Posttraumatic stress disorder (PTSD) is commonly assessed with self-rated or clinician-rated measures. Although scores from these assessment modalities are strongly associated, they are often discrepant for individual symptoms, total symptom severity, and diagnostic status. To date, no known studies have empirically identified the sources of these discrepancies. In the present study, we had three aims: (a) replicate previously identified discrepancies; (b) examine contribution of possible objective predictors of discrepancies, including negative response bias, random responding, conscientiousness, neuroticism, and verbal IQ; and (c) identify subjective sources of discrepancies through analysis of participant feedback. Trauma-exposed undergraduates (N = 60) were administered the PTSD Checklist for DSM-5 (PCL-5), the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5), and other questionnaires. Interviewers identified discrepancies between corresponding PCL-5/CAPS-5 scores and asked participants to describe their attributions for discrepancies. Discrepancies, both dimensional and dichotomous, occurred at the item, cluster, and total score level. Objective predictors were weakly associated with discrepancies. The most commonly reported reasons for discrepancies were time-frame reminders, comprehension of symptoms, trauma-related attribution errors, increased awareness, and general errors. These findings help explain discordance between the PCL-5 and CAPS-5, and inform use and interpretation of these two widely used PTSD measures in clinical and research applications.

创伤后应激障碍 (PTSD) 通常通过自我评定或临床医生评定的措施进行评估。虽然这些评估方式的分数密切相关，但它们在个体症状、总体症状严重程度和诊断状态方面往往存在差异。迄今为止，还没有已知的研究根据经验确定这些差异的来源。在本研究中，我们有三个目标：(a) 复制先前发现的差异；(b) 检查差异的可能客观预测因素的贡献，包括消极反应偏差、随机反应、责任心、神经质和语言智商；(c) 通过分析参与者的反馈来确定差异的主观来源。创伤暴露的本科生（N = 60）接受了 PTSD 检查表DSM-5 (PCL-5)、临床医生管理的DSM-5 PTSD 量表(CAPS-5) 和其他问卷。采访者确定了相应的 PCL-5/CAPS-5 分数之间的差异，并要求参与者描述他们对差异的归因。维度和二分法的差异发生在项目、集群和总分级别。客观预测因子​​与差异微弱相关。最常报告的差异原因是时间框架提醒、对症状的理解、与创伤相关的归因错误、意识增强和一般错误。这些发现有助于解释 PCL-5 和 CAPS-5 之间的不一致，并为临床和研究应用中这两种广泛使用的 PTSD 测量方法的使用和解释提供信息。