Post traumatic stress disorder screening test

PTSD Screening Instruments - PTSD: National Center for PTSD

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VA » Health Care » PTSD: National Center for PTSD » Providers » Assessment » PTSD Screening Instruments

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PTSD Screening Instruments

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PTSD Screening Instruments

Below is a list of PTSD screens, that is, brief questionnaires that may identify people who are more likely to have PTSD. 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.

For each measure, a brief description, sample items, versions, references, and information on how to obtain the measure are provided.

Primary Care PTSD Screen for DSM-5 (PC-PTSD-5)
SPAN
SPRINT
Trauma Screening Questionnaire (TSQ)

PLEASE NOTE: Screens are to be used to determine possible problems, and positive cases should be followed up by assessment with a structured interview for PTSD.

Measure availability: We provide information on a variety of measures assessing trauma and PTSD. These measures are intended for use by qualified mental health professionals and researchers. Measures authored by National Center staff are available as direct downloads or by request. Measures developed outside of the National Center can be requested via contact information available on the information page for the specific measure.

Other sources of information on measures and how to obtain them include:

American Psychological Association: PsycTESTS
International Society for Traumatic Stress Studies: Clinical Resources (Assessments)
National Child Traumatic Stress Network: Measures Review Database

Primary Care PTSD Screen for DSM-5 (PC-PTSD-5)

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VA » Health Care » PTSD: National Center for PTSD » Providers » Assessment » Primary Care PTSD Screen for DSM-5 (PC-PTSD-5)

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Primary Care PTSD Screen for DSM-5 (PC-PTSD-5)

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Primary Care PTSD Screen for

DSM-5 (PC-PTSD-5)

To Obtain Scale

Description

The Primary Care PTSD Screen for DSM-5 (PC-PTSD-5) is a 5-item screen that was designed to identify individuals with probable PTSD in primary care settings. The measure begins with an item which assesses lifetime exposure to traumatic events. If a respondent denies exposure, the PC-PTSD-5 is complete with a score of 0. However, if a respondent indicates that they have had any lifetime exposure to trauma, the respondent is instructed to respond to 5 additional yes/no questions about how that trauma exposure has affected them over the past month.

Because the PC-PTSD-5 was designed to identify respondents with probable PTSD, those screening positive require further assessment, preferably with a structured interview such as the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5). Administration of a clinical interview is not always possible due to time and personnel requirements. In these cases, it is recommended that additional assessment is conducted using a validated self-report measure. Specifically, the PTSD Checklist for DSM-5 (PCL-5) is a psychometrically sound self-report questionnaire that can be used for this purpose.

Changes from Previous PC-PTSD for

DSM-IV

Several important revisions were made to the PC-PTSD in updating it for DSM-5:

PC-PTSD asked individuals to respond to questions about DSM-IV PTSD symptoms in reference to an experience that was "frightening, horrible, or upsetting," which could lead respondents to refer to events that, while stressful, were not considered Criterion A traumas (e.g., divorce). To avoid this, the PC-PTSD-5 asks respondents whether they have experienced prior trauma(s), and provides examples of events that qualify (e.g., sexual assault, war). If respondents have not been exposed to any traumatic events, they do not complete the remainder of the PC-PTSD-5. If they do endorse prior exposure to trauma(s), they respond to questions about DSM-5 PTSD symptoms related to those trauma(s).
PC-PTSD included 4 questions about DSM-IV PTSD symptoms, whereas the PC-PTSD-5 added a 5th item to assess whether the respondent has experienced guilt and/or a distorted sense of blame regarding the trauma(s). This additional item is consistent with more up-to-date knowledge about the PTSD diagnosis as described in DSM-5.

Scoring

If a respondent endorses a trauma exposure, they can score a 0-5 on the PC-PTSD-5, which is a count of "yes" responses to the 5 questions about how the trauma has affected them in the past month. Research in a large sample of VA primary care patients found that a cut-point of 4 ideally balanced false negatives and false positives for the overall sample and for men. However, for women, a cut-point of 4 resulted in high numbers of false negatives. Practitioners may consider a lower cut-point for women in some settings if evaluation resources are available. In contrast, a higher cut-point may be preferable if resources are such that false positives will substantially decrease clinician availability. Because performance parameters will change according to sample, clinicians should consider sample characteristics and screening purposes when selecting a cut-point.

