On the concordance between CAPS-5 and PCL-5 scores.

Background

As reported in this journal, Resick and colleagues (2023) investigated discrepancies between scores from two widely used PTSD measures: the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5; Weathers et al., 2013) and the PTSD Checklist for DSM-5 (PCL-5; Weathers et al., 2013), a clinician-rated structured interview and a self-rated questionnaire, respectively. Using data from four clinical trials of active-duty military personnel and veterans, the authors replicated the common finding that PCL-5 scores are higher than CAPS-5 scores. They then examined item response distributions, finding that ratings on the PCL-5 were more evenly distributed across all five options whereas specific CAPS-5 scores were used relatively infrequently. Concluding that this finding indicates a problem that should be addressed, they offered suggestions for revising anchors and items to improve correspondence between the two measures.

Objective

The results are informative and the nature and size of the sample are well-suited to this important research question. However, we have a number of concerns and comments about this paper.

Conclusion

In our view, the authors mischaracterized the CAPS-5 and PCL-5 in several important ways, resulting in some erroneous conclusions about their findings and the expected nature of the relationship between the CAPS-5 and PCL-5. Given that these issues are vital to the field of traumatic stress, we felt compelled to address them and provide an alternative perspective.