Trauma study

Life Events Checklist
for DSM-5 (LEC-5)

Standard Version

Version date: 12 April 2018

Reference: Weathers, F. W., Blake, D. D., Schnurr,
P. P., Kaloupek, D. G., Marx, B. P., & Keane, T. M.
(2013). The Life Events Checklist for DSM-5 (LEC-5) –
Standard. [Measurement instrument].
Available from https://www.ptsd.va.gov/

URL: https://www.ptsd.va.gov/professional/assess-
ment/te-measures/life_events_checklist.asp

Note: This is a fillable form. You may complete it electronically.

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Page 1 of 1LEC-5 Standard (12 April 2018) National Center for PTSD

LEC-5 Standard

Instructions: Listed below are a number of difficult or stressful things that sometimes happen to people. For each
event check one or more of the boxes to the right to indicate that: (a) it happened to you personally; (b) you witnessed
it happen to someone else; (c) you learned about it happening to a close family member or close friend; (d) you were
exposed to it as part of your job (for example, paramedic, police, military, or other first responder); (e) you’re not sure if
it fits; or (f) it doesn’t apply to you.

Be sure to consider your entire life (growing up as well as adulthood) as you go through the list of events.

Event Happened to me
Witnessed

it
Learned
about it

Part of
my job

Not
sure

Doesn’t
apply

1. Natural disaster (for example, flood, hurricane,
tornado, earthquake)

2. Fire or explosion

3. Transportation accident (for example, car
accident, boat accident, train wreck, plane crash)

4. Serious accident at work, home, or during
recreational activity

5. Exposure to toxic substance (for example,
dangerous chemicals, radiation)

6. Physical assault (for example, being attacked, hit,
slapped, kicked, beaten up)

7. Assault with a weapon (for example, being
shot, stabbed, threatened with a knife, gun,
bomb)

8. Sexual assault (rape, attempted rape, made to
perform any type of sexual act through force or
threat of harm)

9. Other unwanted or uncomfortable sexual
experience

10. Combat or exposure to a war-zone (in the
military or as a civilian)

11. Captivity (for example, being kidnapped,
abducted, held hostage, prisoner of war)

12. Life-threatening illness or injury

13. Severe human suffering

14. Sudden violent death (for example, homicide,
suicide)

15. Sudden accidental death

16. Serious injury, harm, or death you caused to
someone else

17. Any other very stressful event or experience

1. Check Box1: Off
2. Check Box2: Off
3. Check Box3: Off
4. Check Box4: Off
5. Check Box5: Off
6. Check Box6: Off
7. Check Box7: Off
8. Check Box8: Off
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69. Check Box70: Off
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101. Check Box102: Off
102. Check Box103: Off

Steps in Completing the
CAPS-5

C. Clinician-Administered PTSD Scale for
DSM-5 (CAPS-5)

 The CAPS is the gold standard in
PTSD assessment.

 The CAPS-5 is a 30-item structured
interview that can be used to:

 Make current (past month)
diagnosis of PTSD

 Make lifetime diagnosis of PTSD
 Assess PTSD symptoms over the

past week
 The full interview takes about 45-60

minutes to administer.
2

3

 In addition to assessing the 20 DSM-5 PTSD
symptoms, questions target:
 the onset and duration of symptoms,
 subjective distress,
 impact of symptoms on social and occupational

functioning,
 improvement in symptoms since a previous CAPS

administration,
 overall response validity,
 overall PTSD severity, and
 specifications for the dissociative subtype

(depersonalization and derealization).

 For each symptom, standardized
questions and probes are provided.

 Administration requires identification
of an index traumatic event to serve
as the basis for symptom inquiry.

 The Life Events Checklist for DSM-5
(LEC-5) is recommended in
addition to the Criterion A inquiry
included in the CAPS-5.

 The CAPS was designed to be
administered by clinicians and
clinical researchers who have a
working knowledge of PTSD, but
can also be administered by
appropriately trained
paraprofessionals.

4

1. CAPS Training
 To learn about giving a CAPS-5 assessment, there are

links for video training on the CAPS-5 website.
 Technical manuals are also available for the DSM-IV

versions of the CAPS and CAPS-CA can be found at
“Western Psychological Services” (WPS) website.

 Search their online list of available products for CAPS
(which includes the CAPS-CA).

 Interview booklets, interview guides, and a technical
manual are available for the CAPS and CAPS-CA.

 To obtain the CAPS-5, at the website, click on the link
at the bottom and complete the online form.

5

Important Links:
• CAPS-5 webpage:

https://www.ptsd.va.gov/professional/assessment/
adult-int/caps.asp

• CAPS-5 training:
https://www.ptsd.va.gov/professional/continuing_
ed/caps5_clinician_training.asp

• To obtain permission to get a copy of the scale:
https://www.ptsd.va.gov/professional/assessment/
ncptsd-instrument-request-form.asp

2. Scoring

7

 Detailed scoring information is included with the CAPS-5 and
should be reviewed carefully before administering.

 The assessor combines information about frequency and
intensity of an item into a single severity rating, which
is calculated by summing severity scores for the 20 DSM-5
PTSD symptoms.

 Similarly, CAPS-5 symptom cluster severity scores are
calculated by summing the individual item severity scores for
symptoms corresponding to a given DSM-5 cluster: Criterion
B (items 1-5); Criterion C (items 6-7); Criterion D (items 8-
14); and, Criterion E (items 15-20).

 A symptom cluster score may also be calculated for
dissociation by summing items 19 and 20.

 To receive a PTSD diagnosis, the client must meet:
 At least one Criterion B symptom (Intrusion)
 At least one Criterion C symptom (Avoidance)
 At least two Criterion D symptoms (Negative Thinking/Feeling)
 At least two Criterion E symptoms (Arousal/Reactivity)
 Criterion F is met (disturbance has lasted One Month)
 Criterion G is met (disturbance causes either/both Clinically

Significant Distress or Functional Impairment)

8

3. Severity Rating

0. Absent: The respondent denied the
problem or the respondent’s report
doesn’t fit the DSM-5 symptom
criterion.

1. Mild / subthreshold: The
respondent described a problem
that is consistent with the symptom
criterion but isn’t severe enough to
be considered clinically significant.
The problem doesn’t satisfy the
DSM-5 symptom criterion and thus
doesn’t count toward a PTSD
diagnosis.

9

2. Moderate / threshold: The respondent described a clinically
significant problem. The problem satisfies the DSM-5 symptom
criterion and thus counts toward a PTSD diagnosis. The
problem would be a target for intervention. This rating requires
a minimum frequency of 2 x month or some of the time (20-
30%) PLUS a minimum intensity of Clearly Present.

3. Severe / markedly elevated: The respondent described a
problem that is above threshold. The problem is difficult to
manage and at times overwhelming, and would be a prominent
target for intervention. This rating requires a minimum
frequency of 2 x week or much of the time (50-60%) PLUS a
minimum intensity of Pronounced.

4. Extreme / incapacitating: The respondent described a dramatic
symptom, far above threshold. The problem is pervasive,
unmanageable, and overwhelming, and would be a high-priority
target for intervention.

10

Criteria for DSM-5 listed
Questions to help guide the

interview
A place to record the

“index” event
Comment box for client’s

responses (try to always
get client’s actual words)

Checklist for exposure type
Three choices of traumatic

event type
Is criteria A met? Yes?

No? Maybe so?
11

4. Let’s Look at
the parts:

Rest of the criteria/pages
are similar to this:

Criteria for DSM-5 listed
Questions to help guide the

interview (try to always
get client’s actual words)

Client’s severity rating
Circle the level of distress

they are having
Number of times in the

past month
Key explanations for rating

a client with moderate
and severe intensity/
distress

12

5. Criterion F, G, and
“Global Rating”

 Items 21 and 22 look at
Criterion F – making sure
the duration if the
disturbance is at least or
more than one month.

 Criterion G – does the
disturbance cause clinically
significant distress across:
 #23: Subjective areas
 #24: Social areas
 #25: Occupational/

Other areas

13

 Item 26 looks at the
validity of the client’s
responses; Are they
accurate? Are there
other factors involved
that decrease
accuracy?

 Item 27: based on
your opinion after
doing the CAPS-5,
rate the severity of
their PTSD symptoms.

 Item 28: has there
been any improvement
for the client over the
past month? 14

6. Depersonalization & Derealization
 The CAPS-5 looks for

possible Dissociative
symptoms that can
occur from trauma.