Scale

Sometimes things happen to people that are unusually or especially frightening, horrible, or traumatic. For example:

a serious accident or fire
a physical or sexual assault or abuse
an earthquake or flood
a war
seeing someone be killed or seriously injured
having a loved one die through homicide or suicide.

Have you ever experienced this kind of event?
YES / NO

If no, screen total = 0. Please stop here.

If yes, please answer the questions below.

In the past month, have you...

Had nightmares about the event(s) or thought about the event(s) when you did not want to?
YES / NO
Tried hard not to think about the event(s) or went out of your way to avoid situations that reminded you of the event(s)?
YES / NO
Been constantly on guard, watchful, or easily startled?
YES / NO
Felt numb or detached from people, activities, or your surroundings?
YES / NO
Felt guilty or unable to stop blaming yourself or others for the event(s) or any problems the event(s) may have caused?
YES / NO

Citation

Prins, A. , Bovin, M. J., Kimerling, R., Kaloupek, D. G., Marx, B. P., Pless Kaiser, A., & Schnurr, P. P. (2015). The Primary Care PTSD Screen for DSM-5 (PC-PTSD-5). [Measurement instrument].

References (PC-PTSD-5)

Bovin, M. J., Kimerling, R., Weathers, F. W., Prins, A., Marx, B. P., Post, E. P., & Schnurr, P. P. (2021). Diagnostic accuracy and acceptability of the Primary Care Posttraumatic Stress Disorder Screen for the Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) among US Veterans (PDF). JAMA Network Open, 4(2), e2036733. https://doi.org/10.1001/jamanetworkopen.2020.36733

Prins, A., Bovin, M. J., Smolenski, D. J., Mark, B. P., Kimerling, R., Jenkins-Guarnieri, M. A., Kaloupek, D. G., Schnurr, P. P., Pless Kaiser, A., Leyva, Y. E., & Tiet, Q. Q. (2016). The Primary Care PTSD Screen for DSM-5 (PC-PTSD-5): Development and evaluation within a Veteran primary care sample. (PDF) Journal of General Internal Medicine, 31, 1206-1211. https://doi.org/10.1007/s11606-016-3703-5

References (PC-PTSD for

DSM-IV)

Prins, A., Ouimette, P., Kimerling, R., Cameron, R. P., Hugelshofer, D. S., Shaw-Hegwer, J., Thrailkill, A., Gusman, F.D., Sheikh, J. I. (2003). The Primary Care PTSD Screen (PC-PTSD): Development and operating characteristics (PDF). Primary Care Psychiatry, 9(1), 9-14. https://doi.org/10.1185/135525703125002360

Prins, A., Ouimette, P., Kimerling, R., Cameron, R. P., Hugelshofer, D. S., Shaw-Hegwer, J., Thrailkill, A., Gusman, F.D., Sheikh, J. I. (2004). The Primary Care PTSD Screen (PC-PTSD): Corrigendum (PDF). Primary Care Psychiatry, 9(151), 10-1185.

To Obtain Scale

This measure was developed by staff at VA's National Center for PTSD and is in the public domain and not copyrighted. In accordance with the American Psychological Association's ethical guidelines, this instrument is intended for use by qualified health professionals and researchers.

Download the Primary Care PTSD Screen for DSM-5 (PC-PTSD-5):

PC-PTSD-5 Screen (PDF)

Download the Primary Care PTSD Screen for DSM-IV (PC-PTSD)

PC-PTSD Screen DSM-IV (PDF)

Are you using this measure with U.S. Veterans or Service members?

Our PTSD Consultation Program can answer administration or scoring questions: [email protected] or 866-948-7880.

