Trauma Test (PC-PTSD-5)

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.

What the PC-PTSD-5 measures

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 screener'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.

How to administer the PC-PTSD-5

The PC-PTSD-5 can be self-completed or read aloud by a primary care provider; in the original study, patients preferred administration by their primary care provider over other providers or self-report (Prins et al., 2016). It first asks whether the person has ever experienced a traumatic event; only if they answer yes are the five symptom questions asked, each about the past month.

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:

1. Re-experiencing — Had nightmares about the event, or thought about it when you did not want to?
2. Avoidance — Tried hard not to think about the event, or went out of your way to avoid situations that reminded you of it?
3. Hyperarousal — Been constantly on guard, watchful, or easily startled?
4. Numbing — Felt numb or detached from people, activities, or your surroundings?
5. Negative mood — Felt guilty or unable to stop blaming yourself or others for the event or any problems it caused?

PC-PTSD-5 scoring and interpretation

Each item is scored Yes (1) or No (0), for a total of 0–5. A score of ≥3 is the recommended positive screen threshold: in the original veteran sample a cut score of 3 maximized sensitivity, 4 maximized overall efficiency and 5 maximized specificity (Prins et al., 2016). Use the score interpreter above to check a total. A positive screen is not a diagnosis; follow it with the PCL-5 or a structured clinical interview.

Psychometric properties

• Veterans (Prins et al., 2016): In 398 veterans in primary care, compared with a MINI-based PTSD interview, the PC-PTSD-5 had excellent diagnostic accuracy (AUC = 0.941), and patients found it acceptable.
• Civilian primary care (Williamson et al., 2022): In 198 patients of an integrated behavioural health service, accuracy was excellent (AUC = 0.933); in that sample a cutoff of 4 gave a sensitivity of 100% (Williamson et al., 2022) with a specificity of 85.2% and maximized efficiency.
• Subgroups of veterans (Tiet & Tiet, 2024): In 519 VA primary care patients, sensitivity ranged from 81.25% to 100% and specificity from 80.54% to 88.31% across demographic groups; specificity fell as low as 60.00% in some diagnostic subgroups.

Limitations

• Screening, not diagnosis. A positive result indicates that fuller assessment is needed; only a clinical evaluation can confirm PTSD.
• False positives with other conditions. Symptom overlap means false positives are more likely in people with depression or substance use disorders (Tiet & Tiet, 2024).
• Optimal cutoff varies. The recommended cutoff of 3 favours sensitivity; a civilian primary care study found 4 performed best.
• Validation samples. Most evidence comes from US veteran and primary care samples.
• Requires a trauma exposure question. People who do not disclose trauma exposure are not asked the symptom items.

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.

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 measures exist for PTSD screening and symptom monitoring, varying in length, purpose, and clinical context.

The PC-PTSD-5 and PCL-5 are paired tools 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.