Clinical Profile on the PTSD Checklist for DSM-5 (PCL-5) of Veterans versus Patients Injured in Motor Vehicle Accidents

Abstract

Background: The 20 items of PTSD Checklist for DSM-5 (PCL-5) can be rank ordered from highest to the lowest, based on item mean scores in a particular clinical group. Thus, they can provide an overview of the relative importance of each of the symptoms represented by these 20 items, i.e., a clinical profile for the particular type of patients. This study compared such ranking of PCL-5 items by US veterans with those of patients injured in high impact motor vehicle accidents (MVAs).
 Method: De-identified PCL-5 data were available for 80 post-MVA patients (mean age 38.9 years, SD=12.8) and for 468 US veterans (mean age 55.4 years, SD=13.8). The US veterans’ data are those published by Bovin et al. in 2016.
 Results and Discussion: The overall rank order of PCL-5 items was significantly similar in the two groups (Spearman’s rho=.83), perhaps due to certain similarities of the two groups (potential threat to life or of severe physical injury). Both groups rated the Item 20 (sleep difficulties) as the most prominent, and they rated Item 16 (taking too many risks) and then Item 8 (trouble remembering details of the stressful event) as least prominent.
 The largest clinically interesting difference in the item rank was on Item 12 (loss of interest in previously enjoyed activities) which was more prominent in the MVA patients, presumably due to their persistent post-accident pain (all but one MVA patient reported pain, and in 82.5% the pain was rated as more than mild).
 Conclusions: In both groups, the ratings of sleep difficulties were the most prominent and ratings of taking excessive risks and of not remembering details of stressful evens were least prominent. The overall rank order of the 20 items was significantly similar in the two groups.