PTSD Checklist 5 (PCL-5)

Description

The PCL-5 is a 20 item self-report measure of the 20 DSM-5 symptoms of Post Traumatic Stress Disorder (PTSD). Included in the scale are four domains consistent with the four criterion of PTSD in DSM-5:
- Re-experiencing (criterion B)
- Avoidance (criterion C)
- Negative alterations in cognition and mood (criterion D)
- Hyper-arousal (criterion E)

The PCL-5 can be used to monitor symptom change, to screen for PTSD, or to make a provisional PTSD diagnosis.

Validity

The PCL-5 is a relatively new scale (released in 2013), therefore only preliminary validation is currently available. Validation research points to the clinical utility of the PCL-5. All four criterion scales demonstrate high internal consistency (Cohen et al., 2015). There was also a high correlation of PTSD prevalence in a student sample (n = 2490) between the symptom severity (1.4% meeting PTSD criteria) and diagnostic classification scoring methods (1.3% meeting PTSD criteria) (Cohen et al., 2015).

Interpretation

Scores consist of a total symptom severity score (from 0 to 80) and scores for four subscales:
- Re-experiencing (items 1-5 – max score = 20)
- Avoidance (items 6-7 – max score = 8)
- Negative alterations in cognition and mood (items 8-14 – max score = 28)
- Hyper-arousal (items 15-20 – max score = 24)

In addition to a raw score being presented, a “mean score” is also computed, which is the subscale score divided by the number of items. These scores range between 0 to 5, where higher scores represent higher severity. Consistent with the likert scale:
0 = Not at all
1 = A little bit
2 = Moderately
3 = Quite a bit
4 = Extremely

A provisional PTSD diagnosis can be made by treating each item rated as 2="Moderately" or higher as an endorsed symptom, then following the DSM-5 diagnostic rule which requires at least: 1 B item (questions 1-5), 1 C item (questions 6-7), 2 D items (questions 8-14), 2 E items (questions 15-20).

A cut-off raw score is 38 for a provisional diagnosis of PTSD. This cut-off has high sensitivity (.78) and specificity (.98) (Cohen et al., 2015).
If the scale is used to track symptoms over time, a minimum 10 point change represents clinically significant change (as based on the PCL for DSM-IV change scores).

Developer

Weathers, F.W., Litz, B.T., Keane, T.M., Palmieri, P.A., Marx, B.P., & Schnurr, P.P. (2013).The PTSD Checklist for DSM-5 (PCL-5). Scale available from the National Center for PTSD at www.ptsd.va.gov.