PCL-5
PTSD Checklist for DSM-5
In this guide
Twenty-item self-report aligned with DSM-5 PTSD criteria — provisional diagnosis, severity, and symptom-cluster scores.
Ready to administer PCL-5?
Open interactive assessment →The PCL-5 is a free 20-item self-report measure of the DSM-5 symptoms of PTSD, developed by the National Center for PTSD (Weathers et al., 2013). Clients rate how much each symptom bothered them in the past month. It is used to screen, to support a provisional diagnosis, and to track change across trauma treatment.
When to use the PCL-5
Use the PCL-5 when a client has a known or suspected index trauma and you need to quantify PTSD symptoms across the four DSM-5 clusters. Administer at intake after the trauma is identified, then every 4 weeks during trauma-focused treatment.
What the PCL-5 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.
Use the PCL-5 when
- A positive trauma screen or a disclosed index event
- Establishing a provisional PTSD diagnosis before starting EMDR, CPT, or PE
- Tracking symptom change across a trauma-focused protocol
- Distinguishing PTSD from depression or generalized anxiety when presentations overlap
Why use the PCL-5 instead of another measure
The PCL-5 is anchored to a specific index event and maps directly onto DSM-5 Criteria B–E, so a cluster-level read tells you which symptoms to target (intrusions vs avoidance vs negative cognitions vs hyperarousal). It is free, self-report, and the standard outcome measure in trauma trials.
When not to use the PCL-5
- No index trauma has been identified — screen for exposure first (e.g. LEC-5)
- You need a confirmed diagnosis for legal or disability purposes — use the CAPS-5 clinician interview
- The client is actively dissociating or unsafe; stabilize before detailed symptom inventory
Scoring and bands
PCL-5 scores should be interpreted alongside the clinical interview, the client's context, and the measure's intended population. A cutoff suggests follow-up; it does not establish a diagnosis.
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).
What PCL-5 results mean — and what to do next
Below the provisional diagnostic threshold in most settings.
Next stepTreat the specific elevated clusters; consider whether depression or anxiety better explains the presentation.
At or above the provisional PTSD threshold (≥31–33).
Next stepOffer a trauma-focused protocol (CPT, PE, EMDR) and build stabilization skills first if needed.
High symptom burden.
Next stepTrauma-focused treatment with attention to sleep, dissociation, and safety; consider medication consult and paced sessions.
How often to re-administer
Every 4 weeks during active treatment. A 10-point change is considered clinically meaningful.
What to pair it with
ACE questionnaire (developmental adversity), PHQ-9 (comorbid depression), and AUDIT (substance use as avoidance).
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
PCL-5 scoring — total score
Add the 20 item ratings (0–4 each) for a total from 0 to 80. Research in veteran and civilian samples supports a total of 31–33 as a provisional PTSD cutoff (Bovin et al., 2016). A score at or above the cutoff suggests the client should be assessed further — the PCL-5 alone does not make a diagnosis; a structured interview such as the CAPS-5 is the reference standard.
PCL-5 symptom-cluster scoring
Cluster sums: B intrusions (items 1–5), C avoidance (items 6–7), D negative changes in thinking and mood (items 8–14), E arousal and reactivity (items 15–20). For a provisional DSM-5 symptom pattern, treat any item rated 2 (Moderately) or higher as endorsed, then check for at least 1 B item, 1 C item, 2 D items and 2 E items.
What counts as meaningful change on the PCL-5?
National Center for PTSD guidance treats a 5–10 point drop as reliable change (not due to chance) and a 10–20 point drop as clinically meaningful. Re-administer every few sessions during trauma-focused treatment such as CPT, PE or EMDR to track response.
Frequently asked questions about the PCL-5
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.
Is the PCL-5 free to use?
Yes. The PCL-5 is in the public domain and is available from the National Center for PTSD.
What is the PCL-5 cutoff score?
A total of 31–33 is the commonly used provisional cutoff for PTSD. Use it as a screen, then confirm with a clinical interview.
References
Scoring bands and cutoffs on this page come from these published sources. This guide is educational and does not replace clinical judgment.
- 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.Supports: The instrument and official scoring guidance
- Blevins, C. A., Weathers, F. W., Davis, M. T., Witte, T. K., & Domino, J. L. (2015). The Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5): Development and initial psychometric evaluation. Journal of Traumatic Stress, 28(6), 489–498.Supports: Psychometric evaluation
- Bovin, M. J., Marx, B. P., Weathers, F. W., et al. (2016). Psychometric properties of the PTSD Checklist for DSM-5 (PCL-5) in veterans. Psychological Assessment, 28(11), 1379–1391.Supports: Provisional cutoff range of 31–33