A Primer on Using the Clinician
Administered PTSD Scale
(CAPS)
Dudley Blake, Ph.D.
&
Pat VanWyk, Ph.D
CAPS Features
Symptom-Based Interview for Assessing
and Diagnosing PTSD
 Standardized Administration
 Week or Month Time Frame
 Ratings made for Frequency/Duration and
Intensity of Symptom and Disorder
 Rating Continua with Anchor Descriptors
 Well Validated

Advantages of CAPS Interview
 Provides
fine-grained, multidimensional data on PTSD
symptom status
 Serves as a clinical assessment
tool
General CAPS Interview Conventions
Establish positive interview tone
 Explain interview purpose (i.e., assess possible
problems in past week/month)
 Predict and normalize arousal or temporary
symptom increase
 Describe interview structure, e.g., will ask two
sets of questions about 20 or so problems
 Encourage interviewee to give specific (brief)
answers to specific questions

Assessing Traumatic
Stress Exposure
 Orient
the interviewee to
trauma assessment
 Administer the LEC
 Ask trauma questions
» Objective features of the
trauma
» Subjective response to trauma
DSM-IV PTSD Stressor
Criterion (Criterion A)
To be considered a trauma, a stressor
must involve…
1. Actual or threatened death or injury to
oneself or to others, and
2. The person must have responded with
intense fear, helplessness, or horror
CAPS Life
Events Checklist
(LEC)
Procedure for Assessing
Traumatic Events
Life Events Checklist
Sixteen event categories and
one “other” category
Three Types of Exposure:
 Happened to me
 Witnessed it
 Learned about it
General CAPS interview Item Conventions

Always ask standard prompt question (or, in some
cases, an equivalent)

Rephrase or elaborate on prompt questions, as
needed

Offer two (2) rating options, if needed

Frequently repeat ratings back to interviewee
CAPS Rating Conventions for
Frequency/Duration:
Has interviewee ever had the problem?
If yes, has interviewee had the problem in
the past month (or past week)?
How often or how much of the time in the
past month has the interviewee had the
problem?
Frequency rating prompts for
distressing dreams (B-2)
 Have
you ever had unpleasant dreams
about (EVENT)?
 Describe
a typical dream. (What
happens in them?)
 How
often have you had these dreams
in the past month?
Frequency rating continua for
distressing dreams (B-2)

Never

Once or twice

Once or twice a week

Several times a week

Daily or almost every day
Frequency/duration rating prompts
for feelings of detachment or
estrangement from others (C-5)

Have you felt distant or cut off from other
people?

What was that like?

How much of the time in the past month
have you felt that way?
Frequency rating continua for
feelings of detachment (C-5)

None of the time

Very little of the time (less than 10%)

Some of the time (approx 20-30%)

Much of the time (approx 50-60%)

Most or all of the time (more than 80%)
CAPS Rating Conventions
Intensity:
Questions assessing degree of impact
that the symptom has had on the
interviewee’s life
Behavioral referents of impact that are
unique to the symptom (in both prompt
questions and rating anchors)
Intensity rating prompts for feelings of
detachment or estrangement (C-5)

How strong were your feelings of being
distant or cut off from others?

(Who do you feel closest to? How many
people do you feel comfortable talking with
about personal things?)
Intensity rating continua for
estrangement or detachment (B-2)
No feelings of detachment or estrangement
 Mild, may feel “out of synch” with others
 Moderate, feelings of detachment clearly present,
but still feels some interpersonal connection
 Severe, marked feelings of detachment or
estrangement from most people, may feel close to
only one or two people
 Extreme, feels completely detached or estranged
from others, not close with anyone

Challenges in PTSD Assessment
Co-Morbid Disorders
 Symptom Overlap
 Multiple Traumas
 Culture and Language (Ethnic, Gender)
 Symptom Over-reporting

CAPS Interview Prerequisites
 Exposure to PTSD population(s)
 Working knowledge of DSM-IV criteria for
PTSD
 Careful reading of CAPS Administration
Manual
 Practice, Practice, Practice (first with nonpatients, then with patients)
CAPS Training Resources
National Center for PTSD’s website that
includes:
 CAPS and CAPS-C training manuals
 CAPS training DVD ordering information
 Information about obtaining CAPS training in
the VA
http://www.ptsd.va.gov/professional/pages/assess
ments/caps-training.asp