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Purpose: To provide a brief overview of the developmental and psychometric properties of the PCL-M. This paper is available as a mail-out from the NCPTSD.
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Purpose: To compare the two versions of the PCL, the PCL-M and PCL-C.
Sample: Study 1: n=123 male Vietnam veterans and Study 2: n= 1006 Persian Gulf veterans. The mean (SD) PCL scores for study 1 and 2 PTSD subjects were 63.6 (SD=14.1) and 64.2 (SD=9.1), respectively. The Vietnam group demographic characteristics were: mean (SD) age, 43.74 (2.69) years; 100% men; 35% High school education, 24.4% less than high school; 28% married, 27% divorced, 26% single; 48% Army, 29.3% Marines; 73.2% White, 22.8% Black, and 2.4% Hispanic.
Methods: Study 1: subjects contacted the National Center for PTSD (NCPTSD) for clinical services or research participation. The subjects completed the PCL twice, 2-3 days apart, along with other measures of PTSD and general psychopathology as well as the PTSD module of the Structured Clinical Interview for DSM-III-R (SCID). Study 2: The subjects completed the PCL and Mississippi Scale either at the time of counseling (50%) or at an Army base, National Guard, or Reserve Unit (50%).
Implications: The PCL was found to be a reliable, easy to use, self-report rating scale that measures the 17 DSM-III-R PTSD symptoms. Also, the PCL correlated strongly with the Mississippi Scale, the PK scale of the MMPI-2, and the Impact of Event Scale; it moderately correlated with the level of combat exposures.

Purpose: To evaluate changes in PTSD Checklist (PTSD) scores from pre- to post-treatment related to accuracy and symptom severity against the “gold standard” of the Clinician Administered PTSD Scale (CAPS) interview.
Sample: N = 97 Vietnam veterans. Demographic characteristics: mean (SD) age, 51.69 (5.14) years; 86% were married; 16% were employed at the time of intake; 67% were currently receiving a pension where more than half of those were applying for an increase; mean (SD) CAPS and PCL scores at intake were 82.82 (SD=17.21) and 66.18 (SD=9.39) respectively.
Methods: Informed consent was obtained from all participants; the PCL and a battery of questionnaires were completed upon admission. The group treatment program was 12 weeks long and was divided into 4-week inpatient phase followed by a daily outpatient phase for 8 weeks; assessments were taken 12 months after initial treatment (9 months post-treatment). Also, the CAPS was re-administered, and the follow-up battery of questionnaires along with the PCL were completed.
Implications: The PCL had a tendency to underrate improvements as a function of treatment. The veterans’ PTSD ratings at intake were found to be higher than clinician ratings. Overall, the results suggest that small changes in self-report measures post-treatment may actually reflect a more significant clinical improvement.

Purpose: To examine the relationship between post-traumatic stress disorder (PTSD) and perceived physical health among Gulf War veterans.
Sample: N = 3682 Gulf War Veterans. Approximately half (51%) of the sample were deployed to the Persian Gulf, 53% served in a regular military unit during the time the Gulf War, 89% were enlisted, 56% were in the Army, 14% Air Force, 14% Marines, and 16% Navy or Coast Guard. Demographic characteristics: 91% mail, 96% White, 49% were >25 years of age. The mean (SD) PCL-M score was 58.7 (2.68) for those that screened positive for PTSD and 19.7 (0.24) for those that screened negative for PTSD.
Methods: Investigators at the University of Iowa, along with the Iowa Department of Public Health and the Centers for Disease Control and Prevention, conducted the study. The eligible subjects then completed a telephone interview. The assessment instruments included the PTSD Checklist-Military (PCL-M), which was used to assess PTSD symptoms. The physical health symptoms were assessed by questions from the Brief Symptom Inventory (BSI) and the Chronic Fatigue Syndrome Questionnaire (CFSQ) which led to seven categories: 1) constitutional symptoms (i.e hot or cold spells, fever), 2) neurologic symptoms (i.e loss of hearing or ringing in the ears), 3) cardiovascular symptoms (i.e heart palpitations), 4) gastrointestinal symptoms (i.e. reflux), 5) genitourinary symptoms (i.e. frequent or painful urination), 6) dermatologic symptoms (i.e. skin redness or skin rash), 7) musculoskeletal symptoms (i.e. back pain). Subjects also were asked to indicate whether specific medical conditions were present in the year before the interview; the Medical Outcomes Study Short Form-36 (SF-36) was used to assess functional status and health-related quality of life.
Implications: The subjects that were deployed to the Persian Gulf theater were twice as likely to screen positive for PTSD as those who were not. Current smoking status was also highly related with PTSD status. A significant relation was found between PTSD and several indices of self-reported physical health, along with lower rating of overall health status and health-related quality of life. The current study results confirmed previous studies results that there is an association between PTSD and increased reported of physical health symptoms in Vietnam and Gulf War veterans.

