Trauma and posttraumatic growth in cancer: validation of the post-traumatic stress disorder checklist for DSM-5 and the posttraumatic growth inventory-short form in patients with breast cancer
9 affiliations
- 1Champalimaud Clinical Centre, Champalimaud Foundation
- 2Faculdade de Ciências da Saúde e Enfermagem, Universidade Católica Portuguesa
- 3Graduate Programme in Clinical and Health Psychology, Faculdade de Psicologia da Universidade de Lisboa
- 4Digital Neurotherapeutics Centre, Champalimaud Foundation
- 5Centro de Investigação Interdisciplinar em Saúde (CIIS), Universidade Católica Portuguesa
- 6Clinical and Health Services Research, Faculty of Medicine of the University of Porto (FMUP)
- 7Neuroscience of Disease Programme, Champalimaud Foundation
- 8NOVA Medical School (NMS), Faculdade de Ciências Médicas (FCM), Universidade NOVA de Lisboa
- 9ISPA-Instituto Universitário de Ciências Psicológicas, Sociais e da Vida
Abstract
Cancer diagnosis is a stressful event that may trigger post-traumatic stress (PTS) symptoms, while also fostering positive psychological changes known as post-traumatic growth (PTG). Although distinct, PTS and PTG often co-occur among women with breast cancer. Despite their clinical relevance, validated self-report measures of PTS and PTG remain limited in oncology. This study validated the Portuguese versions of the Post-Traumatic Stress Disorder Checklist for DSM-5 (PCL-5) and the Posttraumatic Growth Inventory – Short Form (PTGI-SF) in women with breast cancer. A total of 122 women with early-stage breast cancer completed both scales at 12 and 18 months after diagnosis, considering the cancer experience as the traumatic event. Cross-sectional analyses, including confirmatory factor analyses, internal consistency estimates, and construct validity correlations, used the 12-month assessment. Test-retest reliability was examined between the 12- and 18-month assessments. Construct validity was examined with the Positive and Negative Affect Schedule – Short Form (PANAS-SF) and the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30). The PCL-5 demonstrated excellent four-factor fit, high internal consistency, and generally acceptable test-retest reliability, although reliability was poor for the Avoidance subscale. Convergent validity was supported by positive correlations with negative affect (PANAS-SF), and divergent validity by negative correlations with positive affect (PANAS-SF) and quality of life (EORTC QLQ-C30). The PTGI-SF showed a good fit to a unidimensional model, with excellent internal consistency (α = 0.91; ω = 0.91) and high test-retest reliability (ICC = 0.91), although correlations with affect and quality of life were non-significant, indicating limited convergent and divergent validities. Overall, findings support the psychometric adequacy of the PCL-5 and, to a lesser extent, the PTGI-SF, in patients with breast cancer and low PTS symptom levels. The PCL-5 appears robust for assessing PTS symptoms in this population, while the PTGI-SF captures global growth experiences, despite weaker evidence for validity. Combined use of both instruments may provide a comprehensive assessment of vulnerability and resilience following breast cancer, supporting more individualized psychosocial care and guiding future research on psychological responses to cancer, including larger and more clinically diverse samples, as patients with higher PTS symptom severity.
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BibTeX
@article{castanheira2026trauma,
title = {{Trauma and posttraumatic growth in cancer: validation of the post-traumatic stress disorder checklist for DSM-5 and the posttraumatic growth inventory-short form in patients with breast cancer}},
author = {Cláudio Castanheira and Sílvia Almeida and Isabel Manica and André Abreu and Diana Frasquilho and Berta Sousa and Maria Vânia Silva-Nunes and Albino J. Oliveira-Maia and Raquel Lemos},
journal = {Frontiers in Psychiatry},
year = {2026},
month = oct,
doi = {10.3389/fpsyt.2026.1855703},
url = {https://www.frontiersin.org/articles/10.3389/fpsyt.2026.1855703/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Trauma and posttraumatic growth in cancer: validation of the post-traumatic stress disorder checklist for DSM-5 and the posttraumatic growth inventory-short form in patients with breast cancer
AU - Cláudio Castanheira
AU - Sílvia Almeida
AU - Isabel Manica
AU - André Abreu
AU - Diana Frasquilho
AU - Berta Sousa
AU - Maria Vânia Silva-Nunes
AU - Albino J. Oliveira-Maia
AU - Raquel Lemos
PY - 2026
DA - 2026/10/20
JO - Frontiers in Psychiatry
DO - 10.3389/fpsyt.2026.1855703
UR - https://www.frontiersin.org/articles/10.3389/fpsyt.2026.1855703/full
AB - Cancer diagnosis is a stressful event that may trigger post-traumatic stress (PTS) symptoms, while also fostering positive psychological changes known as post-traumatic growth (PTG). Although distinct, PTS and PTG often co-occur among women with breast cancer. Despite their clinical relevance, validated self-report measures of PTS and PTG remain limited in oncology. This study validated the Portuguese versions of the Post-Traumatic Stress Disorder Checklist for DSM-5 (PCL-5) and the Posttraumatic Growth Inventory – Short Form (PTGI-SF) in women with breast cancer. A total of 122 women with early-stage breast cancer completed both scales at 12 and 18 months after diagnosis, considering the cancer experience as the traumatic event. Cross-sectional analyses, including confirmatory factor analyses, internal consistency estimates, and construct validity correlations, used the 12-month assessment. Test-retest reliability was examined between the 12- and 18-month assessments. Construct validity was examined with the Positive and Negative Affect Schedule – Short Form (PANAS-SF) and the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30). The PCL-5 demonstrated excellent four-factor fit, high internal consistency, and generally acceptable test-retest reliability, although reliability was poor for the Avoidance subscale. Convergent validity was supported by positive correlations with negative affect (PANAS-SF), and divergent validity by negative correlations with positive affect (PANAS-SF) and quality of life (EORTC QLQ-C30). The PTGI-SF showed a good fit to a unidimensional model, with excellent internal consistency (α = 0.91; ω = 0.91) and high test-retest reliability (ICC = 0.91), although correlations with affect and quality of life were non-significant, indicating limited convergent and divergent validities. Overall, findings support the psychometric adequacy of the PCL-5 and, to a lesser extent, the PTGI-SF, in patients with breast cancer and low PTS symptom levels. The PCL-5 appears robust for assessing PTS symptoms in this population, while the PTGI-SF captures global growth experiences, despite weaker evidence for validity. Combined use of both instruments may provide a comprehensive assessment of vulnerability and resilience following breast cancer, supporting more individualized psychosocial care and guiding future research on psychological responses to cancer, including larger and more clinically diverse samples, as patients with higher PTS symptom severity.
SN - 1664-0640
ER -