Psychometric properties of the Turkish version of the PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (PCL-5)

Figures & data

Table 1. Sample demographical characteristics.

		n	%
Sex	Male	180	38.96
Marital status	Single	381	82.47
Education	No education	13	2.81
	Elementary	32	6.93
	High school	28	6.06
	University	389	84.20
Psychiatric diagnosis	Control	360	77.92
	Depression	73	15.80
	PTSD	29	6.28
Physical illness		64	13.85
Prior psychiatric illness		55	11.90
Family history of psychopathology		45	9.74

Table 2. Prior trauma rated on the LEC-5.

	n	%
Natural disaster	337	72.94
Fire/explosion	55	11.90
Motor vehicle accident	101	21.86
Other serious accident	38	8.23
Exposure to toxic substance	31	6.71
Physical assault	105	22.73
Assault with weapon	22	4.76
Sexual assault	19	4.11
Unwanted sexual experience	22	4.76
Combat	16	3.46
Captivity	1	0.22
Life-threatening injury/illness	33	7.14
Severe suffering	110	23.81
Witness violent death	23	4.98
Sudden death of important others	34	7.36
Caused death/injury of another	13	2.81
Other stressful events	196	42.42

Table 3. Model fit indices from multi-sample CFA of the PCL-5.

	Factor	df	S–B χ^2	RMSEA	TLI	CFI	IFI	SRMR1	SRMR2
Constrained model	4	374	648.03	.056	.98	.98	.98	.055	.13
Unconstrained model	4	354	616.04	.057	.98	.98	.98	.050	.094

Note: df = degrees of freedom, S–B χ² = Satorra–Bentler Scaled χ², RMSEA = root mean square of approximation, TLI = Tucker–Lewis Index, CFI = comparative fit index, IFI = incremental fit index, SRMR = standardized root mean residuals.

Table 4. Standardized factor loadings of the PCL for DSM-5 from multi-sample CFA.

	Factor I: re-experiencing		Factor II: avoidance		Factor III: negative alterations		Factor IV: hyper-arousal
	Control	Clinical	Control	Clinical	Control	Clinical	Control	Clinical
Item 1	.69	.83
Item 2	.59	.82
Item 3	.65	.87
Item 4	.69	.96
Item 5	.67	.65
Item 6			.74	.94
Item 7			.77	.89
Item 8					.66	.80
Item 9					.66	.72
Item 10					.63	.78
Item 11					.68	.90
Item 12					.66	.64
Item 13					.65	.71
Item 14					.69	.69
Item 15							.74	.76
Item 16							.62	.80
Item 17							.66	.72
Item 18							.56	.82
Item 19							.66	.70
Item 20							.61	.64
Composite reliability (for the overall scale = 0.94 and 0.97, respectively)	.79	.92	.73	.91	.85	.90	.81	.88
% of variance explained	10.86	17.31	5.70	8.38	15.32	19.83	12.45	16.54

Note: Statistical significance for all factor loadings exceeded the significance threshold (p < .05).

Table 5. Descriptives and item statistics of the measures.

