Validation of the post-traumatic stress disorder checklist for DSM-V (PCL-5) in the Maltese perinatal population

Abstract

BACKGROUND: Perinatal post-traumatic stress disorder (PPTSD) is a stress-induced mental health condition, occurring in pregnancy and/or following childbirth. Left untreated, PPTSD can result in negative consequences for the entire family unit. This paper reports the validation of the self-report Post-Traumatic Checklist for DSM-V (PCL-5) questionnaire against the gold standard Clinician-Administered PTSD Scale for DSM-V (CAPS-5) diagnostic interview in the Maltese perinatal population.

METHODS: The original English version of the PCL-5 was translated into Maltese and culturally adapted for use in this population. A total of 175 pregnant and/or post-partum mothers were recruited and self-completed the PCL-5 questionnaire. 28 mothers met criteria for CAPS-5 assessment which was performed by one of two trained professionals, following inter-rater reliability assessment.

RESULTS: A strong, positive correlation between the Maltese and English-version of the PCL-5 was obtained (Kendall's tau-b 0.812; p-value <0.001). The internal consistency of the PCL-5 was high (Cronbach alpha=0.935) and the instrument showed a good validity (Pearson Correlation=0.710; p-value 0.004). The suggested PCL-5 cut off point for a provisional PPTSD diagnosis is 36. The prevalence of PPTSD for Malta ranges between 0% and 3.63%. This figure needs to be interpreted given the relatively small sample size.

CONCLUSION: The Maltese-language version of PCL-5 has good reliability and validity, confirming its diagnostic utility as a screening instrument in the early and timely detection of PPTSD sufferers.