Trauma Load Check (PCL-5)

What the PCL-5 Is

The PTSD Checklist for DSM-5 (PCL-5) is a 20-item self-report questionnaire that asks about the 20 symptoms of posttraumatic stress disorder (PTSD) listed in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). It was developed in 2013 by Frank Weathers, Brett Litz, Terence Keane, Patrick Palmieri, Brian Marx, and Paula Schnurr at the U.S. Department of Veterans Affairs (VA) National Center for PTSD (Weathers et al., 2013). It updated the original PTSD Checklist so that it would match the DSM-5 symptom criteria (Blevins et al., 2015). The PCL-5 is in the public domain, and the National Center for PTSD lists screening and tracking symptom change over time among its main uses (U.S. Department of Veterans Affairs, National Center for PTSD [NCPTSD], n.d.).

What It Measures

The 20 items are grouped into four symptom clusters (NCPTSD, n.d.):

• Items 1–5: unwanted memories, upsetting dreams, feeling as if the event is happening again, and strong emotional or physical reactions to reminders.
• Items 6–7: avoiding memories, feelings, or outside reminders of the experience.
• Items 8–14: changes in thinking and mood, such as strong negative beliefs, blame, guilt or shame, loss of interest, and feeling cut off from others.
• Items 15–20: changes in alertness and reactivity, such as irritability, risk taking, being on guard, startling easily, trouble concentrating, and trouble sleeping.

How the Self-Check Works

Time Frame and Response Scale

Each item asks how much you have been bothered by a problem in the past month. Answers are rated on a 5-point scale: 0 (not at all), 1 (a little bit), 2 (moderately), 3 (quite a bit), and 4 (extremely). Most people finish in about 5 to 10 minutes (NCPTSD, n.d.).

Scoring and Commonly Cited Cutoffs

Your total score is the sum of all 20 items and ranges from 0 to 80; higher scores mean more distress from these symptoms. The National Center for PTSD notes that a total score in the range of 31 to 33 is commonly used to suggest probable PTSD, while cautioning that the best cutoff depends on the group being screened and the purpose of screening (NCPTSD, n.d.). That 31–33 range came from a study of veterans (Bovin et al., 2016). A study of firefighters, emergency medical technicians, and police officers found that a higher cutoff of 41 worked best in that sample (Morrison et al., 2021). For tracking change over time, the National Center for PTSD suggests that a drop of about 10 points is a meaningful sign of improvement (NCPTSD, n.d.).

What the Research Shows

In its first evaluation, with two samples of trauma-exposed college students (N = 278 and N = 558), the PCL-5 showed strong internal consistency (α = .94), good test–retest reliability (r = .82), and strong agreement with related measures (Blevins et al., 2015).

The PCL-5 has also been studied with the people Healing the Hero serves. In 468 veterans receiving care at a VA medical center, scores showed excellent internal consistency (α = .96) and test–retest reliability (r = .84), and they were compared with a structured clinical interview to establish the 31–33 cutoff range (Bovin et al., 2016). In 912 active-duty service members seeking help for PTSD, the PCL-5 again showed high internal consistency and tracked change over time about as well as a clinician interview (Wortmann et al., 2016). Among 133 firefighters, emergency medical technicians, and police officers seeking help for PTSD, scores showed strong internal consistency and good accuracy (Morrison et al., 2021). Two more recent studies of help-seeking first responders (N = 390; Ahmadi, Galusha, et al., 2023) and veterans served outside the VA and Department of Defense (N = 493; Ahmadi, Ponder, et al., 2023) supported the PCL-5's structure in both groups.

Limitations

This self-check is a screening self-check, not a diagnosis. The National Center for PTSD describes a structured clinical interview, such as the Clinician-Administered PTSD Scale for DSM-5, as the gold standard, and it notes that PCL-5 results should be interpreted by a clinician (NCPTSD, n.d.). Cutoff scores are guides rather than verdicts, and they shift from one population to another (Morrison et al., 2021; NCPTSD, n.d.). A high score does not tell you why you are struggling or what will help most, and a low score does not mean your experiences do not matter. Please discuss your results with a qualified professional, especially if your score is high or if anything on this list is getting in the way of your work, relationships, or sleep.

How Healing the Hero Uses This Self-Check

Healing the Hero USA offers this self-check free of charge to veterans, first responders, corrections officers, Gold Star Families, Families of the Fallen, and the people who love them. It is confidential. Your answers are scored right on the page, and your results stay private unless you choose to share them with us. If you do choose to share, a Healing the Hero coach will connect with you within 24 hours to talk through what you are noticing and to help you find peer support or a qualified professional who fits your needs. You never have to explain yourself to a stranger first, and you are never obligated to take a next step you are not ready for.