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PCL-5 Scale

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HANDOUT 3.1
PTSD Checklist-5 (PCL-5): Scale and Scoring
Date:
Client:
The PTSD Checklist (PCL) was recently revised for the DSM-5 (this version is known as the
PCL-5).
While this instrument alone is not sufficient to diagnose PTSD, it gives you a sense of whether an
individual is experiencing PTSD symptoms and how severe his or her symptoms are.
For your purposes, add up your client’s scores on the 20 items. If the total score is 38 or above,
refer him or her for a PTSD assessment/evaluation, if needed, for confirmation of the diagnosis.
You can track your client’s scores by plotting them on the PCL graph at the end of this handout.
There are two versions of the PCL-5:
1. The PCL-5 Monthly is administered before the start of Session 1 of CPT. It uses the past
month as the time frame reference. There is an alternative format of the PCL-5 Monthly,
which may be used before the start of Session 1 in order to assess the Criterion A trauma
in more depth (PCL-5 with a brief Criterion A assessment).
2. The PCL-5 Weekly is used during CPT for Session 2 and for all other sessions. Remind
the client to use only the preceding week as the time frame for each item. Score it immediately upon receipt, and ask the client for any clarifications needed.
If the client’s scores have not dropped significantly by Session 6, the therapist should explore
whether the client is still avoiding affect, has been engaging in self-harm or other therapyinterfering behavior, or has not changed his or her assimilated beliefs about the traumatic event.
Processing the lack of improvement with the client will be important at that point.
Please note: Several important revisions were made to the PCL in updating it for DSM-5.
Changes involve the rating scale (now a 0–4 range for each symptom) and an increase from
17 to 20 items. This means that PCL-5 scores are not compatible with scores on versions of the
PCL for DSM-IV (e.g., the PCL-S, which is in previous editions of the CPT manual), and that the
PCL-5 cannot be used interchangeably with these earlier versions.
(continued)
Both versions of the PCL-5 are from Weathers, Litz, Keane, Palmieri, Marx, and Schnurr (2013). The scale is available from
the National Center for PTSD at www.ptsd.va.gov and is in the public domain. Reprinted in Cognitive Processing Therapy for
PTSD: A Comprehensive Manual by Patricia A. Resick, Candice M. Monson, and Kathleen M. Chard. Copyright © 2017 The
Guilford Press. Permission to photocopy this handout is granted to purchasers of this book for personal use or for use with
individual clients (see copyright page for details).
HANDOUT 3.1 (p. 2 of 7)
PCL-5 WITH BRIEF CRITERION A ASSESSMENT: MONTHLY
Instructions: This questionnaire asks about problems you may have had after a very stressful
experience involving actual or threatened death, serious injury, or sexual violence. It could be
something that happened to you directly, something you witnessed, or something you learned
happened to a close family member or close friend. Some examples are a serious accident; fire;
disaster such as a hurricane, tornado, or earthquake; physical or sexual attack or abuse; war;
homicide; or suicide.
First, please answer a few questions about your worst event, which for this questionnaire means
the event that currently bothers you the most. This could be one of the examples above or some
other very stressful experience. Also, it could be a single event (for example, a car crash) or
multiple similar events (for example, multiple stressful events in a war zone or repeated sexual
abuse).
Briefly identify the worst event (if you feel comfortable doing so):
How long ago did it happen?
Did it involve actual or threatened death, serious injury, or sexual violence?
†Yes
†No
How did you experience it?
†It happened to me directly
†I witnessed it
†I learned about it happening to a close family member or close friend
†I was repeatedly exposed to details about it as part of my job (for example, paramedic,
police, military, or other first responder)
†Other (please describe)
If the event involved the death of a close family member or close friend, was it due to some kind
of accident or violence, or was it due to natural causes?
†Accident or violence
†Natural causes
†Not applicable (the event did not involve the death of a close family member or close
friend)
Second, keeping this worst event in mind, read each of the problems on the next page and then
circle one of the numbers to the right to indicate how much you have been bothered by that
problem in the past month.
(continued)
HANDOUT 3.1 (p. 3 of 7)
PCL-5: MONTHLY
Instructions: Below is a list of problems that people sometimes have in response to a very stressful experience. Please read each problem carefully, and then circle one of the numbers to the
right to indicate how much you have been bothered by that problem in the past month.
In the past month, how much
were you bothered by:
Not at all
A little bit
Moderately
1. Repeated, disturbing, and
unwanted memories of the
stressful experience?
0
1
2
3
4
2. Repeated, disturbing
dreams of the stressful
experience?
0
1
2
3
4
3. Suddenly feeling or
acting as if the stressful
experience were actually
happening again (as if you
were actually back there
reliving it)?