➤ Post Traumatic Stress Disorder (PTSD) Diagnosis: Online Test

1. Repeated, restless memories, images, thoughts about the stressful situation you have experienced

at all
a little

quite strong

2. Repeating, disturbing dreams about stress events

not at all
a little
moderately
strong
very strong

3. Suddenly you felt or acted as if you were re-experiencing the stressful situation (as if you actually came back and revived it)

not at all
a little
moderately
strong
very strong

4. Feel very upset when something reminds you of the stress you experienced

not at all
a little
moderately
severely
very severely

5. Strong physiological reactions when something reminds you of the stressful experience (eg, rapid heartbeat, shortness of breath, sweating)

none at all
slightly
moderately
strong
very strong

6. Avoided memories, thoughts or feelings related to the stress experienced

not at all
a little
moderately
severely
very severely

strongly
very strongly

8. It was difficult to remember important episodes of the stressful event

not at all
a little
moderately
strong
very strong

9. You could not get rid of negative ideas about yourself, other people or the world around you (for example, thoughts such as: “I am bad; something is wrong with me; no one can be trusted ; the whole world around is dangerous…”)

not at all
a little
moderately
severely
very severely

10. Have you blamed yourself or someone else for what happened or for what happened after that

Not at all
A little
Moderately
Strongly
Very strongly

strong
very strong

12. Loss of interest in what used to please you

not at all
a little
moderately
strong
very strong

problems with positive emotions (for example, inability to feel happiness or love for loved ones)

not at all
a little
moderately
a lot
very strong

15. Annoyance, outbursts of anger, or aggressive actions

not at all
a little
moderately
strongly
very strong

very much harm you

not at all
a little
moderately
severely
very severely

0005

Absolutely not
a little

strongly
very strongly

18. They felt nervousness,

were easily scared
A little

strongly
Very strong 9000 9000 9000 19. difficulty concentrating

not at all
a little
moderately
severe
very severe

20. Could not sleep or woke up often

not at all
a little
moderately
severely
very severely

Post Traumatic Stress Disorder: How can PTSD self-assessment tests help you recognize symptoms? | mental health articles | Emotional & Mental Health center

What role can self-screening tests for PTSD play in helping you understand that you are suffering from post-traumatic stress disorder? Can you self-diagnose PTSD? And what are the best screening tests? nine0006
If you're here, I'm assuming you're here because you want to know if it's possible (at least roughly) to self-diagnose PTSD, perhaps using online self-assessment tests. Or, of course, for an amateur diagnosis of someone you care about who you suspect has PTSD after experiencing a traumatic event. You can also learn which screening tests to use.

"Too long, unread" answer option would be:

“PTSD screening tests can determine fairly accurately whether someone has PTSD symptoms, but there are other factors that mean self-diagnosing PTSD is often a bad idea after all. Most people should only use self-assessments to find out if they are likely to have PTSD and need professional help. But if you suspect you have PTSD, you might still be able to take advantage of this help.” nine0006

Now let's move on to the longer version. We'll look at whether people with PTSD can figure out they have a trauma-related anxiety disorder, what role self-reflection tests for PTSD can play in someone's path to treatment, and what screening tests are used. We'll also look at what to do if you think you have PTSD.

Do people with PTSD tend to realize after a traumatic event that they have a disorder?

As a loyal "netizen" (Internet citizen), I have no doubt you will come across people claiming to be suffering from post-traumatic stress disorder after their rabbit passed away in a completely non-violent way after a long and supposedly happy life. (I don't came up with this. Someone on a forum I was on actually shared this story.) While most of these people are probably hyperbolic and quite aware that they don't actually have PTSD, sadly few of these people will be absolutely serious.0006
A study among law enforcement officers involved in shooting incidents in a country where gun violence is rare, on the other hand, shows that many officers who were found to meet diagnostic criteria for post-traumatic stress disorder did not realize that dealt with PTSD. Indeed, both they and their bosses noticed that their performance was negatively affected after the traumatic event, but their bosses didn't bind them either. None of the employees with PTSD - part of a particular, masculine, work culture that is not conducive to the exploration of emotions - sought professional help for symptoms prior to the start of the study. nine0006
There you have two extremes: people who believe they have PTSD even if they don't meet the very first diagnostic criterion when they are exposed to a traumatic event, and people who clearly have PTSD but don't realize it. Of course, there will be a third group of people who are already familiar with PTSD, recognize the symptoms in themselves, and conclude that they are suffering from PTSD because they do.

These people are likely to use self-assessments alone to find out more as they try to understand what they are experiencing in more detail and perhaps prepare them for seeing a psychologist. nine0006
What are screening tests?