 “Depersonalization”
looks for clients who
feel like they are:
 “detached” from

themselves
 an outside observer
 like they are in a dream
 feeling as if things are

“unreal”
 time is moving slowly

15

 “Derealization”
looks for clients who
feel like the world
around them is
experienced as:
 unreal
 dream-like
 distant
 distorted
 feels like they are in

a “movie”

16

7. Summarizing
Scoring is very simple;

transfer items from each
page that matches the

correct item and section:
1. Is Criteria A met? (if

“No,” consider ASD or
Adjustment D/O)

2. The severity scores (0-4)
3. Total sum of severity
4. Is the severity above 2?

Circle 1 = Yes if so.
5. Total number of “Yeses”

17

 Add up “Total Severity” and
“Total Symptoms” from
Criterion B, C, D, E)

 Circle for Criteria F: “Has the
current duration of the
disturbance been a month or
longer?” (if “No,” consider
ASD or Adjustment D/O)

 Add and total up the severity
and symptoms for Criteria G.

 Place the numbers for the
three “Global Ratings.”

 Place and total the severity
and symptoms for any
“Dissociative Symptoms.”

 Make your Diagnostic
Impression based on the data.

18

19

Using the PTSD Checklist for
DSM-5 (PCL-5)

www.ptsd.va.gov

Using the PTSD Checklist for DSM-5

What is the PCL-5?

The PTSD Checklist for DSM-5 is a 20-item self-report measure that assesses
the presence and severity of PTSD symptoms. Items on the PCL-5 correspond
with DSM-5 criteria for PTSD. The PCL-5 has a variety of purposes, including:

• Quantifying and monitoring symptoms over time

• Screening individuals for PTSD

• Assisting in making a provisional diagnosis of PTSD

The PCL-5 should not be used as a stand-alone diagnostic tool. When
considering a diagnosis, the clinician will still need to use clinical interviewing
skills, and a recommended structured interview (e.g., Clinician-Administered
PTSD Scale for DSM-5, CAPS-5) to determine a diagnosis.

Three formats of the PCL-5 measure are available:

• PCL-5 without Criterion A component

• PCL-5 with extended Criterion A assessment

• PCL-5 with LEC-5 and extended Criterion A assessment

How is the PCL-5 administered?

The PCL-5 is a self-report measure that can be read by respondents
themselves or read to them either in person or over the telephone. It can be
completed in approximately 5-10 minutes.

The preferred administration is for the patient to self-administer the PCL-5.
Patients can complete the measure: in the waiting area prior to a session,
at the beginning of a session, at the close of a session, or at home prior to
an appointment.

The PCL-5 is intended to assess patient symptoms in the past month.
Versions of the PCL-5 that assess symptoms over a different timeframe (e.g.,
past day, past week, past 3 months) have not been validated. For various
reasons it often makes sense to administer the PCL-5 more or less frequently
than once a month, and in those cases the timeframe in the directions may be
changed to meet the purpose of the assessment, though providers should be
aware that such changes may alter the psychometric properties of the measure.

http://www.ptsd.va.gov/professional/assessment/adult-sr/ptsd-checklist.asp Page 1 of 4

NOTE:

The PCL for DSM-IV was
revised in accordance with DSM- 5
(PCL-5). Several important
revisions were made to the PCL-
5, including changes to existing
symptoms and the addition of
three new symptoms of PTSD.
The self-report rating scale for
PCL-5 was also changed to 0-4.
Therefore, the change in the
rating scale combined with the
increase from 17 to 20 items
means that PCL-5 scores are
not compatible with PCL for
DSM-IV scores and cannot be
used interchangeably.

Initial research suggests that
a PCL-5 cutoff score between
31-33 is indicative of probable
PTSD across samples. However,
additional research is needed.
Further, because the population
and the purpose of the screening
may warrant different cutoff
scores, users are encouraged
to consider both of these factors
when choosing a cutoff score.

How is the PCL-5 scored and interpreted?

Respondents are asked to rate how bothered they have been by each of 20 items in the past month on a 5- point
Likert scale ranging from 0-4. Items are summed to provide a total severity score (range = 0-80).

0 = Not at all 1 = A little bit 2 = Moderately 3 = Quite a bit 4 = Extremely

The PCL-5 can determine a provisional diagnosis in two ways:

• Summing all 20 items (range 0-80) and using a cut-point score of 31-33 appears to be reasonable based
upon current psychometric work. However, when choosing a cutoff score, it is essential to consider the goals
of the assessment and the population being assessed. The lower the cutoff score, the more lenient the
criteria for inclusion, increasing the possible number of false-positives. The higher the cutoff score, the more
stringent the inclusion criteria and the more potential for false-negatives.

• Treating each item rated as 2 = “Moderately” or higher as a symptom endorsed, then following the DSM-5
diagnostic rule which requires at least: 1 Criterion B item (questions 1-5), 1 Criterion C item (questions 6-7),
2 Criterion D items (questions 8-14), 2 Criterion E items (questions 15-20). In general, use of a cutoff score
tends to produce more reliable results than the DSM-5 diagnostic rule.

If a patient meets a provisional diagnosis using either of the methods above, he or she needs further assessment
(e.g., CAPS-5) to confirm a diagnosis of PTSD.

There are currently no empirically derived severity ranges for the PCL-5.

How might the PCL-5 help my patients?

Treatment Planning

When given at an intake or assessment session, the PCL-5 may be used to help determine the appropriate next steps
or treatment options. For example:

• A total score of 31-33 or higher suggests the patient may benefit from PTSD treatment. The patient can
either be referred to a PTSD specialty clinic or be offered an evidence-based treatment for PTSD such as
Prolonged Exposure (PE), Cognitive Processing Therapy (CPT), or Eye Movement Desensitization and
Reprocessing (EMDR).

• Scores lower than 31-33 may indicate the patient either has subthreshold symptoms of PTSD or does not
meet criteria for PTSD, and this information should be incorporated into treatment planning.

Keeping the goal of the assessment in mind, it may make sense to lower the cut-point score to maximize the
detection of possible cases needing additional services or treatment. A higher cut-point score should be considered
when attempting to minimize false positives.

http://www.ptsd.va.gov/professional/assessment/adult-sr/ptsd-checklist.asp Page 2 of 4

Measuring Change

Good clinical care requires that clinicians monitor patient progress. Evidence for the PCL for DSM-IV suggested 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. Change scores for the PCL-5
are currently being determined. It is expected that reliable and clinically meaningful change will be in a similar
range. We recommend following DSM-IV recommendations until new information is available.

Addressing Lack of Improvement

If repeated administrations of the PCL-5 suggest little movement or worsening in your patient’s overall score during
treatment, you can:

•

Refer back to the protocol and/or recommended supplemental treatment materials

•

Work to identify possible therapy-interfering behaviors while also reviewing application and response to

interventions

•

Explore and process the lack of improvement with the patient

•

If seeing the patient less frequently than once a week, consider seeing them weekly to increase the dose of

treatment while using the PCL-5 to track symptom change

•

If an adequate dose of the current treatment has been given (e.g. typically 10-15 sessions), and scores

remain high or are getting higher, consider switching to another evidence-based treatment for PTSD

•

Seek consultation with an experienced provider or contact the PTSD Consultation Program (866- 948-7880

or [email protected])

Is the PCL-5 psychometrically sound?

The PCL-5 is a psychometrically sound measure of DSM-5 PTSD. (See Studies that Informed Our Recommendations
below for references.) It is valid and reliable, useful in quantifying PTSD symptom severity, and sensitive to change
over time in military Servicemembers and undergraduate students.

Questions?

