c. keith conners, ph.d. dsm-5 updatedsm-5 symptom scales). symptom criteria covered by the conners...

C. Keith Conners, Ph.D.

DSM-5 UPDATE

™

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Conners Comprehensive Behavior Rating Scales and Conners CBRS are trademarks of Multi-Health Systems Inc.

DSM, DSM-IV, DSM-IV-TR, and DSM-5 are trademarks of the American Psychiatric Association.

Copyright © 2014 Multi-Health Systems Inc. All rights reserved. No part of this technical report, or any related materials protected by copyrights are to be printed or otherwise reproduced by any means, including electronic storage within a computer program or database, without the permission of the publisher. These materials may not be translated into a natural or computer language without permission. This copyright is protected through the laws of the United States, Canada, and other countries. Persons who violate the copyrights on these materials may be liable to prosecution. Ethical codes of various professional associations to which users are likely to belong specifically prohibit both illegal behaviors and actions that would deny other parties fair compensation for their work. Persons who violate professional ethical codes related to inappropriate and unfair use of these materials may be brought before the relevant professional associations to which they belong. The information included in this technical report does not constitute, and shall not be considered, the advice, recommendation, assessment, or endorsement of MHS. To the extent permitted by law, any statutory or implied warranty of merchantability or fitness for a particular purpose is completely denied and disclaimed. MHS shall not be liable for any third party claims, lost profits, lost savings, loss of information, or any other incidental damages or other economic consequential damages resulting from the use of the technical report.

Published in Canada by Multi-Health Systems Inc.

Printed in Canada.

July, 2014

Conners Comprehensive Behavior Rating Scales™ (Conners CBRS™)

DSM-5 Update

C. Keith Conners, Ph.D.

OverviewThe Conners Comprehensive Behavior Rating Scales™ (Conners CBRS™) features direct links between scale content on the full-length forms (i.e., Conners CBRS Parent [Conners CBRS–P], Conners CBRS Teacher [Conners CBRS–T], and Conners CBRS Self-Report [Conners CBRS–SR]), and symptom criteria in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR; American Psychiatric Association, 2000). The symptom criteria assessed on the Conners CBRS correspond to the following disorders: Attention-Deficit/Hyperactivity Disorder (ADHD), Conduct Disorder (CD), Oppositional Defiant Disorder (ODD), Major Depressive Episode, Manic Episode, Generalized Anxiety Disorder (GAD), Separation Anxiety Disorder, Social Phobia, Obsessive-Compulsive Disorder (OCD), Autistic Disorder, and Asperger’s Disorder. Items on the Conners CBRS DSM Symptom Scales approximate symptom-level criteria from the DSM; diagnostic criteria (e.g., course, age of onset, differential diagnosis, level of impairment, and pervasive-ness) are not represented in its entirety. (See the DSM for full diagnostic criteria.)

The American Psychiatric Association released a new edition of the DSM in May, 2013: The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5; APA, 2013). As a result, the Conners CBRS was reviewed to evaluate essential changes to scoring and interpretation of the assessment, including updates to software and online components (e.g., the Assessment, Progress, and Compara-tive reports). A few minor changes bring scoring and inter-pretation of the DSM Symptom Scales on the Conners CBRS in line with new diagnostic criteria. One substantial update in the DSM-5, the reconceptualization of the Pervasive Devel-opmental Disorders, informed scoring and interpretation of a new DSM Symptom Scale for Autism Spectrum Disorder (ASD); however, essentially the same items comprise this scale as were represented on the Conners CBRS for Autistic Disorder and Asperger’s Disorder (with the exception of items related to delayed communication, which is no longer a criterion of ASD; see Table 1 for details).

Changes to the Conners CBRS Corresponding to DSM-5 Criteria Updates The main source for administration, scoring, and interpretation information is still the Conners CBRS Manual. Updates to symptom criteria for ADHD, ODD, Major Depressive Episode, Manic Episode, Social Phobia, Obsessive-Compulsive Disorder (OCD), Autistic Disorder, and Asperger’s Disorder are outlined in this update, as are changes made to scoring and interpretative considerations in the Conners CBRS (see Table 1 for a summary of changes; see Tables 2a to 13 for DSM-5 criteria, the associated Conners CBRS form items, and the response choices for when symptoms are Indicated, May be Indicated, or Not Indicated). Psychometric properties for any of the DSM Symptom Scales with items that were added or deleted (i.e., Major Depressive Episode, Social Anxiety Disorder [Social Phobia]), OCD, and ASD) are also provided in this update (see Standardization and Reliability of the Conners CBRS DSM-5 Symptom Scales). Symptom criteria covered by the Conners CBRS for CD, GAD, and Separation Anxiety Disorder did not change (see Tables 3, 9 and 10).

A DSM scoring option is now included among the report options to allow the assessor to choose either DSM-IV-TR scoring or DSM-5 scoring:

• Selecting the DSM-IV-TR scoring option will produce reports identical to the original Conners CBRS reports.

• Selecting the DSM-5 scoring option will produce reports that include DSM-5 raw scores, T-scores, Symptom Counts and interpretative considerations.

The DSM-5 scoring option includes the following changes:

i. An update to the ADHD Symptom Count for 17- to 18-year-olds.

ii. An amendment to the order of ODD Criterion A symptoms, as well as to the symptom count requirements on the self-report form for ODD Criterion A8 (Note: parent and teacher forms were not impacted by the modification to Criterion A8).

1


2

iii. An additional item for Major Depressive Episode, Criterion A1, and feedback on the “With mixed features” specifier for Major Depressive Episode.

iv. A change to the symptom count requirements for Manic Episode, Criterion A, and feedback on the “With mixed features” specifier for Manic Episode.

v. Reworking of symptom count requirements for Social Anxiety Disorder (Social Phobia), including the deletion of two items, as well as the addition of one item to Criterion B.

vi. Fewer and reorganized items on the OCD Symptom Scale.

vii. Restructured and integrated symptom count requirements for Autistic Disorder and Asperger’s Disorder, resulting in a single ASD scale.

All scoring and structural changes to the DSM Symptom Scales are outlined in Table 1. As with the original DSM-IV-TR Symptom Scales, several interpretive notes are provided in the computerized reports to further enhance the interpretation of the Conners CBRS results. The bolded notes under Tables 2a to 13 provide the updated DSM-5 interpretative considerations.

Table 1. Changes to the DSM Symptom Scales

Symptom Scale Change to DSM-5 Change to Conners CBRS

Attention-Deficit/Hyperactivity Disorder

Fewer symptoms (5 rather than 6) are required for older adolescents and adults (17 years and older).

For individuals aged 17 years and older, and for both ADHD Predominantly Inattentive Presentation, and ADHD Predominantly Hyperactive-Impulsive Presentation, the Symptom Count is probably met when 5 or more symptoms are endorsed. ADHD Combined Presentation requires 5 or more symptoms from each of inattentive and hyperactive-impulsive symptom criteria.

ADHD subtypes are reclassified as presentations.

The DSM-5 ADHD Symptom Scales are renamed: ADHD Predominantly Inattentive Presentation, ADHD Predominantly Hyperactive-Impulsive Presentation, and ADHD Combined Presentation.

Oppositional Defiant Disorder

Criterion A symptoms are reorganized into three categories: Angry/Irritable Mood, Argumentative/Defiant Behavior, and Vindictiveness.

Any tables in the Conners CBRS reports that present ODD symptom criteria and/or corresponding items on the DSM-5 ODD Symptom Scale are reorganized with subheadings. Symptom criteria are reordered accordingly.

A frequency qualifier of no less than twice in 6 months is added to Criterion A8, spiteful or vindictive behavior.

Symptom Count scoring criteria for the parent and teacher forms account for this frequency of spiteful or vindictive behavior; a score of 1 (Just a little true; Occasionally) is used to reflect the frequency expressed in the DSM-5. Criterion status score requirements are updated on the Conners CBRS–SR; a score of 1 now also contributes to the Symptom Count.

Major Depressive Episode

Criterion A1 includes hopelessness among the examples of subjective report of depressed mood.1

An existing Conners CBRS item that accounts for a hopeless manifestation of depressed mood has been assigned to the Symptom Count, raw score, and T-score.

Manic Episode Increased goal-directed activity or increased energy is a symptom covered by Criterion A.

An existing Conners CBRS item for Criterion B6 (i.e., increase in goal-directed activity or psychomotor agitation) has been integrated into the Symptom Count for Criterion A (see Table 7). The raw score formula that is used to calculate the Manic Episode T-score is unaffected by this addition (i.e., the item is summed only once in calculating the raw score for Manic Episode).

Table continued next page...

DSM-5 Update

3

Table 1. (continued) Changes to the DSM Symptom Scales


Mixed Episode Mixed Episode is removed from the DSM-5 Bipolar and Related Disorders section and has been replaced with:• a “With mixed features” specifier that

outlines manic symptoms that would lead to a classification of Depressive Episode, with mixed features

• a “With mixed features” specifier that outlines depressive symptoms that would lead to a classification of Manic Episode, with mixed features.

The Mixed Episode section of the Conners CBRS reports has been removed.

When the Symptom Count is probably met for Major Depressive Episode, a note beneath the DSM-5 Manic Episode Symptom Table in the Conners CBRS reports highlights the manic symptoms that comprise mixed features and details which of these symptoms are Indicated, May be Indicated, or Not Indicated. Interpretative considerations are outlined in a separate section of the Assessment report labeled Mixed Features.

When the Manic Episode Symptom Count is probably met, a note appears below the DSM-5 Major Depressive Episode Symptom Table in the Conners CBRS reports. This note highlights the depressive symptoms that are Indicated, May be Indicated, or Not Indicated for the mixed features specifier. A separate Mixed Features section in the Assessment report outlines interpretative considerations related to this specifier.

Social Anxiety Disorder (Social Phobia)

All of Criteria A, B, C, and D are required. For the Symptom Count to be probably met, the Conners CBRS item responses must result in all of the criteria being designated as Indicated/May be Indicated.

Criterion A no longer requires evidence of the capacity for age appropriate social relationships.

The Conners CBRS item, “Is unable to develop peer relationships” (parent and teacher form), “I get along with people once I am comfortable with them” (self-report form), has been dropped from the Symptom Count for Social Phobia.

DSM-IV-TR, Criterion A is split into two components: (1) the feared social situation (Criterion A); and (2) the feared reaction or behavior (Criterion B).

• Conners CBRS items measuring these different components were consequently reapplied to the appropriate criterion (see Table 11).

• To cover the new emphasis in Criterion B on fear of negative evaluation, the item “Worries about what others think of him/her” was added to the Symptom Count (see Table 11).

• Criterion C qualifies Criterion A, stating that “the social situations almost always provoke fear or anxiety.”

• Criterion C specifies how fear or anxiety may be expressed in children (i.e., “by crying, tantrums, freezing, clinging, shrinking, or failing to speak in social situations”).

• The same item on the Conners CBRS applies both to Criterion A and C (“Panics about social situations or when doing things in front of other people”), addressing the feared social situation component, as well as the qualification that fear or anxiety almost always occurs in response to the feared social situation.

• An item that measures these child-specific expressions of fear or anxiety (i.e., “Cries, throws tantrums, avoids, or freezes in social situations with unfamiliar people”) contributes to symptoms for Criterion C.

Obsessive-Compulsive Disorder

• Two symptom criteria (DSM-IV-TR A2 and A4) are removed from Obsessions, Criterion A.

• Wording for Criterion A1 has been modified such that the obsessions cause marked anxiety or distress in most individuals.

The item that measured the DSM-IV-TR Obsessions, Criterion A2 symptom (“Worries about things that are not real life problems”), has been deleted from the OCD Symptom Count. The item that formerly measured the DSM-IV-TR Obsessions, Criterion A4 symptom (“Creates thoughts or pictures that get stuck in his/her mind” [parent and teacher report] or “I create upsetting thoughts or pictures that get stuck in my mind” [self-report]) has been repurposed in the DSM-5 scale to measure Obsessions, Criterion A1 (see Table 12). That is, to account for the change in language to Criterion A1 (that obsessions cause marked anxiety or distress in most individuals), an item was added that measures obsessions, separate from the upsetting reaction to these thoughts, urges, or images. The parent and teacher version of this item does not require that obsessive thoughts are anxiety-provoking or cause distress, thus accounting for the qualifier that only “in most individuals” is distress associated with obsessions. Because the equivalent item on the self-report includes the term “upsetting,” if Criterion A1 (item 94 or 31) is not endorsed on the self-report, follow-up is recommended to determine if the individual has obsessive thoughts that do not cause anxiety or distress.

Table continued next page...


4

Table 1. (continued) Changes to the DSM Symptom Scales


Autism Spectrum Disorder

The Pervasive Developmental Disorders, including Autistic Disorder and Asperger’s Disorder, are reorganized into one all-encompassing classification: ASD.

DSM Symptom Scales for Autistic Disorder and Asperger’s Disorder are reorganized into a DSM-5 Symptom Scale for ASD, which assesses (1) deficits in social communication and social interaction, and (2) restricted repetitive patterns of behavior, interests, and activities. Items on the Conners CBRS are restructured accordingly. Two items—“Was a late talker” on the parent form, and “Uses spoken language to communicate” on the teacher form—no longer apply to symptom criteria and are neither included in the Symptom Count, nor in the raw score and T-score calculations.

Criteria regarding the absence of “spontaneous make-believe or social imitative play,” and “persistent preoccupation with parts of objects” are removed.

Items covering these concepts (i.e., “Lacks varied, spontaneous make-believe play” and “Is over-focused or over-interested in one part of an object or toy”) do not contribute to the Symptom Count for ASD, because this count is based on direct association of items to symptom criteria in the DSM-5.2

1 Not all behavioral examples noted in the DSM symptom criteria are represented on the Conners CBRS DSM Symptom Scales. Expert review of DSM-5 criteria led to the determination that because hopelessness is a main feature of the cognitive theory of depression (Beck, Rush, Shaw, & Emery, 1979), and cognitive-behavioral therapy is “currently the treatment of choice for anxiety and depressive disorders in children and adoles-cents” (Compton, March, Brent, Albano, Weersing, & Curry, 2004, p. 930), it is important to measure this concept on the Conners CBRS.2 Expert review of changes to diagnostic criteria for ASD drove the determination that although the language of these items no longer directly corresponds to DSM-5 symptom criteria, the concepts covered by the items represent core aspects of the disorder. The absence of social-imitative play is a symptom that is related to the broad category of deficits in social communication and social interaction, and captures an important devel-opmental precursor to the types of behaviors assessed by ASD, Criterion A (e.g., Fuchs, 2013; Gallese & Goldman, 1998; Rizzolatti & Craighero, 2004; Toth, Munson, Meltzoff, & Dawson, 2006). Similarly, a focus on parts of objects applies broadly to the different areas covered by ASD, Criterion B, restricted repetitive patterns of behaviors, interests, or activities: A child that becomes focused on one part of an object or toy may be doing so due to the stereotyped or repetitive use of it (Criterion B1), the ritualized pattern or sense of sameness provided by it (Criterion B2), a preoccupation with the object itself (Criterion B3), or the smell or feel of the object (Criterion B4). As such, these two items are included in the raw score (and therefore, T-score) calculation for ASD.

DSM-5 Update

5

Tabl

e 2a

. D

SM-5

Sym

ptom

Cou

nt a

nd C

riter

ion

Stat

us S

core

Req

uire

men

ts fo

r AD

HD

D

SM-5

Sym

ptom

Cou

nt R

equi

rem

ents

:•ADHDPredominantlyInattentivePresentation:Atleast6ofthe9sym

ptom

sforindividuals≤16yearsofage;atleast5ofthe9sym

ptom

sforindividuals≥17yearsofage.

•ADHDCom

binedPresentation:Meetscriteriaforb

othInattentiveandHyperactive-Impulsivepresentations.

DS

M-5

Cri

teri

on A

Form

Item

Item

#

Indicated

May be Indicated

Not Indicated

Oft

en f

ails

to

giv

e cl

ose

atte

nti

on t

o d

etai

ls o

r m

akes

car

eles

s m

ista

kes

in s

choo

lwor

k, a

t w

ork,

or

du

rin

g o

ther

act

ivit

ies

(e.g

.,

over

look

s or

mis

ses

det

ails

, w

ork

is in

accu

rate

).1a

PD

oesn

’t pa

y at

tent

ion

to d

etai

ls; m

akes

car

eles

s mis

take

s.12

3, 2

–1,

0

TD

oesn

’t pa

y at

tent

ion

to d

etai

ls; m

akes

car

eles

s mis

take

s.5

3, 2

–1,

0

SRIt

is h

ard

for m

e to

pay

atte

ntio

n to

det

ails

.81 -o

r- 37

3, 2

-or- 3

–1,

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nd-

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I mak

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ista

kes b

y ac

cide

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2

Oft

en h

as d

ifficu

lty

sust

ain

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att

enti

on in

tas

ks o

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lay

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es (

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as d

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lty

rem

ain

ing

foc

use

d d

uri

ng

lect

ure

s,

con

vers

atio

ns,

or

len

gth

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adin

g).

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Has

trou

ble

keep

ing

his/

her m

ind

on w

ork

or o

n pl

ay fo

r lon

g.13

63,

2–

1, 0

TH

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oubl

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g hi

s/he

r min

d on

wor

k or

pla

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r lon

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3, 2

–1,

0SR

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uble

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min

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ten

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.86

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Doe

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sten

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hat i

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id to

him

/her

.11

73,

2–

1, 0

SRI h

ave

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le k

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ng m

y m

ind

on w

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–1,

0

Oft

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th

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on

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P

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nder

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ands

and

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ying

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-8

3, 2

-and

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2

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plet

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he

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tryi

ng to

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T

Doe

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roug

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inst

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(eve

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hen

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he

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nd is

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109

-and

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-and

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2

–1,

0-o

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plet

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hool

wor

k or

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hen

he/s

he

unde

rsta

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nd is

tryi

ng to

coo

pera

te).

