PCL-5 | Post Traumatic Stress Disorder

The PCL-5 Scale

The PCL-5 is a self-report measure, which means clients can fill it out independently before session or with the assistance of their clinician. The measure takes approximately 5-10 minutes to complete and asks clients to indicate the level to which each symptom has impacted them in the last month. The PCL-5 uses a 5 point likert scale to measure symptom severity, with options “Not at all,” “A little bit,” Moderately,” “Quite a bit,” and “Extremely,” that correspond to scores of 1-5.

Below is a list of problems that people often have in response to a stressful or traumatic experience. Clients should read each experience and then choose one of the numbers to indicate the level to which **they have been experienced that symptom in the past month.

Tip: If you notice that a client has skipped an item on the PCL-5, Dr. Michelle Bovin recommends asking the client if that was intentional. If they did so purposefully, she advises against asking them to complete it during that time, as this represents a boundary or topic they may not be able to discuss in that moment.

Scoring the PCL-5

Items on the PCL-5 are summed to provide a total score.

Using the PCL-5 for Probable Diagnosis

It’s important to note that the interpretation of the PCL-5 should be determined by a clinician and that the measure cannot provide definitive diagnostic status. A clinical interview must be conducted by a trained PTSD professional for a diagnosis is confirmed.

1. A probable PTSD diagnosis can be made by treating each item within the DSM-V clusters that are rated as 2 or higher (“Moderately” or higher) as a qualifying score under that cluster. Then you may follow the DSM-5 diagnostic rule which requires from each cluster at least:

• 1 item from B (questions 1-5) which measures re-experiencing symptoms
• 1 item from C (questions 6-7) which measures avoidance symptoms
• 2 items from D (questions 8-14) which measure negative change to cognition and mood
• 2 items from E (questions 15-20) which measure hyper-arousal symptoms.

1. If calculating the total symptom severity score (range of 0-80)—which can be obtained by summing the scores for each of the 20 items— research suggests that a PCL-5 cutoff score between 31-33 can be used for a provisional PTSD diagnosis. There is also reason to believe that different populations or reasons for the screening could warrant different cutoff scores, thus both should be considered when determining if further psychometric work to diagnose and treat PTSD is warranted.

A note about Determining probable PTSD: When using severity scores to make a probable diagnosis, a few other factors should be considered. These include the setting that the client is completing the assessment in and the goal of assessment. If you’re screening for PTSD or interested in maximizing your ability to detect possible cases, a lower cut point should be used. A higher cut-point score should be considered when making a probable diagnosis or when the goal is to minimize false positives.

Using the PCL-5 to Determine PTSD Severity

1. Total symptom severity score

For the purpose of using the PCL-5 for ongoing progress measurement, clinicians may calculate and leverage the total symptom severity score. Severity can be determined adding scores of each item together to determine a total score. A total score of 33 or higher may indicate severe PTSD and suggests the patient needs further assessment to confirm a diagnosis of PTSD.