If you have any questions about the use of the PCL-5 or PTSD assessment more broadly, we recommend seeking
consultation with a supervisor or experienced provider, or contacting the PTSD Consultation Program (866-948-7880
or [email protected]).

http://www.ptsd.va.gov/professional/assessment/adult-sr/ptsd-checklist.asp Page 3 of 4

Studies that Informed Our Recommendations

Blevins, C. A., Weathers, F. W., Davis, M. T., Witte, T. K., & Domino, J. L. (2015). The Posttraumatic Stress Disorder
Checklist for DSM-5 (PCL-5): Development and initial psychometric evaluation. Journal of Traumatic Stress, 28, 489–498.
doi:10.1002/jts.22059

Bovin, M. J., Marx, B. P., Weathers, F. W., Gallagher, M. W., Rodriguez, P., Schnurr, P. P., & Keane, T. M. (2016).
Psychometric properties of the PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition (PCL-
5) in Veterans. Psychological Assessment, 28, 1379-1391. doi:10.1037/pas0000254

Clapp, J. D., Kemp, J. J., Cox, K. S., & Tuerk, P. W. (2016). Patterns of change in response to prolonged exposure:
Implications for treatment outcome. Depression and Anxiety, 33, 807-815. doi: 10.1002/da.22534

Cohen, J., Kanuri, N., Kieschnick, D., Blasey, C., Taylor, C. B., Kuhn, E., Lavoie, C., Ryu, D., Gibbs, E., Ruzek, J., &
Newman, M. (2014). Preliminary evaluation of the psychometric properties of the PTSD Checklist for DSM-5. Paper
presented at the 48th Annual Convention of the Association of Behavior and Cognitive Therapies, Philadelphia, PA.
doi:10.13140/2.1.4448.5444

Galovski, T. E., Harik, J. M., Blain, L. M., Farmer, C., Turner, D., & Houle, T. (2016). Identifying patterns and predictors of
PTSD and depressive symptom change during cognitive processing therapy. Cognitive Therapy and Research, 40, 617-626.
doi 10.1007/s10608-016-9770-4

National Center for PTSD. (2016). PTSD Checklist for DSM-5 (PCL-5). Retrieved from www.ptsd.va.gov/professional/
assessment/adult-sr/ptsd-checklist.asp

Valenstein, M., Adler, D. A., Berlant, J., Dixon, L. B., Dulit, R. A., Goldman, B., Hackman, A., Oslin, D. W., & Sonis, W. A.
(2009). Implementing standardized assessments in clinical care: Now’s the time. Psychiatric Services, 60, 1372-1375.
doi:10.1176/ps.2009.60.10.1372

Weathers, F. W., Litz, B. T., Keane, T. M., Palmieri, P. A., Marx, B. P., & Schnurr, P. P. (2013). The PTSD Checklist for DSM-5
(PCL-5) – Standard [Measurement instrument]. Available from www.ptsd.va.gov

Wortmann, J. H., Jordan, A. H., Weathers, F. W., Resick, P. A., Dondanville, K. A., Hall-Clark, B., Foa, E. B., Young-
McCaughan, S., Yarvis, J. S., Hembree, E. A., Mintz, J., Peterson, A., & Litz, B. T. (2016). Psychometric analysis of the
PTSD Checklist-5 (PCL-5) among treatment-seeking military service members. Psychological Assessment, 28, 1392-1403.
doi:10.1037/pas0000260

http://www.ptsd.va.gov/professional/assessment/adult-sr/ptsd-checklist.asp Page 4 of 4

___________

Page 20 of 21

CAPS-5 SUMMARY SHEET

Name: ___________________________ ID#: ________ Interviewer: ___________________________ Study: _____________ Date:

A. Exposure to actual or threatened death, serious injury, or sexual violence
Criterion A met? 0 = NO 1= YES

B. Intrusion symptoms (need 1 for diagnosis) Past Week
Symptom Sev Sx (Sev > 2 )?
(1) B1 – Intrusive memories 0 = NO 1= YES
(2) B2 – Distressing dreams 0 = NO 1= YES
(3) B3 – Dissociative reactions 0 = NO 1= YES
(4) B4 – Cued psychological distress 0 = NO 1= YES
(5) B5 – Cued physiological reactions 0 = NO 1= YES

B subtotals B Sev = #B Sx =

C. Avoidance symptoms (need 1 for diagnosis) Past Week
Symptom Sev Sx (Sev > 2 )?
(6) C1 – Avoidance of memories, thoughts, feelings 0 = NO 1= YES
(7) C2 – Avoidance of external reminders 0 = NO 1= YES

C subtotals C Sev = #C Sx =

D. Cognitions and mood symptoms (need 2 for diagnosis) Past Week
Symptom Sev Sx (Sev > 2 )?
(8) D1 – Inability to recall important aspect of event 0 = NO 1= YES
(9) D2 – Exaggerated negative beliefs or expectations 0 = NO 1= YES
(10) D3 – Distorted cognitions leading to blame 0 = NO 1= YES
(11) D4 – Persistent negative emotional state 0 = NO 1= YES
(12) D5 – Diminished interest or participation in activities 0 = NO 1= YES
(13) D6 – Detachment or estrangement from others 0 = NO 1= YES
(14) D7 – Persistent inability to experience positive emotions 0 = NO 1= YES

D subtotals D Sev = #D Sx =

E. Arousal and reactivity symptoms (need 2 for diagnosis) Past Week
Symptom Sev Sx (Sev > 2 )?
(15) E1 – Irritable behavior and angry outbursts 0 = NO 1= YES
(16) E2 – Reckless or self-destructive behavior 0 = NO 1= YES
(17) E3 – Hypervigilance 0 = NO 1= YES
(18) E4 – Exaggerated startle response 0 = NO 1= YES
(19) E5 – Problems with concentration 0 = NO 1= YES
(20) E6 – Sleep disturbance 0 = NO 1= YES

E subtotals E Sev = #E Sx =

CAPS-5 Past Week (16 April 2018) National Center for PTSD

0 0

0 0

0 0

0 0

Page 2CAPS-5 Past Week (16 April 2018) 1 of 21

PTSD totals Past Week
Totals Total Sev Total # Sx

Sum of subtotals (B+C+D+E)

F. Duration of disturbance Current
(22) NOT APPLICABLE

G. Distress or impairment (need 1 for diagnosis) Past Week
Criterion Sev Cx (Sev > 2 )?
(23) Subjective distress 0 = NO 1= YES
(24) Impairment in social functioning 0 = NO 1= YES
(25) Impairment in occupational functioning 0 = NO 1= YES

G subtotals G Sev = #G Cx =

Global ratings Past Week
(26) Global validity
(27) Global severity
(28) Global improvement

Dissociative symptoms (need 1 for subtype) Past Week
Symptom Sev Sx (Sev > 2 )?
(29) 1 – Depersonalization 0 = NO 1= YES
(30) 2 – Derealization 0 = NO 1= YES

Dissociative subtotals Diss Sev = #Diss Sx =

National Center for PTSDNational Center for PTSD

0 0

0 0

0 0

______

______

______

________

______

Clinician-Administered PTSD
Scale for DSM-5 (CAPS-5)

Past Week Version

Version date: 16 April 2018

Reference: Weathers, F. W., Blake, D. D., Schnurr, P.
P., Kaloupek, D. G., Marx, B. P., & Keane, T. M. (2015).
The Clinician-Administered PTSD Scale for DSM-5
(CAPS-5) – Past Week [Measurement instrument].
Available from https://www.ptsd.va.gov/

URL: https://www.ptsd.va.gov/professional/
assessment/adult-int/caps.asp

Note: This is a fillable form. You may complete it
electronically.

Name:

Interviewer:

Study:

ID#:

Date: _

___________________________________

______________________________

___________________________________

___________________________________

___________________________________

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CAPS-5 Past Week

Instructions:

Administration

1. Criterion A should already have been evaluated in a prior administration of the PAST MONTH version of the CAPS-5.
Thus, for most applications of the PAST WEEK version, Criterion A does not need to be re-evaluated. However, if
Criterion A has not been established, to identify an index traumatic event to serve as the basis for symptom inquiry,
administer the Life Events Checklist and Criterion A inquiry provided on p. 4 , or use some other structured,
evidence-based method. The index event may involve either a single incident (e.g., “the accident”) or multiple,
closely related incidents (e.g., “the worst parts of your combat experiences”).

2. Read prompts verbatim, one at a time, and in the order presented, EXCEPT:

a.

b. Rephrase standard prompts to acknowledge previously reported information, but return to verbatim phrasing
as soon as possible. For example, inquiry for item 20 might begin: “You already mentioned having problem
sleeping. What kinds of problems?”

c.
repeating the initial prompt often helps refocus the respondent.

d.
provided explicitly.

3.
be nec
respondent has been given ample opportunity to answer spontaneously.

4. DO NOT read rating scale anchors to the respondent. They are intended only for you, the interviewer, because
appropriate use requires clinical judgment and a thorough understanding of CAPS-5 scoring conventions.

5.

a.

b.

c. Minimize note-taking and write while the respondent is talking to avoid long pauses.

d.
questions, pressing for examples, or pointing out contradictions.

Standard administration and scoring of the CAPS-5 are essential for producing reliable and valid scores and diagnostic

various symptoms, and detailed knowledge of the features and conventions of the CAPS-5 itself.

The CAPS-5 Past Week instrument assesses PTSD symptoms which have occurred in the past week. This version is best
used for determining whether PTSD symptoms have changed over time (e.g., in a treatment study in which you are
interested in comparing a participant’s PTSD symptoms at baseline versus mid-treatment). It should NOT be used to
establish PTSD diagnostic status.