–

SRI h

ave

troub

le fo

llow

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inst

ruct

ions

.12

9-a

nd-

103

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2

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–

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aniz

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nd

act

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es).

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PH

as tr

oubl

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zing

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s or a

ctiv

ities

.23

3, 2

−1,

0

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as d

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lty o

rgan

izin

g ta

sks o

r act

iviti

es.

503,

2−

1, 0

SRI h

ave

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le k

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ng m

ysel

f org

aniz

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323

21,

0

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21,

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that

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t of e

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423

21,

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g th

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that

mak

e m

e th

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hard

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32

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ses

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gs

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essa

ry f

or t

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or

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, p

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ks,

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xt p

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..


6

Tabl

e 2a

. (

cont

inue

d) D

SM-5

Sym

ptom

Cou

nt a

nd C

riter

ion

Stat

us S

core

Req

uire

men

ts fo

r AD

HD

DS

M-5

Cri

teri

on A

Form

Item

Item

#

Indicated

May be Indicated

Not Indicated

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ften

eas

ily d

istr

acte

d b

y ex

tran

eou

s st

imu

li (f

or o

lder

ad

oles

cen

ts a

nd

ad

ult

s, m

ay in

clu

de

un

rela

ted

th

oug

hts

).1h

a

PIs

eas

ily d

istra

cted

by

sigh

ts o

r sou

nds.

154

3, 2

−1,

0T

Is e

asily

dis

tract

ed b

y si

ghts

or s

ound

s.60

3, 2

−1,

0SR

I get

dis

tract

ed b

y th

ings

that

are

goi

ng o

n ar

ound

me.

653

21,

0

Is o

ften

for

get

ful i

n d

aily

act

ivit

ies

(e.g

., d

oin

g c

hor

es,

run

nin

g

erra

nd

s; f

or o

lder

ad

oles

cen

ts a

nd

ad

ult

s, r

etu

rnin

g c

alls

, p

ayin

g

bill

s, a

nd

kee

pin

g a

pp

oin

tmen

ts).

1iP

Is fo

rget

ful i

n da

ily a

ctiv

ities

.1

3, 2

−1,

0T

Is fo

rget

ful i

n da

ily a

ctiv

ities

.15

13,

2−

1, 0

SRI f

orge

t stu

ff.15

43

21,

0

DSM

-5 D

iagn

ostic

Crit

eria

is re

prin

ted

with

per

mis

sion

from

the

Dia

gnos

tic a

nd S

tatis

tical

Man

ual o

f Men

tal D

isor

ders

, Fift

h Ed

ition

™, (

Cop

yrig

ht ©

201

3). A

mer

ican

Psy

chia

tric A

ssoc

iatio

n.

All

Rig

hts R

eser

ved.

The

Am

eric

an P

sych

iatri

c Ass

ocia

tion

is n

ot a

ffilia

ted

with

and

is n

ot e

ndor

sing

this

pro

duct

.

Not

es:

P =

pare

nt; T

= te

ache

r; SR

= se

lf-re

port.

The

follo

win

g re

spon

se k

ey a

pplie

s to

the

crite

rion

stat

us sc

ore

requ

irem

ents

not

ed in

the

Indi

cate

d, M

ay b

e In

dica

ted,

and

Not

Indi

cate

d co

lum

ns:

0 =

Not

true

at a

ll (N

ever

, Sel

dom

); 1

= Ju

st a

littl

e tru

e (O

ccas

iona

lly);

2 =

Pret

ty m

uch

true

(Ofte

n, Q

uite

a b

it); 3

= V

ery

muc

h tru

e (V

ery

ofte

n, V

ery

freq

uent

ly).

Inte

rpre

tativ

e C

onsi

dera

tions

: W

hen

cons

ider

ing

DSM

-5 sy

mpt

om c

rite

ria

for A

DH

D, t

he a

sses

sor

need

s to

ensu

re th

at th

e sy

mpt

oms a

re n

ot so

lely

a m

anife

stat

ion

of o

ppos

ition

al b

ehav

ior,

defia

nce,

hos

tility

, or

failu

re to

und

er-

stan

d ta

sks o

r in

stru

ctio

ns.

a Cri

teri

on A

1h st

ates

that

in o

lder

ado

lesc

ents

, the

tend

ency

to b

e ea

sily

dis

trac

ted

by e

xtra

neou

s sti

mul

i may

incl

ude

unre

late

d th

ough

ts a

s the

sour

ce o

f dis

trac

tion.

Fol

low

-up

is r

ecom

men

ded

to

che

ck if

Cri

teri

on A

1h h

as b

een

met

.

DSM-5 Update

7

Tabl

e 2b

. D

SM-5

Sym

ptom

Cou

nt a

nd C

riter

ion

Stat

us S

core

Req

uire

men

ts fo

r AD

HD

D

SM-5

Sym

ptom

Cou

nt R

equi

rem

ents

: •ADHDPredominantlyHyperactive-ImpulsivePresentation:Atleast6ofthe9sym

ptom

sforindividuals≤16yearsofage;atleast5ofthe9sym

ptom

sforthose≥17yearsofage.

•ADHDCom

binedPresentation:Meetscriteriaforb

othInattentiveandHyperactive-Impulsivepresentations.

DS

M-5

Cri

teri

on A

Form

Item

Item

#

Indicated

May be Indicated

Not Indicated

Oft

en fi

dg

ets

wit

h o

r ta

ps

han

ds

or f

eet

or s

qu

irm

s in

sea

t.2a

PFi

dget

s or s

quirm

s in

seat

.11

73,

2−

1, 0

TFi

dget

s or s

quirm

s in

seat

.86

3, 2

−1,

0SR

It is

har

d fo

r me

to si

t stil

l.51

32

1, 0

Oft

en le

aves

sea

t in

sit

uat

ion

s w

hen

rem

ain

ing

sea

ted

is e

xpec

ted

(e

.g.,

leav

es h

is o

r h

er p

lace

in t

he

clas

sroo

m,

in t

he

office

or

oth

er

wor

kpla

ce,

or in

oth

er s

itu

atio

ns

that

req

uir

e re

mai

nin

g in

pla

ce).

2bP

Leav

es se

at w

hen

he/s

he sh

ould

stay

seat

ed.

283,

2−

1, 0

TLe

aves

seat

whe

n he

/she

shou

ld st

ay se

ated

.11

23,

2−

1, 0

SRI g

et o

ut o

f my

seat

whe

n I a

m n

ot su

ppos

ed to

.11

03,

2−

1, 0

Oft

en r

un

s ab

out

or c

limb

s in

sit

uat

ion

s w

her

e it

is in

app

rop

riat

e.

(Not

e: I

n a

dol

esce

nts

or

adu

lts,

may

be

limit

ed t

o fe

elin

g r

estl

ess.

)2c

a

PR

uns o

r clim

bs w

hen

he/s

he is

not

supp

osed

to.

32 -or- 89

3, 2

-or-

3, 2

1 -or- 1

0-a

nd-

0R

estle

ss o

r ove

ract

ive.

TR

uns o

r clim

bs w

hen

he/s

he is

not

supp

osed

to.

51 -or-

139

3, 2

-or-

3, 2

1 -or- 1

0-a

nd-

0R

estle

ss o

r ove

ract

ive.

SRI r

un o

r clim

b ev

en w

hen

I am

not

supp

osed

to.

114

-or- 86

3, 2

-or-

3, 2

–1,

0-a

nd-

1,0

I am

rest

less

.–

Oft

en u

nab

le t

o p

lay

or e

ng

age

in le

isu

re a

ctiv

itie

s q

uie

tly.

2dP

Is n

oisy

and

loud

whe

n pl

ayin

g or

usi

ng fr

ee ti

me.

148

3, 2

−1,

0T

Is n

oisy

and

loud

whe

n pl

ayin

g or

usi

ng fr

ee ti

me.

103,

2−

1, 0

SRI h

ave

troub

le p

layi

ng o

r doi

ng th

ings

qui

etly

.82

3, 2

−1,

0

Is o

ften

“on

th

e g

o,”

acti

ng

as

if “

dri

ven

by

a m

otor

” (e

.g.,

is

un

able

to

be

or u

nco

mfo

rtab

le b

ein

g s

till

for

exte

nd

ed t

ime,

as

in r

esta

ura

nts

, m

eeti

ng

s; m

ay b

e ex

per

ien

ced

by

oth

ers

as b

ein

g

rest

less

or

diffi

cult

to

keep

up

wit

h).

2e

PA

cts a

s if d

riven

by

a m

otor

.18

0-o

r- 16

3, 2

-or-

3, 2

1 -or- 1

0-a

nd-

0Is

con

stan

tly m

ovin

g

TA

cts a

s if d

riven

by

a m

otor

.6 -or- 49

3, 2

-or-

3, 2

1 -or- 1

0-a

nd-

0Is

con

stan

tly m

ovin

g.

SRI f

eel l

ike

I am

driv

en b

y a

mot

or.

29 -or- 71

3, 2

-or- 3

1 -or- 2

0-a

nd-

1,0

I lik

e to

be

on th

e go

rath

er th

an b

eing

in o

ne p

lace

.

Oft

en t

alks

exc

essi

vely

.2f

PTa

lks t

oo m

uch.

104

3, 2

−1,

0T

Talk

s too

muc

h.16

43,

2−

1, 0

SRI t

alk

too

muc

h.76

3, 2

−1,

0

Tabl

e co

ntin

ued

next

pag

e...


8

Tabl

e 2b

. (

cont

inue

d) D

SM-5

Sym

ptom

Cou

nt a

nd C

riter

ion

Stat

us S

core

Req

uire

men

ts fo

r AD

HD

DS

M-5

Cri

teri

on A

Form

Item

Item

#

Indicated

May be Indicated

Not Indicated

Oft

en b

lurt

s ou

t an

an

swer

bef

ore

a q

ues

tion

has

bee

n c

omp

lete

d

(e.g

., c

omp

lete

s p

eop

le's

sen

ten

ces;

can

not

wai

t fo

r tu

rn in

co

nve

rsat

ion

).2g

PB

lurts

out

ans

wer

s bef

ore

the

ques

tion

has b

een

com

plet

ed.

193,

2−

1, 0

TB

lurts

out

ans

wer

s bef

ore

the

ques

tion

has b

een

com

plet

ed.

333,

2−

1, 0

SRI b

lurt

out t

he a

nsw

er b

efor

e th

e qu

estio

n is

fini

shed

.25

3, 2

−1,

0

Oft

en h

as d

ifficu

lty

wai

tin

g h

is o

r h

er t

urn

(e.

g.,

wh

ile w

aiti

ng

in

line)

.2h

PH

as d

ifficu

lty w

aitin

g fo

r his

/her

turn

.99

3, 2

−1,

0T

Has

diffi

culty

wai

ting

for h

is/h

er tu

rn.

185

3, 2

−1,

0SR

I hav

e tro

uble

wai

ting

for m

y tu

rn.

993,

2−

1, 0

Oft

en in

terr

up

ts o

r in

tru

des

on

oth

ers

(e.g

., b

utt

s in

to

con

vers

atio

ns,

gam

es,

or a

ctiv

itie

s; m

ay s

tart

usi

ng

oth

er p

eop

le’s

th

ing

s w

ith

out

aski

ng

or

rece

ivin

g p

erm

issi

on;

for

adol

esce

nts

an

d

adu

lts,

may

intr

ud

e in

to o

r ta

ke o

ver

wh

at o

ther

s ar

e d

oin

g).

2iP

Inte

rrup

ts o

ther

s (fo

r exa

mpl

e, b

utts

into

con

vers

atio

ns o

r gam

es).

169

3, 2

−1,

0T

Inte

rrup

ts o

ther

s (e.

g., b

utts

into

con

vers

atio

ns o

r gam

es).

145

3, 2

−1,

0SR

I int

erru

pt o

ther

peo

ple.

173,

2−

1, 0

DSM

-5 D

iagn

ostic

Crit

eria

is re

prin

ted

with

per

mis

sion

from

the

Dia

gnos

tic a

nd S

tatis

tical

Man

ual o

f Men

tal D

isor

ders

, Fif

th E

ditio

n ™

, (C

opyr

ight

©20

13).

Am

eric

an P

sych

iatr

ic A

ssoc

iatio

n.

All

Rig

hts R

eser

ved.

The

Am

eric

an P

sych

iatr

ic A

ssoc

iatio

n is

not

affi

liate

d w

ith a

nd is

not

end

orsi

ng th

is p

rodu

ct.

Not

es:

P =

pare

nt; T

= te

ache

r; SR

= se

lf-re

port.

The

follo

win

g re

spon

se k

ey a

pplie

s to

the

crite

rion

stat

us sc

ore

requ

irem

ents

not

ed in

the

Indi

cate

d, M

ay b

e In

dica

ted,

and

Not

Indi

cate

d co

lum

ns: 0

= N

ot tr

ue a

t al

l (N

ever

, Sel

dom

); 1

= Ju

st a

littl

e tru

e (O

ccas

iona

lly);

2 =

Pret

ty m

uch

true

(Ofte

n, Q

uite

a b

it); 3

= V

ery

muc

h tru

e (V

ery

ofte

n, V

ery

freq

uent

ly).

Inte

rpre

tativ

e C

onsi

dera

tions

:

Whe

n co

nsid

erin

g D

SM-5

sym

ptom

cri

teri

a fo

r AD

HD

, the

ass

esso

r ne

eds t

o en

sure

that

the

sym

ptom

s are

not

sole

ly a

man

ifest

atio

n of

opp

ositi

onal

beh

avio

r, de

fianc

e, h

ostil

ity, o

r fa

ilure

to u

nder

-st

and

task

s or

inst

ruct

ions

.a C

riter

ion

A2c

stat

es th

at in

ado

lesc

ents

, ove

ract

ivity

may

be

expe

rienc

ed a

s sub

ject

ive

feel

ings

of r

estle

ssne

ss. F

ollo

w-u

p is

reco

mm

ende

d to

ens

ure

crite

rion

A2c

has

bee

n m

et fo

r you

nger

chi

ldre

n.

DSM-5 Update

9

Tabl

e 3.

D

SM-5

Sym

ptom

Cou

nt a

nd C

riter

ion

Stat

us S

core

Req

uire

men

ts fo

r CD

DSM

-5Sym

ptom

CountRequirements:A

tleast3ofthe15symptom

s.

DS

M-5

Cri

teri

on A

Form

Item

Item

#

Indicated

May be Indicated

Not Indicated

Ag

gre

ssio

n t

o P

eop

le a

nd

An

imal

s

Oft

en b

ulli

es,

thre

aten

s, o

r in

tim

idat

es o

ther

s.1

PB

ullie

s, th

reat

ens,

or sc

ares

oth

ers.

177

3, 2

10

TB

ullie

s, th

reat

ens,

or sc

ares

oth

ers.

733,

21

0SR

I bul

ly o

r thr

eate

n ot

her p

eopl

e.6

3, 2

10

Oft

en in

itia

tes

ph

ysic

al fi

gh

ts.

2P

Star

ts fi

ghts

with

oth

ers o

n pu

rpos

e.69

3, 2

10

TIn

tent

iona

lly st

arts

figh

ts w

ith o

ther

s.14

83,

21

0SR

I sta

rt fig

hts w

ith o

ther

peo

ple.

853,

21

0

Has

use

d a

wea

pon

th

at c

an c

ause

ser

iou

s p

hys

ical

har

m t

o ot

her

s (e

.g.,

a b

at,

bri

ck,

bro

ken

bot

tle,

kn

ife,

gu

n).

3

PU

ses a

wea

pon

(for

exa

mpl

e, a

bat

, bric

k, b

roke

n bo

ttle,

kni

fe, o

r gu

n).

122

3, 2

, 1−

0

TU

ses a

wea

pon

(e.g

., a

bat,

bric

k, b

roke

n bo

ttle,

kni

fe, o

r gun

).10

13,

2, 1

−0

SRI u

se a

wea

pon

(like

a b

at, b

rick,

bro

ken

glas

s, kn

ife, o

r gun

) to

scar

e or

hur

t peo

ple.

170

3, 2

, 1−

0

Has

bee

n p

hys

ical

ly c

ruel

to

peo

ple

.4

PPh

ysic

ally

hur

ts p

eopl

e.14

43,

2, 1

−0

TPh

ysic

ally

hur

ts p

eopl

e.52

3, 2

, 1−

0SR

I do

thin

gs to

hur

t peo

ple.

144

3, 2

, 1−

0

Has

bee

n p

hys

ical

ly c

ruel

to

anim

als.

5P

Is c

ruel

to a

nim

als.

161

3, 2

, 1−

0T

Is c

ruel

to a

nim

als.

115

3, 2

, 1−

0SR

I am

mea

n to

ani

mal

s.11

23,

2, 1

−0

Has

sto

len

wh

ile c

onfr

onti

ng

a v

icti

m (

e.g

., m

ug

gin

g,

pu

rse

snat

chin

g,

exto

rtio

n,

arm

ed r

obb

ery)

.6

PSt

eals

whi

le c

onfr

ontin

g a

pers

on (f

or e

xam

ple,

mug

ging

, pur

se

snat

chin

g or

arm

ed ro

bber

y).

116

3, 2

, 1−

0

TSt

eals

whi

le c

onfr

ontin

g a

pers

on (e

.g.,

mug

ging

, pur

se sn

atch

ing,

or

arm

ed ro

bber

y).

