PC-PTSD-5: Primary Care PTSD Screen for DSM-5

Overview

The PC-PTSD-5 begins with an unscored question about lifetime trauma exposure. A No answer ends the screen at 0. A Yes answer opens five past-month yes-or-no symptom questions, each worth one point. The 0-to-5 result is a brief first-stage screen. It is not a diagnosis or a symptom-severity scale.

How the official branch works

The VA's current PC-PTSD-5 page defines this sequence:

1. Answer the lifetime trauma-exposure question.
2. Stop with a total of 0 after No.
3. Answer all five symptom questions after Yes.
4. Add one point for each symptom answered Yes.

Survey Doctor now enforces that branch by answer identity on the client and server. It rejects symptom answers submitted behind a No gate and requires all five symptoms after Yes.

Why score 0 has two meanings

A total of 0 can follow either path:

• No qualifying trauma exposure was reported, so the five symptoms were not asked
• Exposure was reported, but none of the five symptoms was endorsed

The total alone cannot distinguish those paths. Review the stored gate answer when that difference matters.

Cutoff evidence

The 2016 development study tested the screen in 398 veterans in VA primary care. A cutoff of 3 gave the highest sensitivity and 5 the highest specificity. A cutoff of 4 gave the best balance of missed and incorrect positive screens.

The current VA guidance draws on a later VA primary-care study. There, a cutoff of 4 balanced missed and incorrect positive screens for the overall sample and for men, but missed many cases among women. The VA says a lower cutoff may suit women where evaluation resources allow. A higher one may suit settings where false positives would strain clinician time. Choose the cutoff for the population, purpose, and follow-up capacity. No cutoff confirms or rules out PTSD.

How Survey Doctor shows the result

Survey Doctor shows the 0-to-5 symptom count and the gate answer without a severity label, because the sources publish cutoffs rather than score bands.

Earlier records may carry labels from a retired grouping at 0-2, 3, and 4-5. Result, report, and export views withhold them, since terms such as Unlikely or Probable can overstate an individual result.

What the symptoms cover

The five questions ask about unwanted memories or nightmares, avoidance, being on guard, detachment, and guilt or blame. A Yes response counts presence, not intensity.

The screen does not cover every DSM-5 PTSD criterion, functional impairment, or other explanations for similar symptoms. It should not be used as a detailed severity tracker.

Comparing older records

Confirm that each record used the current one-gate, five-symptom branch before comparing totals. Earlier Survey Doctor code went through different gate and scoring behaviors. A score-only record cannot establish which path produced it.

Do not convert a result from the older four-item PC-PTSD or mix it with this 0-to-5 series.

Using the result

Use the screen to decide whether a fuller conversation may help. The PCL-5 records all 20 DSM-5 PTSD symptoms, while the PCL-C is a different 17-item DSM-IV legacy form. None is a diagnostic interview.

For a reader-focused explanation, see what your PC-PTSD-5 score means. The TSQ is another brief adult trauma screen with different questions and timing.

When to seek support

Talk with a qualified mental health professional when trauma-related symptoms affect sleep, work, relationships, daily activities, or safety. You do not need a positive screen to ask for help.

If these questions bring up immediate safety concerns, stop and seek support.

If you need help now. In the US, Call 988 or text 988. Call 911 if you are in immediate danger. Outside the US, contact your local emergency number or find support in your country.