CAPS-5 Past Week (16 April 2018) National Center for PTSD Page 1 of 21

Page 2 of 21CAPS-5 Past Week (16 April 2018) National Center for PTSD

Scoring

1. As with previous versions of the CAPS, CAPS-5 symptom severity ratings are based on symptom frequency and
intensity, except for items 8 (amnesia) and 12 (diminished interest), which are based on amount and intensity.
However, CAPS-5 items are rated with a single severity score, in contrast to previous versions of the CAPS which
required separate frequency and intensity scores for each item that were either summed to create a symptom
severity score or combined in various scoring rules to create a dichotomous (present/absent) symptom score. Thus,
on the CAPS-5 the clinician combines information about frequency and intensity before making a single severity
rating. Depending on the item, frequency is rated as either the number of occurrences (how often in the past
month) or percent of time (how much of the time in the past month). Intensity is rated on a four-point ordinal scale
with ratings of Minimal, Clearly Present, Pronounced, and Extreme. Intensity and severity are related but distinct.
Intensity refers to the strength of a typical occurrence of a symptom. Severity refers to the total symptom load
over a given time period, and is a combination of intensity and frequency. This is similar to the quantity/frequency
assessment approach to alcohol consumption. In general, intensity rating anchors correspond to severity scale
anchors described below and should be interpreted and used in the same way, except that severity ratings require
joint consideration of intensity and frequency. Thus, before taking frequency into account, an intensity rating
of Minimal corresponds to a severity rating of Mild / subthreshold, Clearly Present corresponds with Moderate
/ threshold, Pronounced corresponds with Severe / markedly elevated, and Extreme corresponds with Extreme /
incapacitating.

2.
interpreted and used as follows:

0 Absent DSM-5 symptom
criterion.

1 Mild / subthreshold The respondent described a problem that is consistent with the symptom criterion but isn’t
sev DSM-5 symptom criterion
and thus doesn’t count toward a PTSD diagnosis.

2 Moderate / threshold DSM-
5 symptom criterion and thus counts toward a PTSD diagnosis. The problem would be a target for intervention.
This rating requires a minimum frequency of 2 X month or some of the time (20-30%) PLUS a minimum intensity of
Clearly Present.

3 Severe / markedly elevated The respondent described a problem that is well above threshold. The problem
o manage and at times overwhelming, and would be a prominent target for intervention. This

rating requires a minimum frequency of 2 X week or much of the time (50-60%) PLUS a minimum intensity of
Pronounced.

4 Extreme / incapacitating The respondent described a dramatic symptom, far above threshold. The problem is
pervasive, unmanageable, and overwhelming, and would be a high-priority target for intervention.

3. Use the scoring grid on the next page to determine the appropriate severity score for each CAPS-5 item. Start on
the left side of the grid with the row corresponding to your intensity rating. Then follow the row that corresponds
to the reported frequency to determine the severity score. For example, if your intensity rating is Pronounced, and
the reported frequent is 2 x week, the corresponding severity score would be Severe / markedly elevated. However,
if your intensity rating is Pronounced, but the reported frequency is 10%, then the corresponding severity score
would be Moderate / threshold.

Page 3 of 21CAPS-5 Past Week (16 April 2018) National Center for PTSD

CAPS-5 Past Week Scoring Rules

INTENSITY FREQUENCY (# of times or %) SEVERITY

Minimal 1x/week or more 1-100% 1 = Mild / subthreshold

Clearly Present 1-19% 1 = Mild / subthreshold

1x/week or morea 20-100% 2 = Moderate / threshold

Pronounced 1x/week onlya 1-49% 2 = Moderate / threshold

2x/week or moreb 50-100% 3 = Severe / markedly elevated

Extreme 1x/week onlya 1-19% 2 = Moderate / threshold

At least 2x/week but not daily/almost every day b 20-79% 3 = Severe / markedly elevated

Daily/almost every dayc 80-100% 4 = Extreme / incapacitating

aFor D1: 1-2 important parts bFor D1: several important parts cFor D1: most/all important parts

4. You need to establish that a symptom not only meets the DSM-5 criterion phenomenologically, but is also
functionally related to the index traumatic event, i.e., started or got worse as a result of the event. CAPS-5 items 1-8
and 10 (reexperiencing, effortful avoidance, amnesia, and blame) are inherently linked to the event. Evaluate the
remaining items for trauma-relatedness (TR) using the TR inquiry and rating scale. The three TR ratings are:

a. Definite = the symptom can clearly be attributed to the index trauma, because (1) there is an obvious change
from the pre-trauma level of functioning and/or (2) the respondent makes the attribution to the index trauma
with confidence.

b. Probable = the symptom is likely related to the index trauma, but an unequivocal connection can’t be made.
Situations in which this rating would be given include the following: (1) there seems to be a change from the
pre-trauma level of functioning, but it isn’t as clear and explicit as it would be for a Definite; (2) the respondent
attributes a causal link between the symptom and the index trauma, but with less confidence than for a rating
of Definite; (3) there appears to be a functional relationship between the symptom and inherently trauma-linked
symptoms such as reexperiencing symptoms (e.g., numbing or withdrawal increases when reexperiencing
increases).

c. Unlikely = the symptom can be attributed to a cause other than the index trauma because (1) there is an
obvious functional link with this other cause and/or (2) the respondent makes a confident attribution to
this other cause and denies a link to the index trauma. Because it can be difficult to rule out a functional link
between a symptom and the index trauma, a rating of Unlikely should be used only when the available evidence
strongly points to a cause other than the index trauma. NOTE: Symptoms with a TR rating of Unlikely should not
be counted toward a PTSD diagnosis or included in the total CAPS-5 symptom severity score.

5. CAPS-5 total symptom severity score is calculated by summing severity scores for items 1-20. NOTE: Severity
scores for the two dissociation items (29 and 30) should NOT be included in the calculation of the total CAPS-5
severity score.

6. CAPS-5 symptom cluster severity scores are calculated by summing the individual item severity scores for
symptoms contained in a given DSM-5 cluster. Thus, the Criterion B (reexperiencing) severity score is the sum of the
individual severity scores for items 1-5; the Criterion C (avoidance) severity score is the sum of items 6 and 7; the
Criterion D (negative alterations in cognitions and mood) severity score is the sum of items 8-14; and the Criterion
E (hyperarousal) severity score is the sum of items 15-20. A symptom cluster score may also be calculated for
dissociation by summing items 29 and 30.

7. PTSD diagnostic status should be evaluated with the PAST MONTH version of the CAPS-5. This PAST WEEK version
of the CAPS-5 should be used only to evaluate PTSD symptom severity over the past week.

Page 4 of 21

NOTE: This is the PAST WEEK version of the CAPS-5, which should be used only to evaluate PTSD symptom severity
over the past week. PTSD diagnostic status should be evaluated with the PAST MONTH version of the CAPS-5.

Criterion A:

Exposure to actual or threatened death, serious injury, or sexual violence in one (or more) of the following ways:

1. Directly experiencing the traumatic event(s).

2. Witnessing, in person, the event(s) as it occurred to others.

3. Learning that the traumatic event(s) occurred to a close family member or close friend. In cases of actual or
threatened death of a family member or friend, the event(s) must have been violent or accidental.

4. Experiencing repeated or extreme exposure to aversive details of the traumatic event(s) (e.g., first responders
collecting human remains; police officers repeatedly exposed to details of child abuse). Note: Criterion A4 does
not apply to exposure through electronic media, television, movies, or pictures, unless this exposure is work
related.

NOTE: Criterion A should already have been evaluated in a prior administration of the PAST MONTH version of the
CAPS-5. Thus, for most applications of the PAST WEEK version, Criterion A does not need to be re-evaluated.

[Administer Life Events Checklist or other structured trauma screen]

I’m going to ask you about the stressful experiences questionnaire you filled out. First I’ll ask you to tell me
a little bit about the event you said was the worst for you. Then I’ll ask how that event may have affected you
over the past week. In general I don’t need a lot of information – just enough so I can understand any problems
you may have had. Please let me know if you find yourself becoming upset as we go through the questions
so we can slow down and talk about it. Also, let me know if you have any questions or don’t understand
something. Do you have any questions before we start?

The event you said was the worst was (EVENT). What I’d like for you to do is briefly describe what happened.

Index event (specify): _______________________________________________________________________________

What happened? (How old were you? How were you involved? Who else
was involved? Was anyone seriously injured or killed? Was anyone’s life in
danger? How many times did this happen?)

Exposure type:

____ Experienced
____ Witnessed
____ Learned about
____ Exposed to aversive details

Life threat?
NO YES (self ___ other ___ )

Serious injury?
NO YES (self ___ other ___ )

Sexual violence?
NO YES (self ___ other ___ )

Criterion A met?
NO PROBABLE YES

CAPS-5 Past Week (16 April 2018) National Center for PTSD

Page 5 of 21

For the rest of the interview, I want you to keep (EVENT) in mind as I ask you about different problems it may
have caused you. You may have had some of these problems before, but for this interview we’re going to focus
just on the past week. For each problem I’ll ask if you’ve had it in the past week, and if so, how often and how
much it bothered you.

