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The Posttraumatic Stress Disorder Checklist, Military Version (PCL-M) is an adult 17-item self-report inventory to assess symptom severity or to determine a PTSD diagnosis based on closely on the DSM-IV criteria (Weather et al., 1993). The PCL-M has been widely used with peacekeepers and combat veterans. However, there are constant debates about the optimally efficient cutoff scores and the factor structure of the PCL, both Military and Civilian versions.
The purposes of this study were (1) to examine the overall prevalence and severity of PTSD symptom, (2) to revisit the psychometric properties of the PCL-M with older male peacekeepers; and (3) to confirm structure of this scale by testing alternative CFA models.
Methods: The present study used the secondary data as part of a health status assessment conducted by Veterans' Affairs Canada (VAC) in fall of 1999. 456 United Nations peacekeepers were systematically selected from a larger sample of 1968 regular and reserve force of the Canadian military with three criteria: Males, deployed overseas to a conflict threat more than one time, and 55 year older. In addition to the PCL_M, major variables (e.g., CES-D, AUDIT, General Health Index, # of Medications) were included to perform the criterion and construct validity.
Results: The PCLM scores ranged from 17 to 83 (Mean+ SD = 23.73+ 10.25). With different cutoff score of 31 (44 & 50), 17% (7% & 3%) of total respondents may be diagnosed with the probable PTSD. The overall reliability of the PCL-M scale was excellent (alpha = .93) and the three subscales' alpha ranges from are very good (Re-experiencing = .90, Avoiding = .84, Numbing = .81, Hyper-arousal = 83). Comparing with three-factor and hierarchical four-factor model, the intercorrelated four-factor model showed the best and most adequate fit indices (χ2 = 374.57, df = 113, RMSEA = .080, CFI = .97, NFI = 97). The data also supported criterion validity and PTSD is significantly correlated with depression (r = .726), alcohol use and related problem (r = - .219), general health status (r = .359), and total number of medications (r = .435). Of the four PCL_M subscales, Hyperarousal factor has the strongest positive correlation with the above criterion variables. Implication and Conclusions: Given rising deployments of military forces on peacekeeping missions to various conflict zones, it is important to better understand the risk factors for PTSD for these veterans. This study implied that the deployed combat experiences among older peacekeepers may cause the development of PTSD, which naturally leads to the age-related affective disorder and substance abuse disorder. The present study proved the excellent psychometric properties of the PCL-M in a sample of older male peacekeepers and demonstrated in research, as a screening tool, and in conjunction with clinician interview for diagnosis and treatment. The PCL-M can be recommended as an effective and efficient component of a comprehensive veteran based compensation and pension evaluation.