	n	α	Intra r	Rjt	Inter-item r	M	SD	M range (items)	SD range (items)
PCL for DSM-5	462	.94	.80**	.57–.71	.27 to .64	39.19	17.47	1.51–2.38	1.11–1.43
Re-experiencing (B Criteria)	462	.84	.70**	.60–.67	.45 to .61	10.15	4.70	1.62–2.38	1.11–1.29
Avoidance (C Criteria)	462	.78	.64**	.64–.64	.64 to .64	4.10	2.27	2.04–2.06	1.24–1.27
Negative alterations (D Criteria)	462	.87	.78**	.60–.67	.38 to .60	13.60	6.81	1.71–2.11	1.18–1.38
Hyper-arousal (E Criteria)	462	.83	.76**	.57–.66	.37 to .55	11.34	5.94	1.51–2.22	1.30–1.43
TSC-40	462	.94	.73**	.21–.73	−.04 to .69	34.19	20.80	0.18–1.80	0.55–1.12
Dissociation	462	.79	.75**	.45–.65	.27 to .54	6.27	4.18	0.45–1.47	0.81–1.09
Anxiety	462	.79	.73**	.24–.61	.10 to .48	7.77	5.29	0.18–1.40	0.55–1.08
Depression	462	.81	.71**	.36–.64	.14 to .59	8.80	5.80	0.36–1.80	0.81–1.12
Sexual Abuse Trauma Index	462	.70	.72**	.27–.49	.10 to .44	5.40	3.93	0.24–1.47	0.65–1.09
Sleep disturbance	462	.77	.67**	.31–.66	.19 to .69	2.59	4.12	0.26–1.63	0.69–1.11
Sexual problems	462	.84	.70**	.36–.69	.11 to .65	6.93	4.17	0.24–0.41	0.65–0.85
LEC-5	462	.63	.83**	.07–.43	−.08 to .36	2.50	1.97	0.01–.073	0.05–0.85
DES	462	.94		.40–.67	.11 to .61	21.38	16.18	0.66–4.31	15.64–32.30
BAI	462	.94		.48–.75	.21 to .72	19.27	13.82	0.24–1.65	0.65–1.10
BDI	462	.93		.37–.76	.14 to .61	16.91	12.47	0.25–1.21	0.59–1.18
PTCI	462	.97		.45–.78	.17 to .76	96.58	45.80	2.05–4.90	1.69–2.30
Negativistic Cognitions About Self	462	.96		.63–.80	.40 to .76	53.07	32.11	2.05–3.43	1.69–2.24
Negativistic Cognitions About World	462	.89		.64–.74	.45 to .70	29.24	11.93	3.54–4.90	2.11–2.30
Self-blame	462	.76		.50–.63	.23 to .51	14.28	7.35	2.23–3.53	1.81–2.20

Note: n = sample size, α = internal consistency, intra r = 15-day interval test retest intra-correlations (n = 53), Rjt = corrected item-total correlations (range), inter-item r = Spearman inter-item correlations (range), M = mean, SD = standard deviation, M range (items) = item means (range), SD range (items) = item standard deviations (range).

**p < .01.

Table 6. Comparison of mean scale scores between groups.

	Control (n = 360)		Depression (n = 73)		PTSD (n = 29)
	Mean	SD	Mean	SD	Mean	SD	F(2, 459)	p	η^2	Post hoc^a
PCL for DSM-5	36.26	16.31	46.84	17.36	56.34	16.49	29.193	<.001	.113	Control < Depression < PTSD
Re-experiencing (B Criteria)	9.41	4.37	12.07	4.89	14.55	4.66	25.703	<.001	.101	Control < Depression < PTSD
Avoidance (C Criteria)	3.83	2.16	4.86	2.23	5.52	2.76	13.088	<.001	.054	Control < Depression = PTSD
Negative alterations (D Criteria)	12.52	6.42	16.63	6.91	19.45	6.19	24.755	<.001	.097	Control < Depression < PTSD
Hyper-arousal (E Criteria)	10.51	5.64	13.27	5.91	16.83	5.69	21.538	<.001	.086	Control < Depression < PTSD
TSC-40	29.59	18.15	46.45	20.72	60.48	20.29	55.169	<.001	.194	Control < Depression < PTSD
Dissociation	5.71	3.95	7.32	4.10	10.59	4.15	23.073	<.001	.091	Control < Depression < PTSD
Anxiety	6.78	4.87	10.70	4.91	12.72	5.85	34.623	<.001	.131	Control < Depression < PTSD
Depression	7.48	4.96	12.56	6.25	15.72	5.37	56.262	<.001	.197	Control < Depression < PTSD
Sexual Abuse Trauma Index	4.66	3.45	7.11	4.15	10.24	4.32	41.559	<.001	.153	Control < Depression < PTSD
Sexual problems	1.61	2.77	5.51	5.63	7.48	6.36	61.947	<.001	.213	Control < Depression < PTSD
Sleep disturbance	6.29	3.89	8.56	4.34	10.76	4.15	24.200	<.001	.095	Control < Depression < PTSD
LEC-5	2.33	1.82	2.73	2.17	4.10	2.47	11.992	<.001	.050	Control = Depression < PTSD
DES	20.81	15.55	18.51	15.84	35.63	18.09	13.295	<.001	.055	Control = Depression < PTSD
BAI	16.44	12.32	28.37	14.13	31.52	14.52	40.783	<.001	.151	Control < Depression < PTSD
BDI	13.24	9.67	28.36	11.84	33.59	14.11	104.684	<.001	.313	Control < Depression = PTSD
PTCI	87.62	40.05	118.14	50.50	153.66	42.41	44.582	<.001	.163	Control < Depression < PTSD
Negative Cognitions About Self	45.69	26.97	72.89	35.08	94.76	31.08	60.123	<.001	.208	Control < Depression < PTSD
Negative Cognitions About World	28.42	11.66	29.56	12.67	38.55	9.28	10.093	<.001	.042	Control = Depression < PTSD
Self-blame	13.51	7.00	15.68	7.83	20.34	7.29	13.943	<.001	.057	Control = Depression < PTSD

