Posttraumatic Stress Disorder 527
PTSD Checklist
The PTSD Checklist (PCL) is a 17-item questionnaire developed at the National Cen-
ter for PTSD to assess severity of PTSD symptoms (see review by Norris & Hamblen,
2004). Revised for DSM-IV, symptoms are rated on five-point scales for the past month
with two versions of the questionnaire available: one that assesses how much you are
bothered by symptoms from stressful experiences in the past (PCL-C) or how much you
are bothered by symptoms in reaction to a specific event (PCL-S). In addition there is a
military version of the PCL (PCL-M). The PCL possesses sound psychometric proper-
ties. In the original validation study conducted on the PCL-M, the Total Score (summed
over the 17 items) had high internal consistency (alpha = .97), test– retest reliability (r =
.96), and strong convergent validity with other measures of PTSD (see Norris & Ham-
blen, 2004, for discussion). The reliability, convergent validity, and diagnostic efficiency
of the PCL have been well supported (e.g., Blanchard, Jones- Alexander, Buckley, &
Forneris, 1996; Bliese et al., 2008; Ruggiero, Del Ben, Scotti, & Rabalais, 2003). How-
ever, studies of the factorial validity of the PCL failed to confirm a three- factor model
that corresponds to the DSM-IV three- factor structure (DuHamel et al., 2004; Palmieri
et al., 2007). Even though a suggested cutoff score of 60 yielded good diagnostic utility
when compared with the CAPS, different PCL scoring options tend to produce differ-
ences in sensitivity, specificity, and diagnostic efficiency (Pratt, Brief, & Keane, 2006).
A lower cutoff value between 30 and 34 is recommended for primary care settings and
50 has been suggested for military samples (Bliese et al., 2008). The PCL, then, appears
to be a strong measure of PTSD symptoms but suffers from the same limitations that
are apparent in most self- report measures of the disorder. A copy of the PCL is available
from the National Center for PTSD (www.ncptsd.va.gov/ncmain/assessment).
Measures of Cognition
Taylor (2006) noted that several measures have been developed to assess beliefs in
trauma survivors but most are research instruments with little psychometric evaluation.
For example, the World Assumptions Scale was developed by Janoff- Bulman (1989) to
assess beliefs about the world that may be challenged by traumatic events. Although
often cited in the PTSD literature, the measure appears to have some psychometric
limitations (Kaler et al., 2008) and fails to assess the full range of beliefs described in
current CBT models of PTSD.
Posttraumatic Cognitions Inventory
The Posttraumatic Cognitions Inventory (PTCI) is a 33-item questionnaire that assesses
trauma- related thoughts and beliefs across three factorially derived cognitive domains:
negative cognitions about self, negative cognitions about world, and self-blame for the
trauma (Foa, Ehlers, et al., 1999). The factorial structure of the PTCI was supported in
a confirmatory factor analysis of motor vehicle survivors (J. G. Beck et al., 2004). In the
validation study the internal consistency coefficients of all three subscales were high (a’s
of .86 to .97) and 1-week test– retest reliability indicated temporal stability (r’s of .75 to
.89). The PTCI subscales and total score correlate highly with PTSD symptom severity