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14 July 2022

Self-report scale to assess symptoms of post-traumatic stress disorder (PTSD). PCL-5 measure

14 July 2022

The Post-traumatic Stress Disorder Checklist (PCL-5) is a self-report instrument for the post-traumatic stress disorder (PTSD) based on the DSM-5 diagnosis criteria.

It’s a 20-item self-report measure that assesses the presence and severity of PTSD symptoms. The questions of the PCL-5 correspond to the DSM-5 criteria for PTSD. The PCL-5 has a variety of purposes, including:

  • quantifying and monitoring symptoms over time,
  • screening individuals for PTSD,
  • assisting in making a provisional diagnosis of PTSD.

The PCL-5 is a self-report instrument and can be completed in approximately 5‒10 minutes. It was developed by the USA National Center for PTSD. The PCL-5 should not be used as a stand-alone diagnostic tool. When considering a diagnosis, the clinician will still need to use the clinical interviewing skills, and a recommended structured interview (e.g., Clinician-Administered PTSD Scale for DSM-5, CAPS-5) to determine a diagnosis.

Self-report scale to assess symptoms of post-traumatic stress disorder (PTSD). PCL-5 measure

Below is a list of problems that people sometimes have in response to the stressful experience. Please read each item carefully and choose the reply to indicate how much you have been bothered by that problem in the past month.

1. Repeated, disturbing, and unwanted memories of the past stressful experience?

Not at all – 0

A little bit – 1

Moderately – 2

Quite a bit  – 3

Extremely – 4

2. Repeated, disturbing dreams of the stressful experience?

Not at all – 0

A little bit – 1

Moderately – 2

Quite a bit  – 3

Extremely – 4

3. Suddenly feeling as if the stressful experience were actually happening again (as if you were actually back there reliving it)?

Not at all – 0

A little bit – 1

Moderately – 2

Quite a bit  – 3

Extremely – 4

4. Feeling very upset when something reminded you of the past stressful experience?

Not at all – 0

A little bit – 1

Moderately – 2

Quite a bit  – 3

Extremely – 4

5. Having strong physical reactions when something reminded you of the stressful experience (for example, heart pounding, trouble breathing, sweating)?

Not at all – 0

A little bit – 1

Moderately – 2

Quite a bit  – 3

Extremely – 4

6. Avoiding thoughts or talks about the stressful situation in the past or avoiding feelings related to this situation?

Not at all – 0

A little bit – 1

Moderately – 2

Quite a bit  – 3

Extremely – 4

7. Avoiding certain activity or situations as they remind you of the stressful experience in the past?

Not at all – 0

A little bit – 1

Moderately – 2

Quite a bit  – 3

Extremely – 4

8. Trouble remembering important parts of the stressful experience from the past?

Not at all – 0

A little bit – 1

Moderately – 2

Quite a bit  – 3

Extremely – 4

9. Having strong negative beliefs about yourself, other people, or the world (for example, having thoughts such as: I am bad, there is something seriously wrong with me, no one can be trusted, the world is completely dangerous)?

Not at all – 0

A little bit – 1

Moderately – 2

Quite a bit  – 3

Extremely – 4

10. Blaming yourself or someone else for the stressful experience or what happened after it?

Not at all – 0

A little bit – 1

Moderately – 2

Quite a bit  – 3

Extremely – 4

11. Having strong negative feelings such as fear, horror, anger, guilt, or shame?

Not at all – 0

A little bit – 1

Moderately – 2

Quite a bit  – 3

Extremely – 4

12. Loss of interest in activities that you used to enjoy?

Not at all – 0

A little bit – 1

Moderately – 2

Quite a bit  – 3

Extremely – 4

13. Feeling distant or cut off from other people?

Not at all – 0

A little bit – 1

Moderately – 2

Quite a bit  – 3

Extremely – 4

14. Trouble experiencing positive feelings (for example, being unable to feel happiness or have loving feelings for people close to you)?

Not at all – 0

A little bit – 1

Moderately – 2

Quite a bit  – 3

Extremely – 4

15. Irritable behavior, angry outbursts, or acting aggressively?

Not at all – 0

A little bit – 1

Moderately – 2

Quite a bit  – 3

Extremely – 4

16. Taking too many risks or doing things that could cause you harm?

Not at all – 0

A little bit – 1

Moderately – 2

Quite a bit  – 3

Extremely – 4

17. Being “superalert” or watchful or on guard?

Not at all – 0

A little bit – 1

Moderately – 2

Quite a bit  – 3

Extremely – 4

18. Feeling jumpy or easily startled?

Not at all – 0

A little bit – 1

Moderately – 2

Quite a bit  – 3

Extremely – 4

19. Having difficulty concentrating?

Not at all – 0

A little bit – 1

Moderately – 2

Quite a bit  – 3

Extremely – 4

20. Trouble falling or staying asleep?

Not at all – 0

A little bit – 1

Moderately – 2

Quite a bit  – 3

Extremely – 4

PCL-5 interpretation

PCL-5 checklist involves 20 questions each of which ranges from 0 to 4 points depending on the symptom severity. This checklist is usually used for PTSD screening. Questions of this scale represent the corresponding symptoms of PTSD in accordance with DSM-5 classification:

  • Criterion А — description of traumatic event.
  • Criterion В, intrusion symptoms — questions 1 to 5.
  • Criterion C, avoidance symptoms — questions 6 and 7.
  • Criterion D, negative thoughts and emotions — questions 8 to 14.
  • Criterion Е, hyperarousal symptoms — questions 15 to 20.

Minimum possible score is 0, maximum possible score is 80. To diagnose PTSD, presence of exposure to the traumatic event is mandatory.

PCL-5 findings show that 5 points are a minimum threshold for determining whether an individual has responded to treatment and 10 points are a minimum threshold for determining whether the improvement is clinically meaningful.

Screening for PTSD is suggested positive if sum of the points is more than 33.

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Sources

  1. https://uk.e-medjournal.com/index.php/psp/article/view/8#tbl1
  2. https://www.ptsd.va.gov/professional/assessment/adult-sr/ptsd-checklist.asp
  3. 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.

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