Outcome MeasurePTSD

CAPS-4

Clinician-Administered PTSD Scale (DSM-IV version)

7 Papers in Blossom

About This Instrument

The Clinician-Administered PTSD Scale for DSM-IV (CAPS-4) is a structured clinical interview considered the gold standard for diagnosing and measuring the severity of post-traumatic stress disorder. Developed at the U.S. National Center for PTSD, it assesses 17 symptoms across three clusters: re-experiencing, avoidance/numbing, and hyperarousal. Each symptom is rated on both frequency (0–4) and intensity (0–4) dimensions, yielding total scores from 0 to 136. A score of 40 or above is the most commonly used cutoff for a PTSD diagnosis. The CAPS-4 was a primary endpoint in the landmark MAPS-sponsored MDMA-assisted psychotherapy trials for PTSD and has excellent interrater reliability (κ > 0.90) and strong convergent validity with self-report PTSD measures.

Clinical Thresholds

0136
Subthreshold
Score 0–19
Mild
Score 20–39
Moderate
Score 40–59
Severe
Score 60–79
Extreme
Score 80–136

Outcome Data Across Studies

Reported results for CAPS-4 across 2 studies with quantitative data.

Outcome data across 9 study arm–timepoint observations
SD
3,4-Methylenedioxymethamphetamine-assisted psychotherapy for treatment of chronic posttraumatic stress dis - order: a randomized phase 2 controlled trial
2018Primary
MDMA 40 mg(active_comparator)0684.88.0—
3,4-Methylenedioxymethamphetamine-assisted psychotherapy for treatment of chronic posttraumatic stress dis - order: a randomized phase 2 controlled trial
2018Primary
MDMA 40 mg(active_comparator)28673.324.5—
3,4-Methylenedioxymethamphetamine-assisted psychotherapy for treatment of chronic posttraumatic stress dis - order: a randomized phase 2 controlled trial
2018Primary
MDMA 40 mg(active_comparator)286-11.5Δ21.2—
3,4-Methylenedioxymethamphetamine-assisted psychotherapy for treatment of chronic posttraumatic stress dis - order: a randomized phase 2 controlled trial
2018Primary
MDMA 40 mg(active_comparator)28580.618.8—
3,4-Methylenedioxymethamphetamine-assisted psychotherapy for treatment of chronic posttraumatic stress dis - order: a randomized phase 2 controlled trial
2018Primary
MDMA 40 mg(active_comparator)285-4.0Δ11.9—
3,4-Methylenedioxymethamphetamine-assisted psychotherapy for treatment of chronic posttraumatic stress dis - order: a randomized phase 2 controlled trial
2018Primary
MDMA 40 mg(active_comparator)60538.629.2—
3,4-Methylenedioxymethamphetamine-assisted psychotherapy for treatment of chronic posttraumatic stress dis - order: a randomized phase 2 controlled trial
2018Primary
MDMA 40 mg(active_comparator)365531.024.2—
3,4-methylenedioxymethamphetamine (MDMA)-assisted psychotherapy for post-traumatic stress disorder in military veterans, firefighters, and police officers: a randomised, double-blind, dose-response, phase 2 clinical trial
2018Primary
Full dose(experimental)0380.0——
3,4-methylenedioxymethamphetamine (MDMA)-assisted psychotherapy for post-traumatic stress disorder in military veterans, firefighters, and police officers: a randomised, double-blind, dose-response, phase 2 clinical trial
2018Primary
Full dose(experimental)60332.0——

Papers Using CAPS-4

Open Accessindividual

Preliminary evidence for the importance of therapeutic alliance in MDMA-assisted psychotherapy for posttraumatic stress disorder

This analysis of a clinical trial (n=22) examines the role of therapeutic alliance in MDMA-assisted psychotherapy (MDMA-AP) for treating chronic PTSD. It reports that after controlling for baseline PTSD severity, a strong therapeutic alliance at the mid and late stages of treatment (sessions 4 and 9) significantly predicts lower clinician-assessed and self-reported PTSD severity post-treatment.

Published
Journal
European Journal of Psychotraumatology
Authors
Zeifman, R. J., Kettner, H., Ross, S., Weiss, B., Mithoefer, M. C., Mithoefer, A. T., Wagner, A. C.
Open Accessindividual

Altered brain activity and functional connectivity after MDMA-assisted therapy for post-traumatic stress disorder

In nine veterans and first‑responders with chronic PTSD, fMRI before and two months after MDMA‑assisted therapy showed reduced trauma‑related cuneus activation and clinical improvement that correlated with changes in connectivity involving the left amygdala (bilateral PCC and left insula) and left isthmus cingulate–left posterior hippocampus, with a trend toward increased left amygdala–left hippocampus resting connectivity. These preliminary findings indicate MDMA‑AT modulates amygdala–hippocampus–insula networks implicated in PTSD recovery but require replication and comparison with other treatments.

