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The Life Events Checklist for DSM-5 (LEC-5) is a self-report tool developed by the National Center for Post-traumatic Stress Disorder (PTSD) to measure exposure to potentially traumatic events and assist with the diagnosis of PTSD. The LEC-5 contains 17 questions inquiring about the experiences of potentially traumatic events associated with post-traumatic difficulties in adults (18+ years). The LEC-5 is used to establish exposure to a PTSD Criterion A traumatic event and is subsequently used in combination with other measures (e.g. PTSD Checklist for DSM-5 (PCL-5)) to establish if other diagnostic criteria are present (Weathers et al., 2013).
The scale finds applications in clinical settings for screening purposes. Its primary objective is to detect exposure to potentially traumatic events, serving as an initial step towards recognising and further investigating such events when identified.
The LEC-5 is designed to screen potentially traumatic events in adults as opposed to definitively establishing that an individual has experienced an event of sufficient severity to meet DSM-5 diagnostic criteria for traumatic exposure.
Example LEC-5 items:
Given that many people with PTSD engage in avoidance and minimisation of traumatic incidence, the LEC-5 can be useful in asking about an explicit set of events. In addition, some individuals may have normalised their traumatic experiences, especially if exposed to prolonged or repeated trauma (e.g., childhood abuse). They might not recognise certain events as traumatic or noteworthy unless specifically asked. Finally, the LEC-5 can help clinicians identify specific patterns of exposure to traumatic events, helping clinicians better understand the root causes of a patient’s symptoms and tailor treatment accordingly.
The LEC-5 is intended to gather information about the potentially traumatic experiences a person has experienced. There is no formal scoring protocol or interpretation per se, other than identifying whether a person has experienced one or more of the events listed. Respondents indicate varying levels of exposure to each type of potentially traumatic event included on a 6-point nominal scale, and respondents may endorse multiple levels of exposure to the same trauma type (Weathers et al., 2013). If a traumatic event is reported (i.e., Criterion A for a DSM-5 PTSD diagnosis), it is advisable to administer a combination of measures, such as the PTSD Checklist for DSM-5 (PCL-5), to confirm the presence of other diagnostic criteria in order to determine if a PTSD diagnosis is applicable.
The LEC-5 is designed to screen potentially traumatic events in adults as opposed to definitively establishing that an individual has experienced an event of sufficient severity to meet DSM-5 diagnostic criteria for traumatic exposure. Initially, the psychometric properties of the LEC-5 were assessed using a sample comprising 108 university students (Mean age = 20.1, SD = 3.4; 32% men, 68% women) and 131 combat veterans (Mean age = 54; 100% men) (Gray et al., 2004). The evaluation involved examining the reliability and validity of the questionnaire items (Gray et al., 2004). The scale displayed good test-retest reliability over a one-week-period (r = .82) and sufficient inter-rater reliability (κ = .61). In non-clinical samples, the LEC-5 also has moderate test-retest reliability, with events that were directly experienced being the most reliably reported (Pugach et al., 2020). The LEC-5 demonstrates strong convergence with measures of psychopathology and PTSD. The scale also showed significant correlations with the Traumatic Life Events Questionnaire.
Three traumatic event-type clusters were identified (Contractor et al., 2020):
Weathers, F.W., Blake, D.D., Schnurr, P.P., Kaloupek, D.G., Marx, B.P., & Keane, T.M. (2013). The Life Events Checklist for DSM-5 (LEC-5). Instrument available from the National Center for PTSD at www.ptsd.va.gov
Contractor, A. A., Weiss, N. H., Natesan Batley, P., & Elhai, J. D. (2020). Clusters of Trauma Types as Measured by the Life Events Checklist for DSM-5. International Journal of Stress Management, 27(4), 380–393. https://doi.org/10.1037/str0000179
Gray, M. J., Litz, B. T., Hsu, J. L., & Lombardo, T. W. (2004). Psychometric Properties of the Life Events Checklist. Assessment (Odessa, Fla.), 11(4), 330–341. https://doi.org/10.1177/1073191104269954
Pugach, C. P., Nomamiukor, F. O., Gay, N. G., & Wisco, B. E. (2021). Temporal Stability of Self‐Reported Trauma Exposure on the Life Events Checklist for DSM‐5. Journal of Traumatic Stress, 34(1), 248–256. https://doi.org/10.1002/jts.22611
Weathers, F.W., Blake, D.D., Schnurr, P.P., Kaloupek, D.G., Marx, B.P., & Keane, T.M. (2013). The Life Events Checklist for DSM-5 (LEC-5). Instrument available from the National Center for PTSD at www.ptsd.va.gov
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