Published September 5, 2026
NCMHCE Screening Instruments Cheat Sheet (PHQ-9, GAD-7, PCL-5, AUDIT, C-SSRS, MoCA and More)
By David Zimmerman · 8 min read · Clinical content
Instrument questions are some of the most learnable points on the NCMHCE. The exam rarely asks you to score a measure; it asks you to pick the right tool for a presentation, or to notice when a plausible tool measures the wrong construct. This is the reference table, the traps, and an eight-item quiz to check yourself.
The table
Cut-offs are the commonly used clinical thresholds; the exam tests what an instrument is for far more than exact numbers.
| Instrument | Measures | Format | Commonly used thresholds |
|---|---|---|---|
| PHQ-9 | Depression severity (past 2 weeks) | 9 items, 0–27; item 9 = ideation flag | 5 mild · 10 moderate · 15 moderately severe · 20 severe |
| GAD-7 | Generalized anxiety severity | 7 items, 0–21 | 5 mild · 10 moderate · 15 severe |
| PCL-5 | PTSD symptom severity (DSM-5) | 20 items, 0–80 | Roughly 31–33 suggests probable PTSD; confirm clinically |
| CAPS-5 | PTSD diagnosis (clinician-administered) | Structured interview | Gold-standard diagnostic interview, not a screen |
| AUDIT / AUDIT-C | Hazardous alcohol use | 10 items (0–40) / 3 items (0–12) | AUDIT ≥ 8; AUDIT-C ≥ 4 men, ≥ 3 women |
| CAGE | Alcohol problem screen | 4 yes/no items | ≥ 2 positive |
| DAST-10 | Drug use (non-alcohol) problems | 10 items | ≥ 3 moderate concern |
| C-SSRS | Suicidal ideation severity and behavior | Structured screen / full scale | Any specific plan or intent = high risk |
| BDI-II / BAI | Depression / anxiety severity (Beck) | 21 items each, 0–63 | BDI-II: 14 mild · 20 moderate · 29 severe |
| MoCA | Cognitive screen (sensitive to mild impairment) | 30 points | < 26 abnormal |
| MMSE | Cognitive screen (dementia-range impairment) | 30 points | < 24 abnormal |
| MDQ | Bipolar spectrum screen (lifetime) | 13 symptom items + clustering + impairment | Positive screen → clinical interview |
| Y-BOCS | OCD symptom severity | 10 items, 0–40 | 16+ moderate |
| ASRS v1.1 | Adult ADHD screen | 6-item screener | 4+ shaded items positive |
| Vanderbilt | Childhood ADHD (parent / teacher) | Rating scales | Symptom counts by presentation |
| EPDS | Perinatal depression | 10 items, 0–30 | ≥ 10–13 warrants follow-up; check item 10 (self-harm) |
The traps
- Real instrument, wrong construct. The PHQ-9 offered for suicide risk; the BAI offered for a PTSD presentation; the AUDIT for drug use. Match the construct, then the tool.
- Screen vs diagnosis. Screens (PHQ-9, GAD-7, PCL-5, MDQ) flag; structured interviews and clinical judgment diagnose. An item asking what “confirms” a diagnosis is not answered by a self-report screen.
- Sensitivity matters for cognition. Mild cognitive complaints in an educated adult: MoCA over MMSE.
- Item-level follow-ups. PHQ-9 item 9 and EPDS item 10 require a risk conversation regardless of total score.
- Use scores to make decisions now, not only as baselines. A PHQ-9 of 22 with active ideation changes today’s plan; see Domain 3A.
Interactive
Which instrument?
A 42-year-old reports constant worry across work, health, and money, muscle tension, and poor sleep for eight months. Which instrument quantifies severity?
Instruments appear inside full cases
Practice choosing the right tool in context: 5 full case simulations and 18 drills are free, every option explained.
Study move that works
Sources
- Patient Health Questionnaire (PHQ-9) and GAD-7 screener instruments
- National Center for PTSD — PTSD Checklist for DSM-5 (PCL-5)
- Columbia-Suicide Severity Rating Scale (C-SSRS) — The Columbia Lighthouse Project
- Montreal Cognitive Assessment (MoCA)
- American Psychiatric Association — Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR)
- Substance Abuse and Mental Health Services Administration (SAMHSA)
Frequently asked questions
Which screening instruments do I need to know for the NCMHCE?
At minimum the PHQ-9, GAD-7, PCL-5, AUDIT and AUDIT-C, CAGE, DAST-10, C-SSRS, MoCA and MMSE, MDQ, Y-BOCS, ASRS, Vanderbilt, and EPDS, including what each measures and what it does not.
Does the NCMHCE ask for exact cut-off scores?
Rarely. It tests matching the instrument to the presentation and recognizing screens versus diagnostic interviews. Knowing common thresholds helps but construct matching matters more.
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