The CAPS is the gold standard in PTSD assessment. The CAPS-5 is a 30-item structured interview that can be used to:
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 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.
Several important revisions were made to the CAPS in updating it for DSM-5:
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.
PTSD diagnostic status is determent by first dichotomizing each symptom as "present" or "absent," then following the DSM-5 diagnostic rule. A symptom is considered present only if the corresponding item severity score is rated 2 ("moderate/threshold") or higher. The DSM-5 PTSD diagnostic rule requires:
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 thing about something else? How often have you had these memories in the past month? # of times ______.
0. Absent: The respondent denied the problem of 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. He problem is pervasive, unmanageable, and overwhelming, and would be a high-priority target for intervention.
In the past there were different versions of this measure corresponding to different time periods. The CAPS-1 assessed current and lifetime PTSD. The CAPS-2 assessed one week symptom status. These versions were then renamed CAPS-DX (for diagnosis) and CAPS-SX (for symptom). These two versions were later combined into the CAPS for DSM-IV, which could be used to assess either symptoms or diagnoses. A version for children and adolescents (CAPS-CA) is also available.
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Gray, M., Litz, B., Hsu, J., & Lombardo, T. (2004). Psychometric properties of the Life Events Checklist. (PDF) Assessment, 11, 330-341. doi: 10.1177/1073191104269954
Weathers, F. W., Keane, T. M., & Davidson, J. R. (2001). Clinician-Administered PTSD Scale: A review of the first ten years of research. (PDF) Depression and Anxiety, 13, 132-156. doi: 10.1002/da.1029
Weathers, F. W., Ruscio, A. M., & Keane, T. M. (1999). Psychometric properties of nine scoring rules for the Clinician-Administered Posttraumatic Stress Disorder Scale. (PDF) Psychological Assessment, 11, 124-133. doi: 10.1037//1040-3518.104.22.168
Orsillo (2001) (PDF) p. 259.
Orsillo, Susan M. (2001). Measures for acute stress disorder and posttraumatic stress disorder. In M.M. Antony & S.M. Orsillo (Eds.), Practitioner's guide to empirically based measures of anxiety (pp. 255-307). New York: KluwerAcademic/Plenum. PILOTS ID 24368
To learn about training to give a CAPS assessment, see CAPS Training Information.
This measure was created by staff at the VA National Center for PTSD. To obtain this scale complete the online request form.
Measure availability: Information on measures is available to everyone. However, the assessment tools themselves can only be distributed to qualified mental health professionals and researchers. We maintain measures developed by affiliated staff of the National Center for PTSD.
See Assessment Measures Specifically for VA Providers and Staff to download the CAPS.