Outcome MeasurePTSD

CAPS-4

Clinician-Administered PTSD Scale (DSM-IV version)

13 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 12 studies with quantitative data.

Outcome data across 53 study arm–timepoint observations
SD
The safety and efficacy of ±3,4-methylenedioxymethamphetamine-assisted psychotherapy in subjects with chronic, treatment-resistant posttraumatic stress disorder: the first randomized controlled pilot study
2010Primary
MDMA-AT(experimental)01279.223.6—
The safety and efficacy of ±3,4-methylenedioxymethamphetamine-assisted psychotherapy in subjects with chronic, treatment-resistant posttraumatic stress disorder: the first randomized controlled pilot study
2010Primary
MDMA-AT(experimental)281237.88.40.013
The safety and efficacy of ±3,4-methylenedioxymethamphetamine-assisted psychotherapy in subjects with chronic, treatment-resistant posttraumatic stress disorder: the first randomized controlled pilot study
2010Primary
MDMA-AT(experimental)561229.36.50.002
The safety and efficacy of ±3,4-methylenedioxymethamphetamine-assisted psychotherapy in subjects with chronic, treatment-resistant posttraumatic stress disorder: the first randomized controlled pilot study
2010Primary
MDMA-AT(experimental)1121225.57.70.013
The safety and efficacy of ±3,4-methylenedioxymethamphetamine-assisted psychotherapy in subjects with chronic, treatment-resistant posttraumatic stress disorder: the first randomized controlled pilot study
2010Primary
Placebo + therapy(inactive)0879.622.0—
The safety and efficacy of ±3,4-methylenedioxymethamphetamine-assisted psychotherapy in subjects with chronic, treatment-resistant posttraumatic stress disorder: the first randomized controlled pilot study
2010Primary
Placebo + therapy(inactive)28874.110.30.013
The safety and efficacy of ±3,4-methylenedioxymethamphetamine-assisted psychotherapy in subjects with chronic, treatment-resistant posttraumatic stress disorder: the first randomized controlled pilot study
2010Primary
Placebo + therapy(inactive)56866.88.00.002
The safety and efficacy of ±3,4-methylenedioxymethamphetamine-assisted psychotherapy in subjects with chronic, treatment-resistant posttraumatic stress disorder: the first randomized controlled pilot study
2010Primary
Placebo + therapy(inactive)112859.19.40.013
A randomized, controlled pilot study of MDMA (±3,4-Methylenedioxymethamphetamine)- assisted psychotherapy for treatment of resistant, chronic Post-Traumatic Stress Disorder (PTSD)
2012Primary
Full dose MDMA(experimental)0866.413.6—
A randomized, controlled pilot study of MDMA (±3,4-Methylenedioxymethamphetamine)- assisted psychotherapy for treatment of resistant, chronic Post-Traumatic Stress Disorder (PTSD)
2012Primary
Full dose MDMA(experimental)70863.017.8—

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

Effects of a dissociative drug on fronto-limbic resting-state functional connectivity in individuals with posttraumatic stress disorder: a randomized controlled pilot study

In a randomised controlled pilot study of 26 individuals with PTSD, subanesthetic ketamine (vs midazolam) did not increase resting‑state functional connectivity between the amygdala and medial prefrontal cortex subregions. Instead, ketamine induced a transient decrease in vmPFC–amygdala connectivity, challenging prior correlational links between dissociation and fronto‑limbic overconnectivity.

Published
Journal
Psychopharmacology
Authors
Danböck, S. K., Duek, O., Ben-Zion, Z., Korem, N., Amen, S. L., Kelmendi, B., Wilhelm, F. H., Levy, I., Harpaz-Rotem, I.
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

Sleep Quality Improvements After MDMA-Assisted Psychotherapy for the Treatment of Posttraumatic Stress Disorder

In four randomised, double‑blind Phase 2 trials (n=63), 2–3 sessions of MDMA‑assisted psychotherapy significantly improved self‑reported sleep quality and produced larger reductions in PTSD symptoms than low‑dose/control MDMA, with sleep gains maintained at 12 months. At the primary endpoint CAPS‑IV scores fell by −34.0 versus −12.4 and PSQI total score changed by −3.5 versus +0.6 for active versus control (p = .003 for both).

Published
Journal
Journal of Traumatic Stress
Authors
Ponte, L., Jerome, L., Hamilton, S., Mithoefer, M. C., Yazar-Klosinski, B. B., Vermetten, E., Feduccia, A. A.
Open Accessindividual

3,4-methylenedioxymethamphetamine (MDMA)-assisted psychotherapy for victims of sexual abuse with severe post-traumatic stress disorder: an open label pilot study in Brazil

This open-label clinical pilot study (n=3) investigated the efficacy of MDMA-assisted psychotherapy (75 mg in the 1st session, 75 or 125 mg in the 2nd and 3rd sessions) for patients suffering from severe post-traumatic stress disorder due to sexual abuse. One showed small but clinically significant improvement, one showed moderate improvement, and one showed strong improvement, with regard to diagnostic symptoms for PTSD.

Published
Journal
brazilian Journal of Psychiatry
Authors
Jardim, A. V., Jardim, D. V., Chaves, B. D. R., Steglich, M., Ot’alora G, M., Mithoefer, M. C., da Silveira, D. X., Tófoli, L.F., Ribeiro, S., Doblin, R., Schenberg, E. E.
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.

Quick Facts

Full Name
Clinician-Administered PTSD Scale (DSM-IV version)
Domain
PTSD
Papers Indexed
13
Score Range
0–136
Interpretation
Lower = better
Unit
points
Reference
Visit
All Measures