particularly among vulnerable populations, such as those exposed to trauma. Our results did not support the immigration paradox: stress and sleep associations were similar regardless of generational status. Future studies are needed to better understand the role of generational status on sleep across different immigrant subgroups. Support (If Any)

The COVID‐19 pandemic has resulted in substantial changes in individual and socio‐economic factors that may negatively impact sleep health. We examined associations between COVID‐19 related distress and sleep among trauma‐exposed South Asian adults in the United States. Since a health advantage among foreign‐born individuals has been previously noted in the literature (the ‘immigrant paradox’), we also explored if generational status (number of generations one's family has been in the U.S.) moderated associations between COVID‐19 related distress and sleep health. Participants were 196 trauma‐exposed South Asian adults residing in the U.S. (54% male, 63% U.S.‐born citizens, average age = 34.51 years), who completed measures of generational status, COVID‐19 related distress, trauma exposure, sleep‐related impairment (SRI), and sleep disturbances. Greater COVID‐19 distress was associated with more sleep disturbances ( b = 0.15, p < 0.001) and SRI ( b = 0.24, p < 0.001). Generational status was not associated with sleep, nor did it modify associations between COVID‐19 distress and sleep. Findings highlight the potential importance of developing interventions to reduce stress and sleep difficulties during the pandemic. Our results did not support the immigration paradox. Future studies are needed to better understand the role of generational status on sleep health across immigrant subgroups.