Trauma Test (PC-PTSD-5)
Free trauma screener using the PC-PTSD-5 (Primary Care PTSD Screen for DSM-5-TR). 5 yes/no questions covering re-experiencing, avoidance, negative mood, hyperarousal, and numbing. Positive screen ≥3. Links to full PCL-5. Prins et al. (2016).
This trauma test uses the PC-PTSD-5 (Primary Care PTSD Screen for DSM-5-TR), a validated 5-item PTSD screener. Positive screen: ≥3 of 5 items. Used across primary care, emergency, and general clinical settings. Prins et al. (2016). Connects to the full PCL-5.
About This Trauma Test
The PC-PTSD-5 (Primary Care PTSD Screen for DSM-5-TR) is a brief, validated yes/no screener developed by Prins and colleagues (2016) for use in primary care and general medical settings. Updating the earlier PC-PTSD to align with DSM-5 criteria, it first asks about lifetime trauma exposure, then assesses the five symptom domains most discriminating for PTSD: re-experiencing, avoidance, negative mood, hyperarousal, and emotional numbing.
In the original veteran sample, the PC-PTSD-5 demonstrated excellent diagnostic accuracy (AUC = 0.941). A cut score of 3 maximizes sensitivity — the threshold recommended for screening contexts where missing a true case is the primary concern — while a cut score of 4 maximizes overall efficiency. Civilian primary care validation by Williamson et al. (2022) confirmed strong diagnostic accuracy (AUC = 0.933), supporting the instrument's use beyond VA settings.
A positive PC-PTSD-5 screen (≥3 items) warrants further assessment using the full PCL-5 (PTSD Checklist for DSM-5-TR), a 20-item self-report measure mapping to all DSM-5-TR PTSD symptom clusters. Evidence-based PTSD treatments — including Prolonged Exposure (PE), Cognitive Processing Therapy (CPT), and EMDR — are strongly recommended in major clinical practice guidelines.
Trauma Screener (PC-PTSD-5)
Sometimes things happen to people that are unusually or especially frightening, horrible, or traumatic. For example: a serious accident or fire; being physically or sexually assaulted or abused; seeing someone seriously injured or killed; a sudden, unexpected death of someone close to you; war or combat; natural disaster.
Have you ever experienced this kind of event?
If yes, in the past month have you:
- Re-experiencing — Had nightmares about the event, or thought about it when you did not want to?
- Avoidance — Tried hard not to think about the event, or went out of your way to avoid situations that reminded you of it?
- Hyperarousal — Been constantly on guard, watchful, or easily startled?
- Numbing — Felt numb or detached from people, activities, or your surroundings?
- Negative mood — Felt guilty or unable to stop blaming yourself or others for the event or any problems it caused?
Each item is scored Yes (1) or No (0). Total score range: 0–5. A score of ≥3 is the recommended positive screen threshold.
PTSD Symptom Clusters (DSM-5-TR)
DSM-5-TR PTSD requires Criterion A (trauma exposure) plus symptoms across four clusters lasting more than one month with significant impairment in social, occupational, or other important areas of functioning.
| Cluster | Label | Examples |
|---|---|---|
| B | Intrusion symptoms | Distressing memories, nightmares, flashbacks, intense psychological or physiological reactions to trauma cues |
| C | Avoidance | Avoiding distressing memories/thoughts, or external reminders (people, places, conversations, activities) |
| D | Negative alterations in cognition and mood | Persistent negative cognitions about oneself or the world, distorted blame, persistent negative emotions, diminished interest, feelings of detachment, inability to experience positive emotions |
| E | Alterations in arousal and reactivity | Irritability, reckless behaviour, hypervigilance, exaggerated startle response, concentration problems, sleep disturbance |
Complex PTSD (C-PTSD), recognized in ICD-11, develops after prolonged or repeated trauma such as childhood abuse, domestic violence, or captivity, and adds disturbances in self-organization — including emotion dysregulation, persistent negative self-concept, and relational difficulties — to the core PTSD symptom clusters above.
