If you are experiencing symptoms of post-traumatic stress disorder (PTSD), the PCL-5 form may be used to provide a provisional diagnosis that supports your claim for Veterans disability benefits or to evaluate whether the PTSD treatment you are currently receiving is meeting your needs.
About the PCL-5
PTSD is more than just combat stress. It is a serious mental health disorder associated with a wide range of symptoms that can affect a person’s daily life. The PCL-5 is a 20-item self-reported measure that assesses the symptoms of PTSD outlined in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5).
PCL-5 is an update to PCL for DSM-IV. The prior PCL form had three versions: PCL-M (military), PCL-C (civilian), and PCL-S (specific). In PCL-5, there is only one version of the form.
Veterans are typically asked to complete the form while waiting to visit with their healthcare provider. If the form is being used to make a provisional diagnosis, it should be followed by a structured clinical interview such as the Clinician-Administered PTSD Scale (CAPS-5).
To complete the PCL-5, Veterans are asked to rate symptoms on a scale from 0 to 4.
- 0 – Not at all
- 1 – A little bit
- 2 – Moderately
- 3 – Quite a bit
- 4 – Extremely
The individual questions ask how often specific symptoms have been experienced in the past month:
- Repeated, disturbing, and unwanted memories of the stressful experience?
- Repeated, disturbing dreams of the stressful experience?
- Suddenly feeling or acting as if the stressful experience were actually happening again (as if you were actually back there reliving it)?
- Feeling very upset when something reminded you of the stressful experience?
- Having strong physical reactions when something reminded you of the stressful experience (for example, heart pounding, trouble breathing, sweating)?
- Avoiding memories, thoughts, or feelings related to the stressful experience?
- Avoiding external reminders of the stressful experience (for example, people, places, conversations, activities, objects, or situations)?
- Trouble remembering important parts of the stressful experience?
- Having strong negative beliefs about yourself, other people, or the world (for example, having thoughts such as: l am bad, there is something seriously wrong with me, no one can be trusted, the world is completely dangerous)?
- Blaming yourself or someone else for the stressful experience or what happened after it?
- Having strong negative feelings such as fear, horror, anger, guilt, or shame?
- Loss of interest in activities that you used to enjoy?
- Feeling distant or cut off from other people?
- Trouble experiencing positive feelings (for example, being unable to feel happiness or have loving feelings for people close to you)?
- Irritable behavior, angry outbursts, or acting aggressively?
- Taking too many risks or doing things that could cause you harm?
- Being "superalert" or watchful or on guard?
- Feeling jumpy or easily startled?
- Having difficulty concentrating?
- Trouble falling or staying asleep?
How the PCL-5 Is Scored
A total symptom severity score is calculated by adding a Veteran’s scores for each of the 20 items. Symptom severity scores range from 0 to 80. Cluster scores are obtained by adding scores for each of the symptoms within a specific category: cluster B (items 1-5), cluster C (items 6-7), cluster D (items 8-14), and cluster E (items 15-20). If a Veteran has 1 B item (questions 1-5), 1 C item (questions 6-7), 2 D items (questions 8-14), and 2 E items (questions 15-20) rated as 2 (moderately) or higher, this qualifies for a provisional PTSD diagnosis.
If the PCL-5 is being used to evaluate the effectiveness of treatment, a 5-10 point difference represents a reliable change not due to chance. A clinically significant change is defined as a 10-20 point difference in scores between each time the test is administered.
Scores from the PCL-5 can’t be compared to scores from the PCL for DSM-IV due to the change in the rating scale and the increase from 17 to 20 items.
Let Us Help You Get the VA Disability Benefits You Deserve
PTSD is a serious disability that is often misunderstood. If you’re struggling with service-connected PTSD and having trouble accessing your VA disability benefits, our Veteran's benefits attorney can help. Call the office of Sean Kendall, Attorney-at-Law today to schedule a free, no-obligation initial consultation.