Exploration of PCL-5 symptom validity indices for detection of exaggerated and feigned PTSD

ABSTRACT

Introduction

There are very few symptom validity indices directly examining overreported posttraumatic stress disorder (PTSD) symptomatology, and, until recently, there were no symptom validity indices embedded within the PTSD Checklist for the DSM-5 (PCL-5), which is one of the most commonly used PTSD measures. Given this, the current study sought to develop and cross-validate symptom validity indices for the PCL-5.

Method

Multiple criterion groups comprised of Veteran patients were utilized (N = 210). Patients were determined to be valid or invalid responders based on Personality Asessment Inventory symptom validity indices. Three PCL-5 symptom validity indices were then examined: the PCL-5 Symptom Severity scale (PSS), the PCL-5 Extreme Symptom scale (PES), and the PCL-5 Rare Items scale (PRI).

Results

Area under the curve statistics ranged from .78 to .85. The PSS and PES both met classification accuracy statistic goals, with the PES achieving the highest sensitivity rate (.39) when maintaining specificity at .90 or above across all criterion groups. When an ad hoc analysis was performed, which included only patients with exceptionally strong evidence of invalidity, sensitivity rates increased to .60 for the PES while maintaining specificity at .90.

Conclusions

These findings provide preliminary support for new PTSD symptom validity indices embedded within one of the most frequently used PTSD measures.

KEYWORDS:

• PCL-5
• symptom validity
• PTSD
• malingering

Disclosure statement

The views within this article are those of the authors, and they should not be taken as Veterans Administration policy, position, or decision.

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.