PCL-5
PTSD Checklist for DSM-5
The DSM-5-aligned self-report measure of PTSD symptoms.
20
7 min
adult
0–80
About the PCL-5
The PTSD Checklist for DSM-5 (PCL-5) is a 20-item self-report measure of the symptoms of post-traumatic stress disorder, with each item corresponding to a DSM-5 PTSD criterion. It is used to screen for PTSD, to support provisional diagnosis, and to monitor symptom change during and after treatment.
Respondents rate how much they have been bothered by each symptom in the past month, from 0 ("not at all") to 4 ("extremely"), giving a total severity score of 0 to 80. A total of around 31–33 is a commonly cited provisional cut-point, though the optimal threshold varies by population and purpose.
What it measures
- Intrusion — unwanted memories, nightmares, flashbacks, and distress at reminders
- Avoidance — of trauma-related thoughts, feelings, and external reminders
- Negative alterations in cognition and mood — blame, fear, anhedonia, detachment
- Alterations in arousal and reactivity — irritability, hypervigilance, startle, sleep problems
PCL-5 questions
- 1
Repeated, disturbing, and unwanted memories of the stressful experience?
intrusion - 2
Repeated, disturbing dreams of the stressful experience?
intrusion - 3
Suddenly feeling or acting as if the stressful experience were actually happening again (as if you were actually back there reliving it)?
intrusion - 4
Feeling very upset when something reminded you of the stressful experience?
intrusion - 5
Having strong physical reactions when something reminded you of the stressful experience (for example, heart pounding, trouble breathing, sweating)?
intrusion - 6
Avoiding memories, thoughts, or feelings related to the stressful experience?
avoidance - 7
Avoiding external reminders of the stressful experience (for example, people, places, conversations, activities, objects, or situations)?
avoidance - 8
Trouble remembering important parts of the stressful experience?
negative_cognitions_mood - 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)?
negative_cognitions_mood - 10
Blaming yourself or someone else for the stressful experience or what happened after it?
negative_cognitions_mood - 11
Having strong negative feelings such as fear, horror, anger, guilt, or shame?
negative_cognitions_mood - 12
Loss of interest in activities that you used to enjoy?
negative_cognitions_mood - 13
Feeling distant or cut off from other people?
negative_cognitions_mood - 14
Trouble experiencing positive feelings (for example, being unable to feel happiness or have loving feelings for people close to you)?
negative_cognitions_mood - 15
Irritable behavior, angry outbursts, or acting aggressively?
arousal - 16
Taking too many risks or doing things that could cause you harm?
arousal - 17
Being "superalert" or watchful or on guard?
arousal - 18
Feeling jumpy or easily startled?
arousal - 19
Having difficulty concentrating?
arousal - 20
Trouble falling or staying asleep?
arousal
Items reproduced from a documented, freely usable source. Item wording is preserved exactly as published.
Scoring & interpretation
The PCL-5 takes five to ten minutes. A provisional diagnosis can be made either by a total cut-point (commonly 31–33) or by treating items rated 2 ("moderately") or higher as symptoms present and applying the DSM-5 criterion rule.
It is best paired with a measure of the index trauma; the standard version asks about symptoms in relation to a "stressful experience".
| Range | Band | Interpretation |
|---|---|---|
| 0–32 | Below threshold | Symptoms below the suggested provisional-diagnosis threshold; clinical interview indicated if other risk factors are present. |
| 33–80 | Provisional PTSD | Score is at or above the suggested threshold (≥33) for a provisional PTSD diagnosis. Confirm with structured clinical interview (CAPS-5). |
Higher scores indicate greater symptom severity.
Clinical applications
- Screening for probable PTSD after trauma exposure
- Supporting a provisional DSM-5 PTSD diagnosis alongside clinical interview
- Tracking symptom change across trauma-focused treatment (a 10–20 point drop is often used as a reliable-change benchmark)
Strengths & considerations
- A high score is not a diagnosis — confirm with a structured clinical interview such as the CAPS-5.
- Optimal cut-points differ by setting; use local guidance where available.
Frequently asked questions
What PCL-5 score indicates PTSD?
A total score of roughly 31–33 is a commonly used provisional cut-point for probable PTSD, but the optimal threshold depends on the population and should be confirmed clinically.
How is the PCL-5 used to track progress?
It is repeated over treatment; a reduction of about 10–20 points is widely used as evidence of reliable, clinically meaningful improvement.
Source & references
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