PCL-5

Screen for and measure PTSD symptom severity. Monitors treatment response. Self-report measure — the patient completes it.

Indication

Screen for and measure PTSD symptom severity. Monitors treatment response. Self-report measure — the patient completes it.

Criteria

id: pcl_1; label: 1. Repeated, disturbing, unwanted memories of the experience; type: options; options: value: 0; label: 0 — Not at all; value: 1; label: 1 — A little bit; value: 2; label: 2 — Moderately; value: 3; label: 3 — Quite a bit; value: 4; label: 4 — Extremely
id: pcl_2; label: 2. Repeated disturbing dreams of the experience; type: options; options: value: 0; label: 0 — Not at all; value: 1; label: 1 — A little bit; value: 2; label: 2 — Moderately; value: 3; label: 3 — Quite a bit; value: 4; label: 4 — Extremely
id: pcl_3; label: 3. Suddenly feeling/acting as if the experience were happening again (flashbacks); type: options; options: value: 0; label: 0 — Not at all; value: 1; label: 1 — A little bit; value: 2; label: 2 — Moderately; value: 3; label: 3 — Quite a bit; value: 4; label: 4 — Extremely
id: pcl_4; label: 4. Feeling very upset when reminded of the experience; type: options; options: value: 0; label: 0 — Not at all; value: 1; label: 1 — A little bit; value: 2; label: 2 — Moderately; value: 3; label: 3 — Quite a bit; value: 4; label: 4 — Extremely
id: pcl_5; label: 5. Strong physical reactions when reminded of the experience; type: options; options: value: 0; label: 0 — Not at all; value: 1; label: 1 — A little bit; value: 2; label: 2 — Moderately; value: 3; label: 3 — Quite a bit; value: 4; label: 4 — Extremely
id: pcl_6; label: 6. Avoiding memories, thoughts, or feelings related to the experience; type: options; options: value: 0; label: 0 — Not at all; value: 1; label: 1 — A little bit; value: 2; label: 2 — Moderately; value: 3; label: 3 — Quite a bit; value: 4; label: 4 — Extremely
id: pcl_7; label: 7. Avoiding external reminders of the experience; type: options; options: value: 0; label: 0 — Not at all; value: 1; label: 1 — A little bit; value: 2; label: 2 — Moderately; value: 3; label: 3 — Quite a bit; value: 4; label: 4 — Extremely
id: pcl_8; label: 8. Trouble remembering important parts of the experience; type: options; options: value: 0; label: 0 — Not at all; value: 1; label: 1 — A little bit; value: 2; label: 2 — Moderately; value: 3; label: 3 — Quite a bit; value: 4; label: 4 — Extremely
id: pcl_9; label: 9. Strong negative beliefs about yourself, others, or the world; type: options; options: value: 0; label: 0 — Not at all; value: 1; label: 1 — A little bit; value: 2; label: 2 — Moderately; value: 3; label: 3 — Quite a bit; value: 4; label: 4 — Extremely
id: pcl_10; label: 10. Blaming yourself or someone else for the event or its aftermath; type: options; options: value: 0; label: 0 — Not at all; value: 1; label: 1 — A little bit; value: 2; label: 2 — Moderately; value: 3; label: 3 — Quite a bit; value: 4; label: 4 — Extremely
id: pcl_11; label: 11. Strong negative feelings (fear, horror, anger, guilt, shame); type: options; options: value: 0; label: 0 — Not at all; value: 1; label: 1 — A little bit; value: 2; label: 2 — Moderately; value: 3; label: 3 — Quite a bit; value: 4; label: 4 — Extremely
id: pcl_12; label: 12. Loss of interest in activities you used to enjoy; type: options; options: value: 0; label: 0 — Not at all; value: 1; label: 1 — A little bit; value: 2; label: 2 — Moderately; value: 3; label: 3 — Quite a bit; value: 4; label: 4 — Extremely
id: pcl_13; label: 13. Feeling distant or cut off from other people; type: options; options: value: 0; label: 0 — Not at all; value: 1; label: 1 — A little bit; value: 2; label: 2 — Moderately; value: 3; label: 3 — Quite a bit; value: 4; label: 4 — Extremely
id: pcl_14; label: 14. Trouble experiencing positive feelings; type: options; options: value: 0; label: 0 — Not at all; value: 1; label: 1 — A little bit; value: 2; label: 2 — Moderately; value: 3; label: 3 — Quite a bit; value: 4; label: 4 — Extremely
id: pcl_15; label: 15. Irritable behavior, angry outbursts, or acting aggressively; type: options; options: value: 0; label: 0 — Not at all; value: 1; label: 1 — A little bit; value: 2; label: 2 — Moderately; value: 3; label: 3 — Quite a bit; value: 4; label: 4 — Extremely
id: pcl_16; label: 16. Taking too many risks or doing things that could cause harm; type: options; options: value: 0; label: 0 — Not at all; value: 1; label: 1 — A little bit; value: 2; label: 2 — Moderately; value: 3; label: 3 — Quite a bit; value: 4; label: 4 — Extremely
id: pcl_17; label: 17. Being super-alert, watchful, or on guard; type: options; options: value: 0; label: 0 — Not at all; value: 1; label: 1 — A little bit; value: 2; label: 2 — Moderately; value: 3; label: 3 — Quite a bit; value: 4; label: 4 — Extremely
id: pcl_18; label: 18. Feeling jumpy or easily startled; type: options; options: value: 0; label: 0 — Not at all; value: 1; label: 1 — A little bit; value: 2; label: 2 — Moderately; value: 3; label: 3 — Quite a bit; value: 4; label: 4 — Extremely
id: pcl_19; label: 19. Having difficulty concentrating; type: options; options: value: 0; label: 0 — Not at all; value: 1; label: 1 — A little bit; value: 2; label: 2 — Moderately; value: 3; label: 3 — Quite a bit; value: 4; label: 4 — Extremely
id: pcl_20; label: 20. Trouble falling or staying asleep; type: options; options: value: 0; label: 0 — Not at all; value: 1; label: 1 — A little bit; value: 2; label: 2 — Moderately; value: 3; label: 3 — Quite a bit; value: 4; label: 4 — Extremely

Interpretation

function(score) { if (score < 33) return { risk: score + '/80', tier: 'Below provisional PTSD threshold', action: 'Below cutoff (33). Continue monitoring; re-screen if symptoms change.', color: 'green' }; if (score < 50) return { risk: score + '/80', tier: 'Provisional PTSD diagnosis', action: 'At or above cutoff (33) \u2014 clinical interview recommended. Consider trauma-focused CBT/EMDR.', color: 'yellow' }; return { risk: score + '/80', tier: 'Severe PTSD symptoms', action: 'High symptom burden \u2014 full diagnostic evaluation warranted. Trauma-focused therapy +/- SSRI/SNRI.', color: 'red' }; }

Clinical pearls

A cutoff of 33 has sensitivity ~80% and specificity ~85% for PTSD
Assesses all 4 DSM-5 symptom clusters; pair with a trauma screen (PC-PTSD-5)
First-line treatments are trauma-focused CBT and EMDR; SSRIs/SNRIs are first-line pharmacotherapy
Prazosin is specifically used for PTSD-related nightmares
A ≥10-point decrease = meaningful improvement; ≥20-point decrease = reliable change

Source and review

Weathers FW et al. National Center for PTSD 2013; Blevins CA et al. J Trauma Stress 2015. Last reviewed: 2025-01-01