PCL-5
PTSD Checklist for DSM-5
Twenty-item self-report aligned with DSM-5 PTSD criteria — provisional diagnosis, severity, and symptom-cluster scores.
What it measures
Past-month severity of the four DSM-5 PTSD symptom clusters: intrusion (B), avoidance (C), negative alterations in cognition/mood (D), and arousal/reactivity (E). Yields a total severity score and cluster scores.
Scoring and bands
Cutoffs
Cutoff of ≥31–33 is most commonly used for provisional PTSD diagnosis. A 5-point change is reliable; a 10-point change is clinically meaningful. Cluster diagnosis requires meeting symptom criteria within each cluster (B ≥1 item ≥2; C ≥1; D ≥2; E ≥2).
How to talk about the score
Share the total and what it suggests provisionally. Walk through cluster scores so the client sees which dimensions are most active. The PCL-5 is sensitive — scores often shift week to week during active treatment, which is useful data.
Limitations
- Tied to a specific index event — must be clear which trauma the client referenced
- Self-report — under-reporting common with severe avoidance
- Provisional diagnosis only; full clinical interview needed for definitive diagnosis
- May be elevated by recent re-experiencing without meeting full criteria
Best used for
- PTSD screening and provisional diagnosis
- Treatment response tracking (especially PE, CPT, EMDR)
- Research and outcomes monitoring
FAQ
Which trauma do I anchor the PCL-5 to?
The index trauma is the one currently driving distress. If multiple traumas, use the LEC-5 to identify the worst event, then anchor the PCL-5 to that.
What if scores drop mid-treatment but symptoms haven't changed clinically?
Look at cluster scores. Symptom shifting is common — intrusion may drop while avoidance is just being maintained, which is a partial improvement worth noting.