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PCL-5

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24 views

PCL-5

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kacikit492
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© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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MATHARI NATIONAL TEACHING AND REFERRAL HOSPITAL

PCL-5
NAME OF PATIENT_______________________ PATIENT’S NO_________________
DATE________________________

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.

Not A little Quit


In the past month, how much were you bothered by: at all bit Moderatel ea Extremel
y bit y
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 0 1 2 3 4
back there reliving it)?
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, 0 1 2 3 4
heart pounding, trouble breathing, sweating)?
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, 0 1 2 3 4
objects, or situations)?
8. Trouble remembering important parts of the stressful
experience? 0 1 2 3 4
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 0 1 2 3 4
me, no one can be trusted, the world is completely
dangerous)?
10. Blaming yourself or someone else for the stressful
experience or what happened after it? 0 1 2 3 4

PCL-5 (8/14/2013) Weathers, Litz, Keane, Palmieri, Marx, & Schnurr -- National Center for PTSD
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 0 1 2 3 4
people close to you)?
15. Irritable behavior, angry outbursts, or acting 0 1 2 3 4
aggressively?
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

Printable Version

Scoring

The interpretation of the PCL-5 should be made by a clinician. The PCL-5 can be scored in different ways:
using a total symptom severity score, calculating DSM-5 symptom cluster severity scores, as a diagnostic
tool.

A total symptom severity score (range of 0-80) can be obtained by summing the scores for each of the 20
items. Preliminary validation work is sufficient to make initial cut-point suggestions, but this information may
be subject to change. A PCL-5 cut-point of 33 appears to be a reasonable value to propose until further
psychometric work is available. This cut-point has been determined based on the significant body of research
supporting the PCL for DSM-IV (the previous version, identifying DSM-IV symptoms).

Evidence for the PCL for DSM-IV suggests that a 5-10 point change represents reliable change and a 10-20
point change represents clinically significant change. Change scores for PCL-5 are not yet available, although
it is expected that reliable and clinically meaningful change will be in a similar range.

Name of Psychologist_____________________ Reg. No_________________

Tel No________________

PCL-5 (8/14/2013) Weathers, Litz, Keane, Palmieri, Marx, & Schnurr -- National Center for PTSD

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