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Clinician Administered PTSD Scale

Overview

 

The Clinician Administered PTSD Scale (CAPS-5) is based on the DSM-5 and is the gold standard in PTSD assessment.

 

The CAPS-5 is a 30-item structured interview that can be used to:

  • Make current (past month) diagnosis of PTSD
  • Make lifetime diagnosis of PTSD
  • Assess PTSD symptoms over the past week

It can be administered by clinicians and clinical researchers (or appropriately trained paraprofessionals) who have a working knowledge of PTSD and takes 45-60 minutes. A child/adolescent and German version is also available (see Versions below).

Author/Publisher Details

National Center for PTSD, Boston, USA

Citation

Weathers, F.W., Blake, D.D., Schnurr, P.P., Kaloupek, D.G., Marx, B.P., & Keane, T.M. (2013). The Clinician-Administered PTSD Scale for DSM-5 (CAPS-5). [Assessment] Available from www.ptsd.va.gov.

German version author details

Jan C. Cwik (jcwik@uni-koeln.de), Universität Köln, Marcella L. Woud (marcella.woud@ruhr-uni-bochum.de, Ruhr-Universität Bochum, Ulrich Schnyder (ulrich.schnyder@access.uzh.ch), Universität Zürich

Date(s)

2013
2021 (German Version)

Description

The CAPS-5 is a structured interview designed to make a categorical PTSD diagnosis, as well as to provide a measure of PTSD symptom severity. The structure corresponds to the DSM-5 criteria, with B, C, D and E symptoms rated for both frequency and intensity which are summed to provide severity ratings.

In addition to assessing the 20 DSM-5 PTSD symptoms, questions target the onset and duration of symptoms, subjective distress, impact of symptoms on social and occupational functioning, improvement in symptoms since a previous CAPS administration, overall response validity, overall PTSD severity, and specifications for the dissociative subtype (depersonalization and derealization).

For each symptom, standardized questions and probes are provided. Administration requires identification of an index traumatic event to serve as the basis for symptom inquiry. The Life Events Checklist for DSM-5 (LEC-5) is recommended in addition to the Criterion A inquiry included in the CAPS-5.

The CAPS-5 was designed to be administered by clinicians and clinical researchers who have a working knowledge of PTSD, but can also be administered by appropriately trained paraprofessionals. The full interview takes 45-60 minutes to administer.
There are three versions of the CAPS-5 corresponding to different time periods:

  • Past week
  • Past month
  • Worst month (lifetime)

PTSD diagnostic status should be evaluated with the past month (for current PTSD) or worst month (for lifetime PTSD) versions of the CAPS-5. The past week version of the CAPS-5 should be used only to evaluate PTSD symptoms over the past week.

The CAPS-5 is ideal for research settings and can be a little cumbersome for use in routine clinical practice, especially for those less experienced with the interview.

Scoring

Detailed scoring information is included with the CAPS-5 and should be reviewed carefully before administering. Briefly, the assessor combines information about frequency and intensity of an item into a single severity rating. CAPS-5 total symptom severity score is calculated by summing severity scores for the 20 DSM-5 PTSD symptoms. Similarly, CAPS-5 symptom cluster severity scores are calculated by summing the individual item severity scores for symptoms corresponding to a given DSM-5 cluster: Criterion B (items 1-5); Criterion C (items 6-7); Criterion D (items 8-14); and, Criterion E (items 15-20). A symptom cluster score may also be calculated for dissociation by summing items 19 and 20.

  • At least one Criterion B symptom
  • At least one Criterion C symptom
  • At least two Criterion D symptoms
  • At least two Criterion E symptoms
  • Criterion F is met (disturbance has lasted one month)
  • Criterion G is met (disturbance causes either clinically significant distress or functional impairment)

Sample Item

In the past month, have you had any unwanted memories of (EVENT) while you were awake, so not counting dreams?

  • How does it happen that you start remembering (EVENT)?
  • [If not clear:] (Are these unwanted memories, or are you thinking about [EVENT] on purpose?)
  • How much do these memories bother you?
  • Are you able to put them out of your mind and think about something else?
  • How often have you had these memories in the past month?

