This lesson presented information on rating the frequency, intensity, and severity of PTSD symptoms; establishing the trauma-relatedness of symptoms; and establishing whether PTSD criteria is met using the CAPS-5. Some key points you should remember include:

• The CAPS-5 rates intensity on a four-point ordinal scale: Minimal, Clearly Present, Pronounced, and Extreme.
• Depending on the symptom, intensity ratings may be based on a judgment of degree of distress or discomfort caused by the symptom:
  • Degree (or strength) of symptom occurrence
  • Impairment resulting from the symptom
• Frequency ratings are based on:
  • number of times the symptom has occurred during the time frame being assessed;
  • the percentage of time during the time frame being assessed that the interviewee experienced the symptom; or
  • as an amount within the time frame being assessed.
• In general, make a severity rating only if the minimum frequency and intensity for that rating are both met.
• To count a symptom as part of the PTSD constellation, the reported symptom must be linked to the index event. In cases in which the symptom is not inherently linked to the trauma by content, you will assess a potential temporal link by querying about trauma-relatedness. You will rate trauma-relatedness (TR) using the following rating scale: Definite, Probable, and Unlikely. Unless it is clear that the symptom does not have any relation to the trauma(s), interviewers should code trauma-relatedness as definite or probable.
• You should rate CAPS-5 items based on the typical or average symptom severity. When an interviewee's report involves one distinct aspect of behavior that could be counted toward multiple symptoms, code each symptom only once, in the most appropriate category that best accounts for the phenomenon, to minimize double coding and to avoid inflating overall PTSD symptom count. coding and to avoid inflating overall PTSD symptom count. 
• It can be difficult to determine whether a symptom is trauma related for a variety of reasons, including long time intervals between the stressor exposure and PTSD assessment, confounding factors, and non-trauma-related factors mimicking trauma. Unless you are certain that a symptom is not trauma related, give a rating of "probable" or "definite," and count it towards the diagnosis and overall symptom severity.  
• Remember that the scoring rule has three parts:
• If frequency and intensity match each other, that is also your severity rating.
• If frequency and intensity do not match, the lower one will match your severity score.
• The only exception to rule #2 is if intensity is 2 or more steps above frequency, you can give a severity score that is one step above frequency. However, this only works for this situation and only for intensity – we never round up for frequency.