Assessment and diagnosis always includes a comprehensive history and physical exam. In order to be diagnosed with PTSD, three different types of symptoms must be manifest: re-experiencing symptoms, avoidance and numbing symptoms, and arousal/stress-related symptoms. For diagnosis, each of these must disrupt normal activities and functions of living.
Initial screening questions can last from 15 minutes to 1 hour. If the screening questions are positive, then a formal structured interview should take place. Standardized questions are then asked by the interviewer and can come from either the CAPS questionnaire or the Structure Clinical Interview for DSM (SCID). Self-report questionnaires can also be helpful and used as screenings (Kilpatrick et al., 2013). Additional interviews and screening tools may be used to further diagnose and differentiate between PTSD and other mental health disorders such as generalized anxiety or depression (Friedman et al., 2011).
The Clinician Administered PTSD Scale for SDM-5 (CAPS-5) is the gold standard for assessing and diagnosing PTSD. Clinicians must be trained how to ask the questions to patients with possible PTSD. Professional courses are available through the U.S. Department of Veterans Affairs to train clinicians on how to orient a client to the CAPs interview and assess for trauma exposure. The course is free to VA Employees through their VHA TRAIN program and non VA employees who work in mental health as a clinician.
The CAPS-5 is a 30-item, semi-structured interview to assess PTSD symptoms and given a severity rating. Sample questions include:
- In the past month, have you had any unwanted memories of an event while you were awake?
- How does it happen that you start remembering the event?
- How much do these memories bother you?
- Are you able to put them out of your mind and think about something else?
Test Your Knowledge
Which of the following can diagnose PTSD?
- The patient declares that he suffers from PTSD because of a trauma experienced.
- A trained clinician diagnoses the disorder after clinical interviews and screening tools are completed.
- A nurse diagnoses a patient as having PTSD based on clinical manifestations.
- Family members can complete online screening tools and determine if their loved one has PTSD.
Apply Your Knowledge
Q: If you noticed someone is exhibiting symptoms of PTSD where would you direct them for additional help?
A: They can complete online screening questions and if they are positive, they need to be referred to a professional mental health counselor or clinican for further evaluation. The trained clinician can then have them complete the CAPS-5 survey.