Severity Rating

0 = Absent: The respondent denied the problem or the respondent's report doesn't fit the DSM-5 symptom criterion.
1 = Mild / subthreshold: The respondent described a problem that is consistent with the symptom criterion but isn't severe enough to be considered clinically significant. The problem doesn't satisfy the DSM-5 symptom criterion and thus doesn't count toward a PTSD diagnosis.
2 = Moderate / threshold: The respondent described a clinically significant problem. The problem satisfies the DSM-5 symptom criterion and thus counts toward a PTSD diagnosis. The problem would be a target for intervention. This rating requires a minimum frequency of 2 x month or some of the time (20-30%) PLUS a minimum intensity of Clearly Present.
3 = Severe / markedly elevated: The respondent described a problem that is above threshold. The problem is difficult to manage and at times overwhelming, and would be a prominent target for intervention. This rating requires a minimum frequency of 2 x week or much of the time (50-60%) PLUS a minimum intensity of Pronounced.
4 = Extreme / incapacitating: The respondent described a dramatic symptom, far above threshold. The problem is pervasive, unmanageable, and overwhelming, and would be a high-priority target for intervention.

Manual

This measure was created by staff at VA's National Center for PTSD. To obtain this scale complete the online request form.

Versions

German

A German adult version is also available which corresponds to the DSM-5.  See below for the psychometric properties of the German version.

Child/Adolescent

A version for children and adolescents ages 7 and above (CAPS-CA-5) is also available. The CAPS-CA-5 corresponds to DSM-5.

DSM-IV

For information on the CAPS based on the DSM-IV, please click here.

Psychometrics

The CAPS-5 German version showed high internal consistencies (total score: α =93; re-experiencing: α =.82; avoidance: α =.65; alterations in cognition and mood: α =.85; alterations in arousal and reactivity: α =.93). Interrater reliability regarding the severity score was high (ICC=.81). With regard to convergent validity we found high correlations between the CAPS severity scores and the Posttraumatic Diagnostic Scale (r =. 87) as well as the Beck Depression Inventory (r =. 72) (Mueller-Engelmann et al., 2018).

The psychometric properties of the CAPS-5 German version (past month) were tested in a clinical sample (N=274, 244 women, 30 men) with more than 80% of the participants fulfilling diagnostic criteria for PTSD, mostly related to childhood sexual and physical abuse Mueller-Engelmann et al., 2018). The CAPS-5 German version showed good internal consistencies for the total scale and the subscales. Internal consistencies were even a little bit higher than those found for the original scale  (Weathers et al., 2018) and for the German version of the CAPS for DSM-IV (Schnyder & Moergeli, 2002).

Key/Core References

Mueller-Engelmann M, Schnyder U, Dittmann C, Priebe K, Bohus M, Thome J, Fydrich T, Pfaltz MC, Steil R (2018) Psychometric properties and factor structure of the German version of the Clinician-Administered PTSD Scale for DSM-5. Assessment 1-11. https://doi.org/10.1177/1073191118774840

Schnyder U, Moergeli H (2002) German version of Clinician-Administered PTSD Scale. Journal of Traumatic Stress 15: 487-492. https://doi.org/10.1023/A:1020922023090

Weathers, F.W., Blake, D.D., Schnurr, P.P., Kaloupek, D.G., Marx, B.P., & Keane, T.M. (2013). The Clinician-Administered PTSD Scale for DSM-5 (CAPS-5). [Assessment] Available from www.ptsd.va.gov.

Weathers, F. W., Bovin, M. J., Lee, D. J., Sloan, D. M., Schnurr, P. P., Kaloupek, D. G., . . . & Marx, B. P. (2018). The Clinician-Administered PTSD Scale for DSM-5 (CAPS-5): Development and initial psychometric evaluation in Military Veterans. Psychological Assessment, 30, 383-395. doi:10.1037/pas0000486

Further Information/Training

Training on the CAPS-5 is offered through the National Center for PTSD.

Two trainings are offered:

Source