PC-PTSD-5 Calculator

The Primary Care PTSD Screen for DSM-5 (PC-PTSD-5) is a five-item screening tool designed to identify individuals in primary care settings who may benefit from further evaluation for post-traumatic stress disorder (PTSD). Developed by Annabel Prins and colleagues at the National Center for PTSD (US Department of Veterans Affairs), the PC-PTSD-5 was updated from the original four-item PC-PTSD to align with changes in PTSD criteria introduced in the DSM-5.

Each item uses a Yes/No response format, with "Yes" scored as 1 and "No" as 0, yielding a total score between 0 and 5. The five items assess key symptom domains: re-experiencing, avoidance, hyperarousal, numbing/detachment, and guilt/negative cognitions. The PC-PTSD-5 is freely available in the public domain.

The PC-PTSD-5 was developed to replace the original four-item PC-PTSD (based on DSM-IV criteria) following the publication of DSM-5, which introduced significant changes to the PTSD diagnostic criteria, including the addition of a new symptom cluster (negative alterations in cognition and mood) and reorganisation from three to four symptom clusters.

The fifth item was added to capture the new DSM-5 criterion of negative alterations in cognitions, specifically guilt and self-blame. Validation studies by Prins, Bovin, Smolenski, and colleagues demonstrated that a cut-off score of 3 provided optimal sensitivity and specificity for identifying probable PTSD in primary care settings.

At a threshold of 3, the PC-PTSD-5 demonstrated a sensitivity of approximately 95% and specificity of approximately 85%, making it an effective first-step screening tool. The high sensitivity ensures that few individuals with PTSD are missed, while the binary Yes/No format keeps administration simple and quick.

The PC-PTSD-5 uses a simple binary scoring format:

Yes = 1 (symptom endorsed) No = 0 (symptom not endorsed)

Total scores range from 0 to 5. The published scoring interpretation is:

0-2: Negative screen — below screening threshold per PC-PTSD-5 guidelines 3-5: Positive screen — further evaluation with the PCL-5 or a structured clinical interview recommended

A score of 3 or above is the recommended threshold for further evaluation. The PC-PTSD-5 begins with a lead-in question asking whether the respondent has ever experienced a traumatic event. If the answer is "No", the remaining items are not administered and the screen is considered negative.

The instrument is designed as a first-step screener, not a severity measure. Individuals who screen positive should be assessed with a more comprehensive measure such as the PCL-5 or a structured clinical interview.

The PC-PTSD-5 was specifically designed for primary care settings, where PTSD is common but often undetected. Its primary applications include:

Primary care screening, where it can be administered as part of routine intake procedures or annual health assessments. Its brevity (typically under two minutes) makes it practical for busy clinical environments.

Emergency departments and acute care settings, where trauma exposure is common and brief screening can identify individuals who may benefit from follow-up.

Veteran and military health settings, where PTSD prevalence is elevated and routine screening is standard practice. The PC-PTSD-5 is widely used in US Veterans Affairs healthcare and has been adopted internationally.

Stepped-care models, where the PC-PTSD-5 serves as an initial screen, with positive results leading to administration of the full PCL-5 or a clinical interview for comprehensive assessment.

The binary Yes/No format makes the PC-PTSD-5 accessible to respondents across a wide range of literacy levels.

In Australia, the PC-PTSD-5 is used in primary care, veteran health, and trauma services as a brief PTSD screening tool. It is particularly relevant in settings that serve trauma-exposed populations, including first responders, defence personnel, and survivors of domestic violence or natural disasters.

Australian GPs and other primary care practitioners use the PC-PTSD-5 as a rapid screening step, with positive screens leading to more comprehensive assessment using the PCL-5 or referral to a specialist. The instrument is used in both civilian and military/veteran settings, including services provided through the Department of Veterans' Affairs (DVA) and Open Arms — Veterans & Families Counselling.

The instrument's public domain status and simple administration format make it accessible across all Australian healthcare settings. Its role as a first-step screener aligns well with Australian stepped-care models of mental healthcare.