PTSD and Trauma Screening Tools
Multiple validated instruments exist for PTSD screening and symptom monitoring, varying in length, purpose, and clinical context.
| Instrument | Items | Format | Primary Use |
|---|---|---|---|
| PC-PTSD-5 | 5 | Yes/No | Initial screen in primary care, emergency, or high-volume settings; cut score ≥3 for sensitivity |
| PCL-5 | 20 | 0–4 Likert | Symptom severity tracking and provisional PTSD diagnosis; optimal efficiency cut scores of 31–33 in veteran samples (Bovin et al., 2016) |
| ITQ | 6 (+6) | 0–4 Likert | Screens for ICD-11 PTSD and Complex PTSD separately; especially relevant when prolonged or repeated trauma is the presenting history |
| CAPS-5 | 30 | Structured interview | Clinician-administered criterion standard for PTSD diagnosis and severity rating; used as criterion measure in PC-PTSD-5 and PCL-5 validation studies |
| TSQ | 10 | Yes/No | Rapid post-trauma screen (within weeks of event) used in acute care and crisis settings |
The PC-PTSD-5 and PCL-5 are paired instruments in many clinical workflows: the 5-item screener identifies who needs fuller evaluation, and the PCL-5 provides detailed symptom mapping and a score suitable for monitoring treatment response over time.
PTSD Outcome Tracking in HiBoop
PCL-5, PC-PTSD-5, PHQ-9, and GAD-7 are integrated into HiBoop for trauma and PTSD outcome monitoring across outpatient, VA, and trauma-specialized programs. Tracking responses over time allows clinicians to monitor symptom trajectories, adjust treatment intensity, and meet measurement-based care standards for PTSD and co-occurring mood and anxiety conditions.
References
- 1.Prins A, Bovin MJ, Smolenski DJ, Marx BP, Kimerling R, Jenkins-Guarnieri MA, Kaloupek DG, Schnurr PP, Kaiser AP, Leyva YE, Tiet QQ. The Primary Care PTSD Screen for DSM-5 (PC-PTSD-5): Development and Evaluation Within a Veteran Primary Care Sample. J Gen Intern Med. 2016;31(10):1206-11.View source
- 2.Bovin MJ, Marx BP, Weathers FW, Gallagher MW, Rodriguez P, Schnurr PP, Keane TM. Psychometric properties of the PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition (PCL-5) in veterans. Psychol Assess. 2016;28(11):1379-1391.View source
- 3.Williamson MLC, Stickley MM, Armstrong TW, Jackson K, Console K. Diagnostic accuracy of the Primary Care PTSD Screen for DSM-5 (PC-PTSD-5) within a civilian primary care sample. J Clin Psychol. 2022;78(11):2299-2308.View source
- 4.Tiet QQ, Tiet TN. Diagnostic Accuracy of the Primary Care PTSD for DSM-5 Screen (PC-PTSD-5) in Demographic and Diagnostic Subgroups of Veterans. J Gen Intern Med. 2024;39(11):2017-2022.View source
Frequently Asked Questions
What score is positive on the PC-PTSD-5?
A score of 3 or more out of 5 is the recommended positive screen threshold. In the original validation by Prins et al. (2016), a cut score of 3 maximized sensitivity (κ[1] = 0.93), making it suitable for ruling out PTSD in primary care settings where missing a true case carries high risk.
Can the PC-PTSD-5 diagnose PTSD?
No. The PC-PTSD-5 is a screener, not a diagnostic tool. A positive result (≥3) indicates that a more thorough assessment — typically the 20-item PCL-5 or a structured clinical interview — is warranted. Only a qualified clinician using established diagnostic criteria can confirm a PTSD diagnosis.
Is the PC-PTSD-5 self-report or clinician-administered?
It is designed as a brief self-report measure that can also be administered verbally by a primary care provider. In the original validation study, patients expressed a preference for it to be reviewed with their primary care clinician rather than completed in isolation.
How does the PC-PTSD-5 differ from the PCL-5?
The PC-PTSD-5 is a 5-item yes/no screener intended to identify individuals who may have PTSD — it is fast and broadly applicable. The PCL-5 is a 20-item self-report questionnaire that maps to all four DSM-5 PTSD symptom clusters and provides a continuous severity score used for diagnosis and treatment monitoring.
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