Clinician-Administered PTSD Scale for DSM-5 (CAPS-5)

MM slash DD slash YYYY

Criterion A:

Exposure to actual or threatened death, serious injury, or sexual violence in one (or more) of the following ways:

  1. Directly experiencing the traumatic event(s).
  2. Witnessing, in person, the event(s) as it occurred to others.
  3. Learning that the traumatic event(s) occurred to a close family member or close friend. In cases of actual or threatened death of a family member or friend, the event(s) must have been violent or accidental.
  4. Experiencing repeated or extreme exposure to aversive details of the traumatic event(s) (e.g., first responders collecting human remains; police officers repeatedly exposed to details of child abuse). Note: Criterion A4 does not apply to exposure through electronic media, television, movies, or pictures, unless this exposure is work related.
Index event (specify):
Exposure type:
Life threat?
Life threat?
Serious injury?
Serious injury?
Sexual violence?
Sexual violence?
Criterion A met?

Criterion B:

Presence of one (or more) of the following intrusion symptoms associated with the traumatic event(s), beginning after the traumatic event(s) occurred:

B1: Recurrent, involuntary, and intrusive distressing memories of the traumatic event(s). Note: In children older than 6 years, repetitive play may occur in which themes or aspects of the traumatic event(s) are expressed.

In the past month, have you had any unwanted memories of (EVENT) while you were awake, so not counting dreams?
(Rate 0=Absent if only during dreams)
[If not clear:] (Rate 0=Absent unless perceived as involuntary and intrusive)
[If not clear:]
Circle: Distress
# of times

B2: Recurrent distressing dreams in which the content and/or affect of the dream are related to the event(s). Note: In children, there may be frightening dreams without recognizable content.

In the past month, have you had any unpleasant dreams about (EVENT)?
What happens?
[If not clear:]
[If yes:]
[If reports not returning to sleep:]
Circle: Distress
# of times

B3: Dissociative reactions (e.g., flashbacks) in which the individual feels or acts as if the traumatic event(s) were recurring. (Such reactions may occur on a continuum, with the most extreme expression being a complete loss of awareness of present surroundings.) Note: In children, trauma-specific reenactment may occur in play.

In the past month, have there been times when you suddenly acted or felt as if (EVENT) were actually happening again?
[If not clear:]
Are you confused about where you actually are?
Do other people notice your behavior? What do they say?
Circle: Dissociation
# of times

B4: Intense or prolonged psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event(s).

In the past month, have you gotten emotionally upset when something reminded you of (EVENT)?
How long does it take?
[If not clear:]
Circle: Distress
# of times

B5: Marked physiological reactions to internal or external cues that symbolize or resemble an aspect of the traumatic event(s).

In the past month, have you had any physical reactions when something reminded you of (EVENT)?
Does your heart race or your breathing change? What about sweating or feeling really tense or shaky?
Circle: Physiological reactivity
# of times

Criterion C:

Persistent avoidance of stimuli associated with the traumatic event(s), beginning after the traumatic event(s) occurred, as evidenced by one or both of the following:

C1: Avoidance of or efforts to avoid distressing memories, thoughts, or feelings about or closely associated with the traumatic event(s).

In the past month, have you tried to avoid thoughts or feelings about (EVENT)?
What kinds of things do you do?
[If not clear:]
Circle: Avoidance
# of times

C2: Avoidance of or efforts to avoid external reminders (people, places, conversations, activities, objects, situations) that arouse distressing memories, thoughts, or feelings about or closely associated with the traumatic event(s).

In the past month, have you tried to avoid things that remind you of (EVENT), like certain people, places, or situations?
Do you have to make a plan or change your activities to avoid them?
[If not clear:]
Circle: Avoidance
# of times

Criterion D:

Negative alterations in cognitions and mood associated with the traumatic event(s), beginning or worsening after the traumatic event(s) occurred, as evidenced by two (or more) of the following:

D1: Inability to remember an important aspect of the traumatic event(s) (typically due to dissociative amnesia and not to other factors such as head injury, alcohol, or drugs).

