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Post Traumatic Stress Disorder (PTSD) Checklist for DSM-5 (PCL-5)

20-item self-report measure of DSM-5 PTSD symptoms over the past month in adult populations (ages 18+).

CreatorDr. Frank W. Weathers, PhD
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Instructions

Below is a list of problems and complaints that people sometimes have in response to stressful life experiences.

How much you have been bothered by that problem IN THE LAST MONTH.

The PCL-5 (PTSD Checklist for DSM-5) is a 20-question self-report survey that measures the symptoms of posttraumatic stress disorder (PTSD) as defined in the DSM-5. Frank W. Weathers, PhD, and colleagues (2013) at the U.S. Department of Veterans Affairs’ National Center for PTSD. The PCL-5 updates the original PTSD Checklist to match the DSM-5 criteria. It can screen for PTSD, measure and monitor symptoms, and help make a provisional diagnosis.

What it asks: Patients think of their worst stressful experience and rate how much each of 20 problems has bothered them in the past month. The items follow the four DSM-5 symptom clusters: intrusion (items 1–5), such as unwanted memories and nightmares; avoidance (items 6–7), such as avoiding reminders of the event; negative changes in thinking and mood (items 8–14), such as guilt, blame, or feeling distant from others; and changes in arousal and reactivity (items 15–20), such as irritability, trouble concentrating, and sleep problems. Each item uses the same five answers: Not at all (0), A little bit (1), Moderately (2), Quite a bit (3), or Extremely (4).

How it’s scored: The PCL-5 can be scored in three ways.

  • Total score: Add all 20 items for a total from 0 to 80, where higher scores mean more severe symptoms.

  • Cluster scores: Add the items within each cluster: intrusion (0–20), avoidance (0–8), negative thinking and mood (0–28), and arousal and reactivity (0–24). Since the clusters have different numbers of items, the average per item (0–4) helps compare them.

  • Provisional DSM-5 diagnosis: Any item rated 2 (Moderately) or higher counts as a symptom present. The criteria are met if there’s at least one symptom in intrusion, one in avoidance, two in negative thinking and mood, and two in arousal and reactivity.

How results are interpreted: A total of 31 to 33 or above indicates probable PTSD. That signals a need for further clinical assessment, not a diagnosis. The PCL-5 has no official severity ranges, so results aren’t labeled mild, moderate, or severe. When the PCL-5 is repeated over time, the National Center for PTSD suggests a change of 10 points as an indicator of treatment response. The PCL-5 doesn’t confirm that a qualifying traumatic event occurred, so a high score alone doesn’t establish PTSD. A diagnosis requires a clinical evaluation.

Results

  1. PCL-5 Total Score: Raw Score will Display with one of two messages.

    1. Above the suggested cutoff (>30 pts). Probable PTSD screen. Further assessment recommended.

    2. Below the suggested cutoff (<31 pts). Unlikely PTSD screen.

      1. Result Description: The total score adds up the ratings for all questions in the measure or cluster. It is the score used for the probable PTSD cutoff and for tracking change over time.

        • A higher score indicates more severe symptoms.

        • The PCL-5 does not assess PTSD Criterion A (exposure to a traumatic event). Therefore, a high total without a qualifying event is not PTSD.

        • The National Center for PTSD, which developed the PCL-5, has not published or validated severity ranges for this measure. Severity labels found elsewhere are not part of the official scoring and may be misleading.

        • Instead, results are interpreted in two ways: a total score at or above the suggested cutoff (31–33) indicates probable PTSD and the need for further clinical assessment.

        • A change of 10 or more points between administrations suggests a meaningful response to treatment.

        • The PCL-5 is a screening and monitoring tool; a diagnosis of PTSD requires a clinical evaluation.

        • For more information on the PCL-5, refer to the National Center for PTSD.

  1. Provisional DSM-5 criteria met

    1. Result Description:

      1. Criteria: At least 1 symptom in Cluster B, 1 in Cluster C, 2 in Cluster D, and 2 in Cluster E, counting any item rated 2 (Moderately) or higher as a symptom present.

      2. The PCL-5 does not assess PTSD Criterion A (exposure to a traumatic event). Therefore, a high total without a qualifying event is not PTSD.

  1. Provisional DSM-5 criteria NOT met

    1. Result Description: The symptom pattern does not reach at least 1 symptom in Cluster B, 1 in Cluster C, 2 in Cluster D, and 2 in Cluster E, counting any item rated 2 (Moderately) or higher as a symptom present.

