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PTSD Symptoms, Severity, and Diagnosis - DSM 5
Date of MHRP final approval:
Date of SC final approval:
About the Measure
Domain:
Measure:
Definition:
Purpose:
PTSD
PTSD Symptoms, Severity, and Diagnosis
A clinician-administered semistructured interview to assess symptoms of posttraumatic
stress disorder (PTSD) and to establish a clinical diagnosis.
This measure is used to make a current (past-month) or lifetime diagnosis of PTSD
and to provide a continuous index of PTSD severity. It also can be used to assess
PTSD symptoms over the past week.
About the Protocol
Description of
Protocol:
Selection
Rationale:
Specific
Instructions:
Protocol Text:
The Clinician-Administered PTSD Scale (CAPS-5) for The Diagnostic and Statistical Manual of
Mental Disorders, Fifth Edition (DSM-5) (is a 30-item, semistructured interview that is used to
make a current (past-month) or lifetime diagnosis of posttraumatic stress disorder (PTSD) and
to provide a continuous index of PTSD severity. It also can be used to assess PTSD symptoms
over the past week. In addition to assessing the 20 DSM-5 PTSD symptoms, questions target
the onset and duration of symptoms, subjective distress, and impact of symptoms on social and
occupational functioning, improvement in symptoms since a previous CAPS administration,
overall response validity, and features for the dissociative subtype (depersonalization and
derealization).
Administration requires identification of an index traumatic event to serve as the basis for
symptom inquiry. The Life Events Checklist for DSM-5 (LEC-5; see Trauma Adversity and
Exposure) is recommended prior to the Criterion A inquiry included in the CAPS-5.
Standardized questions and probes are provided for each symptom.
The Clinician-Administered PTSD Scale (CAPS) is the gold standard in PTSD assessment and
diagnosis for both military Veteran and civilian trauma survivors. The Clinician-Administered
PTSD Scale (CAPS-5) for The Diagnostic and Statistical Manual of Mental Disorders, Fifth
Edition (DSM-5) provides investigators with a framework for collecting data that align with
revised posttraumatic stress disorder (PTSD) criteria.
The potentially traumatic events reflected in the Life Events Checklist for DSM-5 (LEC-5; see
Trauma Adversity and Exposure) are routinely examined in preparation for the Criterion A
inquiry outlined in the Clinician-Administered PTSD Scale (CAPS) for The Diagnostic and
Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). This inquiry can be supplemented
by the potentially traumatic events for military populations covered by the Deployment Risk and
Resilience Inventory (DRRI-2; see Trauma Adversity and Exposure).
Summary of the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5)
The CAPS-5 is a 30-item semi-structured interview that is used to:
 Make current (past month) or lifetime diagnosis of PTSD
 Provide a continuous index of PTSD severity
 Assess PTSD symptoms over the past week
In addition to assessing DSM-5 PTSD symptoms, questions target the onset and duration of
symptoms, subjective distress, and impact of symptoms on social and occupational functioning,
improvement in symptoms since a previous CAPS administration, overall response validity, and
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PTSD Symptoms, Severity, and Diagnosis - DSM 5
Date of MHRP final approval:
Date of SC final approval:
specifications for the dissociative subtype (depersonalization and derealization). Most symptom
severity ratings are anchored to a combination of symptom frequency and intensity; only
amnesia and diminished interest are anchored to amount of disturbance and intensity.
Administration requires identification of an index traumatic event to serve as the basis for
symptom inquiry. The Life Events Checklist for DSM-5 (LEC-5, see Trauma Adversity and
Exposure) is recommended in addition to the Criterion A inquiry included in the CAPS-5.
Standardized questions and probes are provided for each symptom.
The CAPS was designed to be administered by clinicians and clinical researchers who have a
working knowledge of PTSD, but can also be administered by appropriately trained
paraprofessionals. The full interview takes 45–60 minutes to administer.
Changes to CAPS for DSM-5 (compared to CAPS for DSM-IV)

CAPS for DSM-IV asked respondents to endorse up to three traumatic events to keep in
mind during the interview. CAPS-5 requires the identification of a single index
trauma to serve as the basis of symptom inquiry.

CAPS-5 is a 30-item interview, corresponding to the DSM-5 diagnosis for PTSD.
The language of the CAPS-5 reflects changes to the definition of the traumatic event
(Criterion A), changes to existing symptoms, and the addition of new symptoms in DSM5. CAPS-5 asks questions relevant to assessing the dissociative subtype of PTSD
(depersonalization and derealization), but no longer includes other associated
symptoms (e.g., gaps in awareness).

As with previous versions of the CAPS, CAPS-5 symptom severity ratings are based on
symptom frequency and intensity (except for amnesia and diminished interest which are
based on amount and intensity). However, CAPS-5 items are rated with a single
severity score in contrast to previous versions of the CAPS, which required
separate frequency and intensity scores.

