You took the PCL-5, a 20-question assessment that measures PTSD symptoms. Now you have a number between 0 and 80. Here's what it actually tells you—and what it doesn't.
The quick answer
The PCL-5 uses a cutoff of 31-33 points to identify probable PTSD. Here's what different score ranges typically indicate:
| Score | What it means |
|---|---|
| 0-30 | Below clinical threshold |
| 31-32 | At threshold—possible PTSD |
| 33-50 | Probable PTSD |
| 51-80 | Severe PTSD symptoms |
A score of 31 or higher doesn't diagnose PTSD. It means your symptoms are significant enough to warrant a full evaluation by a trauma-specialized provider.
What the PCL-5 measures
The 20 questions cover four symptom groups that define PTSD:
Intrusion (questions 1-5) — Unwanted memories, nightmares, flashbacks, and distress when reminded of the trauma. These are the "re-experiencing" symptoms—your mind keeps going back to what happened.
Avoidance (questions 6-7) — Deliberately avoiding thoughts, feelings, or reminders of the trauma. This might mean staying away from certain places, people, or conversations that bring it back.
Negative changes in thoughts and mood (questions 8-14) — This includes trouble remembering parts of the trauma, negative beliefs about yourself or the world, self-blame, persistent negative emotions, losing interest in activities, feeling detached from others, and difficulty feeling positive emotions.
Arousal and reactivity (questions 15-20) — Irritability, reckless behavior, hypervigilance (constantly on guard), exaggerated startle response, trouble concentrating, and sleep problems.
PTSD isn't just one thing. It's this specific combination of symptoms persisting for more than a month after trauma exposure.
Understanding your cluster scores
Your total score matters, but so does where your symptoms cluster. You can add up the items in each group:
| Cluster | Questions | Max score |
|---|---|---|
| Intrusion | 1-5 | 20 |
| Avoidance | 6-7 | 8 |
| Thoughts/mood | 8-14 | 28 |
| Arousal | 15-20 | 24 |
Someone with a total score of 45 might have very different experiences depending on which clusters are elevated:
- High intrusion + avoidance, lower arousal = more classic re-experiencing presentation
- High arousal + thoughts/mood, lower intrusion = more chronic stress and emotional numbing presentation
This matters for treatment. Different approaches target different symptom clusters.
The one-month timeframe
The PCL-5 asks about the past month. This matters because:
1. It rules out acute stress reactions. It's normal to have some of these symptoms immediately after trauma. PTSD is diagnosed when symptoms persist beyond a month.
2. It captures typical symptom patterns. PTSD symptoms can fluctuate, and a month gives a reasonable picture of your baseline.
3. It's useful for tracking change. If you're in treatment, you can retake it to see if things are improving.
What the cutoff score means
The 31-33 cutoff was chosen based on research comparing PCL-5 scores to gold-standard clinical interviews. At a score of 31:
- About 80% of people who actually have PTSD score at or above this level (sensitivity)
- About 75-80% of people without PTSD score below this level (specificity)
This means some people with PTSD score below 31, and some people without PTSD score above it. The questionnaire is a screening tool, not a diagnostic test.
What to do based on your score
Below 31 (below threshold)
Your symptoms are below the level typically associated with PTSD. This doesn't mean you're fine—you might still be dealing with significant trauma-related distress. But a PTSD diagnosis specifically requires a certain pattern and severity of symptoms.
If you're struggling despite a lower score:
- The trauma might be affecting you in ways this assessment doesn't capture
- A different condition might be involved (depression, anxiety, adjustment disorder)
- Consider talking to a mental health provider anyway if symptoms are impairing your life
31-50 (threshold to probable PTSD)
Your symptoms are at a level where PTSD is likely. Recommended steps:
1. Get a proper evaluation. The PCL-5 suggests PTSD is possible; a clinical interview can confirm it and rule out other conditions.
2. Learn about treatment options. Evidence-based treatments for PTSD include Cognitive Processing Therapy (CPT), Prolonged Exposure (PE), and EMDR. These aren't just "talking about it"—they're structured approaches with strong research support.
3. Consider timing. PTSD doesn't typically improve on its own. Earlier treatment often leads to better outcomes.
51-80 (severe symptoms)
Your symptoms are severe enough to significantly impact daily functioning. Take this seriously:
1. Seek evaluation soon. This level of symptoms warrants prompt professional attention.
2. Consider intensive treatment options. Severe PTSD sometimes benefits from intensive outpatient programs or residential treatment.
3. Address safety. If you're having thoughts of self-harm or engaging in dangerous behavior, prioritize safety evaluation.
How to track over time
If you're in treatment, retaking the PCL-5 regularly helps measure progress:
- A decrease of 5-10 points indicates reliable improvement (not just random fluctuation)
- A decrease of 10-20 points is clinically meaningful—you'd notice the difference
- Scores dropping below 10 typically indicate PTSD remission
Don't expect linear progress. Trauma treatment can temporarily increase distress as you process difficult material. A single higher score doesn't mean treatment isn't working.
What the PCL-5 doesn't tell you
It doesn't assess trauma exposure. The PCL-5 assumes you've experienced a qualifying traumatic event. It measures symptoms, not whether something "counts" as trauma.
It doesn't capture complex PTSD. If you experienced repeated or prolonged trauma (especially in childhood), you might have additional symptoms like emotional dysregulation, dissociation, or relational difficulties that the PCL-5 doesn't fully capture.
It doesn't assess other conditions. Depression, anxiety, substance use, and traumatic brain injury can produce overlapping symptoms. A full evaluation considers these.
It's self-report. The score reflects what you endorse. Underreporting (minimizing symptoms) and overreporting (for various reasons) both happen.
Common questions
My score was high but I don't feel that bad. What gives?
You might be highly functional despite significant symptoms—common in people who've lived with PTSD for years. Or you might have habituated to chronic hyperarousal and not recognize it as abnormal.
I scored below 31 but I'm definitely not okay.
The PCL-5 specifically measures PTSD symptoms. Your distress might be better captured by depression, anxiety, or grief assessments. Or you might have PTSD that presents differently—not everyone experiences all symptom clusters equally.
Can my score go down without treatment?
Some people recover naturally, especially in the months after trauma. But research shows PTSD that persists beyond 3-6 months tends to become chronic without treatment.
Should I take this before seeing a provider?
It can be helpful—you'll have concrete data to discuss. But don't delay seeking help to "prepare."
How often should I take it?
During active treatment: every 1-2 weeks. During maintenance: monthly. After treatment: every few months to monitor for relapse.
Related assessments
If the PCL-5 doesn't quite fit your situation:
- PC-PTSD-5 — A 5-question brief screen if you want something shorter. See what your PC-PTSD-5 score means
- PHQ-9 — Depression assessment (commonly co-occurs with PTSD). See what your PHQ-9 score means
- GAD-7 — Anxiety assessment. See what your GAD-7 score means
- ACE — Childhood trauma history (different from PTSD symptoms). See what your ACE score means
For guidance on tracking your progress over time, see how to track your mental health over time or tracking recovery from trauma.
The bottom line
The PCL-5 is the most widely used PTSD assessment, developed by the National Center for PTSD. A score of 31 or higher suggests symptoms significant enough for professional evaluation. The four symptom clusters—intrusion, avoidance, negative thoughts/mood, and arousal—help identify what you're experiencing and guide treatment focus. If you scored in the probable range, evidence-based treatments exist and work. PTSD is treatable. Your score isn't a verdict—it's information to help you get appropriate care.