  2. Cluster B Total Score

  3. Cluster C Total Score

  4. Cluster D Total Score

  5. PCL-5 Mean Score (all 20 items)

  6. Cluster B Mean Score

  7. Cluster C Mean Score

  8. Cluster D Mean Score

Note:

The Mean Score (average per item)

The average per item divides each cluster’s total by its number of questions, putting every cluster on the same 0–4 scale as the original answers (0 = Not at all, 4 = Extremely). This matters because the clusters differ in size: Avoidance has only 2 questions, while Negative Thoughts & Mood has 7. A total of 6 means something very different in each. In Avoidance it is an average of 3.0 (“Quite a bit”), while in Negative Thoughts & Mood it is an average of about 0.9 (“A little bit” or less).

Averages can help identify which symptom area is most prominent for a patient and guide treatment focus. They are a supplementary view; use the total score for screening decisions and published comparisons.

All questions & possible results

PCL-5 ItemsTitle not visible

How much you have been bothered by that problem IN THE LAST MONTH.

1. Repeated, disturbing, and unwanted memories of the stressful experience?

Select one option:

  • Not at all
  • A little bit
  • Moderately
  • Quite a bit
  • Extremely
2. Repeated, disturbing dreams of the stressful experience?

Select one option:

  • Not at all
  • A little bit
  • Moderately
  • Quite a bit
  • Extremely
3. Suddenly feeling or acting as if the stressful experience were actually happening again (as if you were actually back there reliving it)?

Select one option:

  • Not at all
  • A little bit
  • Moderately
  • Quite a bit
  • Extremely
4. Feeling very upset when something reminded you of the stressful experience?

Select one option:

  • Not at all
  • A little bit
  • Moderately
  • Quite a bit
  • Extremely
5. Having strong physical reactions when something reminded you of the stressful experience (for example, heart pounding, trouble breathing, sweating)?

Select one option:

  • Not at all
  • A little bit
  • Moderately
  • Quite a bit
  • Extremely
6. Avoiding memories, thoughts, or feelings related to the stressful experience?

Select one option:

  • Not at all
  • A little bit
  • Moderately
  • Quite a bit
  • Extremely
7.Avoiding external reminders of the stressful experience (for example, people, places, conversations, activities, objects, or situations)?

Select one option:

  • Not at all
  • A little bit
  • Moderately
  • Quite a bit
  • Extremely
8. Trouble remembering important parts of the stressful experience?

Select one option:

  • Not at all
  • A little bit
  • Moderately
  • Quite a bit
  • Extremely
9. Having strong negative beliefs about yourself, other people, or the world (for example, having thoughts such as: I am bad, there is something seriously wrong with me, no one can be trusted, the world is completely dangerous)?

Select one option:

  • Not at all
  • A little bit
  • Moderately
  • Quite a bit
  • Extremely
10. Blaming yourself or someone else for the stressful experience or what happened after it?

Select one option:

  • Not at all
  • A little bit
  • Moderately
  • Quite a bit
  • Extremely
11. Having strong negative feelings such as fear, horror, anger, guilt, or shame?

Select one option:

  • Not at all
  • A little bit
  • Moderately
  • Quite a bit
  • Extremely
12. Loss of interest in activities that you used to enjoy?

Select one option:

  • Not at all
  • A little bit
  • Moderately
  • Quite a bit
  • Extremely
13. Feeling distant or cut off from other people?

Select one option:

  • Not at all
  • A little bit
  • Moderately
  • Quite a bit
  • Extremely
14. Trouble experiencing positive feelings (for example, being unable to feel happiness or have loving feelings for people close to you)?

Select one option:

  • Not at all
  • A little bit
  • Moderately
  • Quite a bit
  • Extremely
15. Irritable behavior, angry outbursts, or acting aggressively?

Select one option:

  • Not at all
  • A little bit
  • Moderately
  • Quite a bit
  • Extremely
16. Taking too many risks or doing things that could cause you harm?

Select one option:

  • Not at all
  • A little bit
  • Moderately
  • Quite a bit
  • Extremely
17. Being "superalert" or watchful or on guard?

Select one option:

  • Not at all
  • A little bit
  • Moderately
  • Quite a bit
  • Extremely
18. Feeling jumpy or easily startled?