553,

2, 1

−0

SRI s

teal

from

oth

er p

eopl

e (b

y m

uggi

ng, p

urse

snat

chin

g, o

r arm

ed

robb

ery)

.60

3, 2

, 1−

0

Has

for

ced

som

eon

e in

to s

exu

al a

ctiv

ity.

7a

PH

as fo

rced

som

eone

into

sexu

al a

ctiv

ity.

983,

2, 1

−0

TH

as fo

rced

som

eone

into

sexu

al a

ctiv

ity.

106

3, 2

, 1−

0SR

––

––

–D

estr

uct

ion

of

Pro

per

ty

Has

del

iber

atel

y en

gag

ed in

fire

set

tin

g w

ith

th

e in

ten

tion

of

cau

sin

g s

erio

us

dam

age.

8b

PH

as in

tent

iona

lly se

t fire

s for

the

purp

ose

of c

ausi

ng d

amag

e.90

3, 2

, 1−

0T

Has

inte

ntio

nally

set fi

res f

or th

e pu

rpos

e of

cau

sing

dam

age.

127

3, 2

, 1−

0SR

I lik

e to

set t

hing

s on

fire.

623,

21

0

Has

del

iber

atel

y d

estr

oyed

oth

ers'

pro

per

ty (

oth

er t

han

by

fire

se

ttin

g).

9b

PIn

tent

iona

lly d

amag

es o

r des

troys

thin

gs th

at b

elon

g to

oth

ers.

179

3, 2

, 1−

0T

Inte

ntio

nally

dam

ages

or d

estro

ys th

ings

that

bel

ong

to o

ther

s.16

33,

2, 1

−0

SRI d

estro

y st

uff t

hat b

elon

gs to

oth

er p

eopl

e.48

3, 2

, 1−

0Ta

ble

cont

inue

d ne

xt p

age.

..


10

Tabl

e 3.

(c

ontin

ued)

DSM

-5 S

ympt

om C

ount

and

Crit

erio

n St

atus

Sco

re R

equi

rem

ents

for C

D

DS

M-5

Cri

teri

on A

Form

Item

Item

#

Indicated

May be Indicated

Not Indicated

Dec

eitf

uln

ess

or T

hef

t

Has

bro

ken

into

som

eon

e el

se's

hou

se,

bu

ildin

g,

or c

ar.

10P

Has

bro

ken

into

som

eone

els

e's h

ouse

, bui

ldin

g, o

r car

.39

3, 2

, 1−

0T

Has

bro

ken

into

som

eone

els

e's h

ouse

, bui

ldin

g, o

r car

.64

3, 2

, 1−

0SR

I bre

ak in

to h

ouse

s, bu

ildin

gs, o

r car

s.87

3, 2

, 1−

0

Oft

en li

es t

o ob

tain

goo

ds

or f

avor

s or

to

avoi

d o

blig

atio

ns

(i

.e.,

"co

ns"

oth

ers)

.11

PLi

es to

avo

id h

avin

g to

do

som

ethi

ng o

r to

get t

hing

s.14

93,

2−

1, 0

TLi

es to

avo

id h

avin

g to

do

som

ethi

ng o

r to

get t

hing

s.97

3, 2

−1,

0SR

I tel

l lie

s to

get o

ut o

f doi

ng th

ings

or t

o ge

t stu

ff.96

3, 2

−1,

0

Has

sto

len

item

s of

non

triv

ial v

alu

e w

ith

out

con

fron

tin

g a

vic

tim

(e

.g.,

sh

oplif

tin

g,

bu

t w

ith

out

bre

akin

g a

nd

en

teri

ng

; fo

rger

y).

12P

Stea

ls se

cret

ly (f

or e

xam

ple,

shop

liftin

g or

forg

ery)

.12

03,

2, 1

−0

TSt

eals

secr

etly

(e.g

., sh

oplif

ting

or fo

rger

y).

141

3, 2

, 1−

0SR

I ste

al im

porta

nt th

ings

whe

n no

one

is w

atch

ing.

433,

2, 1

−0

Ser

iou

s V

iola

tion

s of

Ru

les

Oft

en s

tays

ou

t at

nig

ht

des

pit

e p

aren

tal p

roh

ibit

ion

s, b

egin

nin

g

bef

ore

age

13

yea

rs.

13c,

d

PG

oes o

ut a

t nig

ht e

ven

thou

gh it

bre

aks t

he ru

les.

147

3, 2

10

T−

−−

−−

SRI g

o ou

t at n

ight

eve

n w

hen

I am

supp

osed

to b

e at

hom

e.16

23,

21

0

Has

ru

n a

way

fro

m h

ome

over

nig

ht

at le

ast

twic

e w

hile

livi

ng

in

the

par

enta

l or

par

enta

l su

rrog

ate

hom

e, o

r on

ce w

ith

out

retu

rnin

g

for

a le

ng

thy

per

iod

.14

c

PR

uns a

way

from

hom

e fo

r at l

east

one

nig

ht.

103,

2, 1

−0

T−

−−

−−

SRI r

un a

way

from

hom

e.64

3, 2

, 1−

0

Is o

ften

tru

ant

from

sch

ool,

beg

inn

ing

bef

ore

age

13

yea

rs.

15e

PSk

ips c

lass

es.

107

3, 2

10

TSk

ips c

lass

es.

160

3, 2

10

SRI s

kip

clas

ses.

673,

21

0

DSM

-5 D

iagn

ostic

Crit

eria

is re

prin

ted

with

per

mis

sion

from

the

Dia

gnos

tic a

nd S

tatis

tical

Man

ual o

f Men

tal D

isor

ders

, Fift

h Ed

ition

™, (

Cop

yrig

ht ©

2013

). A

mer

ican

Psy

chia

tric A

ssoc

iatio

n.

All

Rig

hts R

eser

ved.

The

Am

eric

an P

sych

iatri

c Ass

ocia

tion

is n

ot a

ffilia

ted

with

and

is n

ot e

ndor

sing

this

pro

duct

.

Not

es:

P =

pare

nt; T

= te

ache

r; SR

= se

lf-re

port.

The

follo

win

g re

spon

se k

ey a

pplie

s to

the

crite

rion

stat

us sc

ore

requ

irem

ents

not

ed in

the

Indi

cate

d, M

ay b

e In

dica

ted,

and

Not

Indi

cate

d co

lum

ns:

0 =

Not

true

at a

ll (N

ever

, Sel

dom

); 1

= Ju

st a

littl

e tru

e (O

ccas

iona

lly);

2 =

Pret

ty m

uch

true

(Ofte

n, Q

uite

a b

it); 3

= V

ery

muc

h tru

e (V

ery

ofte

n, V

ery

freq

uent

ly).

Inte

rpre

tativ

e C

onsi

dera

tions

: a

The

Con

ners

CB

RS−

SR d

oes n

ot a

sses

s Crit

erio

n A

7 (f

orce

d se

xual

act

ivity

) due

to th

e se

nsiti

ve n

atur

e of

this

crit

erio

n.b

If b

oth

Crit

erio

n A

8 (fi

re-s

ettin

g) a

nd A

9 (d

estru

ctio

n of

pro

perty

) are

indi

cate

d, th

e as

sess

or m

ust c

onfir

m th

at p

rope

rty w

as d

estro

yed

othe

r tha

n by

fire

-set

ting

in o

rder

to m

eet C

riter

ion

A9.

c Th

e C

onne

rs C

BR

S−T

does

not

ass

ess C

riter

ion

A13

(sta

ying

out

at n

ight

with

out p

erm

issi

on) o

r Crit

erio

n A

14 (r

unni

ng a

way

from

hom

e), a

s tea

cher

s gen

eral

ly w

ould

not

be

dire

ctly

aw

are

of th

ese

infr

actio

ns.

d In

ord

er fo

r DSM

-5 C

riter

ion

A13

(sta

ying

out

at n

ight

) to

be in

dica

ted,

the

asse

ssor

nee

ds to

ens

ure

this

crit

erio

n oc

curr

ed b

efor

e th

e ag

e of

13

year

s.e

In o

rder

for D

SM-5

Crit

erio

n A

15 (t

ruan

cy) t

o be

indi

cate

d, th

e as

sess

or n

eeds

to e

nsur

e th

at th

e tru

ancy

occ

urre

d be

fore

the

age

of 1

3 ye

ars.

DSM-5 Update

11

Tabl

e 4.

D

SM-5

Sym

ptom

Cou

nt a

nd C

riter

ion

Stat

us S

core

Req

uire

men

ts fo

r OD

D

DSM

-5Sym

ptom

CountRequirements:A

tleast4ofthe8sym

ptom

s.

DS

M-5

Cri

teri

on A

Form

Item

Item

#

Indicated

May be Indicated

Not Indicated

An

gry

/Ir

rita

ble

Moo

d

Oft

en lo

ses

tem

per

.1

PLo

ses t

empe

r.45

3, 2

−1,

0

TLo

ses t

empe

r.3

3, 2

10

SRI l

ose

my

tem

per.

583

21,

0

Is o

ften

tou

chy

or e

asily

an

noy

ed.

2

PIs

irrit

able

and

eas

ily a

nnoy

ed b

y ot

hers

.10

83,

2−

1, 0

TIs

irrit

able

and

eas

ily a

nnoy

ed b

y ot

hers

.17

43,

21

0

SRI a

m e

asily

ann

oyed

by

othe

rs.

148

3, 2

−1,

0

Is o

ften

an

gry

an

d r

esen

tfu

l.3

PIs

ang

ry a

nd re

sent

ful.

823,

21

0

TIs

ang

ry a

nd re

sent

ful.

135

3, 2

10

SRPe

ople

mak

e m

e an

gry.

143

3, 2

−1,

0

Arg

um

enta

tive

/D

efian

t B

ehav

ior

Oft

en a

rgu

es w

ith

au

thor

ity

fig

ure

s or

, fo

r ch

ildre

n a

nd

ad

oles

cen

ts,

wit

h a

du

lts.

4

PA

rgue

s with

adu

lts.

703,

2−

1, 0

TA

rgue

s with

adu

lts.

192

3, 2

−1,

0

SRI a

rgue

with

adu

lts.

117

3, 2

−1,

0

Oft

en a

ctiv

ely

defi

es o

r re

fuse

s to

com

ply

wit

h r

equ

ests

fro

m

auth

orit

y fi

gu

res

or w

ith

ru

les.

5

PA

ctiv

ely

refu

ses t

o do

wha

t adu

lts te

ll hi

m/h

er to

do.

127

3, 2

−1,

0

TA

ctiv

ely

refu

ses t

o do

wha

t adu

lts te

ll hi

m/h

er to

do.

126

3, 2

10

SRI d

o w

hat m

y pa

rent

s or o

ther

adu

lts a

sk m

e to

do.

(R)

33 (R

)3

21,

0

Oft

en d

elib

erat

ely

ann

oys

oth

ers.

6

PA

nnoy

s oth

er p

eopl

e on

pur

pose

.16

33,

2−

1, 0

TA

nnoy

s oth

er p

eopl

e on

pur

pose

.12

83,

2−

1, 0

SRI t

ry to

ann

oy o

ther

peo

ple.

134

3, 2

−1,

0

Oft

en b

lam

es o

ther

s fo

r h

is o

r h

er m

ista

kes

or m

isb

ehav

ior.

7

PB

lam

es o

ther

s for

his

/her

mis

take

s or m

isbe

havi

or.

134

3, 2

−1,

0

TB

lam

es o

ther

s for

his

/her

mis

take

s or m

isbe

havi

or.

143

3, 2

10

SRI b

lam

e ot

hers

for t

hing

s I d

o w

rong

.88

3, 2

−1,

0

Tabl

e co

ntin

ued

next

pag

e...


12

Tabl

e 4.

(c

ontin

ued)

DSM

-5 S

ympt

om C

ount

and

Crit

erio

n St

atus

Sco

re R

equi

rem

ents

for O

DD

DS

M-5

Cri

teri

on A

Form

Item

Item

#

Indicated

May be Indicated

Not Indicated

Vin

dic

tive

nes

s

Has

bee

n s

pit

efu

l or

vin

dic

tive

at

leas

t tw

ice

wit

hin

th

e p

ast

6

mon

ths.

8

PTr

ies t

o ge

t eve

n w

ith p

eopl

e.54

3, 2

10

TTr

ies t

o ge

t eve

n w

ith p

eopl

e.18

23,

21

0

SRW

hen

I get

mad

at s

omeo

ne, I

get

eve

n w

ith th

em.

203,

21

0

DSM

-5 D

iagn

ostic

Crit

eria

is re

prin

ted

with

per

mis

sion

from

the

Dia

gnos

tic a

nd S

tatis

tical

Man

ual o

f Men

tal D

isor

ders

, Fift

h Ed

ition

™, (

Cop

yrig

ht ©

2013

). A

mer

ican

Psy

chia

tric A

ssoc

iatio

n.

All

Rig

hts R

eser

ved.

The

Am

eric

an P

sych

iatri

c Ass

ocia

tion

is n

ot a

ffilia

ted

with

and

is n

ot e

ndor

sing

this

pro

duct

.

Not

es:

(R) =

Item

is re

vers

e sc

ored

.P

= pa

rent

; T =

teac

her;

SR =

self-

repo

rt. T

he fo

llow

ing

resp

onse

key

app

lies t

o th

e cr

iterio

n st

atus

scor

e re

quire

men

ts n

oted

in th

e In

dica

ted,

May

be

Indi

cate

d, a

nd N

ot In

dica

ted

colu

mns

: 0

= N

ot tr

ue a

t all

(Nev

er, S

eldo

m);

1 =

Just

a li

ttle

true

(Occ

asio

nally

); 2

= Pr

etty

muc

h tru

e (O

ften,

Qui

te a

bit)

; 3 =

Ver

y m

uch

true

(Ver

y of

ten,

Ver

y fr

eque

ntly

).

Inte

rpre

tativ

e C

onsi

dera

tions

:W

hen

cons

ider

ing

DSM

-5 sy

mpt

om c

rite

ria

for

OD

D, t

he a

sses

sor

need

s to

ensu

re th

at th

e sy

mpt

oms a

re e

xhib

ited

duri

ng in

tera

ctio

n w

ith a

t lea

st o

ne in

divi

dual

who

is n

ot a

sibl

ing.

DSM-5 Update

13

Tabl

e 5.

D

SM-5

Sym

ptom

Cou

nt a

nd C

riter

ion

Stat

us S

core

Req

uire

men

ts fo

r Maj

or D

epre

ssiv

e Ep

isod

e DSM

-5Sym

ptom

CountRequirements:A

tleast5ofthe9sym

ptom

s,includingA1

orA

2.

DS

M-5

Cri

teri

on A

Form

Item

Item

#

Indicated

May be Indicated

Not Indicated

Dep

ress

ed m

ood

mos

t of

th

e d

ay,

nea

rly

ever

y d

ay,

as in

dic

ated

b

y ei

ther

su

bje

ctiv

e re

por

t (e

.g.,

fee

ls s

ad,

emp

ty,

or h

opel

ess)

or

ob

serv

atio

n m

ade

by

oth

ers

(e.g

., a

pp

ears

tea

rfu

l).

(Not

e: I

n

child

ren

an

d a

dol

esce

nts

, ca

n b

e ir

rita

ble

moo

d.)

1

PIs

sad,

glo

omy,

or i

rrita

ble

for m

any

days

at a

tim

e.94

*-o

r-13

7

3, 2

-or-

3, 2

, 1

10

-and

-0

Seem

s hop

eles

s abo

ut th

e fu

ture

.−

TIs

sad,

glo

omy,

or i

rrita

ble

for m

any

days

at a

tim

e.19

3*-o

r-11

6

3, 2

-or-

3, 2

, 1

10

-and

-0

Seem

s hop

eles

s abo

ut th

e fu

ture

.−

SRI f

eel s

ad, g

loom

y, o

r irr

itabl

e fo

r man

y da

ys a

t a ti

me.

115*

-or- 16

3, 2

-or-

3, 2

, 1

10

-and

-0

The

futu

re se

ems h

opel

ess t

o m

e.−

Mar

ked

ly d

imin

ish

ed in

tere

st o

r p

leas

ure

in a

ll, o

r al

mos

t al

l,

acti

viti

es m

ost

of t

he

day

, n

earl

y ev

ery

day

(as

ind

icat

ed b

y ei

ther

su

bje

ctiv

e ac

cou

nt

or o

bse

rvat

ion

).2

PH

as lo

st in

tere

st o

r ple

asur

e in

act

iviti

es.

53*

3, 2

10

TH

as lo

st in

tere

st o

r ple

asur

e in

act

iviti

es.

46*

3, 2

10

SRI d

on’t

feel

like

doi

ng th

ings

that

I us

ed to

enj

oy.

93*

3, 2

−1,

0

Sig

nifi

can

t w

eig

ht

loss

wh

en n

ot d

ieti

ng

or

wei

gh

t g

ain

(e.

g.,

a

chan

ge

of m

ore

than

5%

of

bod

y w

eig

ht

in a

mon

th),

or

dec

reas

e or

incr

ease

in a

pp

etit

e n

earl

y ev

ery

day

. (N

ote:

In

ch

ildre

n,

con

sid

er f

ailu

re t

o m

ake

exp

ecte

d w

eig

ht

gai

n.)

3a

PA

ppet

ite o

r wei

ght h

as c

hang

ed a

lot.

433,

2, 1

−0

TA

ppet

ite o

r wei

ght h

as c

hang

ed a

lot.

162

3, 2

, 1−

0

SRM

y ap

petit

e or

wei

ght h

as c

hang

ed a

lot.

83,

2−

1, 0

Inso

mn

ia o

r h

yper

som

nia

nea

rly

ever

y d

ay.

4b

P

Slee

ps to

o m

uch.

