This appendix outlines the scoring criteria used for the Conners 4 (Conners 4™) DSM SymptomScales. The following information is contained in TablesD.1 to D.3:
The DSM Symptom Count requirement for ADHD, Oppositional Defiant Disorder, and ConductDisorder.
The Conners 4 items corresponding to the DSM1 symptomcriteria for these disorders.
The criterion status requirements (i.e., the item score(s) that contributes to theSymptom Count for the scale).
The relevant interpretive considerations for each DSM Symptom scale.
The following response key applies to the criterion status score requirements noted in theContributes to Symptom Count column for each table:
DO NOT COPY
0= Not true at all(Never/Rarely)
1= Just a little true(Occasionally)
2= Pretty much true(Often, Quite a bit)
3= Completely true (Veryoften/Always)
These items and scales are provided to aid use and interpretation of the tool, but the contents of this appendix are copyrighted/trade secret material that are not intended for public disclosure.
Tables D.1a.DSM Symptom Count and Criterion Status Score Requirements for DSM ADHD InattentiveSymptoms
DSM Symptom CountRequirements: At least 6 of the 9 symptoms for youth ≤ 16 yearsof age; atleast 5 of the 9 symptoms for youth | ||||||
DSM Criterion A | Parent Item # | Teacher Item # | Parent/Teacher Item Text | Self-Report Item # | Self-Report Item Text | Item Score that Contributes to SymptomCount |
1a | 62 | 55 | Fails to pay close attention to details. | 66 | It is hard for me to pay attention todetails. | 2,3 |
-or- | -or- | -or- | -or- | -or- | -or- | |
66 | 59 | Makes careless mistakes in schoolwork orother activities. | 69 | I make careless mistakes. | 2,3 | |
1b | 107 | 98 | Has trouble staying focused on work or playfor a long time. | 108 | I have trouble focusing for a long time. | 2,3 |
1c | 15 | 13 | Doesn’t seem to listen to what people aresaying to them. | 18 | People don’t think I’m listening to them. | 2,3 |
1d | 19 | 17 | Doesn’t finish schoolwork, work, or othertasks. | 22 | I don’t finish things I start, likeschoolwork, work, or other tasks. | One item score = 2,3 |
-and- | -and- | -and- | -and- | -and- | -and- | |
32 | 29 | Fails to follow through on instructions. | 35 | I have trouble following instructions. | other item score = 1,2,3 | |
1e | 57 | 52 | Has trouble organizing tasks or activities. | 60 | I have trouble keeping my things organized. | 2,3 |
1f | 5 | 5 | Avoids or dislikes things that take a lot ofeffort and are not fun. | 6 | I don’t like doing things that make me thinkhard for a long time. | 2,3 |
-or- | -or- | -or- | -or- | -or- | -or- | |
n/a | n/a | n/a | 92 | I avoid doing things that make me think hardfor a long time. | 2,3 | |
1g | 79 | 73 | Loses or misplaces things that they need. | 81 | I lose things that I need. | 2,3 |
1ha | 10 | 10 | Is easily distracted. | 14 | I am easily distracted. | 2,3 |
1i | 2 | 2 | Is forgetful in daily activities. | 2 | I forget to do things. | 2,3 |
Tables D.1b.DSM Symptom Count and Criterion Status Score Requirements for DSM ADHDHyperactive/Impulsive Symptoms
DSM Symptom CountRequirements: At least 6 of the 9 symptoms for youth ≤ 16years of age; at least 5 of the 9 symptoms for youth | ||||||
DSM Criterion A | Parent Item # | Teacher Item # | Parent/Teacher Item Text | Self-Report Item # | Self-Report Item Text | Item Score that Contributes to SymptomCount |
2a | 86 | 80 | Has trouble sittingstill. | 88 | It’s hard for me to sitstill. | 2,3 |
-or- | -or- | -or- | -or- | -or- | -or- | |
108 | 99 | Fidgets or squirms intheir seat. | 109 | I fidget or squirm in myseat. | 2,3 | |
2b | 3 | 3 | Leaves their seat whenthey should stay seated. | 3 | I get out of my seat whenI am not supposed to. | 2,3 |
2cb | 51 | 47 | Runs or climbs when theyare not supposed to. | 52 | I run or climb even whenI am not supposed to. | 2,3 |
