Posttraumatic stress disorder (PTSD) is a common psychiatric condition associated with a stressful experience, and has emerged as a major burden to those affected and to society [1]. Troubles with sleeping, somatic chronic pain, depression, drug abuse, adverse interpersonal relations, and reduced overall wellness are characteristic of PTSD [2, 3]. PTSD follows traumatic events characterized by a typical intrusion symptom pattern, persistence of trauma, inappropriate recruitment of preventative stimuli, physiological and emotional numbness, and hypersensitivity [4].
The Posttraumatic Stress Disorder Checklist (PCL) has long been the leading self-reported instrument for assessing PTSD symptoms [5, 6]. Since the popularization of the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the PCL has been updated to incorporate additional symptoms and to conform with the four-factor PTSD conceptualization of the DSM and its associated symptom clusters: re-experiencing, avoidance, negative changes in cognition and mood, and increased arousal and reactivity. [6, 7]. This transition from the previously outlined three-factor PTSD model in DSM-IV [8], is based on a substantial body of empirical data indicating that this four-factor model better fits the composition of PTSD symptomatology [9, 10].
The PCL-5 [11] consists of 20 items corresponding to the 20 criteria for PTSD outlined in the DSM-5, and includes 4 subscales referring to the 4 symptom clusters mentioned above. It is de facto a modified version of the PCL-4 containing 17 items and three subscales referring to the former three symptom clusters of the DSM-IV [5]. Earlier research on the psychometric properties of PCL-5 has been promising. In a study of college students, PCL-5 illustrated positive and significant correlation, proper test reliability, as well as converging and divergent validity [12]. Such findings are comparable to the psychometric findings in previous versions of the measure [13] and suggest that the PCL-5 has the same psychometric rigor as the previous versions. Preliminary findings on the appropriate PCL-5 cut-off scores were mixed, and reported values ranging from 28 to 38 [11, 12]. Earlier versions of the PCL were available in multiple languages [14]. However, as far as we know, PCL-5 is still available in only a few, limited number of languages.
COVID-19 was first reported in Bangladesh on March 8th, 2020 [15], and similar to many other countries rapidly propagated, with more than 310,800 people infected and 4,248 deaths as of August 31st, 2020 [16, 17]. To reduce the spread of SARS-CoV-2, the Government of Bangladesh imposed strict social isolation, home quarantine, and restricted travel measures starting as of March 26th, 2020 [15, 18]. Experiencing or witnessing the suffering imposed by COVID-19 can cause PTSD among survivors, their families, frontline workers, and even the general public [19]. It is further anticipated that the COVID-19 pandemic will result in a high prevalence of psychological problems at the population level, including PTSD [20], and previous studies involving outbreaks of SARS in 2003 [21] and influenza A H1N1 in 2009 [22] have corroborated such assumption.
In the context of COVID-19, this pandemic will likely impose major adverse effects on mental health, and yet there few if any studies addressing these issues in Bangladesh, as illustrated by the use of a previously not validated tool in a study that was conducted among the survivors of Rana Plaza collapse [2]. To better address this important problem, the PCL-5 was translated to Bangla language, and in the current study, we present the validation of this instrument. As indicated above, the PCL-5 is one of the most widely used self-report measures of PTSD [12]. In an earlier study, Islam et al. (2020) suggested the need to conduct a nationwide survey to investigate PTSD symptoms and prevalence during the COVID-19 pandemic. The present study was designed to explore the presence of acute posttraumatic stress symptoms among Bangladeshi people in the several months that have followed the onset of the COVID-19 outbreak in the country, and to ascertain whether the Bangla version of the PCL-5 is suitable for the Bangladeshi cultural framework as a screening instrument.