59 -or-

126

-or-

181

-or-

110

3, 2

-or-

3, 2

-or-

3, 2

-or-

3, 2

−1,

0-a

nd-

1, 0

-and

-1,

0-a

nd-

1, 0

Has

trou

ble

falli

ng a

slee

p.−

Wak

es u

p to

o ea

rly.

−

Wak

es u

p du

ring

the

nigh

t, th

en h

as tr

oubl

e fa

lling

bac

k to

slee

p.−

TFa

lls a

slee

p in

cla

ss.

181

3, 2

10

SR

I sle

ep to

o m

uch.

125

-or- 70 -or-

158

-or- 1

3, 2

-or-

3, 2

-or-

3, 2

-or-

3, 2

−1,

0-a

nd-

1, 0

-and

-1,

0-a

nd-

1, 0

I hav

e tro

uble

falli

ng a

slee

p.−

I wak

e up

too

early

(and

not

just

bec

ause

of t

he a

larm

clo

ck o

r my

pare

nts)

.−

I wak

e up

dur

ing

the

nigh

t and

hav

e tro

uble

falli

ng b

ack

to sl

eep.

−

Psy

chom

otor

ag

itat

ion

or

reta

rdat

ion

nea

rly

ever

y d

ay (

obse

rvab

le

by

oth

ers;

not

mer

ely

sub

ject

ive

feel

ing

s of

res

tles

snes

s or

bei

ng

sl

owed

dow

n).

5

PIs

agi

tate

d in

the

rest

less

sens

e.35 -o

r-10

3*

3, 2

-or-

3, 2

1 -or- 1

0-a

nd-

0Se

ems p

hysi

cally

slow

ed d

own.

TIs

agi

tate

d in

the

rest

less

sens

e.83 -o

r-13

6*

3, 2

-or-

3, 2

1 -or- 1

0-a

nd-

0Se

ems p

hysi

cally

slow

ed d

own.

SRI a

m re

stle

ss.

86 -or-

26*

3, 2

-or-

3, 2

−1,

0-a

nd-

0I f

eel v

ery

slow

ed d

own

in m

y m

ovem

ents

.1

Tabl

e co

ntin

ued

next

pag

e...


14

DS

M-5

Cri

teri

on A

Form

Item

Item

#

Indicated

May be Indicated

Not Indicated

Fati

gu

e or

loss

of

ener

gy

nea

rly

ever

y d

ay.

6c

PSe

ems t

ired;

has

low

ene

rgy.

171*

3, 2

−1,

0

TSe

ems t

ired;

has

low

ene

rgy.

122*

3, 2

−1,

0

SRI f

eel t

ired,

like

I do

n’t h

ave

enou

gh e

nerg

y.13

7*3,

2−

1, 0

Feel

ing

s of

wor

thle

ssn

ess

or e

xces

sive

or

inap

pro

pri

ate

gu

ilt

(wh

ich

may

be

del

usi

onal

) n

earl

y ev

ery

day

(n

ot m

erel

y se

lf-

rep

roac

h o

r g

uilt

ab

out

bei

ng

sic

k).

7

PFe

els i

napp

ropr

iate

ly g

uilty

.12

4*-o

r- 6*

3, 2

-or-

3, 2

1 -or- 1

0-a

nd-

0Fe

els w

orth

less

.

TFe

els i

napp

ropr

iate

ly g

uilty

.16

9*-o

r-16

6*

3, 2

-or-

3, 2

1 -or- 1

0-a

nd-

0Fe

els w

orth

less

.

SRI f

eel m

ore

guilt

y th

an I

shou

ld.

118*

-or-

135*

3, 2

-or-

3, 2

−1,

0-a

nd-

0I f

eel w

orth

less

.1

Dim

inis

hed

ab

ility

to

thin

k or

con

cen

trat

e, o

r in

dec

isiv

enes

s, n

earl

y ev

ery

day

(ei

ther

by

sub

ject

ive

acco

un

t or

as

obse

rved

by

oth

ers)

.8

PH

as lo

st th

e ab

ility

to th

ink,

con

cent

rate

, or m

ake

deci

sion

s.49

3, 2

10

TH

as lo

st th

e ab

ility

to th

ink,

con

cent

rate

, or m

ake

deci

sion

s.90

3, 2

10

SRI c

an’t

mak

e up

my

min

d ab

out t

hing

s any

mor

e.12 -o

r-14

7

3, 2

-or-

3, 2

−1,

0-a

nd-

1, 0

I am

no

long

er a

ble

to k

eep

my

min

d on

one

thin

g.−

Rec

urr

ent

thou

gh

ts o

f d

eath

(n

ot j

ust

fea

r of

dyi

ng

), r

ecu

rren

t su

icid

al id

eati

on w

ith

out

a sp

ecifi

c p

lan

, or

a s

uic

ide

atte

mp

t or

a

spec

ific

pla

n f

or c

omm

itti

ng

su

icid

e.9d

PH

as ta

lked

abo

ut, t

ried,

or p

lann

ed to

com

mit

suic

ide.

138*

-or-

168*

3, 2

, 1-o

r-3,

2, 1

−0

-and

-0

Has

repe

ated

thou

ghts

of d

eath

or d

ying

.−

TH

as ta

lked

abo

ut, t

ried,

or p

lann

ed to

com

mit

suic

ide.

58*

-or-

191*

3, 2

, 1-o

r-3,

2, 1

−0

-and

-0

Has

repe

ated

thou

ghts

of d

eath

or d

ying

.−

SRI t

hink

abo

ut h

urtin

g m

ysel

f.14

6*3,

2, 1

−0

DSM

-5 D

iagn

ostic

Crit

eria

is re

prin

ted

with

per

mis

sion

from

the

Dia

gnos

tic a

nd S

tatis

tical

Man

ual o

f Men

tal D

isor

ders

, Fift

h Ed

ition

™, (

Cop

yrig

ht ©

2013

). A

mer

ican

Psy

chia

tric A

ssoc

iatio

n.

All

Rig

hts R

eser

ved.

The

Am

eric

an P

sych

iatri

c Ass

ocia

tion

is n

ot a

ffilia

ted

with

and

is n

ot e

ndor

sing

this

pro

duct

.

Not

es:

P =

pare

nt; T

= te

ache

r; SR

= se

lf-re

port;

* =

dep

ress

ive

sym

ptom

s rep

rese

ntin

g th

e m

ixed

feat

ures

spec

ifier

for M

anic

Epi

sode

(see

Tab

le 8

). Th

e fo

llow

ing

resp

onse

key

app

lies t

o th

e cr

iterio

n st

atus

scor

e re

quire

men

ts n

oted

in th

e In

dica

ted,

May

be

Indi

cate

d, a

nd N

ot In

dica

ted

colu

mns

: 0 =

Not

true

at a

ll (N

ever

, Sel

dom

); 1

= Ju

st a

littl

e tru

e (O

ccas

iona

lly);

2 =

Pret

ty m

uch

true

(Ofte

n, Q

uite

a b

it);

3 =

Very

muc

h tru

e (V

ery

ofte

n, V

ery

freq

uent

ly).

Inte

rpre

tativ

e C

onsi

dera

tions

:•

Whe

n co

nsid

erin

g D

SM-5

sym

ptom

cri

teri

a fo

r M

ajor

Dep

ress

ive

Epi

sode

, the

ass

esso

r ne

eds t

o en

sure

the

yout

h ex

peri

ence

s the

se sy

mpt

oms n

earl

y ev

ery

day,

and

that

the

sym

ptom

s rep

rese

nt a

ch

ange

from

pre

viou

s fun

ctio

ning

.•

Pres

ence

of a

cur

rent

Maj

or D

epre

ssiv

e E

piso

de su

gges

ts c

onsi

dera

tion

of M

ajor

Dep

ress

ive

Dis

orde

r, as

wel

l as i

nves

tigat

ion

of p

ast M

anic

or

Hyp

oman

ic E

piso

des t

o de

term

ine

if B

ipol

ar I

Dis

orde

r or

Bip

olar

II D

isor

der

mig

ht b

e ap

prop

riat

e.a

If n

o ch

ange

in w

eigh

t or a

ppet

ite is

repo

rted

(Crit

erio

n A

3), f

ollo

w-u

p is

reco

mm

ende

d to

exa

min

e po

ssib

le fa

ilure

to m

ake

expe

cted

wei

ght g

ains

.b

Crit

erio

n A

4 is

ass

esse

d in

dire

ctly

(i.e

., “F

alls

asl

eep

in c

lass

”), a

s mos

t tea

cher

s do

not h

ave

the

oppo

rtun

ity to

obs

erve

the

yout

h’s s

leep

hab

its a

t nig

ht. F

ollo

w-u

p is

reco

mm

ende

d to

obt

ain

addi

tiona

l inf

or-

mat

ion

abou

t sle

ep p

robl

ems.

c In

vest

igat

ion

by th

e as

sess

or is

reco

mm

ende

d to

det

erm

ine

whe

ther

tire

dnes

s or l

ow e

nerg

y re

pres

ents

a c

hang

e fr

om ty

pica

l ene

rgy

leve

ls (C

riter

ion

A6)

.d

In o

rder

to fu

lly a

sses

s Crit

erio

n A

9 fo

r Con

ners

CBR

S−SR

, fol

low

-up

is re

com

men

ded

to d

eter

min

e if

ther

e ha

ve b

een

recu

rren

t tho

ught

s of d

eath

or s

uici

de, i

f a su

icid

e pl

an h

as b

een

mad

e, o

r if t

here

has

be

en a

suic

ide

atte

mpt

.

Tabl

e 5.

(c

ontin

ued)

DSM

-5 S

ympt

om C

ount

and

Crit

erio

n St

atus

Sco

re R

equi

rem

ents

for M

ajor

Dep

ress

ive

Epis

ode

DSM-5 Update

15

Tabl

e 6.

D

SM-5

Sym

ptom

Cou

nt a

nd C

riter

ion

Stat

us S

core

Req

uire

men

ts fo

r Dep

ress

ive

Epis

ode,

with

mix

ed fe

atur

es

DSM

-5 S

ympt

om C

ount

Req

uire

men

ts:

•Fu

ll cr

iteria

met

for M

ajor

Dep

ress

ive

Epis

ode

•Atleast3ofthe7manic/hypom

anicsym

ptom

s

DS

M-5

Cri

teri

on A

Form

Item

Item

#

Indicated

May be Indicated

Not Indicated

Elev

ated

, ex

pan

sive

moo

d.

1P

Seem

s abn

orm

ally

hap

py fo

r at l

east

one

wee

k.11

13,

2, 1

−0

TSe

ems a

bnor

mal

ly h

appy

for a

t lea

st o

ne w

eek.

114

3, 2

, 1−

0SR

I bec

ome

unus

ually

hap

py o

r irr

itabl

e fo

r a w

eek

or lo

nger

.89

3, 2

10

Infl

ated

sel

f-es

teem

or

gra

nd

iosi

ty.

2

PTh

inks

he/

she

is b

ette

r tha

n ev

eryo

ne a

nd c

an d

o an

ythi

ng.

743,

21

0T

Thin

ks h

e/sh

e is

bet

ter t

han

ever

yone

and

can

do

anyt

hing

.27

3, 2

10

SRI f

eel r

eally

goo

d, li

ke I’

m b

ette

r tha

n ev

eryo

ne e

lse

and

I can

do

anyt

hing

.17

13,

2−

1, 0

Mor

e ta

lkat

ive

than

usu

al o

r p

ress

ure

to

keep

tal

kin

g.

3P

Has

per

iods

of f

ast,

non-

stop

spee

ch.

713,

21

0T

Has

per

iods

of f

ast,

non-

stop

spee

ch.

253,

21

0SR

I fee

l lik

e I c

an't

stop

talk

ing.

633,

2−

1, 0

Flig

ht

of id

eas

or s

ub

ject

ive

exp

erie

nce

th

at t

hou

gh

ts a

re r

acin

g.

4P

Says

thou

ghts

are

raci

ng, o

r com

ing

too

fast

.10

93,

2, 1

−0

TSa

ys th

ough

ts a

re ra

cing

, or c

omin

g to

o fa

st.

152

3, 2

, 1−

0SR

My

thou

ghts

com

e so

fast

that

it is

har

d to

kee

p up

with

them

.27

3, 2

−1,

0

Incr

ease

in e

ner

gy

or g

oal-

dir

ecte

d a

ctiv

ity

(eit

her

soc

ially

, at

w

ork

or s

choo

l, o

r se

xual

ly).

5P

Has

show

n an

unu

sual

incr

ease

in so

cial

, sch

ool,

or se

xual

act

iviti

es.

913,

2, 1

−0

TH

as sh

own

an u

nusu

al in

crea

se in

soci

al, s

choo

l, or

sexu

al a

ctiv

ities

.14

23,

2, 1

−0

SRI s

udde

nly

have

man

y m

ore

plan

s and

act

iviti

es th

an I

used

to.

149

32

1, 0

Incr

ease

d o

r ex

cess

ive

invo

lvem

ent

in a

ctiv

itie

s th

at h

ave

a h

igh

p

oten

tial

for

pai

nfu

l con

seq

uen

ces

(e.g

., e

ng

agin

g in

un

rest

rain

ed

bu

yin

g s

pre

es,

sexu

al in

dis

cret

ion

s, o

r fo

olis

h b

usi

nes

s in

vest

men

ts).

6

PSe

eks p

leas

ure

with

out c

arin

g ab

out w

hat b

ad th

ings

cou

ld h

appe

n.19

83,

2, 1

−0

TSe

eks p

leas

ure

with

out c

arin

g ab

out w

hat b

ad th

ings

cou

ld h

appe

n.15

43,

2, 1

−0

SRI d

o th

ings

that

feel

goo

d, n

o m

atte

r wha

t bad

thin

gs m

ight

hap

pen

afte

rwar

ds.

166

3, 2

−1,

0

Dec

reas

ed n

eed

for

sle

ep (

feel

ing

res

ted

des

pit

e sl

eep

ing

less

th

an

usu

al;

to b

e co

ntr

aste

d w

ith

inso

mn

ia).

7P

Slee

ps m

uch

less

than

he/

she

used

to, b

ut d

oes n

ot se

em ti

red.

253,

21

0T

−−

−−

−SR

I sle

ep m

uch

less

than

I us

ed to

but

I do

n't f

eel t

ired.

108

3, 2

−1,

0D

SM-5

Dia

gnos

tic C

riter

ia is

repr

inte

d w

ith p

erm

issi

on fr

om th

e D

iagn

ostic

and

Sta

tistic

al M

anua

l of M

enta

l Dis

orde

rs, F

ifth

Editi

on™

, (C

opyr

ight

©20

13).

Am

eric

an P

sych

iatri

c Ass

ocia

tion.

A

ll R

ight

s Res

erve

d. T

he A

mer

ican

Psy

chia

tric A

ssoc

iatio

n is

not

affi

liate

d w

ith a

nd is

not

end

orsi

ng th

is p

rodu

ct.

Not

es:

P =

pare

nt; T

= te

ache

r; SR

= se

lf-re

port.

Th

e fo

llow

ing

resp

onse

key

app

lies t

o th

e cr

iterio

n st

atus

scor

e re

quire

men

ts n

oted

in th

e In

dica

ted,

May

be

Indi

cate

d, a

nd N

ot In

dica

ted

colu

mns

: 0 =

Not

true

at a

ll (N

ever

, Sel

dom

);

1 =

Just

a li

ttle

true

(Occ

asio

nally

); 2

= Pr

etty

muc

h tru

e (O

ften,

Qui

te a

bit)

; 3 =

Ver

y m

uch

true

(Ver

y of

ten,

Ver

y fr

eque

ntly

).

Inte

rpre

tativ

e C

onsi

dera

tions

:•

Mix

ed fe

atur

es a

ssoc

iate

d w

ith a

Maj

or D

epre

ssiv

e E

piso

de h

ave

been

foun

d to

be

a si

gnifi

cant

ris

k fa

ctor

for

the

deve

lopm

ent o

f Bip

olar

I D

isor

der,

or B

ipol

ar II

Dis

orde

r.•

Whe

n co

nsid

erin

g D

SM-5

sym

ptom

cri

teri

a fo

r M

ajor

Dep

ress

ive

Epi

sode

, with

mix

ed fe

atur

es, t

he a

sses

sor

need

s to

ensu

re th

at th

e m

ixed

sym

ptom

s are

pre

sent

dur

ing

the

maj

ority

of d

ays o

f the

cu

rren

t or

mos

t rec

ent e

piso

de o

f dep

ress

ion,

and

that

the

mix

ed sy

mpt

oms r

epre

sent

a c

hang

e fr

om th

e pe

rson

’s u

sual

beh

avio

r.In

terp

reta

tive

cons

ider

atio

ns fo

r man

ic sy

mpt

oms w

ith a

n as

teris

k in

Tab

le 7

app

ly to

man

ic sy

mpt

oms a

sses

sed

for t

he D

epre

ssiv

e Ep

isod

e, w

ith m

ixed

feat

ures

spec

ifier

.


16

Tabl

e 7.

D

SM-5

Sym

ptom

Cou

nt a

nd C

riter

ion

Stat

us S

core

Req

uire

men

ts fo

r Man

ic E

piso

de

DSM

-5 S

ympt

om C

ount

Req

uire

men

ts:

•CriterionAElevatedMoodandIncreasedGoal-D

irectedActivityorE

nergyandatleast3ofthe7CriterionBsymptom

s.

- or -

•CriterionAIrritableMoodandIncreasedGoal-D

irectedActivityorE

nergyandatleast4ofthe7CriterionBsymptom

s.

