An Empirical Crosswalk for the PTSD Checklist: Translating DSM‐IV to DSM‐5 Using a Veteran Sample

Abstract

The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) introduced numerous revisions to the fourth edition's (DSM-IV) criteria for posttraumatic stress disorder (PTSD), posing a challenge to clinicians and researchers who wish to assess PTSD symptoms continuously over time. The aim of this study was to develop a crosswalk between the DSM-IV and DSM-5 versions of the PTSD Checklist (PCL), a widely used self-rated measure of PTSD symptom severity. Participants were 1,003 U.S. veterans (58.7% with PTSD) who completed the PCL for DSM-IV (the PCL-C) and DSM-5 (the PCL-5) during their participation in an ongoing longitudinal registry study. In a randomly selected training sample (n = 800), we used equipercentile equating with loglinear smoothing to compute a "crosswalk" between PCL-C and PCL-5 scores. We evaluated the correspondence between the crosswalk-determined predicted scores and observed PCL-5 scores in the remaining validation sample (n = 203). The results showed strong correspondence between crosswalkpredicted PCL-5 scores and observed PCL-5 scores in the validation sample, ICC = .96. Predicted PCL-5 scores performed comparably to observed PCL-5 scores when examining their agreement with PTSD diagnosis ascertained by clinical interview: predicted PCL-5, κ = 0.57; observed PCL-5, κ = 0.59. Subsample comparisons indicated that the crosswalk's accuracy did not differ across characteristics including gender, age, racial minority status, and PTSD status. The results support the validity of this newly developed PCL-C to PCL-5 crosswalk in a veteran sample, providing a tool with which to interpret and translate scores across the two measures.

Differential relationships of PTSD symptom clusters with cortical thickness and grey matter volumes among women with PTSD

“…PCL-5 scores were used as the measure of PTSD symptom severity for each cluster and for overall symptom severity in all analyses including PTSD symptoms. As a result, PCL-C scores were converted to PCL-5 scores using an established and validated crosswalk procedure using equipercentile equating 61 . All interview-based assessments were conducted by trained clinical interviewers.…”

Causal discovery identifies posttraumatic stress as a driver of internalizing symptoms across independent veteran and civilian populations

“…An additional exploratory GFCI analysis was performed to examine the relations among PTSD symptom clusters and depressive symptoms in the MYH sample to identify possible mechanisms of this relationship. As items of the PTSD Checklist (PCL) in MYH were formulated for the DSM-IV, we re-categorized them according to DSM-V re-experiencing, avoidance, negative alterations in cognition and mood (NACM), and hyperarousal clusters (see (67) for a previous analysis taking this approach). Multilevel confirmatory factor analysis (MLCFA) was fitted to the items, with four factors representing the DSM-V symptom clusters (see Figure S6 and the Supplementary MLCFA Method and Results).…”

Service Dogs for Veterans and Military Members With Posttraumatic Stress Disorder: Replication With the PTSD Checklist for DSM‐5

“…As meaningful comparisons cannot be made between raw PCL‐C and PCL‐5 scores, an additional test‐equating procedure was used to compare the results of the present study to the results of the replicated studies. This novel test‐equating procedure, the empirical crosswalk for the PCL, was developed by Moshier and colleagues (2019) to predict equated PCL‐5 scores from observed PCL‐C scores. The applications of this crosswalk for the present and replicated studies are presented in Table 3.…”

“…In addition to score comparisons allowed by Moshier and colleagues’ crosswalk (2019), the present and replicated studies can also be meaningfully compared by their relative effect sizes. The effect size of total PTSD symptom severity in the present study was almost equal to that found by Yarborough and colleagues (2017) and 0.3 units larger than that found by O'Haire and Rodriguez (2018; see Table 3).…”

“…Despite alterations in the wording of seven retained items, correlations have been shown to be high, and there is a strong continuity in symptom reporting between the two versions (Blevins et al., 2015). However, scores from the PCL‐5 and PCL for DSM‐IV are not interchangeable (Weathers et al., 2013), and raw scores may not be compared (Moshier et al., 2019).…”