Your PCL-5 total score reflects the overall severity of PTSD symptoms you have experienced over the past month. Scores range from 0 to 80. A score below 31 generally suggests that PTSD symptom levels are below the clinical threshold, though individual symptoms may still warrant attention. A score of 31 to 33 or higher is considered the preliminary cutoff for probable PTSD and indicates that a comprehensive clinical evaluation is warranted.

Beyond the total score, the PCL-5 can be examined by symptom cluster: intrusion (items 1-5), avoidance (items 6-7), negative alterations in cognitions and mood (items 8-14), and alterations in arousal and reactivity (items 15-20). A provisional PTSD diagnosis can be made by treating each item rated 2 (moderately) or higher as an endorsed symptom and then following DSM-5 diagnostic rules, which require at least one intrusion symptom, one avoidance symptom, two cognition/mood symptoms, and two arousal/reactivity symptoms.

When used for treatment monitoring, a change of 5 to 10 points represents reliable change, while a change of 10 to 20 points represents clinically meaningful improvement. Tracking scores over time provides valuable information about treatment response and can guide clinical decision-making about continuing, modifying, or completing therapy.

The PCL-5 should be used when screening for PTSD in individuals who have been exposed to a traumatic event, such as combat, sexual assault, natural disasters, serious accidents, or other life-threatening experiences. It is appropriate for use in primary care, mental health clinics, VA settings, and research contexts where a validated self-report measure of PTSD symptoms is needed.

This tool is also valuable for monitoring symptom change during evidence-based PTSD treatments such as Cognitive Processing Therapy (CPT) or Prolonged Exposure (PE). Administering the PCL-5 every one to two weeks during treatment allows clinicians to track progress objectively and make data-informed decisions about treatment adjustments. It can also be used to establish a baseline symptom severity before treatment begins.

The PCL-5 is a self-report screening instrument and cannot provide a definitive PTSD diagnosis. A positive screen should always be followed by a structured clinical interview, such as the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5), which remains the gold standard for PTSD diagnosis. Self-report measures are subject to response biases, including symptom over-reporting or under-reporting.

The preliminary cutoff score of 31-33 was established in initial validation studies and may need adjustment depending on the population being screened. Military and veteran populations, civilian trauma survivors, and primary care patients may have different optimal cutoff scores. Clinicians should consider the base rate of PTSD in their setting when interpreting results.

The PCL-5 assesses symptoms over the past month, so it may not capture symptoms that fluctuate or that have recently emerged. It does not assess the full DSM-5 Criterion A (trauma exposure), Criterion F (duration), or Criterion G (functional impairment), all of which are required for a formal PTSD diagnosis.