^aPost hoc analysis was conducted using the Student–Newman–Keuls multiple comparison test.

Table 7. Pearson’s product moment correlations between the PCL for DSM-5 and TSC-40.

	TSC-40	Dissociation	Anxiety	Depression	Sexual Abuse Trauma Index	Sexual problems	Sleep disturbance
PCL for DSM 5	.75**	.67**	.67**	.71**	.67**	.33**	.62**
Re-experiencing (B Criteria)	.66**	.58**	.60**	.62**	.61**	.28**	.57**
Avoidance (C Criteria)	.57**	.50**	.54**	.53**	.51**	.19**	.46**
Negative alterations (D Criteria)	.68**	.61**	.58**	.65**	.60**	.33**	.51**
Hyper-arousal (E Criteria)	.69**	.61**	.62**	.64**	.60**	.29**	.62**

**p < .01.

Table 8. Pearson’s product moment correlations of the PCL for DSM-5 and TSC-40 with psychological variables.

	DES	BAI	BDI	PTCI	Negative Cognitions about Self	Negative Cognitions about the World	Self-blame
PCL for DSM-5	.53**	.66**	.64**	.61**	.58**	.47**	.48**
Re-experiencing (B Criteria)	.43**	.64**	.55**	.54**	.51**	.42**	.41**
Avoidance (C Criteria)	.40**	.51**	.48**	.47**	.44**	.39**	.38**
Negative alterations (D Criteria)	.50**	.57**	.61**	.59**	.57**	.44**	.49**
Hyper-arousal (E Criteria)	.48**	.58**	.56**	.51**	.49**	.39**	.39**
TSC-40	.57**	.75**	.75**	.70**	.70**	.51**	.49**
Dissociation	.63**	.64**	.61**	.60**	.59**	.47**	.42**
Anxiety	.47**	.75**	.63**	.58**	.57**	.43**	.39**
Depression	.47**	.69**	.75**	.67**	.68**	.47**	.47**
Sexual Abuse Trauma Index	.57**	.66**	.66**	.61**	.60**	.47**	.43**
Sexual problems	.26**	.41**	.48**	.41**	.43**	.22**	.29**
Sleep disturbance	.41**	.61**	.56**	.51**	.50**	.39**	.35**

**p < .01.

Figure 1. Receiver operator characteristic curve indicating sensitivity and specificity of the PTSD Checklist for DSM-5 in identifying individuals meeting diagnostic criteria of PTSD based on DSM-5.

Figure 2. Conjoint plot indicating the optimal cut-off point of sensitivity and specificity of the PTSD Checklist for DSM-5 in identifying individuals accurately meeting diagnostic criteria of PTSD based on DSM-5.

Table 9. Sensitivity, specificity, and accuracy of the PCL for DSM-5 cut-off scores.

Score	Sensitivity	Specificity	Diagnostic efficiency
40	.828	.545	.687
41	.828	.559	.694
42	.828	.591	.710
43	.759	.612	.686
44	.759	.633	.696
45	.759	.642	.701
46	.759	.663	.711
47	.759	.691	.725
48	.724	.714	.719
49	.690	.725	.708
50	.690	.744	.717
51	.655	.755	.705
52	.655	.778	.717
53	.621	.792	.707
54	.621	.799	.710
55	.621	.811	.716
56	.621	.824	.723
57	.586	.836	.711
58	.552	.864	.708
59	.483	.878	.681

Note: Sensitivity: true positives/(true positives + false negatives), specificity: true negatives/(true negatives + false positives), diagnostic efficiency = (sensitivity + specificity)/2.