Criterion B:

Presence of one (or more) of the following intrusion symptoms associated with the traumatic event(s), beginning
after the traumatic event(s) occurred:

Item 1 (B1): Recurrent, involuntary, and intrusive distressing memories of the traumatic event(s). Note: In children
older than 6 years, repetitive play may occur in which themes or aspects of the traumatic event(s) are expressed.

In the past week, have you had any unwanted memories of (EVENT) while
you were awake, so not counting dreams? (Rate 0=Absent if only during dreams)

How does it happen that you start remembering (EVENT)?

[If not clear:] (Are these unwanted memories, or are you thinking about
(EVENT) on purpose?) (Rate 0=Absent unless perceived as involuntary and intrusive)

How much do these memories bother you?

Are you able to put them out of your mind and think about something
else?

[If not clear:] (Overall, how much of a problem is this for you? How so?)

Circle: Distress = Minimal Clearly Present Pronounced Extreme

How often have you had these memories in the past week?
# of times __________

0 Absent

1 Mild / subthreshold

2 Moderate / threshold

3 Severe / markedly elevated

4 Extreme / incapacitating

Key rating dimensions =
frequency / intensity of distress

Moderate = at least 1 X week
/ distress clearly present, some
difficulty dismissing memories

Severe = at least 2 X week /
pronounced distress, considerable
difficulty dismissing memories

CAPS-5 Past Week (16 April 2018) National Center for PTSD

Page 6 of 21

Item 2 (B2): Recurrent distressing dreams in which the content and/or affect of the dream are related to the event(s).
Note: In children, there may be frightening dreams without recognizable content.

In the past week, have you had any unpleasant dreams about (EVENT)?

Describe a typical dream. (What happens?)

[If not clear:] (Do they wake you up?)

[If yes:] (What do you experience when you wake up? How long does it take
you to get back to sleep?)

[If reports not returning to sleep:] (How much sleep do you lose?)

How much do these dreams bother you?

Circle: Distress = Minimal Clearly Present Pronounced Extreme

How often have you had these dreams in the past week? # of times ________

0 Absent

1 Mild / subthreshold

2 Moderate / threshold

3 Severe / markedly elevated

4 Extreme / incapacitating

Key rating dimensions =
frequency / intensity of distress

Moderate = at least 1 X week /
distress clearly present, less than
1 hour sleep loss

Severe = at least 2 X week /
pronounced distress, more than 1
hour sleep loss

Item 3 (B3): Dissociative reactions (e.g., flashbacks) in which the individual feels or acts as if the traumatic event(s)
were recurring. (Such reactions may occur on a continuum, with the most extreme expression being a complete loss of
awareness of present surroundings.) Note: In children, trauma-specific reenactment may occur in play.

In the past week, have there been times when you suddenly acted or felt
as if (EVENT) were actually happening again?

[If not clear:] (This is different than thinking about it or dreaming about it –
now I’m asking about flashbacks, when you feel like you’re actually back
at the time of (EVENT), actually reliving it.)

How much does it seem as if (EVENT) were happening again? (Are you
confused about where you actually are?)

What do you do while this is happening? (Do other people notice your
behavior? What do they say?)

How long does it last?

Circle: Dissociation = Minimal Clearly Present Pronounced Extreme

How often has this happened in the past week? # of times __________

0 Absent

1 Mild / subthreshold

2 Moderate / threshold

3 Severe / markedly elevated

4 Extreme / incapacitating

Key rating dimensions =
frequency / intensity of
dissociation

Moderate = at least 1 X week
/ dissociative quality clearly
present, may retain some
awareness of surroundings but
relives event in a manner clearly
distinct from thoughts and
memories

Severe = at least 2 X week /
pronounced dissociative quality,
reports vivid reliving, e.g., with
images, sounds, smells

CAPS-5 Past Week (16 April 2018) National Center for PTSD

Page 7 of 21

Item 4 (B4): Intense or prolonged psychological distress at exposure to internal or external cues that symbolize or
resemble an aspect of the traumatic event(s).

In the past week, have you gotten emotionally upset when something
reminded you of (EVENT)?

What kinds of reminders make you upset?

How much do these reminders bother you?

Are you able to calm yourself down when this happens? (How long does it
take?)

[If not clear:] (Overall, how much of a problem is this for you? How so?)

Circle: Distress = Minimal Clearly Present Pronounced Extreme

How often has this happened in the past week? # of times __________

0 Absent

1 Mild / subthreshold

2 Moderate / threshold

3 Severe / markedly elevated

4 Extreme / incapacitating

Key rating dimensions =
frequency / intensity of distress

Moderate = at least 1 X week
/ distress clearly present, some
difficulty recovering

Severe = at least 2 X week /
pronounced distress, considerable
difficulty recovering

Item 5 (B5): Marked physiological reactions to internal or external cues that symbolize or resemble an aspect of the
traumatic event(s).

In the past week, have you had any physical reactions when something
reminded you of (EVENT)?

Can you give me some examples? (Does your heart race or your breathing
change? What about sweating or feeling really tense or shaky?)

What kinds of reminders trigger these reactions?

How long does it take you to recover?

Circle: Physiological reactivity = Minimal Clearly Present Pronounced Extreme

How often has this happened in the past week? # of times __________

0 Absent

1 Mild / subthreshold

2 Moderate / threshold

3 Severe / markedly elevated

4 Extreme / incapacitating

Key rating dimensions =
frequency / intensity of
physiological arousal

Moderate = at least 1 X week/
reactivity clearly present, some
difficulty recovering

Severe = at least 2 X week /
pronounced reactivity, sustained
arousal, considerable difficulty
recovering

CAPS-5 Past Week (16 April 2018) National Center for PTSD

Page 8 of 21

Criterion C:

Persistent avoidance of stimuli associated with the traumatic event(s), beginning after the traumatic event(s)
occurred, as evidenced by one or both of the following:

Item 6 (C1): Avoidance of or efforts to avoid distressing memories, thoughts, or feelings about or closely associated
with the traumatic event(s).

In the past week, have you tried to avoid thoughts or feelings about
(EVENT)?

What kinds of thoughts or feelings do you avoid?

How hard do you try to avoid these thoughts or feelings? (What kinds of
things do you do?)

[If not clear:] (Overall, how much of a problem is this for you? How would
things be different if you didn’t have to avoid these thoughts or feelings?)

Circle: Avoidance = Minimal Clearly Present Pronounced Extreme

How often in the past week? # of times _________

0 Absent

1 Mild / subthreshold

2 Moderate / threshold

3 Severe / markedly elevated

4 Extreme / incapacitating

Key rating dimensions =
frequency / intensity of
avoidance

Moderate = at least 1 X week /
avoidance clearly present

Severe = at least 2 X week /
pronounced avoidance

Item 7 (C2): Avoidance of or efforts to avoid external reminders (people, places, conversations, activities, objects,
situations) that arouse distressing memories, thoughts, or feelings about or closely associated with the traumatic
event(s).

In the past week, have you tried to avoid things that remind you of
(EVENT), like certain people, places, or situations?

What kinds of things do you avoid?

How much effort do you make to avoid these reminders? (Do you have to
make a plan or change your activities to avoid them?)

[If not clear:] (Overall, how much of a problem is this for you? How would
things be different if you didn’t have to avoid these reminders?)

Circle: Avoidance = Minimal Clearly Present Pronounced Extreme

How often in the past week? # of times __________

0 Absent

1 Mild / subthreshold

2 Moderate / threshold

3 Severe / markedly elevated

4 Extreme / incapacitating

Key rating dimensions =
frequency / intensity of
avoidance

Moderate = at least 1 X week /
avoidance clearly present

Severe = at least 2 X week /
pronounced avoidance

CAPS-5 Past Week (16 April 2018) National Center for PTSD

Page 9 of 21

Criterion D:

Negative alterations in cognitions and mood associated with the traumatic event(s), beginning or worsening after
the traumatic event(s) occurred, as evidenced by two (or more) of the following:

Item 8 (D1): Inability to remember an important aspect of the traumatic event(s) (typically due to dissociative
amnesia and not to other factors such as head injury, alcohol, or drugs).

In the past week, have you had difficulty remembering some important
parts of (EVENT)? (Do you feel there are gaps in your memory of (EVENT )?)

What parts have you had difficulty remembering?

Do you feel you should be able to remember these things?

