CAPS-5: clinician-administered PTSD assessment

What this assessment is

The Clinician-Administered PTSD Scale for DSM-5, or CAPS-5, is a structured clinical interview for posttraumatic stress disorder.

It assesses the 20 PTSD symptoms in DSM-5 and asks about the traumatic event, symptom duration, distress, functional impairment, dissociation, and response validity.

The US Department of Veterans Affairs National Center for PTSD developed the scale. Its current CAPS-5 guide describes it as a benchmark PTSD assessment.

This is a clinical interview, not a self-report questionnaire.

Who it was designed for

The adult CAPS-5 is for people aged 18 and over. A separate CAPS-CA-5 interview is available for children and adolescents aged 7 and over.

The interview requires a clinician or clinical researcher who understands PTSD. The VA strongly encourages specific CAPS-5 training.

Training matters because the rater must clarify answers, connect symptoms to the target event, and combine frequency with intensity. Reading prompts without clinical judgment is not equivalent administration.

The rater decides.

This page covers the standard CAPS-5, not the newer CAPS-5-R.

How it is administered

The full interview usually takes 45 to 60 minutes. The clinician follows structured prompts while asking enough follow-up questions to rate each symptom accurately.

Three timeframe versions exist:

• past month, for current PTSD
• worst month, for lifetime PTSD
• past week, for symptom measurement only

The past-week version should not be used to determine current or lifetime diagnostic status.

The VA recommends using the LEC-5 with the CAPS-5 Criterion A inquiry when establishing exposure to a qualifying traumatic event.

What it measures

The CAPS-5 covers four PTSD symptom clusters: intrusion, avoidance, negative changes in thoughts and mood, and changes in arousal and reactivity.

It also assesses whether symptoms have lasted more than one month and cause significant distress or functional impairment. Those findings are part of diagnostic reasoning but do not all enter the 0-to-80 severity total.

The PCL-5 covers the same 20 symptom criteria in a self-report format. It does not replace the CAPS-5 interview.

Method changes the result.

Keep the instrument name with the score.

How scoring works

The clinician gives each of the 20 symptom items one severity rating from 0 to 4. The rating combines symptom frequency and intensity.

Add the 20 ratings for a total symptom severity score from 0 to 80. Cluster totals can also be calculated for intrusion, avoidance, negative thoughts and mood, and arousal and reactivity.

A rating of 2 or more means that the symptom reaches the CAPS-5 clinical threshold. This is called the SEV2 rule.

Diagnosis uses the pattern, not only the total. It requires at least one intrusion symptom, one avoidance symptom, two negative-thought-or-mood symptoms, and two arousal-or-reactivity symptoms at threshold. Duration and distress or impairment criteria must also be met.

Diagnosis is categorical. Severity is continuous.

Do not diagnose from the total alone.

How to interpret a CAPS-5 score

Higher totals indicate greater clinician-rated PTSD symptom severity.

The total is continuous. The VA does not publish universal mild, moderate, and severe bands for every population and purpose.

Diagnostic status and severity can diverge. Two people can have the same total but different symptom patterns, and only one may meet the full diagnostic rules.

Review the total with cluster scores, threshold symptoms, Criterion A, duration, impairment, dissociation, and the clinician's confidence in the interview.

For repeated assessment, use the same timeframe version and scoring system.

What the score cannot tell you

The CAPS-5 total cannot explain why symptoms occur or identify every condition that may contribute to them. Trauma-related distress can overlap with depression, anxiety, substance use, grief, pain, sleep problems, and medical conditions.

The score also cannot replace safety assessment or broader clinical history.

Do not compare CAPS-5 scores with CAPS-5-R totals. The revised instrument expands each symptom rating from 0 to 10 and the total from 0 to 200.

Same name family. Different scale.

Evidence and limitations

The initial CAPS-5 evaluation found strong agreement between trained raters and expected relationships with other PTSD measures in military veterans.

The interview remains dependent on training, clinical judgment, respondent recall, and willingness to discuss difficult experiences. Administration can be demanding for both the respondent and the clinician.

The newer CAPS-5-R was created to provide more detailed severity ratings. Its initial evaluation describes a separate 0-to-10 item scale with backward-compatible CAPS-5 ratings.

Name the exact version before interpreting or comparing results.