In the past month, have you had difficulty remembering some important parts of (EVENT)?
Do you feel there are gaps in your memory of (EVENT)?
[If not clear:] (Rate 0=Absent if due to head injury or loss of consciousness or intoxication during event)
[If still not clear:] (Rate 0=Absent if due only to normal forgetting)
Circle: Difficulty remembering
(What parts do you still remember?) # of important aspects

D2: Persistent and exaggerated negative beliefs or expectations about oneself, others, or the world (e.g., “I am bad,”“No one can be trusted,”“The world is completely dangerous,”“My whole nervous system is permanently ruined”).

In the past month, have you had strong negative beliefs about yourself, other people, or the world?
What about believing things like “I am bad,” “there is something seriously wrong with me,” “no one can be trusted,” “the world is completely dangerous”?
How convinced are you that these beliefs are actually true? Can you see other ways of thinking about it?
Circle: Conviction
% of time
Do you think they’re related to (EVENT)? How so?
Circle: Trauma-relatedness

D3: Persistent, distorted cognitions about the cause or consequences of the traumatic event(s) that lead the individual to blame himself/herself or others.

In what sense do you see yourself as having caused (EVENT)? Is it because of something you did? Or something you think you should have done but didn’t? Is it because of something about you in general?
In what sense do you see (OTHERS) as having caused (EVENT)? Is it because of something they did? Or something you think they should have done but didn’t?
How convinced are you that (YOU OR OTHERS) are truly to blame for what happened?
Do other people agree with you? Can you see other ways of thinking about it?
Circle: Conviction
% of time

D4: Persistent negative emotional state (e.g., fear, horror, anger, guilt, or shame).

In the past month, have you had any strong negative feelings such as fear, horror, anger, guilt, or shame?
What negative feelings do you experience?
[If not clear:]
Circle: Negative emotions
% of time
Do you think they’re related to (EVENT)? How so?
Circle: Trauma-relatedness

D5: Markedly diminished interest or participation in significant activities.

In the past month, have you been less interested in activities that you used to enjoy?
Anything else?
(Rate 0=Absent if diminished participation is due to lack of opportunity, physical inability, or developmentally appropriate change in preferred activities)
Would you still enjoy (ACTIVITIES) once you got started?
Circle: Loss of interest
% of activities
Do you think it’s related to (EVENT)? How so?
Circle: Trauma-relatedness

D6: Feelings of detachment or estrangement from others.

In the past month, have you felt distant or cut off from other people?
Who do you feel closest to? How many people do you feel comfortable talking with about personal things?
Circle: Detachment or estrangement
% of time
Do you think it’s related to (EVENT)? How so?
Circle: Trauma-relatedness

D7: Persistent inability to experience positive emotions (e.g., inability to experience happiness, satisfaction, or loving feelings).

In the past month, have there been times when you had difficulty experiencing positive feelings like love or happiness?
What feelings are difficult to experience?
Are you still able to experience any positive feelings?
Circle: Reduction of positive emotions
% of time
Do you think it’s related to (EVENT)? How so?
Circle: Trauma-relatedness

Criterion E:

Marked alterations in arousal and reactivity associated with the traumatic event(s), beginning or worsening after the traumatic event(s) occurred, as evidenced by two (or more) of the following:

E1: Irritable behavior and angry outbursts (with little or no provocation) typically expressed as verbal or physical aggression toward people or objects.

In the past month, have there been times when you felt especially irritable or angry and showed it in your behavior?
How do you show it? Do you raise your voice or yell? Throw or hit things? Push or hit other people?)
Circle: Aggression
% of time
Do you think it’s related to (EVENT)? How so?
Circle: Trauma-relatedness

E2: Reckless or self-destructive behavior.

In the past month, have there been times when you were taking more risks or doing things that might have caused you harm?
How dangerous are these behaviors? Were you injured or harmed in some way?
Circle: Risk
% of time
Do you think it’s related to (EVENT)? How so?
Circle: Trauma-relatedness

E3: Hypervigilance.

In the past month, have you been especially alert or watchful, even when there was no specific threat or danger?
Have you felt as if you had to be on guard?
What kinds of things do you do when you’re alert or watchful?
[If not clear:]
Circle: Hypervigilance
% of time
Do you think it’s related to (EVENT)? How so?
Circle: Trauma-relatedness

E4: Exaggerated startle response.

