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PTSD Checklist (PCL)

This document contains the PTSD Checklist (PCL), a self-report rating scale used to screen for PTSD and assess symptom severity. It consists of 17 items corresponding to PTSD symptoms from the DSM-5. Respondents indicate how much they have been bothered by each symptom over the past month using a 5-point Likert scale ranging from "not at all" to "extremely." The PCL is used to aid in the diagnosis of PTSD and monitor symptom change during and after treatment.

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Manikanta Sai Kumar
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270 views

PTSD Checklist (PCL)

This document contains the PTSD Checklist (PCL), a self-report rating scale used to screen for PTSD and assess symptom severity. It consists of 17 items corresponding to PTSD symptoms from the DSM-5. Respondents indicate how much they have been bothered by each symptom over the past month using a 5-point Likert scale ranging from "not at all" to "extremely." The PCL is used to aid in the diagnosis of PTSD and monitor symptom change during and after treatment.

Uploaded by

Manikanta Sai Kumar
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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PTSD Checklist (PCL)

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Patient Name: ___________________________________________________________________ Date: ___________________

If an event listed on the Life Events Checklist happened to you or you witnessed it, please complete the
items below. If more than one event happened, please choose the one that is most troublesome to you now.

The event you experienced was ______________________________________________________ on ______________ .


(EVENT) (DATE)

Instructions: Below is a list of problems and complaints that people sometimes have in response to stress-
ful life experiences. Please read each one carefully, then circle one of the numbers to the right to indicate
how much you have been bothered by the problem in the past month.

NOT A LITTLE QUITE


BOTHERED BY MODERATELY EXTREMELY
AT ALL BIT A BIT

1. Repeated disturbing memories, thoughts, or


images of the stressful experience? 1 2 3 4 5
2. Repeated, disturbing dreams of the stressful
experience? 1 2 3 4 5
3. Suddenly acting or feeling as if the stressful
experience were happening again (as if you
were reliving it)? 1 2 3 4 5
4. Feeling very upset when something reminded
you of the stressful experience? 1 2 3 4 5
5. Having physical reactions (e.g., heart pounding,
trouble breathing, or sweating) when something
reminded you of the stressful experience? 1 2 3 4 5
6. Avoiding thinking about or talking about the
stressful experience or avoiding having feelings
related to it? 1 2 3 4 5
7. Avoiding activities or situations because they
remind you of the stressful experience? 1 2 3 4 5
8. Trouble remembering important parts of the
stressful experience? 1 2 3 4 5
9. Loss of interest in activities that you used to
enjoy? 1 2 3 4 5
10. Feeling distant or cut off from other people? 1 2 3 4 5
11. Feeling emotionally numb or being unable to
have loving feelings for those close to you? 1 2 3 4 5
12. Feeling as if your future will somehow be cut
short? 1 2 3 4 5
13. Trouble falling or staying asleep? 1 2 3 4 5
14. Feeling irritable or having angry outbursts? 1 2 3 4 5
15. Having difficulty concentrating? 1 2 3 4 5
16. Being “super alert” or watchful or on guard? 1 2 3 4 5
17. Feeling jumpy or easily startled? 1 2 3 4 5

CO-OCCURRING DISORDERS PROGRAM: SCREENING AND ASSESSMENT


Document is in the public domain. Duplicating this material for personal or group use is permissible. 17

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