The Clinician-Administered PTSD Scale (CAPS) Test Questions
The Clinician-Administered PTSD Scale (CAPS) is the gold standard diagnostic interview for PTSD that assesses the frequency and intensity of 17 symptoms using standard questions and behaviorally anchored rating scales. 1
Structure and Content of the CAPS
- The CAPS is a structured interview that assesses both the frequency and intensity of PTSD symptoms 1
- It evaluates 17 core PTSD symptoms using standard questions and behaviorally anchored rating scales 1
- The CAPS includes the "distressing dreams item" which specifically assesses PTSD-associated nightmares 1
Different Versions of the CAPS
- CAPS-DX (formerly CAPS-1): Diagnostic version that assesses PTSD symptom severity over the past month or for the worst month since the trauma 1
- CAPS-SX (formerly CAPS-2): Symptom status version to measure PTSD symptom severity over the past week, intended for repeated assessments over relatively brief intervals 1
- Combined version called CAPS: More recent version that combines features of both previous versions 1
- CAPS-5: Updated version aligned with DSM-5 diagnostic criteria 2, 3
Symptom Clusters Assessed
The CAPS evaluates symptoms across three main PTSD symptom clusters:
- Intrusive/re-experiencing symptoms (including nightmares and distressing dreams) 1, 4
- Avoidant/numbing symptoms 1, 4
- Hyperarousal symptoms 1, 4
Scoring and Assessment
- The CAPS evaluates both frequency and intensity of each symptom 5
- Scores can be used to determine both diagnostic status and symptom severity 5, 2
- The "distressing dreams item" on the CAPS specifically scores from 0-8 based on frequency and intensity of trauma-related nightmares 1
- The CAPS has demonstrated excellent reliability, yielding consistent scores across items, raters, and testing occasions 5
Clinical Applications
- The CAPS is considered superior to self-report measures like the PCL-5, as patients tend to score higher on self-report measures compared to clinician-administered interviews 3
- It has excellent convergent and discriminant validity, diagnostic utility, and sensitivity to clinical change 5
- The CAPS can be used to monitor treatment response, with reductions in scores indicating improvement 1
- For PTSD-associated nightmares, a score of ≥5 on the CAPS distressing dreams item is often used as a clinical threshold in research studies 1
Modifications and Extensions
- The Complex PTSD Item Set additional to the CAPS (COPISAC) has been developed to assess ICD-11 Complex PTSD when used alongside the standard CAPS 6
- Hybrid versions combining CAPS-IV and CAPS-5 have been developed for longitudinal studies that span the transition between DSM-IV and DSM-5 2
The CAPS requires trained clinicians to administer and score properly, and while it takes longer to administer than self-report measures, it provides more accurate and comprehensive assessment of PTSD symptoms 7, 3.