Select one option:

  • Not at all
  • A little bit
  • Moderately
  • Quite a bit
  • Extremely
19. Having difficulty concentrating?

Select one option:

  • Not at all
  • A little bit
  • Moderately
  • Quite a bit
  • Extremely
20. Trouble falling or staying asleep?

Select one option:

  • Not at all
  • A little bit
  • Moderately
  • Quite a bit
  • Extremely
Possible results
PCL-5 Total Score: Below the suggested cutoff (<31 pts). Unlikely PTSD screen.

  • The total score adds up the ratings for all questions in the measure or cluster. It is the score used for the probable PTSD cutoff and for tracking change over time.

  • A higher score indicates more severe symptoms.

  • The PCL-5 does not assess PTSD Criterion A (exposure to a traumatic event). Therefore, a high total without a qualifying event is not PTSD.

  • The National Center for PTSD, which developed the PCL-5, has not published or validated severity ranges for this measure. Severity labels found elsewhere are not part of the official scoring and may be misleading.

  • Instead, results are interpreted in two ways: a total score at or above the suggested cutoff (31–33) indicates probable PTSD and the need for further clinical assessment.

  • Achange of 10 or more points between administrations suggests a meaningful response to treatment.

  • The PCL-5 is a screening and monitoring tool; a diagnosis of PTSD requires a clinical evaluation.

  • For more information on the PCL-5, refer to the National Center for PTSD.

Cluster B Mean Score (Intrusion)

  • Sum of items 1-5 divided by 5.

  • A higher score indicates more severe symptoms.

  • The Mean Score (average per item): The average per item divides each cluster’s total by its number of questions, putting every cluster on the same 0–4 scale as the original answers (0 = Not at all, 4 = Extremely). This matters because the clusters differ in size.

  • Averages can help identify which symptom area is most prominent for a patient and guide treatment focus. They are a supplementary view; use the total score for screening decisions and published comparisons.

Cluster C Mean Score (Avoidance)

  • Sum of items 6-7 divided by 2.

  • A higher score indicates more severe symptoms.

  • The Mean Score (average per item): The average per item divides each cluster’s total by its number of questions, putting every cluster on the same 0–4 scale as the original answers (0 = Not at all, 4 = Extremely). This matters because the clusters differ in size.

  • Averages can help identify which symptom area is most prominent for a patient and guide treatment focus. They are a supplementary view; use the total score for screening decisions and published comparisons.

Cluster D Mean Score (Negative Alterations in Cognitions and Mood)

  • Sum of items 8-14 divided by 7.

  • A higher score indicates more severe symptoms.

  • The Mean Score (average per item): The average per item divides each cluster’s total by its number of questions, putting every cluster on the same 0–4 scale as the original answers (0 = Not at all, 4 = Extremely). This matters because the clusters differ in size.

  • Averages can help identify which symptom area is most prominent for a patient and guide treatment focus. They are a supplementary view; use the total score for screening decisions and published comparisons.

Cluster E Mean Score (Alterations in Arousal and Reactivity)

  • Sum of items 15-20 divided by 6.

  • A higher score indicates more severe symptoms.

  • The Mean Score (average per item): The average per item divides each cluster’s total by its number of questions, putting every cluster on the same 0–4 scale as the original answers (0 = Not at all, 4 = Extremely). This matters because the clusters differ in size.

  • Averages can help identify which symptom area is most prominent for a patient and guide treatment focus. They are a supplementary view; use the total score for screening decisions and published comparisons.

Provisional DSM-5 criteria met

  • Criteria: At least 1 symptom in Cluster B, 1 in Cluster C, 2 in Cluster D, and 2 in Cluster E, counting any item rated 2 (Moderately) or higher as a symptom present.

  • The PCL-5 does not assess PTSD Criterion A (exposure to a traumatic event). Therefore, a high total without a qualifying event is not PTSD.

PCL-5 Mean Score (all 20 items)

  • Total score divided by 20 items. Range 0–4, where each item is rated from 0 (Not at all) to 4 (Extremely).

  • A higher score indicates more severe symptoms.

The Mean Score (average per item)

The average per item divides each cluster’s total by its number of questions, putting every cluster on the same 0–4 scale as the original answers (0 = Not at all, 4 = Extremely). This matters because the clusters differ in size: Avoidance has only 2 questions, while Negative Thoughts & Mood has 7. A total of 6 means something very different in each. In Avoidance it is an average of 3.0 (“Quite a bit”), while in Negative Thoughts & Mood it is an average of about 0.9 (“A little bit” or less).

