PTSD Checklist for DSM-5 (PCL-5)

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The PCL-5 (Post-traumatic Stress Disorder Checklist for DSM-5) is a 20-item self-report tool used to assess the presence and severity of PTSD symptoms based on DSM-5 diagnostic criteria. It is commonly used to screen for PTSD, make a provisional diagnosis, and monitor symptom change over time—particularly in trauma-focused care settings.

Developed by the U.S. Department of Veterans Affairs’ National Center for PTSD, the PCL-5 is validated for use in civilian and military populations, and in both clinical and research environments.

Recommended Frequency: At intake and every 4–6 weeks during trauma-focused treatment

About the PCL-5

The PCL-5 is based on the four DSM-5 PTSD symptom clusters:

  1. Intrusion (e.g., flashbacks, nightmares)
  2. Avoidance (e.g., avoiding reminders or conversations)
  3. Negative alterations in cognition and mood (e.g., guilt, detachment, memory issues)
  4. Alterations in arousal and reactivity (e.g., hypervigilance, sleep disturbance, anger)

Each item corresponds to a core PTSD symptom and asks the client to rate how much they have been bothered by it in the past month.

Responses are scored on a 5-point Likert scale:

  • 0 = Not at all
  • 1 = A little bit
  • 2 = Moderately
  • 3 = Quite a bit
  • 4 = Extremely

Who is the PCL-5 For?

The PCL-5 is recommended for clients aged 18 and older who:

  • Have experienced one or more potentially traumatic events (e.g., violence, assault, accidents, loss, combat, disasters)
  • Report distressing symptoms such as nightmares, hypervigilance, emotional numbness, or avoidance behaviors
  • Are in trauma-focused therapy, or being evaluated for PTSD, CPTSD, or trauma-related symptoms

Use this checklist to determine suitability:

  • Has the client experienced an event that meets DSM-5 Criterion A for trauma exposure?
  • Are symptoms interfering with day-to-day functioning, relationships, or emotional regulation?
  • Is the client receiving or being considered for trauma-informed care?

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Note: The PCL-5 should be administered after a known trauma has been disclosed. A Criterion A trauma screener may be used in advance to confirm applicability.

The Scale

The 20 items are rated based on the client’s experiences over the past month.

Sample item:

“Repeated, disturbing dreams of the stressful experience?”

HiBoop logs individual symptom responses, identifies patterns, and highlights items scoring 3 (Quite a bit) or 4 (Extremely) to support focused discussion and safety planning.

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TIP FOR PRACTICE

Use high scores to triage focus areas, not just track severity. For example, if avoidance is high but arousal is low, adjust interventions accordingly. Always assess for safety and dissociation when PTSD symptoms spike.

Each item is scored 0–4, with a total score range of 0–80.

Score Range

0–10 Minimal to no PTSD symptoms

11–32 Mild to moderate symptoms; monitor

33–49 Probable PTSD; recommend clinical review

50–80 Severe symptoms; consider referral or intensive trauma care

A score of 33 or higher is typically used as a cutoff for probable PTSD, although diagnostic decisions must incorporate clinical interviews and full DSM-5 criteria.

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TIP FOR PRACTICE

Use high scores to triage focus areas, not just track severity. For example, if avoidance is high but arousal is low, adjust interventions accordingly. Always assess for safety and dissociation when PTSD symptoms spike.

The PCL-5 in Practice

Ideal for:

  • Screening and diagnostic support for PTSD and complex PTSD
  • Monitoring treatment progress during EMDR, CPT, PE, or trauma-informed CBT
  • Identifying symptom spikes during anniversaries, transitions, or stressors
  • Pairing with mood, dissociation, or anxiety assessments for a holistic symptom profile

In HiBoop, clinicians can view longitudinal symptom graphs, compare with mood and anxiety scales, and activate trauma-specific workflows when high-risk indicators are present.

Copyright

Developed by the U.S. Department of Veterans Affairs National Center for PTSD. The PCL-5 is free for clinical use and may be reproduced without modification for non-commercial purposes.

References

  • Weathers, F. W., Litz, B. T., Keane, T. M., et al. (2013). The PTSD Checklist for DSM-5 (PCL-5). National Center for PTSD.
  • Blevins, C. A., Weathers, F. W., et al. (2015). The Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5): Development and Initial Psychometric Evaluation. Journal of Traumatic Stress, 28(6), 489–498.

Disclaimer

The PCL-5 is a validated PTSD screening and symptom monitoring tool. It is not a diagnostic test. Diagnosis of PTSD requires a structured clinical interview and confirmation of Criterion A trauma and symptom clusters per DSM-5 guidelines.

Permissions

The PCL-5 is in the public domain, developed by the U.S. Department of Veterans Affairs. HiBoop may implement it fully, including scoring and result interpretation, with proper attribution to the National Center for PTSD. https://www.ptsd.va.gov/professional/assessment/adult-sr/ptsd-checklist.asp

Frequently Asked Questions

  • Can I administer the PCL-5 remotely?

    Yes. HiBoop supports secure digital delivery, automated scoring, and flagging for clinical review.

  • How often should I re-administer it?

    Every 4–6 weeks during treatment, or sooner if symptoms escalate.

  • Can I use it with adolescents?

    The PCL-5 is validated for adults. For younger clients, use the Child/Adolescent version (PCL-5-Y) or other age-appropriate trauma screeners.

  • Is it valid for complex trauma (CPTSD)?

    Yes, though CPTSD may require additional assessments (e.g., for dissociation, emotional regulation, or identity disturbance).

  • What if a client scores high but hasn’t disclosed a trauma?

    Follow up gently. Clarify that PCL-5 assumes trauma exposure. If needed, screen for Criterion A events and assess readiness to discuss them.

  • Can the PCL-5 diagnose PTSD?

    No. It suggests probable PTSD, but diagnosis requires full DSM-5 criteria confirmed by a clinician.