What PCL-5 and MDQ Tests Assess
PCL-5 (PTSD Checklist for DSM-5)
The PCL-5 is a 20-item self-report measure that assesses the presence and severity of all DSM-5 PTSD symptoms following trauma exposure. 1
What the PCL-5 Measures
The PCL-5 evaluates four core symptom clusters of PTSD: intrusion symptoms (recurrent memories, nightmares, flashbacks), avoidance behaviors, negative alterations in cognition and mood, and alterations in arousal and reactivity. 2
Each of the 20 items corresponds to a specific DSM-5 PTSD symptom, with respondents rating symptom severity on a 0-4 scale, yielding a total score range of 0-80. 1
The measure assesses symptom frequency and intensity using behaviorally anchored rating scales that allow for both screening and monitoring of treatment response. 3
Clinical Utility and Scoring
A cutoff score of 33 is commonly used to indicate probable PTSD in general populations, though this threshold demonstrates strong psychometric properties with sensitivity and specificity for PTSD diagnosis. 1
In psychiatric outpatient samples, a higher cutoff score of 45 is required to balance sensitivity and specificity, as lower thresholds produce excessive false positives in these populations. 4
The PCL-5 demonstrates strong internal consistency (α = .94), test-retest reliability (r = .82), and convergent validity with other PTSD measures (rs = .74 to .85). 1
Important Clinical Considerations
The PCL-5 may have difficulty differentiating depression and anxiety symptoms from PTSD in trauma-exposed mental health service users, so positive screens require comprehensive diagnostic follow-up with structured interviews like the CAPS-5. 5
Abbreviated 4-item and 8-item versions of the PCL-5 exist that maintain high correlation with the full scale and comparable diagnostic utility, useful in time-limited settings. 6
The measure supports multiple factor structures, with the 7-factor hybrid model (including re-experiencing, avoidance, dysphoria, dysphoric arousal, anxious arousal, negative affect, and anhedonia) demonstrating superior fit compared to the DSM-5 4-factor model. 7
MDQ (Mood Disorder Questionnaire)
The MDQ is a screening tool designed to detect bipolar disorder by assessing for distinct periods of mood elevation with decreased need for sleep and psychomotor activation. 3
What the MDQ Evaluates
The MDQ screens for manic and hypomanic episodes by asking about spontaneous periods of elevated or irritable mood accompanied by characteristic symptoms such as decreased sleep need, increased energy, racing thoughts, and impulsive behavior. 3
The assessment focuses on identifying discrete mood episodes that are distinct from the person's usual state, rather than chronic personality traits or stress reactions. 3
Diagnostic Framework
Positive MDQ screens must be followed by comprehensive evaluation using DSM criteria, including duration requirements of at least 4 days for hypomania or 7 days for mania. 3
Irritability alone is non-specific and occurs across multiple psychiatric diagnoses, so the MDQ emphasizes the constellation of symptoms including decreased sleep need and psychomotor activation as more specific indicators. 3
Clinical Context
- Patients with bipolar disorder should be assessed for comorbid PTSD, as approximately 16% of bipolar patients also meet criteria for PTSD, requiring careful evaluation of temporal relationships between mood episodes and trauma symptoms. 3