Symptom validity indices in the Posttraumatic Stress Disorder Checklist for DSM‐5

Abstract

The use of symptom validity tests (SVTs) is standard practice in psychodiagnostic assessments. Embedded measures are indices within self‐report measures. To date, no embedded SVTs have been identified in the Posttraumatic Stress Disorder Checklist for DSM‐5 (PCL‐5). This research aimed to develop and validate PCL‐5 SVTs in two samples of veterans. Participants completed one of two prospective research studies that included cognitive and psychological tests. Participants in Study 1 were veterans (N = 464) who served following the September 11, 2001, terrorist attacks; participants in Study 2 were veterans or service members (N = 338) who had been deployed to Iraq and/or Afghanistan. Both studies included the PCL‐5 and the Structured Inventory of Malingered Symptomatology (SIMS), the latter of which served as the criterion for identifying PCL‐5 SVTs. For Study 1, two separate SVTs were developed: the PCL‐5 Symptom Severity scale (PSS), based on the PCL‐5 total score, and the PCL‐5 Rare Items scale (PRI), based on PCL‐5 items infrequently endorsed at the highest item ratings. At the most conservative SIMS cutoff score, the PSS achieved excellent discrimination for both the Study 1, AUC = .840, and Study 2 samples, AUC = .858, with specific cutoff scores of ≥ 51 and ≥ 56 maximizing sensitivity while maintaining a specificity of .90. The PRI achieved good discrimination, AUCs = .760 and.726, respectively, with a cutoff score of 2 or higher indicated by both studies. The results of these two studies provide provisional support for these two embedded SVTs in the PCL‐5.

The impact of screening positive for hazardous alcohol use on the diagnostic accuracy of the PTSD Checklist for DSM‐5 among veterans

“…The results were consistent with those reported; the optimally efficient cutoff scores for participants with positive AUDIT-C screens were 34-37, and 30 for participants with negative AUDIT-C screens. Second, to examine the impact of invalid response patterns, we calculated the PCL-5 rare items scale (PRI; Shura et al, 2023) and reran the analyses without participants with potentially invalid scores. Cutoff scores were identical to those reported for participants with and without positive AUDIT-C screens.…”

Assessing the credibility of clinical presentations using performance and symptom validity tests: Current trends and future directions—Part II.

“…This is an introduction to the special issue "Assessing the Credibility of Clinical Presentations Using Performance and Symptom Validity Tests: Current Trends and Future Directions-Part II." Please see the Table of Contents here: http://psycnet.apa.org/PsycARTICLES/ journal/pne/16/3/-DCM embedded (Bodapati et al, 2019;Crighton et al, 2014;Fuermaier et al, 2023;Shura et al, 2023;Vanderploeg et al, 2014) and free-standing SVTs (Merten et al, 2016;Viglione et al, 2017). In contrast, perhaps because there are many more well-validated and widely used PVTs than SVTs Sweet et al, 2021), current PVT research seems to focus more on expanding the knowledge base on existing instruments, in the form of introducing new trials (C. Abeare et al, 2019;C.…”

“…In that article, we also highlighted that there appear to be two slightly different research trends when considering emerging empirical studies that focus on symptom validity tests (SVTs) versus performance validity tests (PVTs). Research on SVTs currently seems to focus on validating existing measures (Carvalho et al, 2021; Geurten et al, 2018; Giromini et al, 2018; Grønnerød et al, 2023; Pignolo et al, 2023; Roma et al, 2020; van Helvoort et al, 2019) and developing new ones in the form of both embedded (Bodapati et al, 2019; Crighton et al, 2014; Fuermaier et al, 2023; Shura et al, 2023; Vanderploeg et al, 2014) and free-standing SVTs (Merten et al, 2016; Viglione et al, 2017). In contrast, perhaps because there are many more well-validated and widely used PVTs than SVTs (Giromini et al, 2022; Sweet et al, 2021), current PVT research seems to focus more on expanding the knowledge base on existing instruments, in the form of introducing new trials (C.…”

“…Capitalizing on these advantages was the engine behind the exponential growth in embedded PVTs (Sherman et al, 2020). It appears that symptom validity research has historically underutilized this approach, although recent publications signal a potential shift in that trend (Fuermaier et al, 2023; Shura et al, 2023).…”