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PCL-5: PTSD Checklist for DSM-5
5-10 min • 20 questions
Understanding the PCL-5: PTSD Screening for DSM-5
The PTSD Checklist for DSM-5 (PCL-5) is a 20-item self-report questionnaire developed by the National Center for PTSD to assess symptoms of post-traumatic stress disorder. Each item corresponds directly to a DSM-5 PTSD symptom criterion, making it one of the most clinically validated trauma screening tools available.
Why the PCL-5 matters: PTSD affects approximately 6% of the U.S. population at some point in their lives, with rates significantly higher among veterans, first responders, and survivors of violence or disasters. Many people with PTSD symptoms don't seek help because they don't recognize their experiences as trauma-related. The PCL-5 provides an objective way to identify symptoms that warrant professional evaluation.
DSM-5 Symptom Clusters: The PCL-5 measures four distinct symptom clusters:
- Cluster B (Intrusion): Items 1-5 assess re-experiencing symptoms like intrusive memories, nightmares, flashbacks, and emotional/physical reactivity to trauma reminders.
- Cluster C (Avoidance): Items 6-7 measure avoidance of trauma-related thoughts, feelings, and external reminders.
- Cluster D (Negative Cognitions/Mood): Items 8-14 evaluate negative beliefs, distorted blame, persistent negative emotions, diminished interest, detachment, and inability to experience positive emotions.
- Cluster E (Arousal/Reactivity): Items 15-20 assess irritability, reckless behavior, hypervigilance, exaggerated startle response, concentration problems, and sleep disturbance.
Validation and reliability: The PCL-5 demonstrates excellent psychometric properties with strong internal consistency (Cronbach's alpha = 0.94-0.96) and test-retest reliability (r = 0.82-0.84). Research across diverse populations including veterans, civilians, and international samples confirms its diagnostic accuracy with an AUC of 0.89-0.95 for detecting PTSD. A cutoff score of 31-33 optimally balances sensitivity and specificity for most populations.
Clinical applications: The PCL-5 serves multiple purposes: initial screening, diagnostic support, symptom severity monitoring, and treatment outcome tracking. Clinicians often administer it at intake, throughout treatment, and at discharge to document progress. A 10-point change is considered clinically meaningful, while a 5-point change represents reliable change.
Important disclaimer: The PCL-5 is a screening and monitoring tool—it cannot diagnose PTSD. A comprehensive clinical evaluation including trauma history, symptom duration, functional impairment, and differential diagnosis is required for formal diagnosis. If you're experiencing severe symptoms or thoughts of self-harm, contact the 988 Suicide & Crisis Lifeline immediately.
Reference: This assessment is based on the official PCL-5 from the National Center for PTSD. The measure is in the public domain and may be used without permission.
Ready to Begin?
This assessment takes about 5-10 min to complete. Your responses are private, never stored, and you can instantly download your results as a PDF.
How to Take the PCL-5 PTSD Assessment
You'll answer 20 questions about how much you've been bothered by specific PTSD symptoms during the past month. Each response is scored from 0 (Not at all) to 4 (Extremely), producing a total score between 0 and 80.
Before you begin: The PCL-5 asks about reactions to a "stressful experience." Think of the most distressing traumatic event you've experienced when answering. If you've experienced multiple traumas, you may focus on the one currently causing the most difficulty.
The 20 symptoms assessed include:
Re-experiencing (Cluster B):
- Intrusive memories of the trauma
- Distressing dreams related to the event
- Flashbacks (feeling like the trauma is happening again)
- Emotional distress when reminded of the trauma
- Physical reactions to trauma reminders
Avoidance (Cluster C):
- Avoiding trauma-related thoughts or feelings
- Avoiding external reminders (people, places, situations)
Negative Cognitions and Mood (Cluster D):
- Memory gaps about the trauma
- Negative beliefs about self, others, or the world
- Distorted blame regarding the trauma
- Persistent negative emotions
- Loss of interest in activities
- Feeling detached from others
- Difficulty experiencing positive emotions
Arousal and Reactivity (Cluster E):
- Irritability or angry outbursts
- Reckless or self-destructive behavior
- Hypervigilance
- Exaggerated startle response
- Concentration difficulties
- Sleep problems
Most people complete the assessment in 5-10 minutes.
PCL-5 Scoring and Clinical Interpretation
Total Score Interpretation (0-80):
0-19 (Minimal): Symptoms are below the clinical threshold. PTSD is unlikely based on this screening. However, even subclinical symptoms may benefit from support if they're causing distress.
20-32 (Mild to Subthreshold): Some PTSD symptoms are present but below the diagnostic cutoff. Monitor symptoms and consider professional consultation if they persist or worsen. Supportive interventions or psychoeducation may be helpful.
33-50 (Moderate - Probable PTSD): Score exceeds the recommended cutoff of 31-33. Symptoms are consistent with a PTSD diagnosis. A comprehensive clinical evaluation is strongly recommended. Evidence-based treatments like Cognitive Processing Therapy (CPT), Prolonged Exposure (PE), or EMDR are highly effective.
51-80 (Severe): Significant PTSD symptom burden requiring prompt professional attention. Intensive treatment and close monitoring are warranted. Safety planning should be considered if suicidal ideation is present.
Provisional DSM-5 Diagnosis Method:
The PCL-5 can also be scored categorically. Treating items rated 2 (Moderately) or higher as symptoms endorsed, a provisional PTSD diagnosis requires:
- At least 1 Cluster B item (questions 1-5)
- At least 1 Cluster C item (questions 6-7)
- At least 2 Cluster D items (questions 8-14)
- At least 2 Cluster E items (questions 15-20)
Cluster Subscores: Your results include separate scores for each DSM-5 symptom cluster, helping identify which symptom domains are most prominent. This can guide treatment focus—for example, high avoidance scores may benefit particularly from exposure-based therapies.
Monitoring treatment: A 10-point decrease from baseline indicates clinically meaningful improvement. Research suggests that achieving a score below 28 indicates transition to a non-clinical population.
Crisis support: If you're experiencing thoughts of suicide or self-harm, please call the 988 Suicide & Crisis Lifeline or go to your nearest emergency room immediately.
Frequently Asked Questions
Common questions about the PCL-5 assessment.