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PTSD Checklist for DSM-5 (PCL-5)

The PCL-5 is a 20-item self-report measure that assesses the 20 DSM-5 symptoms of PTSD (Weathers et al., 2013). The PCL-5 has a variety of purposes, including:

  • Monitoring symptom change during and after treatment
  • Screening individuals for PTSD
  • Making a provisional PTSD diagnosis
The gold standard for diagnosing PTSD is a structured clinical interview such as the Clinician-Administered PTSD Scale (CAPS-5). When necessary, the PCL-5 can be scored to provide a provisional PTSD diagnosis.

Usage

This resource should be used in an ethical and responsible manner and should be used only for the purpose(s) for which it has demonstrable validity. In accordance with the American Psychological Association's ethical guidelines, this instrument is intended for use by qualified health professionals and researchers. Please observe copyright where indicated and reference it appropriately.

English Language Versions:

PCL-5, Past Month
PCL-5, Past Week
PCL-5 with Criterion A
PCL-5 with LEC-5 and Criterion A
Using the PTSD Checklist for DSM-5 (PCL-5)

Author/publisher details   

National Center for PTSD, Boston, USA.

Date   

2013

Description

The PCL-5 is a 20-item self-report checklist of PTSD symptoms based closely on the DSM-5 criteria. Respondents rate each item from 0 ("not at all") to 4 ("extremely") to indicate the degree to which they have been bothered by that particular symptom over the past month (or past week if using the PCL-5 weekly).

The PCL-5 is a self-report measure that can be completed by patients in a waiting room prior to a session or by participants as part of a research study. It takes approximately 5-10 minutes to complete. The PCL-5 can be administered in one of three formats:
  • Without Criterion A (brief instructions and items only), which is appropriate when trauma exposure is measured by some other method
  • With a brief Criterion A assessment
  • With the revised Life Events Checklist for DSM-5 (LEC-5) and extended Criterion A assessment

Scoring

The PCL-5 can be scored in different ways:
  • A total symptom severity score (range - 0-80) can be obtained by summing the scores for each of the 20 items.
  • DSM-5 symptom cluster severity scores can be obtained by summing the scores for the items within a given cluster, i.e., cluster B (items 1-5), cluster C (items 6-7), cluster D (items 8-14), and cluster E (items 15-20).
  • A provisional PTSD diagnosis can be made by treating each item rated as 2 = "Moderately" or higher as a symptom endorsed, then following the DSM-5 diagnostic rule which requires at least: 1 B item (questions 1-5), 1 C item (questions 6-7), 2 D items (questions 8-14), 2 E items (questions 15-20).
  • Initial research suggests that a PCL-5 cutoff score between 31-33 is indicative of probable PTSD across samples. However, additional research is needed. Further, because the population and the purpose of the screening may warrant different cutoff scores, clinicians are encouraged to consider both factors when choosing a cutoff score.

Interpretation

Interpretation of the PCL-5 should be made by a clinician. Characteristics of a respondent's setting should be considered when using PCL-5 severity scores to make a provisional diagnosis. The goal of assessment also should be considered. A lower cut-point score should be considered when screening or when it is desirable to maximize detection of possible cases. A higher cut-point score should be considered when attempting to make a provisional diagnosis or to minimize false positives.

Measuring Change

Good clinical care requires that clinicians monitor patient progress. Evidence for the PCL for DSM-IV suggests that a 5-10 point change represents reliable change (i.e., change not due to chance) and a 10-20 point change represents clinically significant change. Therefore, it was recommended to use 5 points as a minimum threshold for determining whether an individual has responded to treatment and 10 points as a minimum threshold for determining whether the improvement is clinically meaningful using the PCL for DSM-IV.

Change scores for PCL-5 are currently being determined. It is expected that reliable and clinically meaningful change will be in a similar range.

Sample Item
  • Item: In the past month, how much were you been bothered by: "Repeated, disturbing, and unwanted memories of the stressful experience?"
  • Response: 5-point Likert (0 = "Not at all" to 4 = "Extremely")

Psychometrics

PCL-5 test scores have demonstrated strong internal consistency (α = .94 to .96), test-retest reliability (rs = .74 to .85), and convergent and discriminant validity (Blevins et al., 2015; Bovin et al., 2016).

Research on the PCL-5 suggested scores of 31 to 33 were optimally efficient for diagnosing PTSD (Bovin et al., 2016), while validation studies recommended a variety of cutoff scores ranging between 28 and 37 (Ashbaugh et al., 2016; Blevins et al., 2015).

Key/Core References   

Ashbaugh A. R., Houle-Johnson S., Herbert C., El-Hage W., Brunet A. (2016). Psychometric validation of the English and French versions of the Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5). PLOS ONE 11(10):e0161645.  https://doi.org/10.1371/journal.pone.0161645

Blevins, C. A., Weathers, F. W., Davis, M. T., Witte, T. K., & Domino, J. L. (2015). The Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5): Development and initial psychometric evaluation. Journal of Traumatic Stress, 28, 489-498. doi:10.1002/jts.22059

Bovin, M. J., Marx, B. P., Weathers, F. W., Gallagher, M. W., Rodriguez, P., Schnurr, P. P., & Keane, T. M. (2016). Psychometric properties of the PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition (PCL-5) in veterans. Psychological assessment28(11), 1379–1391. https://doi.org/10.1037/pas0000254

Ibrahim, H., Ertl, V., Catani, C. et al. The validity of Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5) as screening instrument with Kurdish and Arab displaced populations living in the Kurdistan region of Iraq. BMC Psychiatry, 18, 259 (2018). https://doi.org/10.1186/s12888-018-1839-z

Weathers, F.W., Litz, B.T., Keane, T.M., Palmieri, P.A., Marx, B.P., & Schnurr, P.P. (2013). The PTSD Checklist for DSM-5 (PCL-5). Scale available from the National Center for PTSD at www.ptsd.va.gov.

Wortmann, J. H., Jordan, A. H., Weathers, F. W., Resick, P. A., Dondanville, K. A., Hall-Clark, B., Foa, E. B., Young-McCaughan, S., Yarvis, J., Hembree, E. A., Mintz, J., Peterson, A. L., & Litz, B. T. (2016). Psychometric analysis of the PTSD Checklist-5 (PCL-5) among treatment-seeking military service members. Psychological Assessment, 28, 1392-1403. doi:10.1037/pas0000260

Manual   

No manual exists for the PCL-5; it is used in the same way as other self report scales and is self-explanatory. For advice on interpretation, see above and refer to key references.

Previous Version(s)

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

Source

National Center for PTSD (29, April 2020). PTSD Checklist-5 (PCL-5).