Purpose: To test the hypothesis that low-dose risperidone decreases aggression and other PTSD-related symptoms in combat veterans.
Sample: N = 15 male combat veterans (n=2 Gulf War Veterans, n=14 Vietnam War veterans). Demographic characteristics: 12 subjects were White, two were Black, and one was Hispanic. Subjects were randomly divided into the risperidone group (n=7) and the placebo group (n=8). The mean (SD) age in the risperidone group was 58.9 (8.3) years and they had a mean (SD) education level of 11.4 (2.0) years. The mean (SD) age in the placebo group was 53.5 (3.0) years and the mean (SD) education level 11.9 years (2.3). The mean (SD) dosage of risperidone was 0.57 (0.19) mg where subjects in the placebo group took tablets equivalent to a 0.62 mg dose of risperidone.
Methods: Patients were recruited at the Veterans Affairs Boston Healthcare System (VABHS). Eligibility requirements included at least a 20 or higher on cluster D (hyperarousal) of the Patient Checklist for PTSD-Military Version (PCL-M). The other assessment instruments included: 1) the Overt Aggression Scale- Modified for Outpatient (OAS-M) measured aggression, irritability, and suicidality, 2) the Buss-Durkee Hostility Index (BDHI) measured anger and hostility, 3) the Spielberger State-Trait Anger Scale (the state-version [STAS-S] and the trait version [STAS-T], 4) the Beck Depression Index (BDI) and the Beck Anxiety Index (BAI), 5) and the Dissociative Experiences Scale (DES) which measured symptoms of dissociation. Exclusion criteria included: history of schizophrenia, bipolar disorder with psychotic features, organic mental disorder, or had ever been prescribed an antipsychotic medication. The subjects were randomized to double-blind treatment with risperidone or placebo. The patients were seen after their initial treatment at weeks 2, 4, and 6; they were given 0.5 mg/day for the first 2 weeks and up to 2.0 mg/day after weeks 2 and 4.
Implications: As measured by the PCL-M, low-dose risperidone significantly reduced irritability and intrusive thoughts in veterans with combat-related PTSD. It was also found to be more effective in reducing measures of anxiety and depression. Suggestions for future research include using risperidone as one form of therapy and as combination therapy with anti-depressants in a larger sample of veterans with combat-related PTSD.

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The PCL-M is a 17-item self-report measure to assess PTSD severity among veterans. Items are based on DSM criteria (DSM-IV criteria for the latest version) and are rated on a 5-point Likert-type scale that allows the derivation of a quantifiable total score.

Overall Usefulness for a Certain Population: The PCL-M was constructed to be used specifically with veterans to assess military-related PTSD. It has been used with both female and male veterans.

Advantages: The PCL-M is very brief, requiring less than 10 minutes for administration, and it is free of charge from the NCPTSD. Reliability evidence is very good.

Disadvantages: Responsiveness evidence is not very strong, and specific normative information was not found.

Recommendation: The PCL-M appears to be very widely used as a measure of PTSD severity among veterans. This review provides only a few of the many available references to the PCL-M. For a list of the other citations, consult the NCPTSD PILOTS database at http://www.ncptsd.va.gov/publications/pilots/index.html. Psychometric evidence supports the use of the PCL-M as based on DSM-III-R criteria, but re-evaluation of psychometric properties based on DSM-IV criteria is required. Since the PCL-M relies so heavily on DSM criteria, periodic review, revision, and validation of the measure will be required. Also, more work is required to document the instrument’s responsiveness to treatment change.