[If not clear:] (Why do you think you can’t? Did you have a head injury during
(EVENT)? Were you knocked unconscious? Were you intoxicated from
alcohol or drugs?) (Rate 0=Absent if due to head injury or loss of consciousness or
intoxication during event)

[If still not clear:] (Is this just normal forgetting? Or do you think you may
have blocked it out because it would be too painful to remember?) (Rate
0=Absent if due only to normal forgetting)

Circle: Difficulty remembering = Minimal Clearly Present Pronounced Extreme

In the past week, how many of the important parts of (EVENT) have you
had difficu y remembering? (What parts do you still remember?)
# of important aspects __________

Would you be able to recall these things if you tried?

0 Absent

1 Mild / subthreshold

2 Moderate / threshold

3 Severe / markedly elevated

4 Extreme / incapacitating

Key rating dimensions = amount
of event not recalled / intensity
of inability to recall

Moderate = at least one
important aspect / difficulty
remembering clearly present,
some recall possible with effort

Severe = several important
aspects / pronounced difficulty
remembering, little recall even
with effort

CAPS-5 Past Week (16 April 2018) National Center for PTSD

Page 10 of 21

Item 9 (D2): Persistent and exaggerated negative beliefs or expectations about oneself, others, or the world (e.g.,
“I am bad,” “No one can be trusted,” “The world is completely dangerous,” “My whole nervous system is permanently
ruined”).

In the past week, have you had strong negative beliefs about yourself,
other people, or the world?

Can you give me some examples? (What about believing things like “I am bad,”
“there is something seriously wrong with me,” “no one can be trusted,” “the world is
completely dangerous”?)

How strong are these beliefs? (How convinced are you that these beliefs are
actually true? Can you see other ways of thinking about it?)

Circle: Conviction = Minimal Clearly Present Pronounced Extreme

How much of the time in the past week have you felt that way, as a
percentage? % of time __________

Did these beliefs start or get worse after (EVENT)? (Do you think they’re
related to (EVENT )? How so?) Circle: Trauma-relatedness = Definite Probable Unlikely

0 Absent

1 Mild / subthreshold

2 Moderate / threshold

3 Severe / markedly elevated

4 Extreme / incapacitating

Key rating dimensions =
frequency / intensity of beliefs

Moderate = some of the time
(20-30%) / exaggerated negative
expectations clearly present,
some difficulty considering more
realistic beliefs

Severe = much of the time (50-
60%) / pronounced exaggerated
negative expectations,
considerable difficulty
considering more realistic beliefs

Item 10 (D3): Persistent, distorted cognitions about the cause or consequences of the traumatic event(s) that lead the
individual to blame himself/herself or others.

In the past week, have you blamed yourself for (EVENT) or what happened
as a result of it? Tell me more about that. (In what sense do you see yourself
as having caused (EVENT )? Is it because of something you did? Or something you
think you should have done but didn’t? Is it because of something about you in
general?)

What about blaming someone else for (EVENT) or what happened as a
result of it? Tell me more about that. (In what sense do you see (OTHERS) as
having caused (EVENT )? Is it because of something they did? Or something you
think they should have done but didn’t?)

How much do you blame (YOURSELF OR OTHERS)?

How convinced are you that (YOU OR OTHERS) are truly to blame for what
happened? (Do other people agree with you? Can you see other ways of thinking
about it?)

(Rate 0=Absent if only blames perpetrator, i.e., someone who deliberately caused the event and
intended harm)

Circle: Conviction = Minimal Clearly Present Pronounced Extreme

How much of the time in the past week have you felt that way, as a
percentage? % of time __________

0 Absent

1 Mild / subthreshold

2 Moderate / threshold

3 Severe / markedly elevated

4 Extreme / incapacitating

Key rating dimensions =
frequency / intensity of blame

Moderate = some of the time
(20-30%) / distorted blame
clearly present, some difficulty
considering more realistic beliefs

Severe = much of the time (50-
60%) / pronounced distorted
blame, considerable difficulty
considering more realistic beliefs

CAPS-5 Past Week (16 April 2018) National Center for PTSD

Page 11 of 21

Item 11 (D4): Persistent negative emotional state (e.g., fear, horror, anger, guilt, or shame).

In the past week, have you had any strong negative feelings such as fear,
horror, anger, guilt, or shame?

Can you give me some examples? (What negative feelings do you experience?)

How strong are these negative feelings?

How well are you able to manage them?

[If not clear:] (Overall, how much of a problem is this for you? How so?)

Circle: Negative emotions = Minimal Clearly Present Pronounced Extreme

How much of the time in the past week have you felt that way, as a
percentage? % of time __________

Did these negative feelings start or get worse after (EVENT)? (Do you think
they’re related to (EVENT )? How so?)
Circle: Trauma-relatedness = Definite Probable Unlikely

0 Absent

1 Mild / subthreshold

2 Moderate / threshold

3 Severe / markedly elevated

4 Extreme / incapacitating

Key rating dimensions =
frequency / intensity of negative
emotions

Moderate = some of the time (20-
30%) / negative emotions clearly
present, some difficulty managing

Severe = much of the time
(50-60%) / pronounced negative
emotions, considerable difficulty
managing

Item 12 (D5): Markedly diminished interest or participation in significant activities.

In the past week, have you been less interested in activities that you used
to enjoy?

What kinds of things have you lost interest in or don’t do as much as you
used to? (Anything else?)

Why is that? (Rate 0=Absent if diminished participation is due to lack of opportunity,
physical inability, or developmentally appropriate change in preferred activities)

How strong is your loss of interest? (Would you still enjoy (ACTIVITIES) once
you got started?)

Circle: Loss of interest = Minimal Clearly Present Pronounced Extreme

Overall, in the past week, how many of your usual activities have you
been less interested in, as a percentage? % of activities __________

What kinds of things do you still enjoy doing?

Did this loss of interest start or get worse after (EVENT)? (Do you think it’s
related to (EVENT )? How so?)
Circle: Trauma-relatedness = Definite Probable Unlikely

0 Absent

1 Mild / subthreshold

2 Moderate / threshold

3 Severe / markedly elevated

4 Extreme / incapacitating

Key rating dimensions = percent
of activities affected / intensity
of loss of interest

Moderate = some activities
(20-30%) / loss of interest clearly
present but still has some
enjoyment of activities

Severe = many activities (50-60%)
/ pronounced loss of interest,
little interest or participation in
activities

CAPS-5 Past Week (16 April 2018) National Center for PTSD

Page 12 of 21

Item 13 (D6): Feelings of detachment or estrangement from others.

In the past week, have you felt distant or cut off from other people?

Tell me more about that.

How strong are your feelings of being distant or cut off from others? (Who
do you feel closest to? How many people do you feel comfortable talking with
about personal things?)

Circle: Detachment or estrangement =
Minimal Clearly Present Pronounced Extreme

How much of the time in the past week have you felt that way, as a
percentage? % of time __________

Did this feeling of being distant or cut off start or get worse after
(EVENT)? (Do you think it’s related to (EVENT )? How so?)
Circle: Trauma-relatedness = Definite Probable Unlikely

0 Absent

1 Mild / subthreshold

2 Moderate / threshold

3 Severe / markedly elevated

4 Extreme / incapacitating

Key rating dimensions =
frequency / intensity of
detachment or estrangement

Moderate = some of the time
(20-30%) / feelings of detachment
clearly present but still feels some
interpersonal connection

Severe = much of the time (50-
60%) / pronounced feelings of
detachment or estrangement
from most people, may feel close
to only one or two people

Item 14 (D7): Persistent inability to experience positive emotions (e.g., inability to experience happiness, satisfaction,
or loving feelings).

In the past week, have there been times when you had difficulty
experiencing positive feelings like love or happiness?

Tell me more about that. (What feelings are difficult to experience?)

How much difficulty do you have experiencing positive feelings? (Are you
still able to experience any positive feelings?)

Circle: Reduction of positive emotions =
Minimal Clearly Present Pronounced Extreme

How much of the time in the past week have you felt that way, as a
percentage? % of time __________

Did this trouble experiencing positive feelings start or get worse after
(EVENT)? (Do you think it’s related to (EVENT )? How so?)
Circle: Trauma-relatedness = Definite Probable Unlikely

0 Absent

1 Mild / subthreshold

2 Moderate / threshold

3 Severe / markedly elevated

4 Extreme / incapacitating

Key rating dimensions =
frequency / intensity of reduction
in positive emotions

Moderate = some of the
time (20-30%) / reduction of
positive emotional experience
clearly present but still able
to experience some positive
emotions

Severe = much of the time (50-
60%) / pronounced reduction
of experience across range of
positive emotions

CAPS-5 Past Week (16 April 2018) National Center for PTSD

Page 13 of 21

Criterion E:

Marked alterations in arousal and reactivity associated with the traumatic event(s), beginning or worsening after
the traumatic event(s) occurred, as evidenced by two (or more) of the following:

Item 15 (E1): Irritable behavior and angry outbursts (with little or no provocation) typically expressed as verbal or
physical aggression toward people or objects.