-or- | -or- | -or- | -or- | -or- | -or- | |
111 | 102 | Is restless. | 112 | I feel restless. | 2,3 | |
2d | 60 | 54 | Is unable to be quietwhen playing or using free time. | 64 | I can’t play or do thingsquietly. | 2,3 |
2e | 14 | 12 | Needs to be movingaround. | 17 | I feel like I need to bemoving around. | 2,3 |
-or- | -or- | -or- | -or- | -or- | -or- | |
95 | 89 | Acts as if driven by amotor. | 98 | I feel like I am drivenby a motor. | 2,3 | |
2f | 47 | 42 | Talks too much. | 47 | I talk too much. | 2,3 |
2g | 106 | 97 | Blurts out answers beforethe question has been completed. | 107 | I blurt out the answerbefore the question is finished. | 2,3 |
2h | 50 | 45 | Has difficulty waitingfor their turn. | 50 | I have trouble waitingfor my turn. | 2,3 |
2i | 55 | 50 | Interrupts other people’sconversations, games, or activities. | 57 | I interrupt people whenthey are talking or playing games. | 2,3 |
-or- | -or- | -or- | -or- | -or- | -or- | |
75 | 70 | Intrudes on or takes overwhat others are doing. | n/a | n/a | 2,3 | |
Interpretative Considerations for Tables D.1a and D.1b:
ADHD Criterion A states that the symptoms indicated by the rater must: (a) have persisted for atleast 6 months, (b) not be consistent withdevelopmental level, and (c) have direct negative impact on the youth’s social andacademic/occupational activities.
ADHD Criterion A states that “…the symptoms are not solely a manifestation of oppositionalbehavior, defiance, hostility, or failure to understand tasksor instructions” (p.69, APA, 2022).
a CriterionA1h states that in older adolescents, the tendency to be easily distracted by extraneous stimulimay includeunrelated thoughts as the source of distraction. Follow-up is recommended to check if CriterionA1h has been met for older adolescents.
b CriterionA2c states that in adolescents, overactivity may be experienced as subjective feelings ofrestlessness.Follow-up is recommended to ensure Criterion A2c has been met for the self-report ofadolescents.
DSM Symptom Count Requirements for ADHD Combined Presentation: Meets symptom countcriteria for both Inattentive and Hyperactive-Impulsivepresentations.
Table D.2.DSM Symptom Count and Criterion Status Score Requirements for DSM Oppositional DefiantDisorder Symptoms
DSM Symptom CountRequirements: At least 4 of the 8 symptoms. | ||||||
DSM Criterion A | Parent Item # | Teacher Item # | Parent/Teacher Item Text | Self-Report Item # | Self-Report Item Text | Item Score that |
Angry/Irritable Mood | ||||||
1 | 4 | 4 | Loses temper. | 4 | I lose my temper. | 2,3 |
2 | 49 | 44 | Is irritable or easily annoyed by others. | 49 | I am easily annoyed. | 2,3 |
3 | 37 | 34 | Is angry and resentful. | 39 | People make me angry. | 2,3 |
Argumentative/Defiant Behavior | ||||||
4 | 98 | 91 | Argues with adults. | 101 | I argue with adults. | 2,3 |
5
| 16 | 14 | Actively refuses to follow the rules. | 19 | I refuse to follow the rules. | 2,3 |
-or- | -or- | -or- | -or- | -or- | -or- | |
83 | 78 | Actively refuses to do what adults tell themto do. | 85 | I refuse to do what adults ask me to do. | 2,3 | |
6 | 59 | 53 | Annoys other people on purpose. | 63 | I annoy people on purpose. | 2,3 |
7 | 91 | 85 | Blames their mistakes or misbehavior onothers. | 94 | I blame others for my mistakes or badbehavior. | 2,3 |
Vindictiveness | ||||||
8a | 45 | 40 | Tries to get even with people. | 45 | When I get mad at someone, I get even withthem. | 1,2,3 |
-or- | -or- | -or- | -or- | -or- | -or- | |
67 | 61 | Upsets or offends others on purpose. | 70 | I upset or offend others on purpose. | 1,2,3 | |
Interpretative Considerations:
Oppositional Defiant Disorder Criterion A requires that the patterns of angry/irritable mood,argumentative/defiant behavior, or vindictiveness bepresent for at least 6 months.
