PTSD: National Center for PTSD

PTSD Checklist for DSM-5 (PCL-5)

Description

The PCL-5 is a 20-item self-report measure that assesses the 20 DSM-5 symptoms of PTSD. 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.

Administration and Scoring

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

Interpretation of the PCL-5 should be made by a clinician. 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, because the population and the purpose of the screening may warrant different cutoff scores, users are encouraged to consider both of these factors when choosing a cutoff score.

Interpretation

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. There is limited evidence to guide decisions about response and clinically meaningful improvement. Examining data from the PCL (for DSM-IV) and PCL-5, 10 points is suggested as an indicator of response. One study found that a PCL-5 < 28 can be used as an indicator of clinically significant change (Marx et al., 2022), where the respondent is likely to belong to a healthy population.

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")

Citation

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.

References

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. https://doi.org/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 Assessment, 28(11), 1379-1391. https://doi.org/10.1037/pas0000254

Marx, B. P., Lee, D. J., Norman, S. B., Bovin, M. J., Sloan, D. M., Weathers, F. W., Keane, T. M., & Schnurr, P. P. (2022). Reliable and clinically significant change in the Clinician-Administered PTSD Scale for DSM-5 and PTSD Checklist for DSM-5 among male Veterans. Psychological Assessment, 34(2), 197-203. https://doi.org/10.037/pas0001098

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(11), 1392-1403. https://doi.org/10.1037/pas0000260

To Obtain Scale

This measure was developed by staff at VA's National Center for PTSD and is in the public domain and not copyrighted. In accordance with the American Psychological Association's ethical guidelines, this instrument is intended for use by qualified health professionals and researchers.

Download the PTSD Checklist for DSM-5 (PCL-5):

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

Download the PTSD Checklist for DSM-IV (PCL):

• PCL-Civilian (PCL-C) for DSM-IV (PDF)
• PCL-Military (PCL-M) for DSM-IV (PDF)
• PCL-Specific (PCL-S) for DSM-IV (PDF)
• PCL Psychometric Information for DSM-IV (PDF)
• PCL Scoring Information for DSM-IV (PDF)
• Using the PTSD Checklist for DSM-IV (PCL) (PDF)

Are you using this measure with U.S. Veterans or Service members?

Our PTSD Consultation Program can answer administration or scoring questions: PTSDconsult@va.gov or 866-948-7880.

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Measure availability: We provide information on a variety of measures assessing trauma and PTSD. These measures are intended for use by qualified mental health professionals and researchers. Measures authored by National Center staff are available as direct downloads or by request. Measures developed outside of the National Center can be requested via contact information available on the information page for the specific measure.