In the past week, have there been times when you felt especially irritable
or angry and showed it in your behavior?

Can you give me some examples? (How do you show it? Do you raise your voice
or yell? Throw or hit things? Push or hit other people?)

Circle: Aggression = Minimal Clearly Present Pronounced Extreme

How often in the past week? # of times __________

Did this behavior start or get worse after (EVENT)? (Do you think it’s related
to (EVENT )? How so?) Circle: Trauma-relatedness = Definite Probable Unlikely

0 Absent

1 Mild / subthreshold

2 Moderate / threshold

3 Severe / markedly elevated

4 Extreme / incapacitating

Key rating dimensions =
frequency / intensity of
aggressive behavior

Moderate = at least 1 X week
/ aggression clearly present,
primarily verbal

Severe = at least 2 X week /
pronounced aggression, at least
some physical aggression

Item 16 (E2): Reckless or self-destructive behavior.

In the past week, have there been times when you were taking more risks
or doing things that might have caused you harm?

Can you give me some examples?

How much of a risk do you take? (How dangerous are these behaviors? Were
you injured or harmed in some way?)

Circle: Risk = Minimal Clearly Present Pronounced Extreme

How often have you taken these kinds of risks in the past week?
# of times __________

Did this behavior start or get worse after (EVENT)? (Do you think it’s related
to (EVENT)? How so?) Circle: Trauma-relatedness = Definite Probable Unlikely

0 Absent

1 Mild / subthreshold

2 Moderate / threshold

3 Severe / markedly elevated

4 Extreme / incapacitating

Key rating dimensions =
frequency / degree of risk

Moderate = at least 1 X week
/ risk clearly present, may have
been harmed

Severe = at least 2 X week /
pronounced risk, actual harm or
high probability of harm

CAPS-5 Past Week (16 April 2018) National Center for PTSD

Page 14 of 21

Item 17 (E3): Hypervigilance.

In the past week, have you been especially alert or watchful, even when
there was no specific threat or danger? (Have you felt as if you had to be on
guard?)

Can you give me some examples? (What kinds of things do you do when you’re
alert or watchful?)

[If not clear:] (What causes you to react this way? Do you feel like you’re in
danger or threatened in some way? Do you feel that way more than most
people would in the same situation?)

Circle: Hypervigilance = Minimal Clearly Present Pronounced Extreme

How much of the time in the past week have you felt that way, as a
percentage? % of time __________

Did being especially alert or watchful start or get worse after (EVENT)?
(Do you think it’s related to (EVENT )? How so?)
Circle: Trauma-relatedness = Definite Probable Unlikely

0 Absent

1 Mild / subthreshold

2 Moderate / threshold

3 Severe / markedly elevated

4 Extreme / incapacitating

Key rating dimensions =
frequency / intensity of
hypervigilance

Moderate = some of the time
(20-30%) / hypervigilance clearly
present, e.g., watchful in public,
heightened awareness of threat

Severe = much of the time
(50-60%) / pronounced
hypervigilance, e.g., scans
environment for danger, may
have safety rituals, exaggerated
concern for safety of self/family/
home

Item 18 (E4): Exaggerated startle response.

In the past week, have you had any strong startle reactions?

What kinds of things made you startle?

How strong are these startle reactions? (How strong are they compared to
how most people would respond? Do you do anything other people would notice?)

How long does it take you to recover?

Circle: Startle = Minimal Clearly Present Pronounced Extreme

How often has this happened in the past week? # of times __________

Did these startle reactions start or get worse after (EVENT)? (Do you think
it’s related to (EVENT )? How so?)
Circle: Trauma-relatedness = Definite Probable Unlikely

0 Absent

1 Mild / subthreshold

2 Moderate / threshold

3 Severe / markedly elevated

4 Extreme / incapacitating

Key rating dimensions =
frequency / intensity of startle

Moderate = at least 1 X week
/ startle clearly present, some
difficulty recovering

Severe = at least 2 X week /
pronounced startle, sustained
arousal, considerable difficulty
recovering

CAPS-5 Past Week (16 April 2018) National Center for PTSD

Page 15 of 21

Item 19 (E5): Problems with concentration.

In the past week, have you had any problems with concentration?

Can you give me some examples?

Are you able to concentrate if you really try?

[If not clear:] (Overall, how much of a problem is this for you? How would
things be different if you didn’t have problems with concentration?)

Circle: Problem concentrating = Minimal Clearly Present Pronounced Extreme

How much of the time in the past week have you had problems with
concentration, as a percentage? % of time __________

Did these problems with concentration start or get worse after (EVENT)?
(Do you think they’re related to (EVENT )? How so?)
Circle: Trauma-relatedness = Definite Probable Unlikely

0 Absent

1 Mild / subthreshold

2 Moderate / threshold

3 Severe / markedly elevated

4 Extreme / incapacitating

Key rating dimensions =
frequency / intensity of
concentration problems

Moderate = some of the time
(20-30%) / problem concentrating
clearly present, some difficulty
but can concentrate with effort

Severe = much of the time
(50-60%) / pronounced problem
concentrating, considerable
difficulty even with effort

Item 20 (E6): Sleep disturbance (e.g., difficulty falling or staying asleep or restless sleep).

In the past week, have you had any problems falling or staying asleep?

What kinds of problems? (How long does it take you to fall asleep? How often
do you wake up in the night? Do you wake up earlier than you want to?)

How many total hours do you sleep each night?

How many hours do you think you should be sleeping?

Circle: Problem sleeping = Minimal Clearly Present Pronounced Extreme

How often in the past week have you had these sleep problems?
# of times __________

Did these sleep problems start or get worse after (EVENT)? (Do you think
they’re related to (EVENT )? How so?)
Circle: Trauma-relatedness = Definite Probable Unlikely

0 Absent

1 Mild / subthreshold

2 Moderate / threshold

3 Severe / markedly elevated

4 Extreme / incapacitating

Key rating dimensions =
frequency / intensity of sleep
problems

Moderate = at least 1 X week /
sleep disturbance clearly present,
clearly longer latency or clear
difficulty staying asleep, 30-90
minutes loss of sleep

Severe = at least 2 X week /
pronounced sleep disturbance,
considerably longer latency or
marked difficulty staying asleep,
90 min to 3 hrs loss of sleep

CAPS-5 Past Week (16 April 2018) National Center for PTSD

Criterion F: –

Duration of the disturbance (Criteria B, C, D, and E) is more than 1 month.

NOTE: Items 21 and 22 are not applicable for the PAST WEEK version. They are listed here without prompts only to
maintain correspondence with item numbering on the PAST MONTH version. Onset and duration of symptoms should
be assessed with

Item 21: Onset of symptoms.

Item 22: Duration of symptoms.

Criterion G:

The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas
of functioning.

Item 23: Subjective distress.

Overall, in the past week, how much have you been
bothered by these (PTSD SYMPTOMS) you’ve told me
about? [Consider distress reported on earlier items]

0 None

1 Mild, minimal distress

2 Moderate, distress clearly present but still
manageable

3 Severe, considerable distress

4 Extreme, incapacitating distress

Item 24: Impairment in social functioning.

In the past week, have these (PTSD SYMPTOMS)
affected your relationships with other people? How
so? [Consider impairment in social functioning reported on earlier
items]

0 No adverse impact

1 Mild impact, minimal impairment in social
functioning

2 Moderate impact, definite impairment but many
aspects of social functioning still intact

3 Severe impact, marked impairment, few aspects of
social functioning still intact

4 Extreme impact, little or no social functioning

CAPS-5 Past Week (16 April 2018) National Center for PTSD Page 16 of 21

Page 17 of 21

Item 25: Impairment in occupational or other important area of functioning.

[If not clear:] Are you working now?

[If yes:] In the past week, have these (PTSD
SYMPTOMS) affected your work or your ability to
work? How so?

[If no:] Why is that? (Do you feel that your (PTSD
SYMPTOMS) are related to you not working now? How so?)

[If unable to work because of PTSD symptoms, rate at least 3=Severe.
If unemployment is not due to PTSD symptoms, or if the link is not
clear, base rating only on impairment in other important areas of
functioning]

Have these (PTSD SYMPTOMS) affected any other
important part of your life? [As appropriate, suggest
examples such as parenting, housework, schoolwork, volunteer
work, etc.] How so?

