Trauma checklist (PCL-C)
(adapted from Weathers, Litz, Huska, & Keane, 1994)
Name: Date:
Below is a list of problems and complaints that people sometimes have in response to
traumatic and stressful life experiences. Please read each one carefully and tick the box to
indicate how much you have been bothered by that problem in the past month.
No Response Not at all A little bit Moderately Quite a bit Extremely
(1) (2) (3) (4) (5)
1 Repeated disturbing memories,
thoughts, or images of a stressful
experience from the past?
2 Repeated disturbing dreams of a
stressful experience from the
past?
3 Suddenly acting or feeling as if a
stressful experience were
happening again (as if you were
reliving it)?
4 Feeling very upset when
something reminded you of a
stressful experience from the
past?
5 Having physical reactions (e.g.
heart pounding, trouble breathing,
or sweating) when something
reminded you of a stressful
experience from the past?
6 Avoid thinking about or talking
about a stressful experience from
the past, or avoid having feelings
related to it?
7 Avoid activities or situations
because they remind you of a
stressful experience from the
past?
8 Trouble remembering important
parts of a stressful experience
from the past?
No Response Not at all A little bit Moderately Quite a bit Extremely
(1) (2) (3) (4) (5)
9 Loss of interest in things that you
used to enjoy?
10 Feeling distant or cut off from
other people?
11 Feeling emotionally numb, or
being unable to have loving
feelings for those close to you?
12 Feeling as if your future will
somehow be cut short?
13 Trouble falling or staying asleep?
14 Feeling irritable or having angry
outbursts?
15 Having difficulty concentrating?
16 Being ‘super alert’ or watchful/on
guard?
17 Feeling jumpy or easily startled?
(adapted from Weathers, Litz, Huska, & Keane, 1994)
Trauma/PTSD checklist (PCL-C)
The PCL-C asks about symptoms in relation to generic stressful experiences, and can be
used with any population. This version simplifies assessment based on multiple traumas,
because symptom endorsements are not attributed to a specific event. In many
circumstances, it is advisable to also assess traumatic event exposure to ensure that a
respondent has experienced at least one event that meets DSM-IV Criterion A.
Administration and Scoring
The PCL is a self-report instrument that can be read by respondents themselves, or read to
them either in person or over the phone. It can be completed in approximately 5-10 minutes.
The PCL-C can be scored in several ways:
1) Treat response categories 3–5 (Moderately or above) as symptomatic and responses 1–
2 (below Moderately) as non-symptomatic, then use the following DSM criteria for a
diagnosis:
Symptomatic response to at least 1 “B” item (Questions 1–5),
Symptomatic response to at least 3 “C” items (Questions 6–12), and
Symptomatic response to at least 2 “D” items (Questions 13–17)
2) Add up the items to create total severity score. A Total symptom severity score (range
17-85) can be obtained by summing the scores from each of the 17 items that have
response options ranging from 1 ‘Not at all’ to 5 ‘Extremely’.
The gold standard for diagnosing PTSD is a structured clinical interview such as the clinician
administered PTSD scale (CAPS). When necessary, the PCL can be scored to provide a
presumptive diagnosis. This has been done in three ways:
1. Determine whether an individual meets DSM-IV symptom criteria, as defined by at
least 1 criterion B item (questions 1-5), 3 criterion C items (questions 6-12) and at
least 2 criterion D items (questions 13-17). Symptoms rated as ‘Moderately’ or above
(responses 3 through 5 on individual items) are counted as present.
2. Determine whether the total severity score exceeds a given normative threshold (see
table below).
3. Combine methods (1) and (2) to ensure that an individual meets both the symptom
pattern and severity threshold.
Choosing a cut-off score
Factors to be considered when choosing a PCL cut-off score include:
The goal of the assessment: A lower cut-off score is considered when screening for
PTSD, or when it is desirable to maximise detection of possible cases. A higher cut-
off score is considered when informing diagnosis or to minimise false positives.
The prevalence of PTSD in the target setting: Generally, the lower the prevalence
of PTSD in a given setting, the lower the optimal cut-off score. In settings with
expected high rates of PTSD, such as specialty mental health clinics, consider a
higher cut-off score. In settings with expected low rates of PTSD such as primary
care clinics, or in circumstances in which patients are reluctant to disclose mental
health problems, consider a lower cut-off score.
Below are suggested cut-off score ranges based on prevalence and setting characteristics.
Consider scores on the low end of the range if the goal is to screen for PTSD. Consider
scores on the high end of the range if the goal is to aid in diagnosis of PTSD.
Suggested PCL cut-off scores
Estimated prevalence of PTSD Suggested PCL cut-off score
Below 15%
(Primary care) 30-35
16-39%
(DVA primary care, specialised medical 36-44
clinics)
Above 40%
(Specialist mental health clinics) 45-50
NB: these recommendations are general and approximate, and are not intended to be used
for legal or policy purposes. Research is needed to establish optimal cut-off scores for a
specific population.
Measuring change
Good clinical practice often involves monitoring client progress. Evidence suggests that a 5-
10 point change is reliable (i.e. not due to chance) and a 10-20 point change is clinically
meaningful (Monson et al., 2008). Therefore, we recommend using 5 points as a minimum
threshold for determining whether an individual has responded to treatment and 10 points as
a minimum threshold for determining whether the improvement is clinically meaningful.
http://www.ptsd.va.gov/professional/pages/assessments/ptsd-checklist.asp