Published
Journal
Frontiers in Psychiatry
Authors
Singleton, S. P., Wang, J. B., Mithoefer, A. T., Mithoefer, M. C., Hanlon, C., George, M. S., Coker, A., Yazar-Klosinski, B., Emerson, A., Doblin, R., Kuceyeski, A., Mithoever, O.
Open Accessindividual

3,4-Methylenedioxymethamphetamine-assisted psychotherapy for treatment of chronic posttraumatic stress dis - order: a randomized phase 2 controlled trial

In this randomised phase 2 dose‑response trial, two active MDMA doses (100 mg and 125 mg) given with eight‑hour psychotherapy sessions produced larger reductions in clinician‑rated PTSD severity than a low (40 mg) dose. Benefits were sustained at 12‑month follow‑up (76% no longer met PTSD criteria) and the treatment was well tolerated with no drug‑related serious adverse events.

Published
Journal
Journal of Psychopharmacology
Authors
Ot'alora G, M., Grigsby, J., Poulter, B., Van Derveer, J. W., Giron, S. G., Jerome, L., Feduccia, A. A., Hamilton, S., Yazar-Klosinski, B., Emerson, A., Mithoefer, M. C., Doblin, R.
Open Accessindividual

3,4-methylenedioxymethamphetamine (MDMA)-assisted psychotherapy for post-traumatic stress disorder in military veterans, firefighters, and police officers: a randomised, double-blind, dose-response, phase 2 clinical trial

This Phase II clinical trial (n=26) finds that MDMA-assisted psychotherapy (75-125 mg) led to significant and sustained decreases in PTSD (CAPS-IV) scores as compared to an active placebo (30 mg). At the 12-month follow-up, the average CAPS-IV score had dropped from 87 to 39 (67% no longer qualified for PTSD diagnosis).

Published
Journal
Lancet Psychiatry
Authors
Mithoefer, A. T., Mithoefer, M. C., Feduccia, A. A., Jerome, L., Wagner, M. T., Wymer, J., Holland, J., Hamilton, S., Yazar-Klosinski, B., Emerson, A., Doblin, R.
Open Accessindividual

Durability of improvement in post-traumatic stress disorder symptoms and absence of harmful effects or drug dependency after 3,4-methylenedioxymethamphetamine-assisted psychotherapy: a prospective long-term follow-up study

In a prospective long-term follow‑up (mean 45.4 months) of the first MDMA‑assisted psychotherapy trial for chronic, treatment‑resistant PTSD (n=19; 16 CAPS completers), symptom reductions observed at study exit were largely maintained (mean CAPS 24.6 vs 23.7; p=0.91) though two participants relapsed. No participants reported harm or evidence of drug dependency, suggesting durable clinical benefit and a favourable safety profile.

Published
Journal
Journal of Psychopharmacology
Authors
Mithoefer, M. C., Wagner, M. T., Mithoefer, A. T., Jerome, L., Martin, S. F., Yazar-Klosinski, B., Michel, Y., Brewerton, T. D., Doblin, R.
Open Accessindividual

A randomized, controlled pilot study of MDMA (±3,4-Methylenedioxymethamphetamine)- assisted psychotherapy for treatment of resistant, chronic Post-Traumatic Stress Disorder (PTSD)

In a randomized, double‑blind, active‑placebo controlled pilot trial of 12 patients with treatment‑resistant chronic PTSD, MDMA‑assisted psychotherapy was safely administered with no drug‑related serious adverse events. The intervention produced significant self‑reported symptom improvement (PDS, p=0.014), a non‑significant clinician‑rated CAPS reduction at end‑of‑treatment (p=0.066) that improved by 1‑year follow‑up, and three MDMA sessions were more effective than two (p=0.016).

Published
Journal
Journal of Psychopharmacology
Authors
Oehen, P., Traber, R., Widmer, V., Schnyder, U.

Quick Facts

Full Name
Clinician-Administered PTSD Scale (DSM-IV version)
Domain
PTSD
Papers Indexed
7
Score Range
0–136
Interpretation
Lower = better
Unit
points
Reference
Visit
All Measures