Oppositional Defiant Disorder Criterion A states that symptoms must be “exhibited duringinteraction with at least one individual who is not a sibling”(p. 522; APA, 2022).
a In order forCriterion A8 (vindictiveness) to be indicated, the assessor needs to ensure this criterionoccurred twicewithin the past 6 months.
TableD.3. DSM Symptom Count and Criterion Status Score Requirements for DSM Conduct DisorderSymptoms
DSM Symptom CountRequirements: At least 3 of the 15 symptoms. | ||||||
DSM Criterion A | Parent Item # | Teacher Item # | Parent/Teacher Item Text | Self-Report Item # | Self-Report Item Text | Item Score that Contributes to SymptomCount |
Aggression to People and Animals | ||||||
1 | 33 | 30 | Bullies, threatens, or scares others. | 36 | I bully, threaten, or scare others. | 2,3 |
2 | 21 | 19 | Starts fights with people. | 24 | I start fights with other people. | 2,3 |
3 | 84 | 79 | Uses a weapon to scare or hurt people. | 87 | I use a weapon to scare or hurt people. | 1,2,3 |
4 | 6 | 6 | Physically hurts people. | 10 | I hurt people by doing things like punching,kicking, or scratching. | 1,2,3 |
5 | 70 | 65 | Is cruel to animals. | 73 | I do things to hurt animals. | 1,2,3 |
6 | 17 | 15 | Steals while confronting a person (forexample, mugging, purse snatching, or armed robbery). | 20 | I steal from people by robbing them. | 1,2,3 |
7 | 101 | 94 | Has forced someone into sexual activity. | 103 | I made someone do something sexual againsttheir will. | 1,2,3 |
Destruction of Property | ||||||
8 | 29 | 26 | Has intentionally set fires for the purposeof causing damage. | 32 | I set things on fire to cause damage. | 1,2,3 |
9a | 81 | 75 | Intentionally damages or destroys thingsthat belong to others. | 83 | I destroy things on purpose that belong toothers. | 1,2,3 |
Deceitfulness or Theft | ||||||
10 | 44 | 39 | Has broken into someone else’s house,building, or car. | 44 | I’ve broken into houses, buildings, or cars. | 1,2,3 |
11 | 68 | 62 | Lies to avoid having to do something or toget things. | 71 | I tell lies to get out of doing things or toget stuff. | 2,3 |
12 | 27 | 25 | Steals valuable things secretly (forexample, through shoplifting or forgery). | 30 | I steal valuable things when no one iswatching. | 1,2,3 |
Serious Violations of Rules | ||||||
61 | n/a | Stays out at night, even though it breaksthe rules. | 65 | I stay out at night, even though it breaksthe rules. | 2,3 | |
104 | n/a | Has run away from home for at least onenight. | 105 | I have run away from home for at least onenight. | 1,2,3 | |
15e | 90 | 84 | Skips classes. | 93 | I skip classes. | 2,3 |
Interpretative Considerations:
Conduct Disorder Criterion A states that a repetitive and persistent pattern of behavior wherethe basic rights of others or major age-appropriatesocietal norms or rules are violated is shown in the past 12 months from any of the categories(aggression to people and animals, destruction of property,deceitfulness or theft, or serious violation of rules), with at least one criterion present inthe past 6 months.
a If bothCriterion A8 (fire setting) and A9 (destruction of property) are indicated, in order to meetCriterion A9, theassessor must confirm that property was destroyed other than by fire-setting.
b TheConners 4 Teacher does not assess Criterion A13 (staying out at night without permission) orCriterion A14 (runningaway from home), as teachers generally would not be directly aware of these infractions.
c In orderfor DSM Criterion A13 (staying out at night without permission) to be indicated, the assessormust ensurethat behavior had occurred before the age of 13 years.
d In orderfor DSM Criterion A14 (running away from home) to be indicated, the assessor must ensure thatthe behavioroccurred at least twice while living in the parental or parental surrogate home, or once withoutreturning for a lengthy period.
e In orderfor DSM Criterion A15 (truancy) to be indicated, the assessor must ensure that the truancy hadoccurredbefore the age of 13 years.
1 Throughout this manual, DSM refers to the Diagnostic and StatisticalManual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR,2022).
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