Validation of the PCL-5, PHQ-9, and GAD-7 in a Sample of First Responders

Mental health professionals working with first responder can conceptualize PTSD by the 7-factor hybrid configuration, depression with two factors (cognitive affective and somatic), and generalized anxiety is a unidimensional construct. Objective First responders (FRs) commonly present for treatment with complex symptom constellations that frequently include posttraumatic stress disorder, depression, and generalized anxiety. To date, no FR study has validated these measures on a treatment-seeking sample. Methods Confirmatory factor analysis was utilized to validate measures that assess these constructs (Posttraumatic Stress Disorder Checklist for DSM-5, Patient Health Questionnaire-9, and Generalized Anxiety Disorder-7) on a treatment-seeking sample of FRs (N = 390). Results The seven-factor posttraumatic stress disorder hybrid configuration was the best fit. The best fitting factor model of the depression measure was a two-factor structure, cognitive-affective and somatic depression. Lastly, generalized anxiety was a unidimensional construct. Limitations Follow-up studies should validate these measures on each FR subtype. Conclusion We position these findings within the FR literature, review clinical implications for providers, and offer recommendations for future research.