DS

M-5

Cri

teri

a A

, B

Form

Item

Item

#

Indicated

May be Indicated

Not Indicated

A d

isti

nct

per

iod

of

abn

orm

ally

an

d p

ersi

sten

tly

elev

ated

, ex

pan

sive

, or

irri

tab

le m

ood

an

d a

bn

orm

ally

an

d p

ersi

sten

tly

incr

ease

d g

oal-

dir

ecte

d a

ctiv

ity

or e

ner

gy,

last

ing

at

leas

t 1

wee

k an

d p

rese

nt

mos

t of

th

e d

ay,

nea

rly

ever

y d

ay (

or a

ny

du

rati

on if

h

osp

ital

izat

ion

is n

eces

sary

).

Aa,

b, c

P

Seem

s abn

orm

ally

hap

py fo

r at l

east

one

wee

k.11

1*-o

r-16

6-a

nd-

91

3, 2

, 1-o

r-3,

2, 1

-and

-3,

2, 1

−0

-and

-0 -or- 0

Has

per

iods

of i

rrita

bilit

y la

stin

g fo

r at l

east

one

wee

k.−

Has

show

n an

unu

sual

incr

ease

in so

cial

, sch

ool,

or se

xual

act

iviti

es.

−

T

Seem

s abn

orm

ally

hap

py fo

r at l

east

one

wee

k.11

4*-o

r- 89 -and

-14

2

3, 2

, 1-o

r-3,

2, 1

-and

-3,

2, 1

−0

-and

-0 -or- 0

Has

per

iods

of i

rrita

bilit

y la

stin

g fo

r at l

east

one

wee

k.−

Has

show

n an

unu

sual

incr

ease

in so

cial

, sch

ool,

or se

xual

act

iviti

es.

−

SRI b

ecom

e un

usua

lly h

appy

or i

rrita

ble

for a

wee

k or

long

er.

89*

-and

-14

9

3, 2

-and

-3

10 -or-

1, 0

I sud

denl

y ha

ve m

any

mor

e pl

ans a

nd a

ctiv

ities

than

I us

ed to

.2

Infl

ated

sel

f-es

teem

or

gra

nd

iosi

ty.

B1

PTh

inks

he/

she

is b

ette

r tha

n ev

eryo

ne a

nd c

an d

o an

ythi

ng.

74*

3, 2

10

TTh

inks

he/

she

is b

ette

r tha

n ev

eryo

ne a

nd c

an d

o an

ythi

ng.

27*

3, 2

10

SRI f

eel r

eally

goo

d, li

ke I’

m b

ette

r tha

n ev

eryo

ne e

lse

and

I can

do

anyt

hing

.17

1*3,

2−

1, 0

Dec

reas

ed n

eed

for

sle

ep (

e.g

., f

eels

res

ted

aft

er o

nly

3 h

ours

of

slee

p).

B2d

PSl

eeps

muc

h le

ss th

an h

e/sh

e us

ed to

, but

doe

s not

seem

tire

d.25

*3,

21

0

T−

−−

−−

SRI s

leep

muc

h le

ss th

an I

used

to b

ut I

don'

t fee

l tire

d.10

8*3,

2−

1, 0

Mor

e ta

lkat

ive

than

usu

al o

r p

ress

ure

to

keep

tal

kin

g.

B3

PH

as p

erio

ds o

f fas

t, no

n-st

op sp

eech

.71

*3,

21

0

TH

as p

erio

ds o

f fas

t, no

n-st

op sp

eech

.25

*3,

21

0

SRI f

eel l

ike

I can

't st

op ta

lkin

g.63

*3,

2−

1, 0

Flig

ht

of id

eas

or s

ub

ject

ive

exp

erie

nce

th

at t

hou

gh

ts a

re r

acin

g.

B4

PSa

ys th

ough

ts ar

e ra

cing

, or c

omin

g to

o fa

st.10

9*3,

2, 1

−0

TSa

ys th

ough

ts ar

e ra

cing

, or c

omin

g to

o fa

st.15

2*3,

2, 1

−0

SRM

y th

ough

ts c

ome

so fa

st th

at it

is h

ard

to k

eep

up w

ith th

em.

27*

3, 2

−1,

0

Tabl

e co

ntin

ued

next

pag

e...

DSM-5 Update

17

DS

M-5

Cri

teri

a A

, B

Form

Item

Item

#

Indicated

May be Indicated

Not Indicated

Dis

trac

tib

ility

(i.

e.,

atte

nti

on t

oo e

asily

dra

wn

to

un

imp

orta

nt

or

irre

leva

nt

exte

rnal

sti

mu

li),

as r

epor

ted

or

obse

rved

.B

5

PA

ttent

ion

too

easil

y dr

awn

to u

nim

porta

nt o

r irre

leva

nt th

ings

.87

3, 2

−1,

0

TA

ttent

ion

too

easil

y dr

awn

to u

nim

porta

nt o

r irre

leva

nt th

ings

.91

3, 2

−1,

0

SRI g

et d

istra

cted

by

thin

gs th

at a

re n

ot im

porta

nt.

126

32

1, 0

Incr

ease

in g

oal-

dir

ecte

d a

ctiv

ity

(eit

her

soc

ially

, at

wor

k or

sc

hoo

l, o

r se

xual

ly)

or p

sych

omot

or a

git

atio

n (

i.e.

, p

urp

osel

ess

non

-goa

l-d

irec

ted

act

ivit

y).

B6

PH

as sh

own

an u

nusu

al in

crea

se in

soci

al, s

choo

l, or

sexu

al a

ctiv

i-tie

s.91

*-o

r- 35

3, 2

, 1-o

r-3,

2

−0

-and

-0

Is a

gita

ted

in th

e re

stle

ss se

nse.

1

TH

as sh

own

an u

nusu

al in

crea

se in

soci

al, s

choo

l, or

sexu

al a

ctiv

i-tie

s.14

2*-o

r- 83

3, 2

, 1-o

r-3,

2

−0

-and

-0

Is a

gita

ted

in th

e re

stle

ss se

nse.

1

SRI s

udde

nly

have

man

y m

ore

plan

s and

act

iviti

es th

an I

used

to.

149*

-or- 86

3 -or-

3, 2

21,

0

-and

-1,

0I a

m re

stle

ss.

−

Exce

ssiv

e in

volv

emen

t in

act

ivit

ies

that

hav

e a

hig

h p

oten

tial

fo

r p

ain

ful c

onse

qu

ence

s (e

.g.,

en

gag

ing

in u

nre

stra

ined

bu

yin

g

spre

es,

sexu

al in

dis

cret

ion

s, o

r fo

olis

h b

usi

nes

s in

vest

men

ts).

B7c

PSe

eks p

leas

ure

with

out c

arin

g ab

out w

hat b

ad th

ings

cou

ld h

ap-

pen.

198*

3, 2

, 1−

0

TSe

eks p

leas

ure

with

out c

arin

g ab

out w

hat b

ad th

ings

cou

ld h

ap-

pen.

154*

3, 2

, 1−

0

SRI d

o th

ings

that

feel

goo

d, n

o m

atte

r wha

t bad

thin

gs m

ight

ha

ppen

afte

rwar

ds.

166*

3, 2

−1,

0

DSM

-5 D

iagn

ostic

Crit

eria

is re

prin

ted

with

per

mis

sion

from

the

Dia

gnos

tic a

nd S

tatis

tical

Man

ual o

f Men

tal D

isor

ders

, Fift

h Ed

ition

™, (

Cop

yrig

ht ©

2013

). A

mer

ican

Psy

chia

tric A

ssoc

iatio

n.

All

Rig

hts R

eser

ved.

The

Am

eric

an P

sych

iatri

c Ass

ocia

tion

is n

ot a

ffilia

ted

with

and

is n

ot e

ndor

sing

this

pro

duct

.

Not

es:

P =

pare

nt; T

= te

ache

r; SR

= se

lf-re

port;

* =

man

ic sy

mpt

oms r

epre

sent

ing

the

mix

ed fe

atur

es sp

ecifi

er fo

r Maj

or D

epre

ssiv

e Ep

isod

e (s

ee T

able

6).

The

follo

win

g re

spon

se k

ey a

pplie

s to

the

crite

rion

stat

us sc

ore

requ

irem

ents

not

ed in

the

Indi

cate

d, M

ay b

e In

dica

ted,

and

Not

Indi

cate

d co

lum

ns: 0

= N

ot tr

ue a

t all

(Nev

er, S

eldo

m);

1 =

Just

a li

ttle

true

(Occ

asio

nally

); 2

= Pr

etty

muc

h tru

e (O

ften,

Qui

te a

bit)

; 3

= Ve

ry m

uch

true

(Ver

y of

ten,

Ver

y fr

eque

ntly

).

Inte

rpre

tativ

e C

onsi

dera

tions

:•

Pres

ence

of a

cur

rent

Man

ic E

piso

de su

gges

ts c

onsi

dera

tion

of B

ipol

ar I

Dis

orde

r.•

Whe

n co

nsid

erin

g D

SM-5

sym

ptom

cri

teri

a fo

r M

anic

Epi

sode

, the

ass

esso

r ne

eds t

o en

sure

the

yout

h ex

peri

ence

s the

Cri

teri

on A

sym

ptom

s nea

rly

ever

y da

y, a

nd th

at th

e C

rite

rion

B sy

mpt

oms

repr

esen

t a n

otic

eabl

e ch

ange

from

usu

al b

ehav

ior.

a C

rite

rion

A r

equi

res i

ncre

ased

goa

l-di

rect

ed a

ctiv

ity o

r in

crea

sed

ener

gy. I

ncre

ased

ene

rgy

is n

ot a

sses

sed

on th

e C

onne

rs C

BR

S. F

ollo

w-u

p is

rec

omm

ende

d to

che

ck if

ther

e ha

s bee

n an

incr

ease

in

ene

rgy.

b If

the

indi

vidu

al w

as h

ospi

taliz

ed fo

r th

e sy

mpt

oms o

f Man

ic E

piso

de, h

e/sh

e is

seve

re e

noug

h to

war

rant

con

side

ratio

n fo

r th

is d

iagn

osis

(eve

n if

sym

ptom

s did

not

per

sist

for

one

wee

k pr

ior

to

hosp

italiz

atio

n).

c If

Crit

erio

n A

May

be

Indi

cate

d or

is In

dica

ted

on th

e C

onne

rs C

BRS−

SR (i

tem

#89

), fo

llow

-up

is re

quire

d to

det

erm

ine

whe

ther

the

yout

h’s m

ood

is e

leva

ted,

exp

ansi

ve, o

r irr

itabl

e.d

The

Con

ners

CBR

S−T

does

not

ass

ess C

riter

ion

B2 (i

.e.,

decr

ease

d ne

ed fo

r sle

ep),

as m

ost t

each

ers d

o no

t hav

e th

e op

port

unity

to o

bser

ve th

is sy

mpt

om.

e C

rite

rion

B7

(exc

essi

ve in

volv

emen

t in

activ

ities

that

hav

e a

high

pot

enti

al fo

r pa

infu

l con

sequ

ence

s) is

ass

esse

d w

ith th

e ite

m “

Seek

s ple

asur

e w

ithou

t car

ing

abou

t wha

t bad

thin

gs c

ould

hap

pen”

[P

, T],

or “

I do

thin

gs th

at fe

el g

ood,

no

mat

ter

wha

t bad

thin

gs m

ight

hap

pen

afte

rwar

ds”

[SR

]. T

he sy

mpt

om c

rite

rion

des

crib

es a

ctiv

ities

ass

ocia

ted

with

shor

t-te

rm p

leas

ure

and

long

-ter

m c

on-

sequ

ence

s (e.

g., s

hopp

ing

spre

es, s

exua

l ind

iscr

etio

ns, r

isky

bus

ines

s inv

estm

ents

), bu

t “pl

easu

re”

or “

feel

ing

good

” is

not

spec

ified

in th

e D

SM-5

. Fur

ther

inve

stig

atio

n is

war

rant

ed to

det

erm

ine

if th

e in

divi

dual

is e

ngag

ed in

hig

h-ri

sk a

ctiv

ities

.

Tabl

e 7.

(c

ontin

ued)

DSM

-5 S

ympt

om C

ount

and

Crit

erio

n St

atus

Sco

re R

equi

rem

ents

for M

anic

Epi

sode


18

Tabl

e 8.

D

SM-5

Sym

ptom

Cou

nt a

nd C

riter

ion

Stat

us S

core

Req

uire

men

ts fo

r Man

ic E

piso

de, w

ith m

ixed

feat

ures

D

SM-5

Sym

ptom

Cou

nt R

equi

rem

ents

:•

Full

crite

ria m

et fo

r Man

ic E

piso

de•

At le

ast 3

of t

he 6

Crit

erio

n A

sym

ptom

s

DS

M-5

Cri

teri

on A

Form

Item

Item

#

Indicated

May be Indicated

Not Indicated

Pro

min

ent

dys

ph

oria

or

dep

ress

ed m

ood

as

ind

icat

ed b

y ei

ther

su

bje

ctiv

e re

por

t (e

.g.,

fee

ls s

ad o

r em

pty

) or

ob

serv

atio

n m

ade

by

oth

ers

(e.g

., a

pp

ears

tea

rfu

l).

1a

PIs

sad,

glo

omy,

or i

rrita

ble

for m

any

days

at a

tim

e.94

3, 2

10

TIs

sad,

glo

omy,

or i

rrita

ble

for m

any

days

at a

tim

e.19

33,

21

0

SRI f

eel s

ad, g

loom

y, o

r irr

itabl

e fo

r man

y da

ys a

t a ti

me.

115

3, 2

10

Dim

inis

hed

inte

rest

or

ple

asu

re in

all,

or

alm

ost

all,

act

ivit

ies

(as

ind

icat

ed b

y ei

ther

su

bje

ctiv

e ac

cou

nt

or o

bse

rvat

ion

mad

e b

y ot

her

s).

2

PH

as lo

st in

tere

st o

r ple

asur

e in

act

iviti

es.

533,

21

0

TH

as lo

st in

tere

st o

r ple

asur

e in

act

iviti

es.

463,

21

0

SRI d

on’t

feel

like

doi

ng th

ings

that

I us

ed to

enj

oy.

933,

2−

1, 0

Psy

chom

otor

ret

ard

atio

n n

earl

y ev

ery

day

(ob

serv

able

by

oth

ers;

n

ot m

erel

y su

bje

ctiv

e fe

elin

gs

of b

ein

g s

low

ed d

own

).3

PSe

ems p

hysi

cally

slow

ed d

own.

103

3, 2

10

TSe

ems p

hysi

cally

slow

ed d

own.

136

3, 2

10

SRI f

eel v

ery

slow

ed d

own

in m

y m

ovem

ents

.26

3, 2

10

Fati

gu

e or

loss

of

ener

gy.

4

PSe

ems t

ired;

has

low

ene

rgy.

171

3, 2

−1,

0

TSe

ems t

ired;

has

low

ene

rgy.

122

3, 2

−1,

0

SRI f

eel t

ired,

like

I do

n’t h

ave

enou

gh e

nerg

y.13

73,

2−

1, 0

Feel

ing

s of

wor

thle

ssn

ess

or e

xces

sive

or

inap

pro

pri

ate

gu

ilt (

not

m

erel

y se

lf-r

epro

ach

or

gu

ilt a

bou

t b

ein

g s

ick)

.5

PFe

els i

napp

ropr

iate

ly g

uilty

.12

4-o

r- 6

3, 2

-or-

3, 2

1 -or- 1

0-a

nd-

0Fe

els w

orth

less

.

TFe

els i

napp

ropr

iate

ly g

uilty

.16

9-o

r-16

6

3, 2

-or-

3, 2

1 -or- 1

0-a

nd-

0Fe

els w

orth

less

.

SRI f

eel m

ore

guilt

y th

an I

shou

ld.

118

-or-

135

3, 2

-or-

3, 2

− 1

1, 0

-and

-0

I fee

l wor

thle

ss.

Tabl

e co

ntin

ued

next

pag

e...

DSM-5 Update

19

DS

M-5

Cri

teri

on A

Form

Item

Item

#

Indicated

May be Indicated

Not Indicated

Rec

urr

ent

thou

gh

ts o

f d

eath

(n

ot j

ust

fea

r of

dyi

ng

), r

ecu

rren

t su

icid

al id

eati

on w

ith

out

a sp

ecifi

c p

lan

, or

a s

uic

ide

atte

mp

t or

a

spec

ific

pla

n f

or c

omm

itti

ng

su

icid

e.6

PH

as ta

lked

abo

ut, t

ried,

or p

lann

ed to

com

mit

suic

ide.

138

-or-

168

3, 2

, 1-o

r-3,

2, 1

−0

-and

-0

Has

repe

ated

thou

ghts

of d

eath

or d

ying

.−

TH

as ta

lked

abo

ut, t

ried,

or p

lann

ed to

com

mit

suic

ide.

58 -or-

191

3, 2

, 1-o

r-3,

2, 1

−0

-and

-0

Has

repe

ated

thou

ghts

of d

eath

or d

ying

.−

SRI t

hink

abo

ut h

urtin

g m

ysel

f.14

63,

2, 1

−0

DSM

-5 D

iagn

ostic

Crit

eria

is re

prin

ted

with

per

mis

sion

from

the

Dia

gnos

tic a

nd S

tatis

tical

Man

ual o

f Men

tal D

isor

ders

, Fift

h Ed

ition

™, (

Cop

yrig

ht ©

2013

). A

mer

ican

Psy

chia

tric A

ssoc

iatio

n.

All

Rig

hts R

eser

ved.

The

Am

eric

an P

sych

iatri

c Ass

ocia

tion

is n

ot a

ffilia

ted

with

and

is n

ot e

ndor

sing

this

pro

duct

.

Not

es:

P =

pare

nt; T

= te

ache

r; SR

= se

lf-re

port.

