Primary Care PTSD Screen for DSM-5 PC-PTSD-5
Primary Care PTSD Screen for DSM-5 PC-PTSD-5 overview
Creator and Context
The Primary Care PTSD Screen for DSM-5 (PC-PTSD-5) is a very brief screening tool: one lifetime trauma exposure question followed by five yes or no symptom questions.
It was developed by Prins, Bovin, Kimerling, Marx, Schnurr and colleagues at the US National Center for PTSD and published in 2016, updating the original DSM-IV version. It is in the public domain.
Presenting Conditions
The five symptom items cover the core presentations of PTSD:
Nightmares or unwanted memories
Avoidance of reminders
Being constantly on guard or easily startled
Feeling numb or detached from people and activities
Guilt or self blame, which was added for the DSM-5 version
Administration
Can be self completed or asked by a clinician. The person first confirms whether they have ever experienced a traumatic event. If they have, they answer five yes or no questions about the past month. If they have not, the screen stops and scores zero.
Desired Audience
Adults, designed specifically for primary care and other high volume, time pressured settings where a full symptom measure is impractical. Developed and validated in veteran primary care populations.
The PC-PTSD-5 is a triage tool. It answers one question quickly: does this person need a fuller trauma assessment? It is well suited to intake, digital front door forms and routine primary care review, where it can be followed by the PCL-5 when positive.
Considerations
This is a screen, not a diagnosis. A positive result should be followed by further assessment, ideally a structured interview or at minimum the PCL-5.
Performance differs by sex. The National Center for PTSD notes that a cut point of 4 produced high numbers of false negatives for women and that practitioners may consider a lower cut point for women.
Validation is heavily weighted towards US veteran populations.
How to score the Primary Care PTSD Screen for DSM-5 PC-PTSD-5
Conducting the assessment
One trauma exposure gate question, then five yes or no items about the past month. Each yes scores one point.
Interpretation
Total score ranges from 0 to 5.
A cut point of 4 best balanced false negatives and false positives in the overall validation sample and for men (National Center for PTSD).
Prins et al. (2016) found a cut score of 3 optimised sensitivity, while 4 optimised overall efficiency.
Bovin et al. (2021) reported an optimal cut score of 4 for men and 3 for women.
Clinical Considerations
Treat a positive screen as a prompt to assess, not as a finding.
Consider using the lower cut point of 3 for women, in line with the published evidence.
Pair the screen with a clear pathway. A screen with no follow up assessment adds nothing.
Primary Care PTSD Screen for DSM-5 PC-PTSD-5 use cases
Rapid screening for probable PTSD in primary care
Intake and digital front door triage
Identifying who needs a fuller trauma assessment
Category
Trauma
Research Summary
Prins, A., Bovin, M. J., Smolenski, D. J., et al. (2016). The Primary Care PTSD Screen for DSM-5 (PC-PTSD-5): Development and evaluation within a Veteran primary care sample. Journal of General Internal Medicine, 31, 1206 to 1211.
Bovin, M. J., Kimerling, R., Weathers, F. W., et al. (2021). Diagnostic accuracy and acceptability of the Primary Care PTSD Screen for DSM-5 among US Veterans. JAMA Network Open, 4(2), e2036733.
Other Assessment Guides
Adverse Childhood Experience (ACE)
Explore the Adverse Childhood Experience (ACE) Assessment, its development, significance, and application in psychological practice. Understand how to calculate ACE scores and interpret results.
PTSD Checklist for DSM-5 PCL-5
A practitioner guide to the PCL-5, the 20 item DSM-5 aligned measure of PTSD symptom severity. Covers administration, scoring, the 31 to 33 screening range and how to track treatment response.
Impact of Event Scale Revised IES-R
A guide to the Impact of Event Scale Revised (IES-R), the 22 item measure of event related distress across intrusion, avoidance and hyperarousal. Covers scoring, the 33 threshold and its DSM-IV limitations.
Note on Assessment licensing
Some assessments are copyright protected and require a licence or the copyright holder's permission for clinical, commercial or digital use. Where that applies, obtaining and maintaining that permission is the responsibility of the practice or organisation using the assessment. Tacklit provides the digital administration, scoring and reporting. We do not grant, transfer or supply rights to the underlying instrument.
