Tests · trauma
Trauma & Stress Test (PC-PTSD-5)
This short test helps you notice how your body and mind are still reacting to something overwhelming you went through, intrusive memories, the urge to avoid reminders, constant tension. It shows how much the event is still affecting your day-to-day life right now. Your result can help you decide whether it's worth gently taking care of yourself, and whether it might help to talk about what happened with someone who can support you.
- 5 questions
- Prins et al., 2016
- About this test
About the PC-PTSD-5
How many of five common reactions to a frightening or traumatic event you've had in the past month, counted as yes or no.
- Asks about
- The past month, in connection with a frightening or traumatic event
- Developed by
- Annabel Prins and colleagues at the U.S. Department of Veterans Affairs National Center for PTSD (paper published 2016)
- Built and tested in
- U.S. Veterans Affairs primary care clinics, mostly men
Where it comes from
The Primary Care PTSD Screen for DSM-5 (PC-PTSD-5) comes from the U.S. Department of Veterans Affairs (VA) National Center for PTSD. Annabel Prins and colleagues published it in 2016 in the Journal of General Internal Medicine. It updates the four-item PC-PTSD, which matched the older DSM-IV criteria, for the PTSD criteria that DSM-5 introduced in 2013.
The team changed the opening question to list qualifying events, kept yes/no answers, and added a fifth question about guilt and blame. The Center describes it as a screen for probable PTSD in primary care. Anyone who screens positive needs further assessment, ideally a structured interview.
What the research found
The 2016 study included 398 veterans from two VA primary care clinics (41% of those approached; 96% men, average age 63). A trained interviewer used a modified PTSD module of the MINI, a short diagnostic interview, as the reference, and 14.3% met PTSD criteria. The screen's area under the curve was 0.941. A score of 3 or more had a sensitivity of .95 and a specificity of .85. A score of 4 gave .83 and .91. At 3, 26.4% of the sample screened positive.
A 2021 study used the CAPS-5, the clinician-administered PTSD interview, as the reference. In 396 veterans at two VA medical centers, 17.2% had PTSD by CAPS-5. The area under the curve was 0.927. A score of 3 gave a sensitivity of .90 and a specificity of .80, and a score of 4 gave .78 and .91. A cut-off of 4 balanced errors for the whole sample and for men, but it missed 6 of the 18 women with PTSD (33.3%), so a cut-off of 3 fit women better.
How scoring works
| Score | Label | What it means |
|---|---|---|
| 0 to 2 | Below the screening cut-off | Below the cut-off of 3 used in the 2016 paper. A low score doesn't rule PTSD out: 5% to 10% of people with PTSD scored below 3 in the two studies. |
| 3 to 5 | Possible post-traumatic reactions | At or above the cut-off of 3, which the 2016 paper found most sensitive (sensitivity .95, specificity .85). About half of the people at this level didn't have PTSD on interview. |
The screen has no official bands, only a cut-off that each setting chooses. The 2016 paper found 3 most sensitive and 4 most efficient. The 2021 paper and the VA's current page say 4 balanced errors best overall and for men, and that a lower cut-off can be considered for women. The labels on our page are ours; the VA speaks of probable PTSD.
What it can't tell you
Every number above comes from veterans in VA primary care, mostly older men, and in the 2016 study a research assistant asked the questions aloud. The authors said the results might not carry over to other settings. Patients in that study preferred being asked by their own doctor over filling the screen out alone, and its reference interview wasn't the CAPS-5.
It's a screen, not a diagnosis. The VA says a positive result doesn't necessarily mean PTSD and calls for a follow-up interview with a mental health professional. A low score doesn't rule PTSD out either. At a cut-off of 3, about 5% (2016 study) to 10% (2021 study) of people with PTSD scored below it, and about half of those who scored 3 or higher didn't have PTSD on interview. The screen applies only after a qualifying event, such as an assault, a serious accident, war, or a loved one's death by homicide or suicide, so the page asks about that first and stops at a score of 0 if the answer is no. The VA says it's intended for qualified health professionals and researchers.
How to use your result
A score of 3 or more is a reason to talk with someone who works with trauma, such as a doctor, psychologist or therapist who can do a full assessment. The score alone doesn't label you. A score of 2 or less doesn't mean nothing is wrong: if nightmares, avoidance or being on edge keep disrupting your days, tell a clinician anyway.
If you're thinking about ending your life, call or text 988 (the 988 Suicide & Crisis Lifeline) or call 911. For a moment when a memory hits hard, try 5-4-3-2-1 grounding. If nightmares are the main problem, see why nightmares happen.
More on this topic: 5-4-3-2-1 grounding, Nightmares: why they happen, Emotional numbness, TIPP skill for crises.
Your answers
Your answers are scored in your browser. If you sign in and choose to save a result, we store the score and its label, not your individual answers. Without an account, nothing is saved.
Sources 4
- Prins et al., Journal of General Internal Medicine, 2016 (PMC full text): the full article: development of the screen, the 398-veteran sample, the modified MINI reference, Table 1 (sensitivity and specificity by cut-off), and the authors' stated limits.
- Bovin et al., JAMA Network Open, 2021 (PMC full text): the full article: 396 veterans, CAPS-5 reference, Tables 1 to 3 (overall, men, women), and the cut-off discussion.
- National Center for PTSD: PC-PTSD-5 page: description, scoring advice, the official items, and the public-domain and intended-use statements.
- National Center for PTSD: PTSD screening instruments: states that a positive screen doesn't necessarily mean PTSD and that positives need a structured interview.