Calculators / Anxiety and trauma

PCL-5

PTSD Checklist for DSM-5. PTSD symptom severity and provisional diagnosis.

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The PCL-5 calculator is in the Library.

Every rating scale calculator comes with the Library, along with the prescribing guides, medication handouts, DSM-5 criteria and sheets, and the Guide Builder.

Use it for

  • Measuring PTSD symptom severity at baseline and over treatment.
  • Screening trauma-exposed people for probable PTSD, after a positive brief screen such as the PC-PTSD-5.
  • Making a provisional DSM-5 diagnosis from the symptom-count rule, pending an interview.

Do not use it for

  • Diagnosing PTSD by itself. The CAPS-5 or a clinical interview is the standard.
  • Checking that an event meets DSM-5 Criterion A. Identify the index trauma first.
  • Complex PTSD or the dissociative specifier. The ITQ covers the ICD-11 complex PTSD picture.

Ask the person to keep one specific stressful experience in mind and answer for how much each problem has bothered them in the past month.

Use the past-week version of the PCL-5 for tracking change week to week in treatment. The items are the same.

Intrusion (items 1 to 5)

In the past month, how much were you bothered by:

1Repeated, disturbing, and unwanted memories of the stressful experience?
2Repeated, disturbing dreams of the stressful experience?
3Suddenly feeling or acting as if the stressful experience were actually happening again (as if you were actually back there reliving it)?
4Feeling very upset when something reminded you of the stressful experience?
5Having strong physical reactions when something reminded you of the stressful experience (for example, heart pounding, trouble breathing, sweating)?

Avoidance (items 6 and 7)

6Avoiding memories, thoughts, or feelings related to the stressful experience?
7Avoiding external reminders of the stressful experience (for example, people, places, conversations, activities, objects, or situations)?

Negative changes in thinking and mood (items 8 to 14)

8Trouble remembering important parts of the stressful experience?
9Having strong negative beliefs about yourself, other people, or the world (for example, having thoughts such as: I am bad, there is something seriously wrong with me, no one can be trusted, the world is completely dangerous)?
10Blaming yourself or someone else for the stressful experience or what happened after it?
11Having strong negative feelings such as fear, horror, anger, guilt, or shame?
12Loss of interest in activities that you used to enjoy?
13Feeling distant or cut off from other people?
14Trouble experiencing positive feelings (for example, being unable to feel happiness or have loving feelings for people close to you)?

Arousal and reactivity (items 15 to 20)

15Irritable behavior, angry outbursts, or acting aggressively?
16Taking too many risks or doing things that could cause you harm?
17Being "superalert" or watchful or on guard?
18Feeling jumpy or easily startled?
19Having difficulty concentrating?
20Trouble falling or staying asleep?

PCL-5

Answer the questions to see the result.

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More about the PCL-5

About the PCL-5What it is and what it is for

The PCL-5 is a 20-item self-report measure that maps one-to-one onto the DSM-5 symptoms of PTSD. Each item asks how much the person has been bothered by a symptom in the past month, from not at all (0) to extremely (4). The total runs from 0 to 80.

It does three things. It gives a severity score, it suggests probable PTSD when the score reaches a cutoff, and it supports a provisional DSM-5 diagnosis when enough symptoms are rated at moderate or higher in each cluster. It works best alongside a clinical interview and an identified index trauma.

How to use itGiving it and scoring it

Choose one index event. Ask the person to rate each of the 20 problems for the past month. Add the 20 items for a total from 0 to 80.

For the symptom-count rule, count items rated 2 (moderately) or higher in each cluster. One intrusion item, one avoidance item, two negative mood items and two arousal items give a provisional DSM-5 diagnosis.

Interpreting the scoreScore ranges and what they suggest
ScoreWhat it suggestsUsual response
0 to 30Below the cutoff rangeFewer symptoms than the usual threshold for probable PTSD.Does not suggest probable PTSD by score. Consider the symptom-count rule and the history.
31 to 33Within the 31 to 33 cutoff rangeAt the cutoff range suggested for probable PTSD.Interview to decide. The right cutoff depends on setting and purpose.
34 to 80Above the cutoff rangeHigher symptom burden. Probable PTSD.Confirm with a clinical interview or CAPS-5 and start treatment planning.

The National Center for PTSD describes a cutoff between 31 and 33 as indicative of probable PTSD, and advises a lower cutoff when screening and a higher one when a provisional diagnosis or fewer false positives is the goal. There are no validated severity bands for the PCL-5 total.

Pearls and pitfallsTips and common mistakes
  • Pair it with the Life Events Checklist for DSM-5 (LEC-5) to document exposure.
  • Item 16 (risky behavior) and item 9 (negative beliefs) are worth a follow-up question whatever the total.
  • People with high scores often have comorbid depression. Run the PHQ-9.
  • In treatment, a score that falls 10 points or more is usually meaningful. A score that does not move after several sessions is a prompt to rethink the plan.
  • Use the same version and the same index event at every administration.
EvidenceAccuracy and reliability
  • Psychometric studies in trauma-exposed students and in veterans found high internal consistency (alpha about 0.94) and good test-retest reliability (Blevins 2015, Bovin 2016).
  • Against the CAPS-5 in veterans, cutoffs from 31 to 33 balanced sensitivity and specificity (Bovin 2016). The National Center for PTSD notes the cutoff depends on the population and the purpose.
  • Change thresholds of 5 and 10 points come from work on the DSM-IV PCL and are the National Center for PTSD's working guidance for the PCL-5.
Source, license and referencesWhere it comes from

The PCL-5 was developed by the National Center for PTSD (Weathers, Litz, Keane, Palmieri, Marx and Schnurr, 2013). It is a US government work, free to use for clinical and research purposes. Credit the National Center for PTSD.

  1. Weathers FW, Litz BT, Keane TM, Palmieri PA, Marx BP, Schnurr PP. The PTSD Checklist for DSM-5 (PCL-5). National Center for PTSD; 2013.
  2. Blevins CA, Weathers FW, Davis MT, Witte TK, Domino JL. The Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5): development and initial psychometric evaluation. J Trauma Stress. 2015;28(6):489-498.
  3. Bovin MJ, Marx BP, Weathers FW, et al. Psychometric properties of the PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (PCL-5) in veterans. Psychol Assess. 2016;28(11):1379-1391.
  4. National Center for PTSD. Using the PTSD Checklist for DSM-5 (PCL-5). US Department of Veterans Affairs.
  5. VA/DoD Clinical Practice Guideline for the Management of Posttraumatic Stress Disorder and Acute Stress Disorder. 2023.

Clinical decision support, not a diagnosis. Each calculator scores a published scale the way its authors intended. A score informs a clinical interview and examination and never replaces them. If you are a patient using this page, please review the result with your clinician. In an emergency, call 911 or call or text 988 in the United States.