The

follo

win

g re

spon

se k

ey a

pplie

s to

the

crite

rion

stat

us sc

ore

requ

irem

ents

not

ed in

the

Indi

cate

d, M

ay b

e In

dica

ted,

and

Not

Indi

cate

d co

lum

ns: 0

= N

ot tr

ue a

t al

l (N

ever

, Sel

dom

); 1

= Ju

st a

littl

e tru

e (O

ccas

iona

lly);

2 =

Pret

ty m

uch

true

(Ofte

n, Q

uite

a b

it); 3

= V

ery

muc

h tru

e (V

ery

ofte

n, V

ery

freq

uent

ly).

Inte

rpre

tativ

e C

onsi

dera

tions

:•

Pres

ence

of a

cur

rent

Man

ic E

piso

de, w

ith m

ixed

feat

ures

sugg

ests

con

side

ratio

n of

Bip

olar

I D

isor

der.

• W

hen

cons

ider

ing

DSM

-5 sy

mpt

om c

rite

ria

for

Man

ic E

piso

de, w

ith m

ixed

feat

ures

, the

ass

esso

r ne

eds t

o en

sure

that

the

mix

ed sy

mpt

oms a

re p

rese

nt d

urin

g th

e m

ajor

ity o

f day

s of t

he c

urre

nt o

r m

ost r

ecen

t epi

sode

of m

ania

, and

that

the

mix

ed sy

mpt

oms r

epre

sent

a c

hang

e fr

om th

e pe

rson

’s u

sual

beh

avio

r.a

The

DSM

-5 n

o lo

nger

incl

udes

irri

tabi

lity

in C

rite

rion

A1

for

mix

ed fe

atur

es.

Inte

rpre

tativ

e co

nsid

erat

ions

for d

epre

ssiv

e sy

mpt

oms w

ith a

n as

teris

k in

Tab

le 5

app

ly to

dep

ress

ive

sym

ptom

s ass

esse

d fo

r the

Man

ic E

piso

de, w

ith m

ixed

feat

ures

spec

ifier

.

Tabl

e 8.

(c

ontin

ued)

DSM

-5 S

ympt

om C

ount

and

Crit

erio

n St

atus

Sco

re R

equi

rem

ents

for M

anic

Epi

sode

, with

mix

ed fe

atur

es


20

Tabl

e 9.

D

SM-5

Sym

ptom

Cou

nt a

nd C

riter

ion

Stat

us S

core

Req

uire

men

ts fo

r Gen

eral

ized

Anx

iety

Dis

orde

r D

SM-5

Sym

ptom

Cou

nt R

equi

rem

ents

:•CriteriaAandB

•Atleast1ofthe6CriterionCsym

ptom

sa

DS

M-5

Cri

teri

a A

, B

, C

Form

Item

Item

#

Indicated

May be Indicated

Not Indicated

Exce

ssiv

e an

xiet

y an

d w

orry

(ap

pre

hen

sive

exp

ecta

tion

), o

ccu

rrin

g

mor

e d

ays

than

not

for

at

leas

t 6

mon

ths,

ab

out

a n

um

ber

of

even

ts o

r ac

tivi

ties

(su

ch a

s w

ork

or s

choo

l per

form

ance

).A

PW

orrie

s abo

ut m

any

thin

gs.

683,

2−

1, 0

TW

orrie

s abo

ut m

any

thin

gs.

593,

2−

1, 0

SRI w

orry

abo

ut lo

ts o

f thi

ngs.

783,

2−

1, 0

The

ind

ivid

ual

fin

ds

it d

ifficu

lt t

o co

ntr

ol t

he

wor

ry.

B

PH

as tr

oubl

e co

ntro

lling

his

/her

wor

ries.

153

3, 2

10

TH

as tr

oubl

e co

ntro

lling

his

/her

wor

ries.

186

3, 2

10

SRI h

ave

troub

le c

ontro

lling

my

wor

ries.

383,

2−

1, 0

Res

tles

snes

s or

fee

ling

key

ed u

p o

r on

ed

ge.

C1

PA

ppea

rs “

on e

dge,

” ne

rvou

s, or

jum

py.

42 -or- 89

3, 2

-or-

3, 2

1 -or- 1

0-a

nd-

0R

estle

ss o

r ove

ract

ive.

TA

ppea

rs “

on e

dge,

” ne

rvou

s, or

jum

py.

194

-or-

139

3, 2

-or-

3, 2

1 -or- 1

0-a

nd-

0R

estle

ss o

r ove

ract

ive.

SRI f

eel n

ervo

us o

r jum

py.

3 -or- 86

3, 2

-or-

3, 2

−1,

0-a

nd-

1, 0

I am

rest

less

.−

Bei

ng

eas

ily f

atig

ued

.C

2

PSe

ems t

ired;

has

low

ene

rgy.

171

-or- 50

3, 2

-or-

3, 2

, 1

−1,

0-a

nd-

0G

ets w

orn

out w

ith w

orry

ing.

−

TSe

ems t

ired;

has

low

ene

rgy.

122

-or- 7

3, 2

-or-

3, 2

, 1

−1,

0-a

nd-

0G

ets w

orn

out w

ith w

orry

ing.

−

SRI f

eel t

ired,

like

I do

n't h

ave

enou

gh e

nerg

y.13

7-o

r- 35

3, 2

-or-

3, 2

−1,

0-a

nd-

1, 0

I get

wor

n ou

t with

wor

ryin

g.−

Diffi

cult

y co

nce

ntr

atin

g o

r m

ind

goi

ng

bla

nk.

C3

PH

as tr

oubl

e co

ncen

tratin

g.4

3, 2

−1,

0

TH

as tr

oubl

e co

ncen

tratin

g.19

93,

2−

1, 0

SRI h

ave

troub

le k

eepi

ng m

y m

ind

on th

ings

.11

33,

2−

1, 0

Irri

tab

ility

.C

4

PB

ecom

es ir

ritab

le w

hen

anxi

ous.

196

-or-

108

3, 2

-or-

3, 2

−1,

0-a

nd-

1, 0

Is ir

ritab

le a

nd e

asily

ann

oyed

by

othe

rs.

−

TB

ecom

es ir

ritab

le w

hen

anxi

ous.

35 -or-

174

3, 2

-or-

3, 2

−1,

0-a

nd-

0Is

irrit

able

and

eas

ily a

nnoy

ed b

y ot

hers

.1

SRW

hen

I fee

l ner

vous

, thi

ngs i

rrita

te m

e.14

23,

2−

1, 0

Tabl

e co

ntin

ued

next

pag

e...

DSM-5 Update

21

DS

M-5

Cri

teri

a A

, B

, C

Form

Item

Item

#

Indicated

May be Indicated

Not Indicated

Mu

scle

ten

sion

.C

5

PM

uscl

es g

et te

nse

whe

n w

orrie

d ab

out s

omet

hing

.7

3, 2

−1,

0

TM

uscl

es g

et te

nse

whe

n w

orrie

d ab

out s

omet

hing

.19

53,

21

0

SRM

y m

uscl

es g

et te

nse

whe

n I a

m w

orrie

d ab

out s

omet

hing

.13

3, 2

−1,

0

Sle

ep d

istu

rban

ce (

diffi

cult

y fa

llin

g o

r st

ayin

g a

slee

p,

or r

estl

ess,

u

nsa

tisf

yin

g s

leep

).C

6b

P

Wor

ries s

o m

uch

that

he/

she

has t

roub

le sl

eepi

ng.

119

-or-

110

-or-

126

-or-

181

3. 2

-or-

3, 2

-or-

3, 2

-or-

3, 2

10

-and

-1,

0-a

nd-

1, 0

-and

-1,

0

Wak

es u

p du

ring

the

nigh

t, th

en h

as tr

oubl

e fa

lling

bac

k to

slee

p.−

Has

trou

ble

falli

ng a

slee

p.−

Wak

es u

p to

o ea

rly.

−

TFa

lls a

slee

p in

cla

ss.

181

3, 2

, 1−

0

SR

I hav

e tro

uble

slee

ping

bec

ause

I am

wor

ryin

g ab

out s

tuff.

10 -or- 1 -or- 70 -or-

158

3, 2

-or-

3, 2

-or-

3, 2 or 3, 2

−1,

0-a

nd-

1, 0

-and

-1,

0-a

nd-

1, 0

I wak

e up

dur

ing

the

nigh

t and

hav

e tro

uble

falli

ng b

ack

to sl

eep.

−

I hav

e tro

uble

falli

ng a

slee

p.−

I wak

e up

too

early

(and

not

just

bec

ause

of t

he a

larm

clo

ck o

r my

pare

nts)

.−

DSM

-5 D

iagn

ostic

Crit

eria

is re

prin

ted

with

per

mis

sion

from

the

Dia

gnos

tic a

nd S

tatis

tical

Man

ual o

f Men

tal D

isor

ders

, Fift

h Ed

ition

™, (

Cop

yrig

ht ©

2013

). A

mer

ican

Psy

chia

tric A

ssoc

iatio

n.

All

Rig

hts R

eser

ved.

The

Am

eric

an P

sych

iatri

c Ass

ocia

tion

is n

ot a

ffilia

ted

with

and

is n

ot e

ndor

sing

this

pro

duct

.

Not

es:

P =

pare

nt; T

= te

ache

r; SR

= se

lf-re

port.

The

follo

win

g re

spon

se k

ey a

pplie

s to

the

crite

rion

stat

us sc

ore

requ

irem

ents

not

ed in

the

Indi

cate

d, M

ay b

e In

dica

ted,

and

Not

Indi

cate

d co

lum

ns: 0

= N

ot tr

ue a

t al

l (N

ever

, Sel

dom

); 1

= Ju

st a

littl

e tru

e (O

ccas

iona

lly);

2 =

Pret

ty m

uch

true

(Ofte

n, Q

uite

a b

it); 3

= V

ery

muc

h tru

e (V

ery

ofte

n, V

ery

freq

uent

ly).

Inte

rpre

tativ

e C

onsi

dera

tions

:a

The

DSM

-5 r

equi

res a

t lea

st o

ne o

f six

cri

teri

on C

sym

ptom

s for

chi

ldre

n; a

t lea

st th

ree

out o

f the

six

sym

ptom

s are

req

uire

d fo

r ad

ults

(no

clar

ifica

tion

is p

rovi

ded

rega

rdin

g “a

dole

scen

ts”)

. The

C

onne

rs C

BR

S Sy

mpt

om C

ount

is b

ased

on

the

DSM

-5 c

rite

ria

for

child

ren.

b C

riter

ion

C6

is a

sses

sed

indi

rect

ly (i

.e.,

“Fal

ls a

slee

p in

cla

ss”)

, as m

ost t

each

ers d

o no

t hav

e th

e op

port

unity

to o

bser

ve th

e yo

uth’

s sle

ep h

abits

at n

ight

. Fol

low

-up

is re

com

men

ded

to o

btai

n ad

ditio

nal i

nfor

-m

atio

n re

gard

ing

slee

p pr

oble

ms.

Tabl

e 9.

(c

ontin

ued)

DSM

-5 S

ympt

om C

ount

and

Crit

erio

n St

atus

Sco

re R

equi

rem

ents

for G

ener

aliz

ed A

nxie

ty D

isor

der


22

Tabl

e 10

. D

SM-5

Sym

ptom

Cou

nt a

nd C

riter

ion

Stat

us S

core

Req

uire

men

ts fo

r Sep

arat

ion

Anx

iety

Dis

orde

r DSM

-5Sym

ptom

CountRequirements:A

tleast3ofthe8sym

ptom

s.

DS

M-5

Cri

teri

on A

Form

Item

Item

#

Indicated

May be Indicated

Not Indicated

Rec

urr

ent

exce

ssiv

e d

istr

ess

wh

en a

nti

cip

atin

g o

r ex

per

ien

cin

g

sep

arat

ion

fro

m h

ome

or f

rom

maj

or a

ttac

hm

ent

fig

ure

s.1

PIs

wor

ried

or d

istre

ssed

abo

ut b

eing

sepa

rate

d fr

om c

areg

iver

s.76

3, 2

10

TSe

ems w

orrie

d or

dist

ress

ed a

bout

bei

ng se

para

ted

from

car

egiv

ers.

13,

21

0

SRI w

orry

abo

ut b

eing

apa

rt fr

om m

y fa

mily

.61

3, 2

−1,

0

Per

sist

ent

and

exc

essi

ve w

orry

ab

out

losi

ng

maj

or a

ttac

hm

ent

fig

ure

s or

ab

out

pos

sib

le h

arm

to

them

, su

ch a

s ill

nes

s, in

jury

, d

isas

ters

, or

dea

th.

2

PW

orrie

s abo

ut so

met

hing

bad

hap

peni

ng to

fam

ily m

embe

rs.

313,

2−

1, 0

TSe

ems w

orrie

d ab

out s

omet

hing

bad

hap

peni

ng to

fam

ily m

embe

rs.

170

3, 2

10

SRI w

orry

that

som

ethi

ng b

ad m

ight

hap

pen

to m

y fa

mily

.24

32

1, 0

Per

sist

ent

and

exc

essi

ve w

orry

ab

out

exp

erie

nci

ng

an

un

tow

ard

ev

ent

(e.g

., g

etti

ng

lost

, b

ein

g k

idn

app

ed,

hav

ing

an

acc

iden

t,

bec

omin

g il

l) t

hat

cau

ses

sep

arat

ion

fro

m a

maj

or a

ttac

hm

ent

fig

ure

.

3

PW

orrie

s abo

ut g

ettin

g lo

st o

r bei

ng k

idna

pped

.88

3, 2

10

TSe

ems w

orrie

d ab

out g

ettin

g lo

st o

r bei

ng k

idna

pped

.68

3, 2

10

SRI w

orry

abo

ut g

ettin

g lo

st o

r bei

ng k

idna

pped

.14

53,

2−

1, 0

Per

sist

ent

relu

ctan

ce o

r re

fusa

l to

go

out,

aw

ay f

rom

hom

e, t

o sc

hoo

l, t

o w

ork,

or

else

wh

ere

bec

ause

of

fear

of

sep

arat

ion

.4

PR

efus

es to

go

to sc

hool

or o

ther

pla

ces f

or fe

ar o

f bei

ng se

para

ted

from

fam

ily m

embe

rs.

443,

21

0

TM

akes

exc

uses

in o

rder

to se

e hi

s/her

fam

ily d

urin

g th

e sc

hool

day

.18

93,

21

0

SRI d

on’t

like

goin

g to

scho

ol o

r oth

er p

lace

s whe

re I

am a

way

from

m

y fa

mily

.15

13,

21

0

Per

sist

ent

and

exc

essi

ve f

ear

of o

r re

luct

ance

ab

out

bei

ng

alo

ne

or

wit

hou

t m

ajor

att

ach

men

t fi

gu

res

at h

ome

or in

oth

er s

etti

ng

s.5

PIs

afr

aid

of b

eing

alo

ne w

ithou

t fam

ily o

r oth

er fa

mili

ar a

dults

.41 -o

r- 58

3, 2

-or-

3, 2

−1,

0-a

nd-

1, 0

Is a

frai

d of

bei

ng a

lone

.−

TIs

afr

aid

of b

eing

alo

ne w

ithou

t fam

ily o

r oth

er fa

mili

ar a

dults

.26

3, 2

10

SRI g

et sc

ared

if I’

m n

ot w

ith m

y fa

mily

or o

ther

adu

lts I

know

wel

l.14 -o

r-14

0

3, 2

-or-

3, 2

−1,

0-a

nd-

1, 0

I wor

ry a

bout

bei

ng a

lone

.−

Per

sist

ent

relu

ctan

ce o

r re

fusa

l to

slee

p a

way

fro

m h

ome

or t

o g

o to

sle

ep w

ith

out

bei

ng

nea

r a

maj

or a

ttac

hm

ent

fig

ure

.6a

PIs

afr

aid

to g

o to

slee

p w

ithou

t a fa

mily

mem

ber n

earb

y.16

03,

21

0

T −

−−

−−

SRI’

m a

frai

d to

go

to sl

eep

if m

y fa

mily

is n

ot n

ear m

e.12

73,

21

0

Rep

eate

d n

igh

tmar

es in

volv

ing

th

e th

eme

of s

epar

atio

n.

7a

PH

as n

ight

mar

es a

bout

bei

ng se

para

ted

from

fam

ily.

813,

2, 1

−0

T −

−−

−−

SRI h

ave

bad

drea

ms a

bout

bei

ng a

way

from

my

fam

ily.

493,

21

0

Tabl

e co

ntin

ued

next

pag

e...

DSM-5 Update

23

DS

M-5

Cri

teri

on A

Form

Item

Item

#

Indicated

May be Indicated

Not Indicated

Rep

eate

d c

omp

lain

ts o

f p

hys

ical

sym

pto

ms

(e.g

., h

ead

ach

es,

stom

ach

ach

es,

nau

sea,

vom

itin

g)

wh

en s

epar

atio

n f

rom

maj

or

atta

chm

ent

fig

ure

s oc

curs

or

is a

nti

cip

ated

.8

PC

ompl

ains

of a

ches

and

pai

ns w

hen

wor

ried

abou

t bei

ng se

para

ted

from

fam

ily.

184

3, 2

, 1−

0

TC

ompl

ains

of a

ches

and

pai

ns w

hen

wor

ried

abou

t bei

ng se

para

ted

from

fam

ily.

111

3, 2

, 1−

0

SRI g

et a

ches

and

pai

ns w

hen

I thi

nk a

bout

bei

ng a

way

from

my

fam

ily.

523,

21

0

DSM

-5 D

iagn

ostic

Crit

eria

is re

prin

ted

with

per

mis

sion

from

the

Dia

gnos

tic a

nd S

tatis

tical

Man

ual o

f Men

tal D

isor

ders

, Fift

h Ed

ition

™, (

Cop

yrig

ht ©

2013

). A

mer

ican

Psy

chia

tric A

ssoc

iatio

n.

