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APPENDIX C
PTSD Screening Tools

Primary Care PTSD Screen (PC-PTSD)

The table below shows the Primary Care PTSD Screen (PC-PTSD) that has been designed for use in primary care and other medical settings. The PC-PTSD is brief and problem-focused. The screen does not include a list of potentially traumatic events. There are two reasons for this:

  • Studies on trauma and health in both male and female patients suggest that the active mechanism linking trauma and physical health is the diagnosis of PTSD. In other words, the relationship between trauma and health appears to be mediated through a current PTSD diagnosis.
  • A symptom-driven screen, rather than a trauma-focused screen, is attractive to primary care staff who may not be able to address a patient’s entire trauma history during their visit with the patient. Such a trauma inquiry might be especially problematic with a VA population where the average number of traumatic events meeting criterion A for PTSD is over four.

A positive response to the screen does not necessarily indicate that a patient has Posttraumatic Stress Disorder. However, a positive response does indicate that a patient may have PTSD or trauma-related problems and further investigation of trauma symptoms by a mental-health professional may be warranted.

Primary Care PTSD Screen

In your life, have you ever had any experience that was so
frightening, horrible, or upsetting that, in the past month, you…
1. Have had nightmares about it or thought about it when you did not want to?

YES                      NO
2. Tried hard not to think about it or went out of your way to avoid situations that reminded you of it?

YES                     NO
3. Were constantly on guard, watchful, or easily startled?

YES                     NO
4. Felt numb or detached from others, activities, or your surroundings?

 YES                    NO
Current research suggests that the results of the PC-PTSD should be considered "positive"
if a patient answers "yes" to any three (3) items .

 

 

PTSD CheckList – Civilian Version (PCL-C)

Patient’s Name: ________________________________________________

Instruction to patient: Below is a list of problems and complaints that veterans sometimes have in response to stressful life experiences. Please read each one carefully, put an “X” in the box to indicate how much you have been bothered by that problem in the last month.

 

No. Response: Not at all (1) A little bit (2) Moderately (3) Quite a bit (4) Extremely (5)
1. Repeated, disturbing memories, thoughts, or images of a stressful experience from the past?          
2. Repeated, disturbing dreams of a stressful experience from the past?          
3. Suddenly acting or feeling as if a stressful experience were happening again (as if you were reliving it)?          
4. Feeling very upset when something reminded you of a stressful experience from the past?          
5. Having physical reactions (e.g., heart pounding, trouble breathing, or sweating) when something reminded you of a stressful experience from the past?          
6. Avoid thinking about or talking about a stressful experience from the past or avoid having feelings related to it?          
7. Avoid activities or situations because they remind you of a stressful experience from the past?          
8. Trouble remembering important parts of a stressful experience from the past?          
9. Loss of interest in things that you used to enjoy?          
10. Feeling distant or cut off from other people?          
11. Feeling emotionally numb or being unable to have loving feelings for those close to you?          
12. Feeling as if your future will somehow be cut short?          
13. Trouble falling or staying asleep?          
14. Feeling irritable or having angry outbursts?          
15. Having difficulty concentrating?          
16. Being “super alert” or watchful on guard?          
17. Feeling jumpy or easily startled?          

________________________________________________________________________________________________

Weathers, F.W., Huska, J.A., Keane, T.M. PCL-C for DSM-IV. Boston: National Center for PTSD – Behavioral Science Division, 1991.

This is a Government document in the public domain.

 

 

PTSD CheckList – Military Version (PCL-M)


Patient’s Name: ______________________________________________________

Instruction to patient: Below is a list of problems and complaints that veterans sometimes have in response to stressful military experiences. Please read each one carefully, put an “X” in the box to indicate how much you have been bothered by that problem in the last month.

 

No. Response: Not at all (1) A little bit (2) Moderately (3) Quite a bit (4) Extremely (5)
1. Repeated, disturbing memories, thoughts, or images of a stressful military experience?          
2. Repeated, disturbing dreams of a stressful military experience?          
3. Suddenly acting or feeling as if a stressful military experience were happening again (as if you were reliving it)?          
4. Feeling very upset when something reminded you of a stressful military experience?          
5. Having physical reactions (e.g., heart pounding, trouble breathing, or sweating) when something reminded you of a stressful military experience?          
6. Avoid thinking about or talking about a stressful military experience or avoid having feelings related to it?          
7. Avoid activities or situations because they remind you of a stressful military experience?          
8. Trouble remembering important parts of a stressful military experience?          
9. Loss of interest in things that you used to enjoy?          
10. Feeling distant or cut off from other people?          
11. Feeling emotionally numb or being unable to have loving feelings for those close to you?          
12. Feeling as if your future will somehow be cut short?          
13. Trouble falling or staying asleep?          
14. Feeling irritable or having angry outbursts?          
15. Having difficulty concentrating?          
16. Being “super alert” or watchful on guard?          
17. Feeling jumpy or easily startled?          

________________________________________________________________________________________________

Weathers, F.W., Huska, J.A., Keane, T.M. PCL-M for DSM-IV. Boston: National Center for PTSD – Behavioral Science Division, 1991.

This is a Government document in the public domain.

 

 

PTSD CheckList – Stressor Specific Version (PCL-S)


The event you experienced was: _________________________________ on: ___________________

 

Instruction to patient: Below is a list of problems and complaints that veterans sometimes have in response to stressful military experiences. Please read each one carefully, put an “X” in the box to indicate how much you have been bothered by that problem in the last month.

 

No. Response: Not at all (1) A little bit (2) Moderately (3) Quite a bit (4) Extremely (5)
1. Repeated, disturbing memories, thoughts, or images of the stressful experience?          
2. Repeated, disturbing dreams of the stressful experience?          
3. Suddenly acting or feeling as if the stressful experience were happening again (as if you were reliving it)?          
4. Feeling very upset when something reminded you of the stressful experience?          
5. Having physical reactions (e.g., heart pounding, trouble breathing, or sweating) when something reminded you of the stressful experience?          
6. Avoid thinking about or talking about the stressful experience or avoid having feelings related to it?          
7. Avoid activities or situations because they remind you of the stressful experience?          
8. Trouble remembering important parts of the stressful experience?          
9. Loss of interest in things that you used to enjoy?          
10. Feeling distant or cut off from other people?          
11. Feeling emotionally numb or being unable to have loving feelings for those close to you?          
12. Feeling as if your future will somehow be cut short?          
13. Trouble falling or staying asleep?          
14. Feeling irritable or having angry outbursts?          
15. Having difficulty concentrating?          
16. Being “super alert” or watchful on guard?          
17. Feeling jumpy or easily startled?          

______________________________________________________________________________

Weathers, F.W., Huska, J.A., Keane, T.M. PCL-S for DSM-IV. Boston: National Center for PTSD – Behavioral Science Division, 1991.

This is a Government document in the public domain.