In the past month, have you had any strong startle reactions?
How strong are they compared to how most people would respond? Do you do anything other people would notice?
Circle: Startle
% of time
Do you think it’s related to (EVENT)? How so?
Circle: Trauma-relatedness

E5: Problems with concentration.

In the past month, have you had any problems with concentration?
[If not clear:]
Circle: Problem concentrating
% of time
Do you think they’re related to (EVENT)? How so?
Circle: Trauma-relatedness

E6: Sleep disturbance (e.g., difficulty falling or staying asleep or restless sleep).

In the past month, have you had any problems falling or staying asleep?
How long does it take you to fall asleep? How often do you wake up in the night? Do you wake up earlier than you want to?
Circle: Problem sleeping
% of time
Do you think they’re related to (EVENT)? How so?
Circle: Trauma-relatedness

Criterion F:

Duration of the disturbance (Criteria B, C, D, and E) is more than 1 month.

F1: Onset of symptoms.

When did you first start having (PTSD SYMPTOMS) you’ve told me about?
[If not clear:] (How long after the trauma did they start? More than six months?)

With delayed onset (> 6 months)?

F2: Duration of symptoms.

[If not clear:]

How long have these (PTSD SYMPTOMS) lasted altogether?

Duration more than 1 month?

Criterion G:

The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.

G1: Subjective distress.

Overall, in the past month, how much have you been bothered by these (PTSD SYMPTOMS) you’ve told me about?
[Consider distress reported on earlier items]

G2: Impairment in social functioning.

In the past month, have these (PTSD SYMPTOMS) affected your relationships with other people? How so?
[Consider impairment in social functioning reported on earlier items]

G3: Impairment in occupational or other important area of functioning.

Are you working now?
[If not clear:]
[If unable to work because of PTSD symptoms, rate at least 3=Severe. If unemployment is not due to PTSD symptoms, or if the link is not clear, base rating only on impairment in other important areas of functioning]
[If yes:]
[If no:] Do you feel that your (PTSD SYMPTOMS) are related to you not working now? How so?
[As appropriate, suggest examples such as parenting, housework, schoolwork, volunteer work, etc.] How so?

G4: Global validity.

Estimate the overall validity of responses. Consider factors such as compliance with the interview, mental status (e.g., problems with concentration, comprehension of items, dissociation), and evidence of efforts to exaggerate or minimize symptoms.

G5: Global severity.

Estimate the overall severity of PTSD symptoms. Consider degree of subjective distress, degree of functional impairment, observations of behaviors in interview, and judgment regarding reporting style.

G6: Global improvement.

Rate total overall improvement since the previous rating. Rate the degree of change, whether or not, in your judgment, it is due to treatment.

Criterion H:

Specify whether with dissociative symptoms: The individual’s symptoms meet the criteria for posttraumatic stress disorder, and in addition, in response to the stressor, the individual experiences persistent or recurrent symptoms of either of the following:

H1: Depersonalization: Persistent or recurrent experiences of feeling detached from, and as if one were an outside observer of, one’s mental processes or body (e.g., feeling as though one were in a dream; feeling a sense of unreality of self or body or of time moving slowly).

In the past month, have there been times when you felt as if you were separated from yourself, like you were watching yourself from the outside or observing your thoughts and feelings as if you were another person?
[If no:]
Do you lose track of where you actually are or what’s actually going on?
Do other people notice your behavior? What do they say?
Circle: Dissociation
[If not clear:] [Rate 0=Absent if due to the effects of a substance or another medical condition]
# of times
Do you think it’s related to (EVENT)? How so?
Circle: Trauma-relatedness

H12: Derealization: Persistent or recurrent experiences of unreality of surroundings (e.g., the world around the individual is experienced as unreal, dreamlike, distant, or distorted).

In the past month, have there been times when things going on around you seemed unreal or very strange and unfamiliar?
[If no:]
Do you lose track of where you actually are or what’s actually going on?
Do other people notice your behavior? What do they say?
Circle: Dissociation
[If not clear:] [Rate 0=Absent if due to the effects of a substance or another medical condition]
# of times
Do you think it’s related to (EVENT)? How so?
Circle: Trauma-relatedness