Screening for PTSD in first responders: Turkish adaptation and psychometric validation of the Primary Care PTSD Screen for DSM-5

Abstract

Objective: Like other first responders, many firefighters show signs of posttraumatic stress disorder (PTSD) that often go undiagnosed. Developing accessible, brief, and efficient screening tools may improve identification and service utilization. The most recent adaptation of the Primary Care PTSD Checklist for the Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition (PCL-5; PC-PTSD-5 [0-20]) demonstrates promising screening performance among firefighters. Our study translated the PC-PTSD-5 [0-20] into Turkish and conducted validity and reliability analyses. Method: The PC-PTSD-5 [0-20] was translated and culturally adapted into Turkish through forward translation, backward translation, and expert-led refinement. We conducted a pilot test with 30 firefighters, followed by carrying out the full study among (N = 215) firefighters from fire stations across all the districts of Istanbul. Participants in the full study completed the Turkish PC-PTSD-5 [0-20] and PCL-5, and we analyzed them for reliability, validity, and diagnostic utility. Results: The Turkish PC-PTSD-5 [0-20] demonstrated favorable psychometric properties: acceptable internal consistency (alpha = .61); high test-retest reliability (r = 0.88, p < .001); and strong convergent validity with PCL-5 (r = 0.81, p < .001). Receiver operating characteristic analysis revealed an area under the curve of 0.947 with an optimal cutoff score of 9 that balanced high accuracy (90.23%), sensitivity (82.86%), and specificity (91.67%), while PTSD prevalence was estimated at 16.3% in the sample. Conclusions: The Turkish PC-PTSD-5 [0-20] demonstrates strong psychometric properties, with high accuracy at a cutoff score of 9, and excellent diagnostic utility for screening PTSD among firefighters. Future research should explore its applicability to other first responder groups and predictive validity in longitudinal studies.