All

Rig

hts R

eser

ved.

The

Am

eric

an P

sych

iatri

c Ass

ocia

tion

is n

ot a

ffilia

ted

with

and

is n

ot e

ndor

sing

this

pro

duct

.

Not

es:

P =

pare

nt; T

= te

ache

r; SR

= se

lf-re

port.

The

follo

win

g re

spon

se k

ey a

pplie

s to

the

crite

rion

stat

us sc

ore

requ

irem

ents

not

ed in

the

Indi

cate

d, M

ay b

e In

dica

ted,

and

Not

Indi

cate

d co

lum

ns: 0

= N

ot tr

ue a

t al

l (N

ever

, Sel

dom

); 1

= Ju

st a

littl

e tru

e (O

ccas

iona

lly);

2 =

Pret

ty m

uch

true

(Ofte

n, Q

uite

a b

it); 3

= V

ery

muc

h tru

e (V

ery

ofte

n, V

ery

freq

uent

ly).

Inte

rpre

tativ

e C

onsi

dera

tions

:a

The

Con

ners

CBR

S−T

does

not

ass

ess C

riter

ion

A6

(relu

ctan

ce o

r ref

usal

to sl

eep

away

from

his

/her

hom

e, o

r to

go to

slee

p w

ithou

t an

atta

chm

ent fi

gure

) or C

riter

ion

A7

(has

nig

htm

ares

abo

ut se

para

tion)

, as

mos

t tea

cher

s do

not h

ave

the

oppo

rtun

ity to

obs

erve

thes

e sy

mpt

oms.

Tabl

e 10

. (

cont

inue

d) D

SM-5

Sym

ptom

Cou

nt a

nd C

riter

ion

Stat

us S

core

Req

uire

men

ts fo

r Sep

arat

ion

Anx

iety

Dis

orde

r


24

Tabl

e 11

. D

SM-5

Sym

ptom

Cou

nt a

nd C

riter

ion

Stat

us S

core

Req

uire

men

ts fo

r Soc

ial A

nxie

ty D

isor

der (

Soci

al P

hobi

a)

DSM-5Sym

ptom

CountRequirements:C

riteriaA,B

,C,andD.

DS

M-5

Cri

teri

on A

, B

, C

, D

Form

Item

Item

#

Indicated

May be Indicated

Not Indicated

Mar

ked

fea

r or

an

xiet

y ab

out

one

or m

ore

soci

al s

itu

atio

ns

in w

hic

h

the

ind

ivid

ual

is e

xpos

ed t

o p

ossi

ble

scr

uti

ny

by

oth

ers.

Exa

mp

les

incl

ud

e so

cial

inte

ract

ion

s (e

.g.,

hav

ing

a c

onve

rsat

ion

, m

eeti

ng

u

nfa

mili

ar p

eop

le),

bei

ng

ob

serv

ed (

e.g

., e

atin

g o

r d

rin

kin

g),

an

d p

erfo

rmin

g in

fro

nt

of o

ther

s (e

.g.,

giv

ing

a s

pee

ch).

Not

e:

In c

hild

ren

, th

e an

xiet

y m

ust

occ

ur

in p

eer

sett

ing

s an

d n

ot j

ust

d

uri

ng

inte

ract

ion

s w

ith

ad

ult

s.

Aa

PPa

nics

abo

ut so

cial

situ

atio

ns o

r whe

n do

ing

thin

gs in

fron

t of

peop

le.

223,

2−

1, 0

TPa

nics

abo

ut so

cial

situ

atio

ns o

r whe

n do

ing

thin

gs in

fron

t of

peop

le.

200

3, 2

10

SRI g

et p

anic

ky w

hen

I hav

e to

do

thin

gs in

fron

t of o

ther

peo

ple

(like

ans

wer

que

stio

ns o

r giv

e a

talk

).46

32

1, 0

The

ind

ivid

ual

fea

rs t

hat

he

or s

he

will

act

in a

way

or

show

an

xiet

y sy

mp

tom

s th

at w

ill b

e n

egat

ivel

y ev

alu

ated

(i.

e.,

will

b

e h

um

iliat

ing

or

emb

arra

ssin

g;

will

lead

to

reje

ctio

n o

r off

end

ot

her

s).

B

PFe

ars b

eing

em

barr

asse

d or

hum

iliat

ed in

fron

t of p

eers

.18

7-o

r- 63

3 -or- 3

2 -or- 2

1, 0

-and

-1,

0W

orrie

s abo

ut w

hat o

ther

s thi

nk o

f him

/her

.

TFe

ars b

eing

em

barr

asse

d or

hum

iliat

ed in

fron

t of p

eers

.34 -o

r- 17

3 -or- 3

2 -or- 2

1, 0

-and

-1,

0W

orrie

s abo

ut w

hat o

ther

s thi

nk o

f him

/her

.

SRI w

orry

that

oth

er p

eopl

e m

ight

laug

h at

me

or m

ake

fun

of m

e.44 -o

r-16

1

3 -or- 3

2 -or- 2

1, 0

-and

-1,

0I w

orry

abo

ut w

hat o

ther

s thi

nk o

f me.

The

soci

al s

itu

atio

ns

alm

ost

alw

ays

pro

voke

fea

r or

an

xiet

y.

Not

e: I

n c

hild

ren

, th

e fe

ar o

r an

xiet

y m

ay b

e ex

pre

ssed

by

cryi

ng

, ta

ntr

um

s, f

reez

ing

, cl

ing

ing

, sh

rin

kin

g,

or f

ailin

g t

o sp

eak

in s

ocia

l si

tuat

ion

s.

Ca,

b, c

P

Pani

cs a

bout

soci

al si

tuat

ions

or w

hen

doin

g th

ings

in fr

ont o

f pe

ople

.22 -o

r- 56

3 -or- 3

2 -or- 2

1, 0

-and

-1,

0C

ries,

thro

ws t

antru

ms,

avoi

ds, o

r fre

ezes

in so

cial

situ

atio

ns w

ith

unfa

mili

ar p

eopl

e.

T

Pani

cs a

bout

soci

al si

tuat

ions

or w

hen

doin

g th

ings

in fr

ont o

f pe

ople

.20

0-o

r-19

7

3 -or- 3

2 -or- 2

1, 0

-and

-1,

0C

ries,

thro

ws t

antru

ms,

avoi

ds, o

r fre

ezes

in so

cial

situ

atio

ns w

ith

unfa

mili

ar p

eopl

e.

SRI g

et p

anic

ky w

hen

I hav

e to

do

thin

gs in

fron

t of o

ther

peo

ple

(like

ans

wer

que

stio

ns o

r giv

e a

talk

).46

32

1, 0

Tabl

e co

ntin

ued

next

pag

e...

DSM-5 Update

25

DS

M-5

Cri

teri

on A

, B

, C

, D

Form

Item

Item

#

Indicated

May be Indicated

Not Indicated

The

soci

al s

itu

atio

ns

are

avoi

ded

or

end

ure

d w

ith

inte

nse

fea

r or

an

xiet

y.D

P

Avoi

ds o

r bec

omes

dis

tress

ed a

bout

doi

ng th

ings

in fr

ont o

f pe

ople

.92 -o

r-17

6

3, 2

-or-

3, 2

−1,

0-a

nd-

0Av

oids

soci

al si

tuat

ions

, or b

ecom

es d

istre

ssed

whe

n re

quire

d to

pa

rtici

pate

.1

T

Avoi

ds o

r bec

omes

dis

tress

ed a

bout

doi

ng th

ings

in fr

ont o

f pe

ople

.24 -o

r-17

1

3, 2

-or-

3, 2

−1,

0-a

nd-

0Av

oids

soci

al si

tuat

ions

, or b

ecom

es d

istre

ssed

whe

n re

quire

d to

pa

rtici

pate

.1

SR

I avo

id o

r get

real

ly st

ress

ed o

ut a

bout

doi

ng th

ings

in fr

ont o

f ot

her p

eopl

e.74 -o

r- 84

3, 2

-or-

3, 2

−1,

0-a

nd-

1, 0

I avo

id o

r get

real

ly st

ress

ed o

ut b

y ta

lkin

g to

unf

amili

ar p

eopl

e.−

DSM

-5 D

iagn

ostic

Crit

eria

is re

prin

ted

with

per

mis

sion

from

the

Dia

gnos

tic a

nd S

tatis

tical

Man

ual o

f Men

tal D

isor

ders

, Fift

h Ed

ition

™, (

Cop

yrig

ht ©

2013

). A

mer

ican

Psy

chia

tric A

ssoc

iatio

n.

All

Rig

hts R

eser

ved.

The

Am

eric

an P

sych

iatri

c Ass

ocia

tion

is n

ot a

ffilia

ted

with

and

is n

ot e

ndor

sing

this

pro

duct

.

Not

es:

P =

pare

nt; T

= te

ache

r; SR

= se

lf-re

port.

The

follo

win

g re

spon

se k

ey a

pplie

s to

the

crite

rion

stat

us sc

ore

requ

irem

ents

not

ed in

the

Indi

cate

d, M

ay b

e In

dica

ted,

and

Not

Indi

cate

d co

lum

ns: 0

= N

ot tr

ue a

t al

l (N

ever

, Sel

dom

); 1

= Ju

st a

littl

e tru

e (O

ccas

iona

lly);

2 =

Pret

ty m

uch

true

(Ofte

n, Q

uite

a b

it); 3

= V

ery

muc

h tru

e (V

ery

ofte

n, V

ery

freq

uent

ly).

Inte

rpre

tativ

e C

onsi

dera

tions

:So

cial

Anx

iety

Dis

orde

r (S

ocia

l Pho

bia)

Cri

teri

on E

stat

es th

at fe

ar o

r an

xiet

y ab

out s

ocia

l situ

atio

ns is

out

of p

ropo

rtio

n to

the

actu

al th

reat

pos

ed b

y th

e so

cial

situ

atio

n an

d to

the

soci

ocul

tura

l con

-te

xt. I

f the

Sym

ptom

Cou

nt is

pro

babl

y m

et fo

r So

cial

Anx

iety

Dis

orde

r, fo

llow

-up

is r

ecom

men

ded

to e

nsur

e th

is r

equi

rem

ent i

s sat

isfie

d.a

Cri

teri

on A

(fea

r or

anx

iety

abo

ut si

tuat

ions

that

invo

lve

poss

ibly

scru

tiny

by

othe

rs) a

nd C

(alw

ays e

xper

ienc

es fe

ar o

r an

xiet

y in

rel

evan

t soc

ial s

ituat

ions

) foc

us o

n fe

ar o

r an

xiet

y, r

athe

r th

an

pani

c. F

urth

er in

vest

igat

ion

is w

arra

nted

to d

eter

min

e if

ther

e is

mar

ked

fear

or

anxi

ety

in so

cial

situ

atio

ns.

b C

rite

rion

C d

oes n

ot li

mit

anxi

ety-

prov

okin

g so

cial

situ

atio

ns to

thos

e th

at in

volv

e un

fam

iliar

peo

ple.

Fur

ther

inve

stig

atio

n is

war

rant

ed to

det

erm

ine

if fe

ar o

r an

xiet

y is

exp

ress

ed in

soci

al si

tua-

tions

with

fam

iliar

peo

ple.

c T

he C

onne

rs C

BR

S−SR

item

for

Cri

teri

on C

focu

ses o

n pe

rfor

man

ce r

athe

r th

an so

cial

situ

atio

ns a

nd d

oes n

ot in

clud

e po

ssib

le c

hild

exp

ress

ions

of f

ear

or a

nxie

ty. F

urth

er in

vest

igat

ion

is w

ar-

rant

ed to

det

erm

ine

if th

ere

is m

arke

d fe

ar o

r an

xiet

y, e

xpre

ssed

via

chi

ld e

xpre

ssio

ns o

r ot

herw

ise,

in o

ne o

r m

ore

soci

al si

tuat

ions

.

Tabl

e 11

. (

cont

inue

d) D

SM-5

Sym

ptom

Cou

nt a

nd C

riter

ion

Stat

us S

core

Req

uire

men

ts fo

r Soc

ial A

nxie

ty D

isor

der (

Soci

al P

hobi

a)


26

Tabl

e 12

. D

SM-5

Sym

ptom

Cou

nt a

nd C

riter

ion

Stat

us S

core

Req

uire

men

ts fo

r Obs

essi

ve-C

ompu

lsiv

e D

isor

der

DS

M-5

Sym

ptom

Cou

nt R

equi

rem

ents

:•Bo

thObsessionssymptom

s -o

r-•Bo

thCom

pulsionssym

ptom

s DS

M-5

Cri

teri

on A

Form

Item

Item

#

Indicated

May be Indicated

Not Indicated

Ob

sess

ion

s

Rec

urr

ent

and

per

sist

ent

thou

gh

ts,

urg

es,

or im

ages

th

at a

re

exp

erie

nce

d,

at s

ome

tim

e d

uri

ng

th

e d

istu

rban

ce,

as in

tru

sive

an

d

un

wan

ted

, an

d t

hat

in m

ost

ind

ivid

ual

s ca

use

mar

ked

an

xiet

y or

d

istr

ess.

A1

PG

ets s

tuck

on

thou

ghts,

urg

es, o

r men

tal p

ictu

res t

hat a

re u

pset

ting.

159

-or-

183

3, 2

-or-

3, 2

, 1

10

-and

-0

Cre

ates

thou

ghts

or p

ictu

res t

hat g

et st

uck

in h

is/h

er m

ind.

−

TG

ets s

tuck

on

thou

ghts,

urg

es, o

r men

tal p

ictu

res t

hat a

re u

pset

ting.

9 -or-

158

3, 2

-or-

3, 2

, 1

10

-and

-0

Cre

ates

thou

ghts

or p

ictu

res t

hat g

et st

uck

in h

is/h

er m

ind.

−

SRU

pset

ting

thou

ghts

or p

ictu

res g

et st

uck

in m

y m

ind

and

it's h

ard

to m

ake

them

go

away

.94 -o

r- 31

3, 2

-or-

3, 2

−1,

0-a

nd-

1, 0

I cre

ate

upse

tting

thou

ghts

or p

ictu

res t

hat g

et st

uck

in m

y m

ind.

−

The

ind

ivid

ual

att

emp

ts t

o ig

nor

e or

su

pp

ress

su

ch t

hou

gh

ts,

urg

es,

or im

ages

, or

to

neu

tral

ize

them

wit

h s

ome

oth

er t

hou

gh

t or

ac

tion

(i.

e.,

by

per

form

ing

a c

omp

uls

ion

).A

2

PH

as u

pset

ting

thou

ghts

, urg

es, o

r men

tal p

ictu

res t

hat h

e/sh

e tri

es

to m

ake

go a

way

.84

3, 2

, 1−

0

TH

as u

pset

ting

thou

ghts

, urg

es, o

r men

tal p

ictu

res t

hat h

e/sh

e tri

es

to m

ake

go a

way

.53

3, 2

, 1−

0

SRU

pset

ting

thou

ghts

or p

ictu

res g

et st

uck

in m

y m

ind

and

I try

to

mak

e th

em g

o aw

ay.

223,

2−

1, 0

Com

pu

lsio

ns

Rep

etit

ive

beh

avio

rs (

e.g

., h

and

was

hin

g,

ord

erin

g,

chec

kin

g)

or

men

tal a

cts

(e.g

., p

rayi

ng

, co

un

tin

g,

rep

eati

ng

wor

ds

sile

ntl

y) t

hat

th

e in

div

idu

al f

eels

dri

ven

to

per

form

in r

esp

onse

to

an o

bse

ssio

n

or a

ccor

din

g t

o ru

les

that

mu

st b

e ap

plie

d r

igid

ly.

A1

PD

oes t

hing

s ove

r and

ove

r aga

in (f

or e

xam

ple,

han

d w

ashi

ng,

doub

le-c

heck

ing,

or c

ount

ing)

.17

83,

21

0

TD

oes t

hing

s ove

r and

ove

r aga

in (f

or e

xam

ple,

han

d w

ashi

ng,

doub

le-c

heck

ing,

or c

ount

ing)

.12

13,

21

0

SRIt’

s har

d to

stop

mys

elf f

rom

doi

ng c

erta

in th

ings

ove

r and

ove

r ag

ain

(like

cou

ntin

g, c

heck

ing

lock

s or o

ther

thin

gs, o

r was

hing

m

y ha

nds)

.54

3, 2

−1,

0

The

beh

avio

rs o

r m

enta

l act

s ar

e ai

med

at

pre

ven

tin

g o

r re

du

cin

g

anxi

ety

or d

istr

ess,

or

pre

ven

tin

g s

ome

dre

aded

eve

nt

or s

itu

atio

n;

how

ever

, th

ese

beh

avio

rs o

r m

enta

l act

s ar

e n

ot c

onn

ecte

d in

a

real

isti

c w

ay w

ith

wh

at t

hey

are

des

ign

ed t

o n

eutr

aliz

e or

pre

ven

t,

or a

re c

lear

ly e

xces

sive

. N

ote:

You

ng

ch

ildre

n m

ay n

ot b

e ab

le t

o ar

ticu

late

th

e ai

ms

of t

hes

e b

ehav

iors

or

men

tal a

cts.