0 No adverse impact

1 Mild impact, minimal impairment in occupational/
other important functioning

2 Moderate impact, definite impairment but
many aspects of occupational/other important
functioning still intact

3 Severe impact, marked impairment, few aspects
of occupational/other important functioning still
intact

4 Extreme impact, little or no occupational/other
important functioning

Global Ratings

Item 26: Global validity.

Estimate the overall validity of responses. Consider factors
such as compliance with the interview, mental status (e.g.,
problems with concentration, comprehension of items,
dissociation), and evidence of efforts to exaggerate or
minimize symptoms.

0 Excellent, no reason to suspect invalid responses

1 Good, factors present that may adversely affect
validity

2 Fair, factors present that definitely reduce validity

3 Poor, substantially reduced validity

4 Invalid responses, severely impaired mental status
or possible deliberate “faking bad” or “faking
good”

Item 27: Global severity.

Estimate the overall severity of PTSD symptoms. Consider
degree of subjective distress, degree of functional
impairment, observations of behaviors in interview, and
judgment regarding reporting style.

0 No clinically significant symptoms, no distress and
no functional impairment

1 Mild, minimal distress or functional impairment

2 Moderate, definite distress or functional
impairment but functions satisfactorily with effort

3 Severe, considerable distress or functional
impairment, limited functioning even with effort

4 Extreme, marked distress or marked impairment in
two or more major areas of functioning

CAPS-5 Past Week (16 April 2018) National Center for PTSD

Page 18 of 21

Item 28: Global improvement.

Rate total overall improvement since the previous rating. Rate the degree of
change, whether or not, in your judgment, it is due to treatment.

0 Asymptomatic

1 Considerable improvement

2 Moderate improvement

3 Slight improvement

4 No improvement

5 Insufficient information

Specify whether with dissociative symptoms: The individual’s symptoms meet the criteria for
posttraumatic stress disorder, and in addition, in response to the stressor, the individual experiences
persistent or recurrent symptoms of either of the following:

Item 29 (1): Depersonalization: Persistent or recurrent experiences of feeling detached from, and as if one were an
outside observer of, one’s mental processes or body (e.g., feeling as though one were in a dream; feeling a sense of
unreality of self or body or of time moving slowly).

In the past week, have there been times when you felt as if you were
separated from yourself, like you were watching yourself from the outside
or observing your thoughts and feelings as if you were another person?

[If no:] (What about feeling as if you were in a dream, even though you were
awake? Feeling as if something about you wasn’t real? Feeling as if time
was moving more slowly?)

Tell me more about that.

How strong is this feeling? (Do you lose track of where you actually are or
what’s actually going on?)

What do you do while this is happening? (Do other people notice your
behavior? What do they say?)

How long does it last?

Circle: Dissociation = Minimal Clearly Present Pronounced Extreme

[If not clear:] (Was this due to the effects of alcohol or drugs? What about a
medical condition like seizures?) [Rate 0=Absent if due to the effects of a substance
or another medical condition]

How often has this happened in the past week? # of times __________

Did this feeling start or get worse after (EVENT)? (Do you think it’s related to
(EVENT )? How so?)
Circle: Trauma-relatedness = Definite Probable Unlikely

0 Absent

1 Mild / subthreshold

2 Moderate / threshold

3 Severe / markedly elevated

4 Extreme / incapacitating

Key rating dimensions =
frequency / intensity of
dissociation

Moderate = at least 1 X week
/ dissociative quality clearly
present but transient, retains
some realistic sense of self and
awareness of environment

Severe = at least 2 X week /
pronounced dissociative quality,
marked sense of detachment and
unreality

CAPS-5 Past Week (16 April 2018) National Center for PTSD

Page 19 of 21

Item 30 (2): Derealization: Persistent or recurrent experiences of unreality of surroundings (e.g., the world around the
individual is experienced as unreal, dreamlike, distant, or distorted).

In the past week, have there been times when things going on around you
seemed unreal or very strange and unfamiliar?

[If no:] (Do things going on around you seem like a dream or like a scene
from a movie? Do they seem distant or distorted?)

Tell me more about that.

How strong is this feeling? (Do you lose track of where you actually are or
what’s actually going on?)

What do you do while this is happening? (Do other people notice your
behavior? What do they say?)

How long does it last?

Circle: Dissociation = Minimal Clearly Present Pronounced Extreme

[If not clear:] (Was this due to the effects of alcohol or drugs? What about a
medical condition like seizures?) [Rate 0=Absent if due to the effects of a substance
or another medical condition]

How often has this happened in the past week? # of times __________

Did this feeling start or get worse after (EVENT)? (Do you think it’s related to
(EVENT )? How so?)
Circle: Trauma-relatedness = Definite Probable Unlikely

0 Absent

1 Mild / subthreshold

2 Moderate / threshold

3 Severe / markedly elevated

4 Extreme / incapacitating

Key rating dimensions =
frequency / intensity of
dissociation

Moderate = at least 1 X week /
dissociative quality clearly present
but transient, retains some
realistic sense of environment

Severe = at least 2 X week /
pronounced dissociative quality,
marked sense of unreality

CAPS-5 Past Week (16 April 2018) National Center for PTSD

___________

Page 20 of 21

CAPS-5 SUMMARY SHEET

Name: ___________________________ ID#: ________ Interviewer: ___________________________ Study: _____________ Date:

A. Exposure to actual or threatened death, serious injury, or sexual violence
Criterion A met? 0 = NO 1= YES

B. Intrusion symptoms (need 1 for diagnosis) Past Week
Symptom Sev Sx (Sev > 2 )?
(1) B1 – Intrusive memories 0 = NO 1= YES
(2) B2 – Distressing dreams 0 = NO 1= YES
(3) B3 – Dissociative reactions 0 = NO 1= YES
(4) B4 – Cued psychological distress 0 = NO 1= YES
(5) B5 – Cued physiological reactions 0 = NO 1= YES

B subtotals B Sev = #B Sx =

C. Avoidance symptoms (need 1 for diagnosis) Past Week
Symptom Sev Sx (Sev > 2 )?
(6) C1 – Avoidance of memories, thoughts, feelings 0 = NO 1= YES
(7) C2 – Avoidance of external reminders 0 = NO 1= YES

C subtotals C Sev = #C Sx =

D. Cognitions and mood symptoms (need 2 for diagnosis) Past Week
Symptom Sev Sx (Sev > 2 )?
(8) D1 – Inability to recall important aspect of event 0 = NO 1= YES
(9) D2 – Exaggerated negative beliefs or expectations 0 = NO 1= YES
(10) D3 – Distorted cognitions leading to blame 0 = NO 1= YES
(11) D4 – Persistent negative emotional state 0 = NO 1= YES
(12) D5 – Diminished interest or participation in activities 0 = NO 1= YES
(13) D6 – Detachment or estrangement from others 0 = NO 1= YES
(14) D7 – Persistent inability to experience positive emotions 0 = NO 1= YES

D subtotals D Sev = #D Sx =

E. Arousal and reactivity symptoms (need 2 for diagnosis) Past Week
Symptom Sev Sx (Sev > 2 )?
(15) E1 – Irritable behavior and angry outbursts 0 = NO 1= YES
(16) E2 – Reckless or self-destructive behavior 0 = NO 1= YES
(17) E3 – Hypervigilance 0 = NO 1= YES
(18) E4 – Exaggerated startle response 0 = NO 1= YES
(19) E5 – Problems with concentration 0 = NO 1= YES
(20) E6 – Sleep disturbance 0 = NO 1= YES

E subtotals E Sev = #E Sx =

CAPS-5 Past Week (16 April 2018) National Center for PTSD

Page 2CAPS-5 Past Week (16 April 2018) 1 of 21

PTSD totals Past Week
Totals Total Sev Total # Sx

Sum of subtotals (B+C+D+E)

F. Duration of disturbance Current
(22) NOT APPLICABLE

G. Distress or impairment (need 1 for diagnosis) Past Week
Criterion Sev Cx (Sev > 2 )?
(23) Subjective distress 0 = NO 1= YES
(24) Impairment in social functioning 0 = NO 1= YES
(25) Impairment in occupational functioning 0 = NO 1= YES

G subtotals G Sev = #G Cx =

Global ratings Past Week
(26) Global validity
(27) Global severity
(28) Global improvement

Dissociative symptoms (need 1 for subtype) Past Week
Symptom Sev Sx (Sev > 2 )?
(29) 1 – Depersonalization 0 = NO 1= YES
(30) 2 – Derealization 0 = NO 1= YES

Dissociative subtotals Diss Sev = #Diss Sx =

National Center for PTSDNational Center for PTSD