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Primary Care PTSD Screen for DSM-5 (PC-PTSD-5)

The PC-PTSD-5 is a 5-item yes/no PTSD screen for people who report a traumatic event, scored 0–5. The VA National Center for PTSD recommends a cut-point of 4 (best balance of false positives and negatives); a cut-point of 3 is more sensitive. Positive screens need a full PTSD assessment.

  • Ever experienced an unusually or especially frightening, horrible or traumatic event (e.g. serious accident, assault, disaster, war, witnessing a death)? (yes/no)
  • Had nightmares about the event(s) or thought about the event(s) when you did not want to? (yes/no, +1)
  • Tried hard not to think about the event(s) or went out of your way to avoid situations that reminded you of the event(s)? (yes/no, +1)
  • Been constantly on guard, watchful, or easily startled? (yes/no, +1)
  • Felt numb or detached from people, activities, or your surroundings? (yes/no, +1)
  • Felt guilty or unable to stop blaming yourself or others for the event(s) or any problems the event(s) may have caused? (yes/no, +1)
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Interpretation

ResultMeaning
No trauma exposureScore 0, screen ends
0–2Negative
3Positive only at the sensitive cut-point
4–5Positive (VA recommended cut-point)

Formula

If trauma exposure is endorsed, score 1 point for each "yes" to the 5 past-month items (nightmares/intrusive thoughts, avoidance, on guard/startle, numb/detached, guilt/blame). Range 0–5. No trauma exposure = 0.

Clinical pearls

  • In the validation study a cut-point of 3 maximised sensitivity, 4 maximised efficiency and 5 maximised specificity; the VA notes a cut-point of 4 produced many false negatives in women, so a lower cut-point may be used when assessment resources allow.
  • A positive screen is not a diagnosis: follow up with a clinical interview (CAPS-5) or the PCL-5 self-report.
  • The PC-PTSD-5 was developed by the VA National Center for PTSD and is in the public domain.

Examples

pc-ptsd-5 trauma yes, nightmares yes, avoidance yes, on guard yes, numb no, guilt noptsd screen: assault survivor with nightmares, avoidance, hypervigilance and feeling numb, no guiltpc ptsd 5 no trauma exposure

FAQ

What is a positive PC-PTSD-5?

The VA National Center for PTSD recommends a score of 4 or more out of 5 as positive. A cut-point of 3 is more sensitive and may be preferred for women or where follow-up assessment is easy to arrange.

What if the patient has no trauma history?

If the patient denies any traumatic event, the score is 0 and the remaining five questions are not asked.

Evidence

  1. Prins A et al. The Primary Care PTSD Screen for DSM-5 (PC-PTSD-5): development and evaluation within a veteran primary care sample. J Gen Intern Med 2016;31:1206–11.
  2. VA National Center for PTSD. Primary Care PTSD Screen for DSM-5 (PC-PTSD-5).

Psychiatry & Substance Use · Reviewed 2026-10-14 · Methodology