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    PCL 5

    Uploaded by

    lisa stewart
    This document is a questionnaire assessing post-traumatic stress symptoms experienced in the past month. It asks the respondent to identify a stressful event and when it occurred, then rates how much 20 common post-traumatic stress problems have bothered them in the past month on a 5-point scale. It provides instructions on scoring and interpreting the results, with higher total scores indicating more severe symptoms.

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    Download as DOCX, PDF, TXT or read online from Scribd

    PCL 5

    Uploaded by

    lisa stewart
    227 views2 pages
    This document is a questionnaire assessing post-traumatic stress symptoms experienced in the past month. It asks the respondent to identify a stressful event and when it occurred, then rates how much 20 common post-traumatic stress problems have bothered them in the past month on a 5-point scale. It provides instructions on scoring and interpreting the results, with higher total scores indicating more severe symptoms.

    Original Description:

    PTSD screen

    Original Title

    PCL-5

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    This document is a questionnaire assessing post-traumatic stress symptoms experienced in the past month. It asks the respondent to identify a stressful event and when it occurred, then rates how much 20 common post-traumatic stress problems have bothered them in the past month on a 5-point scale. It provides instructions on scoring and interpreting the results, with higher total scores indicating more severe symptoms.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    227 views2 pages

    PCL 5

    Uploaded by

    lisa stewart
    This document is a questionnaire assessing post-traumatic stress symptoms experienced in the past month. It asks the respondent to identify a stressful event and when it occurred, then rates how much 20 common post-traumatic stress problems have bothered them in the past month on a 5-point scale. It provides instructions on scoring and interpreting the results, with higher total scores indicating more severe symptoms.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    of 2

    PCL-5: Below is a list of problems and complaints that people sometimes have in response to stressful life experiences.

    Please
    read each problem carefully, then circle one of the numbers to the right to indicate how much you have been bothered by that
    problem IN THE PAST MONTH (please circle your answer)
    STEP 1: The event you experienced was: (please write your answer)

    STEP 2: The event happened: (please circle your answer)


    1 2 3 4 5
    Within the past month Within the past year Within the past 1-5 Within the past 6-10 More than 10 years ago
    years years
    STEP 3: In the past month, how much were you bothered by: (please circle your answer)
    Quite a
    Not at all A little bit Moderately Extremely
    bit
    1. Repeated, disturbing, and unwanted memories of the
    0 1 2 3 4
    stressful experience?
    2. Repeated, disturbing dreams of the stressful
    0 1 2 3 4
    experience?
    3. Suddenly feeling or acting as if the stressful experience
    were actually happening again (as if you were actually 0 1 2 3 4
    back there reliving it)?
    4. Feeling very upset when something reminded you of the
    0 1 2 3 4
    stressful experience?
    5. Having strong physical reactions when something
    reminded you of the stressful experience (for example, 0 1 2 3 4
    heart pounding, trouble breathing, sweating)?
    6. Avoiding memories, thoughts, or feelings related to the
    0 1 2 3 4
    stressful experience?
    7. Avoiding external reminders of the stressful experience
    (for example, people, places, conversations, activities, 0 1 2 3 4
    objects, or situations)?
    8. Trouble remembering important parts of the stressful
    0 1 2 3 4
    experience?
    9. Having strong negative beliefs about yourself, other
    people, or the world (for example, having thoughts such
    as: I am bad, there is something seriously wrong with 0 1 2 3 4
    me, no one can be trusted, the world is completely
    dangerous)?
    10. Blaming yourself or someone else for the stressful
    0 1 2 3 4
    experience or what happened after it?
    11. Having strong negative feelings such as fear, horror,
    0 1 2 3 4
    anger, guilt, or shame?
    12. Loss of interest in activities that you used to enjoy? 0 1 2 3 4
    13. Feeling distant or cut off from other people? 0 1 2 3 4
    14. Trouble experiencing positive feelings (for example,
    being unable to feel happiness or have loving feelings 0 1 2 3 4
    for people close to you)?
    15. Irritable behavior, angry outbursts, or acting
    0 1 2 3 4
    aggressively?
    16. Taking too many risks or doing things that could cause
    0 1 2 3 4
    you harm?
    17. Being “superalert” or watchful or on guard? 0 1 2 3 4
    18. Feeling jumpy or easily startled? 0 1 2 3 4
    19. Having difficulty concentrating? 0 1 2 3 4
    20. Trouble falling or staying asleep? 0 1 2 3 4
    Scoring and Interpretation:

    No or minimal symptoms (0-10)


    Mild symptoms reported (11-20)
    Moderate symptoms reported (21-40)
    Severe symptoms reported (41-60)
    Very severe symptoms reported (61-80)

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