PCL-5 PTSD Checklist

About this resource

The PCL-5 is a 20-item self-report measure of the DSM-5 symptoms of posttraumatic stress disorder, developed at the US National Center for PTSD. Each item is rated for how much the client was bothered by the symptom in the past month, on a 0 to 4 scale, giving a total of 0 to 80. The items map onto the four DSM-5 symptom clusters: intrusions (items 1 to 5), avoidance (items 6 and 7), negative alterations in cognition and mood (items 8 to 14), and alterations in arousal and reactivity (items 15 to 20).

The measure serves three purposes: screening for PTSD, monitoring symptom change during and after treatment, and making a provisional PTSD diagnosis using the cluster-based method. The initial validation studies suggested a total score of 31 to 33 as the cut-off for probable PTSD, and later work in veterans supported a cut-off in the low thirties. The PCL-5 is not a substitute for a structured clinical interview such as the CAPS-5, and the developers are explicit that a diagnosis should be confirmed by interview.

The professional version adds the scoring table, the provisional diagnosis rule, guidance on interpreting change, and the limitations of the checklist. The version reproduced here is the standard form without the Criterion A trauma screen; the National Center for PTSD also publishes versions with a brief Criterion A assessment and with the extended Life Events Checklist.

The instrument is reproduced here because the PCL-5 was developed by US government employees and is in the public domain. Item wording follows the published instrument, including its American spelling.

How to use it

1. Establish that the client has experienced a traumatic event that meets Criterion A before interpreting the PCL-5 as a PTSD measure. Ask the client to complete the items with reference to their worst or most troubling event.
2. Score by summing all 20 items for a total of 0 to 80. Cluster scores are obtained by summing the items in each cluster.
3. Use a total of 31 to 33 or above as an indicator of probable PTSD that warrants a full clinical interview. Use a lower threshold when the priority is not to miss cases, and a higher one when confirmation is more important.
4. For a provisional DSM-5 diagnosis, count an item rated 2 (moderately) or higher as a symptom present, and check whether the client meets the required number in each cluster: at least one intrusion item, one avoidance item, two cognition and mood items, and two arousal and reactivity items.
5. For monitoring, repeat the PCL-5 at regular intervals, for example every session or every two to four weeks during trauma-focused treatment. The developers' initial guidance is that a change of 5 to 10 points suggests reliable change and a change of 10 to 20 points suggests clinically significant change.
6. Follow up any indication of risk. The PCL-5 does not ask about suicidal thoughts; ask directly when scores are high or when the client's presentation suggests it.

References

• 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). National Center for PTSD.
• 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(6), 489-498.
• 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 Assessment, 28(11), 1379-1391.