The types of PTSD self-assessments you find online are screening tests. Screening is a process that can help healthcare professionals "catch" conditions that are not currently recognized. In the case of psychological screening tests, a doctor or psychologist may use these types of tests to evaluate whether a person who is potentially at risk is showing any signs that they may have a particular condition. nine0006
Examples include asking new mothers to take part in a survey to determine if they might have postpartum depression, and, of course, screening veterans and victims of domestic violence for PTSD. The screening test is inconsistent with the diagnosis, but indicates that a more thorough evaluation should be carried out, during which a diagnosis can be made.

What screening tests are used for PTSD?

PTSD screening tests are designed to determine whether a person is likely to develop PTSD or other complications after trauma, and as such, they attempt to find out if the person meets any of the diagnostic criteria for PTSD. In the US, the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) is the document that outlines these diagnostic criteria. nine0006
Here is a summary of the boxes someone needs to check in order to make a diagnosis of PTSD (somewhat abbreviated!) such as prolonged emotional abuse or bullying may also qualify. This includes experiencing the trauma directly and witnessing how it happened to someone else. nine0262
At least one so-called intrusion symptom is recurring, disturbing and intrusive memories of the event, disturbing dreams, flashbacks, profound mental distress when remembering the trauma, and profound physical distress when remembering the trauma.

Constant avoidance of trauma reminders by avoiding external reminders such as people, places, and circumstances, or internal reminders (thoughts and feelings associated with the event), or both. nine0262
At least two symptoms that indicate a negative impact on mood and cognition - inability to recall an important aspect of the trauma, exaggerated negative beliefs about oneself, (unfounded or extreme) guilt or blaming others, a chronically negative emotional state, loss of interest in important activities, feelings of detachment from others or the world and an inability to experience positive emotions.

At least two symptoms indicative of changes in reactivity and arousal are irritable or irritable behavior, reckless or self-destructive behavior, increased vigilance, increased startle response, concentration, and dysfunctional sleep. nine0262
Symptoms must last longer than a month and significantly interfere with daily functioning. They cannot be better explained by another condition or substance abuse.

So screening tests for PTSD will help determine if someone has these symptoms. As such, they ask questions such as:

Have you ever experienced something particularly horrifying, terrifying, or distressing, such as a major accident, war, physical or sexual abuse, or seen someone killed or seriously injured? nine0262
Did you try your best not to think about this event?

Did you have nightmares about it? (One screening test adds "when you didn't want to" ... but who needs nightmares?)

Did you have physical symptoms such as palpitations, sweating and dizziness when you were reminded of this event?

Physician-used screening tests approved by the US Department of Veterans Affairs:

DSM-5 Primary Care PTSD Screen (PC-PTSD-5), which includes five questions. nine0262
Injury survey questionnaire with 10 questions.

SPAN, which gets its name because it looks for "feared, physically upset by reminders, anger, and numbness," a more sophisticated score that allows people to indicate how much they are affected by certain symptoms.

Short interview rated post-traumatic stress disorder (SPRINT), which is similar.

If you are going to perform a self-test, it should ideally be based on one of these test tools. Be careful with "pop quiz" internet tools. Choose reputable sources. nine0006
What role can self-assessment tests for PTSD play? Should you really self-diagnose?

Some people will warn you against self-diagnosis and believe that it will never be accurate, and some will even go so far as to suggest that PTSD is now "fashionable" and people want to think they are when they are not.

As someone who suspected they had PTSD before it was confirmed by a psychologist, I am not necessarily one of them - I believe that many people who have PTSD can adequately identify themselves, although many others those with PTSD will miss the symptoms on their own. nine0006
Indeed, for some people who do not have access to medical treatment and formal diagnosis, this may be the only way. Also, some people who will later be ready for treatment just aren't right now, and these people might still be getting more information about coping mechanisms for PTSD.

However, although I think that a very large proportion of people who believe they have PTSD, in fact, the diagnostic picture may be more complex. You may have depression as well as PTSD, such as PTSD and substance use disorder. And while you may have PTSD, you may miss these comorbid conditions - one of the important reasons for making a formal diagnosis. nine0006
You will also need to see a healthcare provider for an official diagnosis if you want access to treatment, which is another good reason not to avoid this step.

Screening tests can be a useful stop along the way, but they usually shouldn't be your final destination. By the way, even if these tests show that you probably don't have PTSD, there's still no reason not to seek help if you're struggling. You may still have PTSD, or you may be dealing with another condition caused by anxiety events such as depression, acute stress disorder, adjustment disorder, or anxiety.
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