General instructions and scoring information are included with the CAPS-5.
Sample Item:
In the past month, have you had any unwanted memories of (EVENT) while you were awake, so not
counting dreams? How does it happen that you start remembering (EVENT)?
[If not clear:] (Are these unwanted memories, or are you thinking about [EVENT] on purpose?) How
much do these memories bother you? Are you able to put them out of your mind and thing about
something else? How often have you had these memories in the past month? # of times ______.
Severity Rating
0. Absent: The respondent denied the problem of the respondent's report doesn't fit the DSM-5 symptom
criterion.
1. Mild/subthreshold: The respondent described a problem that is consistent with the symptom criterion
but isn't severe enough to be considered clinically significant. The problem doesn't satisfy the DSM-5
symptom criterion and thus doesn't count toward a PTSD diagnosis.
2. Moderate/threshold: The respondent described a clinically significant problem. The problem satisfies
the DSM-5 symptom criterion and thus counts toward a PTSD diagnosis. The problem would be a target
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PTSD Symptoms, Severity, and Diagnosis - DSM 5
Date of MHRP final approval:
Date of SC final approval:
for intervention. This rating requires a minimum frequency of 2 x month or some of the time (20–30%)
PLUS a minimum intensity of Clearly Present.
3. Severe/markedly elevated: The respondent described a problem that is above threshold. The
problem is difficult to manage and at times overwhelming, and would be a prominent target for
intervention. This rating requires a minimum frequency of 2 x week or much of the time (50–60%) PLUS
a minimum intensity of Pronounced.
4. Extreme/incapacitating: The respondent described a dramatic symptom, far above threshold. The
problem is pervasive, unmanageable, and overwhelming, and would be a high-priority target for
intervention.
Scoring:
Detailed scoring information is included with the CAPS-5 and should be reviewed carefully
before administering. Briefly, the assessor combines information about frequency and intensity
of an item into a single severity rating. CAPS-5 total symptom severity score is calculated by
summing severity scores for the 20 DSM-5 PTSD symptoms. Similarly, CAPS-5 symptom
cluster severity scores are calculated by summing the individual item severity scores for
symptoms corresponding to a given DSM-5 cluster: Criterion B (items 1–5); Criterion C (items
6–7); Criterion D (items 8–14); and, Criterion E (items 15–20). A symptom cluster score may
also be calculated for dissociation by summing items 19 and 20.
PTSD diagnostic status is determent by first dichotomizing each symptom as "present" or
"absent," then following the DSM-5 diagnostic rule. A symptom is considered present only if the
corresponding item severity score is rated 2 ("moderate/threshold") or higher. The DSM-5
PTSD diagnostic rule requires:
 At least one Criterion B symptom
 At least one Criterion C symptom
 At least two Criterion D symptoms
 At least two Criterion E symptoms
 Criterion F is met (disturbance has lasted one month)
 Criterion G is met (disturbance cause either clinically significant distress or functional
impairment)
Participant:
Availability:
The Clinician-Administered PTSD Scale for DSM-5 (CAPS-5) is available from the National
Center for PTSD at www.ptsd.va.gov.
Adults, ages 18 and older
Source:
Weathers, F. W., Blake, D. D., Schnurr, P. P., Kaloupek, D. G., Marx, B. P., & Keane, T. M.
(2013). The Clinician-Administered PTSD Scale for DSM-5 (CAPS-5). The CAPS-5 is available
from the National Center for PTSD at www.ptsd.va.gov.
Language of
Source:
English
Personnel and
Training
Required:
The Clinician-Administered PTSD Scale (CAPS) was designed to be administered by clinicians
and clinical researchers who have a working knowledge of posttraumatic stress disorder
(PTSD) but can also be administered by appropriately trained paraprofessionals. The ClinicianAdministered PTSD Scale (CAPS) can only be distributed to qualified mental health
professionals and researchers. Information and training materials for the CAPS are available
from the National Center for PTSD at www.pstd.va.gov.
None
Equipment
Needs:
Version 10 – 10/21/09
PTSD Symptoms, Severity, and Diagnosis - DSM 5
Date of MHRP final approval:
Date of SC final approval:
Protocol Type:
Requirements:
Interviewer-administered questionnaire
Requirements category
Common Data
Elements:
General
References:
Required (Yes/No)
Major equipment
No
Specialized training
Yes
Specialized requirements for biospecimen
collection
Average time of greater than 15 minutes in an
unaffected individual
TBD by PhenX Staff
No
Yes
Gray, M., Litz, B., Hsu, J., & Lombardo, T. (2004). Psychometric properties of the Life Events
Checklist. Assessment, 11, 330–341.
Orsillo, S. M. (2001). Measures for acute stress disorder and posttraumatic stress disorder. In
M. M. Antony & S. M. Orsillo (Eds.). Practitioner's guide to empirically based measures of
anxiety (pp. 255–307). New York: KluwerAcademic/Plenum.
Weathers, F. W., Keane, T. M., & Davidson, J. R. (2001). Clinician-Administered PTSD Scale:
A review of the first ten years of research. Depression and Anxiety, 13, 132–156.
Weathers, F. W., Ruscio, A. M., & Keane, T. M. (1999). Psychometric properties of nine scoring
rules for the Clinician-Administered Posttraumatic Stress Disorder Scale. Psychological
Assessment, 11, 124–133.
Additional Information About the Measure
Essential Data:
Related PhenX
Measures:
Derived Variables:
Current Age, Gender, Trauma and Adversity Exposure
Life Events, Exposure to Violence, Childhood Maltreatment, Perceived Stress,
PTSD Symptoms, Severity and Diagnosis, PTSD Screener, PTSD Symptoms Self
Report
None
Keywords/Related
Concepts:
Trauma, Potentially traumatic event, Stress, Stressor, Posttraumatic stress disorder,
PTSD,
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