Averages can help identify which symptom area is most prominent for a patient and guide treatment focus. They are a supplementary view; use the total score for screening decisions and published comparisons.

Cluster B Total Score (Intrusion)

  • Sum of items 1-5.

  • The total score adds up the ratings for all questions in the cluster. It is the score used for the probable PTSD cutoff and for tracking change over time.

  • A higher score indicates more severe symptoms.

Cluster C Total Score (Avoidance)

  • Sum of items 6-7.

  • The total score adds up the ratings for all questions in the cluster. It is the score used for the probable PTSD cutoff and for tracking change over time.

  • A higher score indicates more severe symptoms.

Cluster D Total Score (Negative Alterations in Cognitions and Mood)

  • Sum of items 8-14.

  • The total score adds up the ratings for all questions in the cluster. It is the score used for the probable PTSD cutoff and for tracking change over time.

  • A higher score indicates more severe symptoms.

Cluster E Total Score (Alterations in arousal and reactivity)

  • Sum of items 15-20.

  • The total score adds up the ratings for all questions in the cluster. It is the score used for the probable PTSD cutoff and for tracking change over time.

  • A higher score indicates more severe symptoms.

Provisional DSM-5 criteria NOT met

  • The symptom pattern does not reach at least 1 symptom in Cluster B, 1 in Cluster C, 2 in Cluster D, and 2 in Cluster E, counting any item rated 2 (Moderately) or higher as a symptom present.

PCL-5 Total Score: Above the suggested cutoff (>30 pts). Probable PTSD screen. Further assessment recommended.

  • The total score adds up the ratings for all questions in the measure or cluster. It is the score used for the probable PTSD cutoff and for tracking change over time.

  • A higher score indicates more severe symptoms.

  • The PCL-5 does not assess PTSD Criterion A (exposure to a traumatic event). Therefore, a high total without a qualifying event is not PTSD.

  • The National Center for PTSD, which developed the PCL-5, has not published or validated severity ranges for this measure. Severity labels found elsewhere are not part of the official scoring and may be misleading.

  • Instead, results are interpreted in two ways: a total score at or above the suggested cutoff (31–33) indicates probable PTSD and the need for further clinical assessment.

  • Achange of 10 or more points between administrations suggests a meaningful response to treatment.

  • The PCL-5 is a screening and monitoring tool; a diagnosis of PTSD requires a clinical evaluation.

  • For more information on the PCL-5, refer to the National Center for PTSD.

Citation

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). National Center for PTSD at www.ptsd.va.gov

Literature

  • Blevins CA, Weathers FW, Davis MT, Witte TK, Domino JL. The Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5): Development and Initial Psychometric Evaluation. J Trauma Stress. 2015 Dec;28(6):489-98.

    https://pubmed.ncbi.nlm.nih.gov/26606250/

  • Bovin MJ, Marx BP, Weathers FW, Gallagher MW, Rodriguez P, Schnurr PP, Keane TM. Psychometric properties of the PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition (PCL-5) in veterans. Psychol Assess. 2016 Nov;28(11):1379-1391.

    https://pubmed.ncbi.nlm.nih.gov/26653052/

  • Marx, B. P., Lee, D. J., Norman, S. B., Bovin, M. J., Sloan, D. M., Weathers, F. W., Keane, T. M., & Schnurr, P. P. (2022). Reliable and clinically significant change in the Clinician-Administered PTSD Scale for DSM-5 and PTSD Checklist for DSM-5 among male Veterans. Psychological Assessment, 34(2), 197-203.

    https://pubmed.ncbi.nlm.nih.gov/34941354/

  • Wortmann, J. H., Jordan, A. H., Weathers, F. W., Resick, P. A., Dondanville, K. A., Hall-Clark, B., Foa, E. B., Young-McCaughan, S., Yarvis, J., Hembree, E. A., Mintz, J., Peterson, A. L., & Litz, B. T. (2016). Psychometric analysis of the PTSD Checklist-5 (PCL-5) among treatment-seeking military service members. Psychological Assessment, 28(11), 1392-1403.

    https://pubmed.ncbi.nlm.nih.gov/26751087/

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