PTSD Checklist Civilian version (PCL)

PTSD Checklist Civilian version (PCL)
PCL-M for DSM-IV (11/1/94)

Name: ______________________________________________________

INSTRUCTIONS TO PATIENT: Below is a list of problems and complaints that people sometimes have in response to stressful experiences. Please read each one carefully, put an X in the box to indicate how much you have been bothered by that problem in the past month.

1.    Repeated, disturbing memories, thoughts, or images of a stressful experience?

          1. Not at all  2. A little bit  3. Moderately  4. Quite a bit  5. Extremely

2.    Repeated, disturbing dreams of a stressful experience?

           1. Not at all  2. A little bit  3. Moderately  4. Quite a bit  5. Extremely

3.    Suddenly acting or feeling as if a stressful experience were happening again (as if you were reliving it)?

           1. Not at all  2. A little bit  3. Moderately  4. Quite a bit  5. Extremely

4.    Feeling very upset when something reminded you of a stressful experience?

           1. Not at all  2. A little bit  3. Moderately  4. Quite a bit  5. Extremely

5.    Having physical reactions (e.g., heart pounding, trouble breathing, sweating) when something reminded you of a stressful experience?

          1. Not at all  2. A little bit  3. Moderately  4. Quite a bit  5. Extremely

6.    Avoiding thinking about or talking about a stressful experience or avoiding having feelings related to it?

         1. Not at all  2. A little bit  3. Moderately  4. Quite a bit  5. Extremely

7.    Avoiding activities or situations because they reminded you of a stressful experience?

          1. Not at all  2. A little bit  3. Moderately  4. Quite a bit  5. Extremely

8.    Trouble remembering important parts of a stressful experience?

           1. Not at all  2. A little bit  3. Moderately  4. Quite a bit  5. Extremely

9.    Loss of interest in activities that you used to enjoy?

          1. Not at all  2. A little bit  3. Moderately  4. Quite a bit  5. Extremely

10.  Feeling distant or cut off from other people?

          1. Not at all  2. A little bit  3. Moderately  4. Quite a bit  5. Extremely

11.  Feeling emotionally numb or being unable to have loving feelings for those close to you?

           1. Not at all  2. A little bit  3. Moderately  4. Quite a bit  5. Extremely

12.  Feeling as if your future will somehow be cut short?

          1. Not at all  2. A little bit  3. Moderately  4. Quite a bit  5. Extremely

13.  Trouble falling or staying asleep?

          1. Not at all  2. A little bit  3. Moderately  4. Quite a bit  5. Extremely

14.  Feeling irritable or having angry outbursts?

           1. Not at all  2. A little bit  3. Moderately  4. Quite a bit  5. Extremely

15.  Having difficulty concentrating?

           1. Not at all  2. A little bit  3. Moderately  4. Quite a bit  5. Extremely

16.  Being “super-alert” or watchful or on guard?

          1. Not at all  2. A little bit  3. Moderately  4. Quite a bit  5. Extremely

17.   Feeling jumpy or easily startled?

END OF TEST

GorskiBooks: http://www.relapse.org

Weathers, Litz, Huska, & Keane; National Center for PTSD – Behavioral Science Division; 
This is a government document in the public domain.

 Here are a few of the references on the PCL. These were taken from PILOTS database (the world’s largest database on traumatic stress) http://www.ncptsd.org/PILOTS.html. There are other citations of the PCL, which has been used in hundreds of studies. Please consult PILOTS for more information.

Smith, Meredith Y; Redd, William H; DuHamel, Katherine; Vickberg, Suzanne Johnson; Ricketts, Patricia. (1999). Validation of the PTSD Checklist-Civilian version in survivors of bone marrow transplantation.Journal of Traumatic Stress (ISSN: 0894-9867), v. 12, no. 3, pp. 485-499

Campbell, Keith A; Rohlman, Diane S; Storzbach, Daniel; Binder, Laurence M; Anger, W Kent; Kovera, Craig A; Davis, Kelly L; Grossmann, Sandra J. (1999). Test-retest reliability of psychological and neurobehavioral tests self-administered by computer.Assessment (ISSN: 1073-1911), v. 6, no. 1, pp. 21-32.

Manne, Sharon L; Du Hamel, Katherine; Gallelli, Kim; Sorgen, Karen; Redd, William H. (1998). Posttraumatic stress disorder among mothers of pediatric cancer survivors: diagnosis, comorbidity, and utility of the PTSD Checklist as a screening instrument. Journal of Pediatric Psychology (ISSN: 0146-8693), v. 23, no. 6, pp. 357-366.

Andrykowski, Michael A; Cordova, Matthew J; Studts, Jamie L; Miller, Thomas W. (1998). Posttraumatic stress disorder after treatment for breast cancer: prevalence of diagnosis and use of the PTSD Checklist – Civilian Version (PCL-C) as a screening instrument. Journal of Consulting and Clinical Psychology (ISSN: 0022-006X), v. 66, no. 3, pp. 586-590.

Blanchard, Edward B; Jones-Alexander, Jacqueline; Buckley, Todd C; Forneris, Catherine A. (1996). Psychometric properties of the PTSD Checklist (PCL). Behaviour Research and Therapy (ISSN: 0005-7967), v. 34, no. 8, pp. 669-673.

Koivisto, Hanna; Haapasalo, Jaana. (1996). Childhood maltreatment and adulthood psychopathology in light of file-based assessments among mental state examinees. Studies on Crime and Crime Prevention (ISSN: 1102-3937), v. 5, no. 1, pp. 91-104.

Cordova, Matthew J; Andrykowski, Michael A; Kenady, Daniel E; McGrath, Patrick C; Sloan, David A; Redd, William H. (1995). Frequency and correlates of posttraumatic-stress-disorder-like symptoms after treatment for breast cancer. Journal of Consulting and Clinical Psychology (ISSN: 0022-006X), v. 63, no. 6, pp. 981-986

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