Table

Aşağıda çok stresli bir olay karşısında insanların yaşayabildikleri problemlerin bir listesi yer almaktadır. Zihninizi meşgul etmeye DEVAM EDEN yaşadığınız en kötü olayı düşünerek aşağıda listelenen her bir problemi dikkatlice okuyun. SON BİR AY İÇİNDE bu olayın size ne kadar sıkıntı verdiğini, sağdaki kutuların içindeki size en uygun rakamı yuvarlak içine alarak gösteriniz
GEÇEN AY içinde aşağıda yer alan durumlar sizi ne ölçüde bunalttı	Hiç	Çok az	Orta derecede	Oldukça fazla	Aşırı
1. Stresli olayın tekrarlayan, rahatsız eden ve istenmeyen anıları sizi ne kadar bunalttı?	0	1	2	3	4
2. Stresli olaya ilişkin tekrarlayan, rahatsız eden rüyalar sizi ne kadar bunalttı?	0	1	2	3	4
3. Aniden stresli olayı sanki gerçekten bir daha yaşıyormuş gibi hissetmek veya davranmak (sanki gerçekten olayın yaşandığı ana geri dönmüş yeniden yaşıyormuş gibi) sizi ne kadar bunalttı?	0	1	2	3	4
4. Bir şeyler size stresli olayı anımsattığı zaman yaşadığınız üzüntü hissi sizi ne kadar bunalttı?	0	1	2	3	4
5. Bir şeyler size stresli olayı anımsattığı zaman güçlü fiziksel tepkiler vermek (örneğin, kalp çarpıntısı, nefes almada güçlük, terleme gibi) sizi ne kadar bunalttı?	0	1	2	3	4
6. Stresli olayla ilişkili anılardan, düşüncelerden ve duygulardan kaçınmaya çalışmak sizi ne kadar bunalttı?	0	1	2	3	4
7. Stresli olayı anımsatan etraftaki hatırlatıcı şeylerden (örneğin, insanlardan, yerlerden, konuşmalardan, etkinliklerden, nesnelerden veya durumlardan) kaçınmaya çalışmak sizi ne kadar bunalttı?	0	1	2	3	4
8. Stresli olaya ilişkin önemli kısımları hatırlamada yaşanan güçlükler sizi ne kadar bunalttı?	0	1	2	3	4
9. Kendiniz, diğer insanlar veya dünya hakkında güçlü olumsuz düşüncelere sahip olmak (örneğin, kötü biriyim, bende ciddi şekilde yanlış olan bir şeyler var, kimseye güvenilmez, dünya tümüyle tehlikeli bir yerdir gibi düşünceler) sizi ne kadar bunalttı?	0	1	2	3	4
10. Stresli olay veya bu olayın sonrasında ortaya çıkan durumlar için kendinizi veya bir başkasını suçlamak sizi ne kadar bunalttı?	0	1	2	3	4
11. Korku, dehşete kapılma, öfke, suçluluk veya utanç gibi güçlü olumsuz duygular sizi ne kadar bunalttı?	0	1	2	3	4
12. Daha önce yapmaktan keyif aldığınız etkinliklere olan ilginizi kaybetmek sizi ne kadar bunalttı?	0	1	2	3	4
13. Başka insanlardan uzak veya kopmuş hissetmek sizi ne kadar bunalttı?	0	1	2	3	4
14. Olumlu duyguları yaşayamamak (örneğin, mutluluğu hissedememek veya size yakın insanlara sevgi dolu hisler duyamamak) sizi ne kadar bunalttı?	0	1	2	3	4
15. Asabi davranışlar, öfke patlamaları veya öfkeli hareketler sizi ne kadar bunalttı?	0	1	2	3	4
16. Çok fazla risk almak veya size zarar verebilecek şeyler yapmak sizi ne kadar bunalttı?	0	1	2	3	4
17. Aşırı tetikte olmak veya temkinli davranmak veya hazırda beklemek sizi ne kadar bunalttı?	0	1	2	3	4
18. Yerinden sıçramak veya kolayca irkilmek sizi ne kadar bunalttı?	0	1	2	3	4
19. Dikkati toplamada güçlükler sizi ne kadar bunalttı?	0	1	2	3	4
20. Uykuya dalma veya uykuyu devam ettirme güçlükleri sizi ne kadar bunalttı?	0	1	2	3	4

PCL-5 (8/14/2013) Weathers, Litz, Keane, Palmieri, Marx, and Schnurr – National Center for PTSD.