PTSD: National Center for PTSD
Primary Care PTSD Screen for DSM-5 (PC-PTSD-5)
Primary Care PTSD Screen for DSM-5 (PC-PTSD-5)
Description
The Primary Care PTSD Screen for DSM-5 (PC-PTSD-5) is a 5-item screen that was designed to identify individuals with probable PTSD in primary care settings. The measure begins with an item which assesses lifetime exposure to traumatic events. If a respondent denies exposure, the PC-PTSD-5 is complete with a score of 0. However, if a respondent indicates that they have had any lifetime exposure to trauma, the respondent is instructed to respond to 5 additional yes/no questions about how that trauma exposure has affected them over the past month.
Because the PC-PTSD-5 was designed to identify respondents with probable PTSD, those screening positive require further assessment, preferably with a structured interview such as the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5). Administration of a clinical interview is not always possible due to time and personnel requirements. In these cases, it is recommended that additional assessment is conducted using a validated self-report measure. Specifically, the PTSD Checklist for DSM-5 (PCL-5) is a psychometrically sound self-report questionnaire that can be used for this purpose.
Changes from Previous PC-PTSD for DSM-IV
Several important revisions were made to the PC-PTSD in updating it for DSM-5:
- PC-PTSD asked individuals to respond to questions about DSM-IV PTSD symptoms in reference to an experience that was "frightening, horrible, or upsetting," which could lead respondents to refer to events that, while stressful, were not considered Criterion A traumas (e.g., divorce). To avoid this, the PC-PTSD-5 asks respondents whether they have experienced prior trauma(s), and provides examples of events that qualify (e.g., sexual assault, war). If respondents have not been exposed to any traumatic events, they do not complete the remainder of the PC-PTSD-5. If they do endorse prior exposure to trauma(s), they respond to questions about DSM-5 PTSD symptoms related to those trauma(s).
- PC-PTSD included 4 questions about DSM-IV PTSD symptoms, whereas the PC-PTSD-5 added a 5th item to assess whether the respondent has experienced guilt and/or a distorted sense of blame regarding the trauma(s). This additional item is consistent with more up-to-date knowledge about the PTSD diagnosis as described in DSM-5.
Scoring
If a respondent endorses a trauma exposure, they can score a 0-5 on the PC-PTSD-5, which is a count of "yes" responses to the 5 questions about how the trauma has affected them in the past month. Research in a large sample of VA primary care patients found that a cut-point of 4 ideally balanced false negatives and false positives for the overall sample and for men. However, for women, a cut-point of 4 resulted in high numbers of false negatives. Practitioners may consider a lower cut-point for women in some settings if evaluation resources are available. In contrast, a higher cut-point may be preferable if resources are such that false positives will substantially decrease clinician availability. Because performance parameters will change according to sample, clinicians should consider sample characteristics and screening purposes when selecting a cut-point.
Scale
Sometimes things happen to people that are unusually or especially frightening, horrible, or traumatic. For example:
- a serious accident or fire
- a physical or sexual assault or abuse
- an earthquake or flood
- a war
- seeing someone be killed or seriously injured
- having a loved one die through homicide or suicide.
Have you ever experienced this kind of event?
YES / NO
If no, screen total = 0. Please stop here.
If yes, please answer the questions below.
In the past month, have you...
- Had nightmares about the event(s) or thought about the event(s) when you did not want to?
YES / NO - Tried hard not to think about the event(s) or went out of your way to avoid situations that reminded you of the event(s)?
YES / NO - Been constantly on guard, watchful, or easily startled?
YES / NO - Felt numb or detached from people, activities, or your surroundings?
YES / NO - Felt guilty or unable to stop blaming yourself or others for the event(s) or any problems the event(s) may have caused?
YES / NO
Citation
Prins, A., Bovin, M. J., Kimerling, R., Kaloupek, D. G., Marx, B. P., Pless Kaiser, A., & Schnurr, P. P. (2015). The Primary Care PTSD Screen for DSM-5 (PC-PTSD-5). [Measurement instrument].
References (PC-PTSD-5)
Bovin, M. J., Kimerling, R., Weathers, F. W., Prins, A., Marx, B. P., Post, E. P., & Schnurr, P. P. (2021). Diagnostic accuracy and acceptability of the Primary Care Posttraumatic Stress Disorder Screen for the Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) among US Veterans (PDF). JAMA Network Open, 4(2), e2036733. https://doi.org/10.1001/jamanetworkopen.2020.36733
Prins, A., Bovin, M. J., Smolenski, D. J., Mark, B. P., Kimerling, R., Jenkins-Guarnieri, M. A., Kaloupek, D. G., Schnurr, P. P., Pless Kaiser, A., Leyva, Y. E., & Tiet, Q. Q. (2016). The Primary Care PTSD Screen for DSM-5 (PC-PTSD-5): Development and evaluation within a Veteran primary care sample. (PDF) Journal of General Internal Medicine, 31, 1206-1211. https://doi.org/10.1007/s11606-016-3703-5
References (PC-PTSD for DSM-IV)
Prins, A., Ouimette, P., Kimerling, R., Cameron, R. P., Hugelshofer, D. S., Shaw-Hegwer, J., Thrailkill, A., Gusman, F.D., Sheikh, J. I. (2003). The Primary Care PTSD Screen (PC-PTSD): Development and operating characteristics (PDF). Primary Care Psychiatry, 9(1), 9-14. https://doi.org/10.1185/135525703125002360
Prins, A., Ouimette, P., Kimerling, R., Cameron, R. P., Hugelshofer, D. S., Shaw-Hegwer, J., Thrailkill, A., Gusman, F.D., Sheikh, J. I. (2004). The Primary Care PTSD Screen (PC-PTSD): Corrigendum (PDF). Primary Care Psychiatry, 9(151), 10-1185.
To Obtain Scale
This measure was developed by staff at VA's National Center for PTSD and is in the public domain and not copyrighted. In accordance with the American Psychological Association's ethical guidelines, this instrument is intended for use by qualified health professionals and researchers.
Download the Primary Care PTSD Screen for DSM-5 (PC-PTSD-5):
- PC-PTSD-5 Screen (PDF)
Download the Primary Care PTSD Screen for DSM-IV (PC-PTSD)
- PC-PTSD Screen DSM-IV (PDF)
Are you using this measure with U.S. Veterans or Service members?
Our PTSD Consultation Program can answer administration or scoring questions: PTSDconsult@va.gov or 866-948-7880.
Measure availability: We provide information on a variety of measures assessing trauma and PTSD. These measures are intended for use by qualified mental health professionals and researchers. Measures authored by National Center staff are available as direct downloads or by request. Measures developed outside of the National Center can be requested via contact information available on the information page for the specific measure.
