PC-PTSD-5: Primary Care PTSD Screen for DSM-5

The Primary Care PTSD Screen for DSM-5 (PC-PTSD-5) is a very short questionnaire that helps find people who may have post-traumatic stress disorder (PTSD). It starts with a short introduction about very stressful or frightening experiences, then asks five yes/no questions about how the person has felt in the past month: nightmares or unwanted thoughts, avoidance, being on guard, feeling numb, and guilt or self-blame. It was developed by Prins, Bovin, Smolenski and colleagues at the US National Center for PTSD (2016).

It is built to be quick, so it can be used at intake or in a busy service. It is a first step: a positive result is followed by a fuller assessment, such as the PCL-5.

The PC-PTSD-5 supports quick screening for PTSD in adults. A therapist reads it with the person's history, the event itself, current safety and other symptoms such as low mood or substance use.

• Intake: a two-minute screen alongside mood and anxiety measures.
• Triage: decide who needs a full trauma assessment.
• Follow-up: a positive screen leads to the PCL-5 and a clinical interview.

The person reads a short introduction describing the kinds of frightening or traumatic events that count, such as a serious accident, an assault, a disaster, a war, or a death by violence. If they have never had such an experience, they answer No to every question. If they have, they answer the five questions about the past month. It takes 1 to 2 minutes.

There is one total score, found in three steps.

1. Give 1 point for every Yes answer and 0 for every No.
2. Add the points. The total runs from 0 to 5.
3. Compare the total with the cut-off, below.

Example: if three of the five answers are Yes, the total is 3, which is a positive screen.

The score is read against a single cut-off.

A score of 3 or more is the suggested cut-off for a positive screen, with good sensitivity and specificity in the original study. Some services use 4 to reduce false positives, and the best cut-off varies between groups and settings.

A positive screen does not diagnose PTSD, and a negative screen does not rule it out. It is a reason to look more closely with the PCL-5 and a clinical interview.

No. None of its questions asks about suicide or self-harm, so a clinician needs to ask about risk directly, whatever the score is. Talking about trauma can also bring up distress, so a therapist should be ready to support the person.

If you or someone you know is in distress or at risk right now, please see our crisis support page.

Crisis support

• It is a screen, not a diagnosis. Only a clinical assessment can diagnose PTSD.
• It does not record what the event was, or check that it meets the DSM-5 definition of a traumatic event.
• It does not measure severity, and is not well suited to tracking change. Use the PCL-5 for that.
• It covers the past month only, and relies on the person's own answers.
• The best cut-off differs between populations, settings and languages.

The PC-PTSD-5 has 5 yes/no questions and gives a quick positive or negative result. The PCL-5 has 20 questions rated 0 to 4, gives a score from 0 to 80 with four symptom clusters, and can track change over time.

Many services use the two together: the PC-PTSD-5 to screen, and the PCL-5 to assess a positive screen and to monitor treatment.

Read about the PCL-5

In the validation study (Prins and colleagues, 2016), done with US veterans in primary care, a cut-off of 3 gave good sensitivity and specificity against a structured PTSD interview. Later work (Bovin and colleagues, 2021) reported similar findings. As with any cut-off, how well it works depends on the group tested, so findings from one population should not be assumed to hold for another.