0
1
2
3
4
4. Feeling very upset when
something reminded you of
the stressful experience?
0
1
2
3
4
5. Having strong physical
reactions when something
reminded you of the
stressful experience (for
example, heart pounding,
trouble breathing,
sweating)?
0
1
2
3
4
6. Avoiding memories,
thoughts, or feelings related
to the stressful experience?
0
1
2
3
4
7. Avoiding external reminders
of the stressful experience
(for example, people,
places, conversations,
activities, objects, or
situations)?
0
1
2
3
4
8. Trouble remembering
important parts of the
stressful experience?
0
1
2
3
4
Quite a bit Extremely
(continued)
HANDOUT 3.1 (p. 4 of 7)
In the past month, how much
were you bothered by:
Not at all
A little bit
Moderately
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)?
0
1
2
3
4
10. Blaming yourself or
someone else for the
stressful experience or what
happened after it?
0
1
2
3
4
11. Having strong negative
feelings such as fear, horror,
anger, guilt, or shame?
0
1
2
3
4
12. Loss of interest in activities
that you used to enjoy?
0
1
2
3
4
13. Feeling distant or cut off
from other people?
0
1
2
3
4
14. Trouble experiencing
positive feelings (for
example, being unable
to feel happiness or have
loving feelings for people
close to you)?
0
1
2
3
4
15. Irritable behavior, angry
outbursts, or acting
aggressively?
0
1
2
3
4
16. Taking too many risks or
doing things that could
cause you harm?
0
1
2
3
4
17. Being “superalert” or
watchful or on guard?
0
1
2
3
4
18. Feeling jumpy or easily
startled?
0
1
2
3
4
19. Having difficulty
concentrating?
0
1
2
3
4
20. Trouble falling or staying
asleep?
0
1
2
3
4
Quite a bit Extremely
(continued)
HANDOUT 3.1 (p. 5 of 7)
PCL-5: WEEKLY
Instructions: Below is a list of problems that people sometimes have in response to a very stressful experience. Please read each problem carefully, and then circle one of the numbers to the
right to indicate how much you have been bothered by that problem in the past week.
In the past week, how much
were you bothered by:
Not at all
A little bit
Moderately
1. Repeated, disturbing, and
unwanted memories of the
stressful experience?
0
1
2
3
4
2. Repeated, disturbing
dreams of the stressful
experience?
0
1
2
3
4
3. Suddenly feeling or
acting as if the stressful
experience were actually
happening again (as if you
were actually back there
reliving it)?
0
1
2
3
4
4. Feeling very upset when
something reminded you of
the stressful experience?
0
1
2
3
4
5. Having strong physical
reactions when something
reminded you of the
stressful experience (for
example, heart pounding,
trouble breathing,
sweating)?
0
1
2
3
4
6. Avoiding memories,
thoughts, or feelings related
to the stressful experience?
0
1
2
3
4
7. Avoiding external reminders
of the stressful experience
(for example, people,
places, conversations,
activities, objects, or
situations)?
0
1
2
3
4
8. Trouble remembering
important parts of the
stressful experience?
0
1
2
3
4
Quite a bit Extremely
(continued)
HANDOUT 3.1 (p. 6 of 7)
In the past week, how much
were you bothered by:
Not at all
A little bit
Moderately
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)?
0
1
2
3
4
10. Blaming yourself or
someone else for the
stressful experience or what
happened after it?
0
1
2
3
4
11. Having strong negative
feelings such as fear, horror,
anger, guilt, or shame?
0
1
2
3
4
12. Loss of interest in activities
that you used to enjoy?
0
1
2
3
4
13. Feeling distant or cut off
from other people?
0
1
2
3
4
14. Trouble experiencing
positive feelings (for
example, being unable
to feel happiness or have
loving feelings for people
close to you)?
0
1
2
3
4
15. Irritable behavior, angry
outbursts, or acting
aggressively?
0
1
2
3
4
16. Taking too many risks or
doing things that could
cause you harm?
0
1
2
3
4
17. Being “superalert” or
watchful or on guard?
0
1
2
3
4
18. Feeling jumpy or easily
startled?
0
1
2
3
4
19. Having difficulty
concentrating?
0
1
2
3
4
20. Trouble falling or staying
asleep?
0
1
2
3
4
Quite a bit Extremely
(continued)
HANDOUT 3.1 (p. 7 of 7)
PCL-5 SCORE SHEET
80
75
70
65
60
PCL-5 Score
55
50
45
40
35
30
25
20
15
10
5
0
0
1
2
3
4
5
6
7
Session #
8
9
10
11
12
13
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