What is the diagnostic criteria for Post-Traumatic Stress Disorder (PTSD)?

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From the Guidelines

The PTSD Checklist for DSM-5 (PCL-5) is the most appropriate questionnaire to diagnose PTSD, as it assesses the presence and severity of PTSD symptoms according to DSM-5 criteria, which include symptoms of intrusion, avoidance, negative alterations in cognitions and mood, and increased arousal that persist for at least 1 month and result in significant impairment in social, academic, or other areas of functioning 1.

Key Features of the PCL-5

  • The PCL-5 is a 20-item self-report measure that assesses the presence and severity of PTSD symptoms
  • Patients rate each symptom on a scale from 0 (not at all) to 4 (extremely), with a total score of 31-33 or higher suggesting probable PTSD
  • The questionnaire covers four symptom clusters: intrusion symptoms, avoidance behaviors, negative alterations in cognition and mood, and hyperarousal symptoms

Importance of Comprehensive Clinical Assessment

  • While the PCL-5 is a valuable tool for screening, a formal diagnosis of PTSD should always involve a comprehensive clinical assessment by a qualified mental health professional 1
  • This assessment should take into account the patient's trauma exposure, subsequent symptoms, and significant impairment in social, academic, or other areas of functioning

Other Diagnostic Tools

  • The Clinician-Administered PTSD Scale (CAPS-5) is considered the gold standard clinical interview for diagnosing PTSD
  • The Primary Care PTSD Screen (PC-PTSD-5) is a brief 5-item screening tool suitable for primary care settings
  • These questionnaires help clinicians identify PTSD by systematically assessing trauma exposure and subsequent symptoms, allowing for appropriate treatment planning 1

From the Research

Questionnaire to Diagnose PTSD

  • The Clinician-Administered PTSD Scale for DSM-5 (CAPS-5) is a widely used structured diagnostic interview for posttraumatic stress disorder (PTSD) 2.
  • The CAPS-5 has demonstrated strong interrater reliability, test-retest reliability, and convergent validity with other measures of PTSD symptoms 2.
  • The PTSD Checklist for DSM-5 (PCL-5) is a self-report measure of PTSD symptoms that has also demonstrated strong internal consistency, test-retest reliability, and convergent validity 3.

Comparison of CAPS-5 and PCL-5

  • Studies have found that PCL-5 scores are often higher than CAPS-5 scores, suggesting that individuals may report more severe symptoms on self-report measures than on clinician-administered interviews 4, 5.
  • The concordance between CAPS-5 and PCL-5 scores has been found to be generally high, but not identical, with CAPS-5 scores indicating somewhat greater symptom improvement over time 5.

Psychometric Evaluation

  • The CAPS-5 and PCL-5 have both undergone psychometric evaluation and have been found to be reliable and valid measures of PTSD symptoms 2, 3.
  • The PCL-5 has been found to have strong internal consistency, test-retest reliability, and convergent validity, and has been shown to be a useful tool for assessing PTSD symptoms in a variety of contexts 3.
  • The CAPS-5 has been found to have strong interrater reliability, test-retest reliability, and convergent validity, and has been shown to be a useful tool for diagnosing PTSD and assessing symptom severity 2.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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