A2

PD

oes t

hing

s ove

r and

ove

r aga

in to

redu

ce a

nxie

ty, b

ut in

an

unre

-al

istic

or e

xces

sive

way

.17

53,

2, 1

−0

TD

oes t

hing

s ove

r and

ove

r aga

in to

redu

ce a

nxie

ty, b

ut in

an

unre

-al

istic

or e

xces

sive

way

.18

33,

2, 1

−0

SRD

oing

thin

gs o

ver a

nd o

ver a

gain

hel

ps m

e fe

el le

ss w

orrie

d.11

93,

2−

1, 0

DSM

-5 D

iagn

ostic

Crit

eria

is re

prin

ted

with

per

mis

sion

from

the

Dia

gnos

tic a

nd S

tatis

tical

Man

ual o

f Men

tal D

isor

ders

, Fift

h Ed

ition

™, (

Cop

yrig

ht ©

2013

). A

mer

ican

Psy

chia

tric A

ssoc

iatio

n.

All

Rig

hts R

eser

ved.

The

Am

eric

an P

sych

iatri

c Ass

ocia

tion

is n

ot a

ffilia

ted

with

and

is n

ot e

ndor

sing

this

pro

duct

.

Not

es:

P =

pare

nt; T

= te

ache

r; SR

= se

lf-re

port.

The

follo

win

g re

spon

se k

ey a

pplie

s to

the

crite

rion

stat

us sc

ore

requ

irem

ents

not

ed in

the

Indi

cate

d, M

ay b

e In

dica

ted,

and

Not

Indi

cate

d co

lum

ns: 0

= N

ot tr

ue a

t al

l (N

ever

, Sel

dom

); 1

= Ju

st a

littl

e tru

e (O

ccas

iona

lly);

2 =

Pret

ty m

uch

true

(Ofte

n, Q

uite

a b

it); 3

= V

ery

muc

h tru

e (V

ery

ofte

n, V

ery

freq

uent

ly).

DSM-5 Update

27

Tabl

e 13

. D

SM-5

Sym

ptom

Cou

nt a

nd C

riter

ion

Stat

us S

core

Req

uire

men

ts fo

r Aut

ism

Spe

ctru

m D

isor

der

DS

M-5

Sym

ptom

Cou

nt R

equi

rem

ents

: •CriterionA,includingA1,A2,andA3

•Atleast2ofthe4CriterionBsymptom

s

DS

M-5

Cri

teri

a A

, B

Form

Item

Item

#

Indicated

May be Indicated

Not Indicated

Defi

cits

in s

ocia

l-em

otio

nal

rec

ipro

city

, ra

ng

ing

, fo

r ex

amp

le,

from

ab

nor

mal

soc

ial a

pp

roac

h a

nd

fai

lure

of

nor

mal

bac

k-an

d-f

orth

co

nve

rsat

ion

; to

red

uce

d s

har

ing

of

inte

rest

s, e

mot

ion

s, o

r aff

ect;

to

fai

lure

to

init

iate

or

resp

ond

to

soci

al in

tera

ctio

ns.

A1

P

Doe

s not

reco

gniz

e or

reac

t app

ropr

iate

ly to

oth

er p

eopl

e’s m

oods

or

feel

ings

.85 -o

r-77

(R)

-or-

156

-or-

186

(R)

3 -or- 3 -or-

3, 2

-or- 3

21,

0-a

nd-

2, 1

, 0-a

nd-

1, 0

-and 1, 0

Is in

tere

sted

in o

ther

peo

ple,

or i

n w

hat t

hey

are

doin

g. (R

)−

Has

trou

ble

star

ting

a co

nver

satio

n or

kee

ping

a c

onve

rsat

ion

goin

g.−

Shar

es fe

elin

gs, i

nter

ests

, or a

chie

vem

ents

with

oth

ers.

(R)

2

T

Doe

s not

reco

gniz

e or

reac

t app

ropr

iate

ly to

oth

er p

eopl

e’s m

oods

or

feel

ings

.80 -o

r-76

(R)

-or- 48 -or-

2 (R

)

3 -or- 3 -or-

3, 2

-or- 3

21,

0-a

nd-

2, 1

, 0-a

nd-

1, 0

-and 1, 0

Is in

tere

sted

in o

ther

peo

ple,

or i

n w

hat t

hey

are

doin

g. (R

)−

Has

trou

ble

star

ting

a co

nver

satio

n or

kee

ping

a c

onve

rsat

ion

goin

g.−

Shar

es fe

elin

gs, i

nter

ests

, or a

chie

vem

ents

with

oth

ers.

(R)

2

Defi

cits

in n

onve

rbal

com

mu

nic

ativ

e b

ehav

iors

use

d f

or s

ocia

l in

tera

ctio

n,

ran

gin

g,

for

exam

ple

, fr

om p

oorl

y in

teg

rate

d v

erb

al

and

non

verb

al c

omm

un

icat

ion

; to

ab

nor

mal

itie

s in

eye

con

tact

an

d

bod

y la

ng

uag

e or

defi

cits

in u

nd

erst

and

ing

an

d u

se o

f g

estu

res;

to

a to

tal l

ack

of f

acia

l exp

ress

ion

s an

d n

onve

rbal

com

mu

nic

atio

n.

A2

PU

ses f

acia

l exp

ress

ions

, eye

con

tact

, and

han

d ge

stur

es

appr

opria

tely

. (R

)2

(R)

32

1, 0

TU

ses f

acia

l exp

ress

ions

, eye

con

tact

, and

han

d ge

stur

es

appr

opria

tely

. (R

)13

8 (R

)3

21,

0

Defi

cits

in d

evel

opin

g,

mai

nta

inin

g,

and

un

der

stan

din

g

rela

tion

ship

s, r

ang

ing

, fo

r ex

amp

le,

from

diffi

cult

ies

adju

stin

g

beh

avio

r to

su

it v

ario

us

soci

al c

onte

xts;

to

diffi

cult

ies

in s

har

ing

im

agin

ativ

e p

lay

or in

mak

ing

fri

end

s; t

o ab

sen

ce o

f in

tere

st in

p

eers

.

A3

PIs

una

ble

to d

evel

op p

eer r

elat

ions

hips

.64

32,

10

TIs

una

ble

to d

evel

op p

eer r

elat

ions

hips

.11

83

2, 1

0

Ste

reot

yped

or

rep

etit

ive

mot

or m

ovem

ents

, u

se o

f ob

ject

s, o

r sp

eech

(e.

g.,

sim

ple

mot

or s

tere

otyp

ies,

lin

ing

up

toy

s or

flip

pin

g

obje

cts,

ech

olal

ia,

idio

syn

crat

ic p

hra

ses)

.B

1

P

Rep

eats

bod

y m

ovem

ents

ove

r and

ove

r (fo

r exa

mpl

e, ro

ckin

g,

spin

ning

, or h

and

flapp

ing)

.18

8

-or- 48

3, 2

, 1

-or-

3, 2

, 1

−0

-and

-

0

Unu

sual

use

of l

angu

age

(for

exa

mpl

e, re

peat

s thi

ngs,

soun

ds

like

a ro

bot o

r a li

ttle

prof

esso

r, us

es a

hig

h-pi

tche

d vo

ice,

or u

ses

mad

e-up

wor

ds).

−

T

Rep

eats

bod

y m

ovem

ents

ove

r and

ove

r (fo

r exa

mpl

e, ro

ckin

g,

spin

ning

, or h

and

flapp

ing)

.13

2

-or- 69

3, 2

, 1

-or-

3, 2

, 1

−0

-and

-

0

Unu

sual

use

of l

angu

age

(e.g

., re

peat

s thi

ngs,

soun

ds li

ke a

robo

t or

a li

ttle

prof

esso

r, us

es a

hig

h-pi

tche

d vo

ice,

or u

ses m

ade-

up

wor

ds).

−

Tabl

e co

ntin

ued

next

pag

e...


28

DS

M-5

Cri

teri

a A

, B

Form

Item

Item

#

Indicated

May be Indicated

Not Indicated

Insi

sten

ce o

n s

amen

ess,

infl

exib

le a

dh

eren

ce t

o ro

uti

nes

, or

ri

tual

ized

pat

tern

s of

ver

bal

or

non

verb

al b

ehav

ior

(e.g

., e

xtre

me

dis

tres

s at

sm

all c

han

ges

, d

ifficu

ltie

s w

ith

tra

nsi

tion

s, r

igid

th

inki

ng

pat

tern

s, g

reet

ing

rit

ual

s, n

eed

to

take

sam

e ro

ute

or

eat

sam

e fo

od v

ery

day

).

B2

PH

as ri

tual

s or r

outin

es a

nd g

ets u

nusu

ally

ups

et if

thes

e ar

e in

ter-

rupt

ed o

r cha

nged

.97

3, 2

10

TH

as ri

tual

s or r

outin

es a

nd g

ets u

nusu

ally

ups

et if

thes

e ar

e in

ter-

rupt

ed o

r cha

nged

.94

3, 2

10

Hig

hly

res

tric

ted

, fi

xate

d in

tere

sts

that

are

ab

nor

mal

in in

ten

sity

or

foc

us

(e.g

., s

tron

g a

ttac

hm

ent

to o

r p

reoc

cup

atio

n w

ith

un

usu

al

obje

cts,

exc

essi

vely

cir

cum

scri

bed

or

per

seve

rati

ve in

tere

sts)

.B

3P

Has

lim

ited

inte

rest

s or g

ets s

tuck

on

one

thin

g.14

33,

2−

1, 0

TH

as li

mite

d in

tere

sts o

r get

s stu

ck o

n on

e th

ing.

183,

2−

1, 0

DSM

-5 D

iagn

ostic

Crit

eria

is re

prin

ted

with

per

mis

sion

from

the

Dia

gnos

tic a

nd S

tatis

tical

Man

ual o

f Men

tal D

isor

ders

, Fift

h Ed

ition

™, (

Cop

yrig

ht ©

2013

). A

mer

ican

Psy

chia

tric A

ssoc

iatio

n.

All

Rig

hts R

eser

ved.

The

Am

eric

an P

sych

iatri

c Ass

ocia

tion

is n

ot a

ffilia

ted

with

and

is n

ot e

ndor

sing

this

pro

duct

.

Not

es:

P =

pare

nt; T

= te

ache

r; SR

= se

lf-re

port.

The

follo

win

g re

spon

se k

ey a

pplie

s to

the

crite

rion

stat

us sc

ore

requ

irem

ents

not

ed in

the

Indi

cate

d, M

ay b

e In

dica

ted,

and

Not

Indi

cate

d co

lum

ns: 0

= N

ot tr

ue a

t al

l (N

ever

, Sel

dom

); 1

= Ju

st a

littl

e tru

e (O

ccas

iona

lly);

2 =

Pret

ty m

uch

true

(Ofte

n, Q

uite

a b

it); 3

= V

ery

muc

h tru

e (V

ery

ofte

n, V

ery

freq

uent

ly).

(R) =

Item

is re

vers

e sc

ored

.In

terp

reta

tive

Con

side

ratio

ns:

Cri

teri

on B

4 (h

yper

- or

hypo

reac

tivity

to se

nsor

y in

put o

r un

usua

l int

eres

t in

sens

ory

aspe

cts o

f the

env

iron

men

t) is

not

ass

esse

d on

the

Con

ners

CB

RS.

Tabl

e 13

. (

cont

inue

d) D

SM-5

Sym

ptom

Cou

nt a

nd C

riter

ion

Stat

us S

core

Req

uire

men

ts fo

r Aut

ism

Spe

ctru

m D

isor

der

DSM-5 Update

29

Standardization and Reliability of the Conners CBRS DSM-5 Symptom ScalesNorm Construction. The construction of the norms for the Conners CBRS DSM-5 Symptom Scales that changed (i.e., Major Depressive Episode, Social Anxiety Disorder, Obsessive Compulsive Disorder, and Autism Spectrum Disorder) was performed in the same fashion as for the original scales of the instrument using the same normative samples (see chapter 10 of the Conners CBRS Manual, Standardization). Actual construction of the norms was conducted by rater type (i.e., Parent, Teacher, and Self-Report) for each of the age and gender groups (see Tables 15 to 17 for the normative samples’ means and standard devia-tions, for scales that have changed from the DSM-IV-TR to the DSM-5. See Tables 10.34 to 10.45 in the Conners CBRS Manual for the means and standard deviations of the other Conners CBRS scales). Note that the means presented in these tables have been statistically smoothed (see chapter 10 in the Conners CBRS Manual for more information on the smoothing process). Standard scores (T-scores with a mean of 50 and standard deviation of 10) were computed for each norm group, as were empirical percentiles.

For scales that have changed, Pearson product-moment correlation coefficients between the DSM-5 Symptom Scales and the DSM-IV-TR Symptom Scales of the Conners CBRS were computed and are reported in Table 14. These values ranged from .909 to .998 across norm groups and rater versions.

Internal Consistency. Cronbach’s alpha coefficients for the DSM-5 Symptom Scales were calculated for each norm group using the same procedure as for the DSM-IV-TR Scale. Reliability coefficients were estimated for the total sample, as well as separately for the general population and clinical samples. Results are similar to the DSM-IV-TR Symptom Scales values for each respective rater version and norm group. The Conners CBRS−P, Conners CBRS−T, and Conners CBRS−SR were observed to demonstrate moderate-to-high levels of internal consistency for the vast majority of the revised scales. Reliability coefficients are shown in Tables 18 to 26 for scales that have changed from the DSM-IV-TR to the DSM-5. See Tables 11.2 to 11.4 in the Conners CBRS Manual for the reliability coefficients for the other Conners CBRS scales.

Standard Error of Measurement. The standard error of measurement (SEM) serves as another tool for measuring the stability of observed scores. SEM provides an indication of the amount of variability that may exist in the observed score, and how much that score may differ from a theoretical true score. More information about SEM can be found in chapter 11 of the Conners CBRS Manual, Reliability.

Tables 27 to 32 present the SEM values for scales that have changed due to changes in the DSM-5. Tables 27 to 28 display the SEM values for the total sample, and Tables 29 to 32 display the SEM values for the general population and clinical samples. For most purposes, SEM values for T-scores are sufficient; however, raw score values are provided for research purposes.

Table 14. Correlations between the Conners CBRS DSM-IV-TR and DSM-5 Symptom Scales

ScaleTotal Sample General Population Clinical Sample

Parent Teacher Self-Report Parent Teacher Self-

Report Parent Teacher Self-Report

Major Depressive Episode .998 .996 .997 .997 .996 .997 .997 .996 .997

Social Anxiety Disorder .939 .936 .963 .910 .909 .956 .960 .964 .970

Obsessive-Compulsive Disorder .973 .973 .979 .949 .952 .997 .979 .978 .980

DSM-5 Autism Spectrum Disorder vs. DSM-IV-TR Autistic Disorder .974 .968 n/a .964 .970 n/a .976 .977 n/a

DSM-5 Autism Spectrum Disorder vs. DSM-IV-TR Asperger’s Disorder .979 .973 n/a .977 .984 n/a .976 .971 n/a

N 2,276 2,360 2,055 1,575 1,690 1,359 704 670 698

Notes: n/a = not applicable (i.e., DSM-5 Autism Spectrum Disorder [as well as DSM-IV-TR Autistic Disorder and Asperger’s Disorder] are not assessed on the self-report form; see the Conners CBRS Manual for more information). All rs significant, p < .001.


30

Tabl

e 15

. C

onne

rs C

BR

S−P

Nor

mat

ive

Sam

ple

Mea

ns a

nd S

tand

ard

Dev

iatio

ns fo

r the

DSM

-5 S

ympt

om S

cale

s (A

ges

6 to

18)

Sca

leA

ge

6A

ge

7A

ge

8A

ge

9A

ge

10

Ag

e 1

1M

FT

MF

TM

FT

MF

TM

FT

MF

T

Maj

or D

epre

ssiv

e Ep

isod

eM

1.82

1.95

1.92

1.93

2.02

1.97

2.03

2.15

2.03

2.12

2.22

2.11

2.20

2.30

2.20

2.28

2.33

2.30

SD2.

443.

032.

583.

252.

903.

262.

442.

822.

553.

412.

813.

202.

752.

852.

953.

602.

963.

03

Soci

al A

nxie

ty

Dis

orde

rM

2.13

2.47

2.30

2.28

2.58

2.43

2.42

2.67

2.55

2.75

2.76

2.65

2.61

2.84

2.73

2.68

2.92

2.81

SD2.

822.

442.

652.

742.

512.

652.

392.

572.

462.

922.

472.

742.

162.

902.

652.

863.

022.

96

Obs

essi

ve-

Com

puls

ive

Dis

orde

rM

0.44

0.42

0.43

0.43

0.46

0.44

0.42

0.50

0.46

0.41

0.53

0.46

0.40

0.56

0.47

0.39

0.58

0.47

SD0.

970.

900.

941.

131.

341.

281.

010.

870.

921.

221.

001.

120.

811.

441.

290.

921.

211.

14

Aut

ism

Spe

ctru

m

Dis

orde

rM

3.55

3.58

3.67

4.15

3.56

3.85

4.00

3.35

3.78

4.25

3.55

3.95

4.00

3.57

3.86

4.21

3.59

3.90

SD3.

232.

942.

993.

834.

073.

963.

043.

063.

094.

193.

343.

853.

693.

593.

544.

003.

343.

56

Sca

leA

ge

12

Ag

e 1

3A

ge

14

Ag

e 1

5A

ge

16

Ag

e 1

7/

18

MF

TM

FT

MF

TM

FT

MF

TM

FT

Maj

or D

epre

ssiv

e Ep

isod

eM

2.05

2.50

2.42

2.41

2.60

2.55

2.46

2.95

2.70

2.50

3.00

2.86

2.54

3.54

3.03

2.57

4.02

3.22

SD2.

473.

133.

132.

713.

352.

903.

083.

643.

413.

533.

983.

593.

334.

394.

082.

994.

864.

01

Soci

al A

nxie

ty

Dis

orde

rM

2.71

2.99

2.87

2.73

2.75

2.91

2.72

2.80

2.94

2.68

3.17

2.96

2.63

3.21

2.96

2.54

3.26

2.95

SD2.

452.

742.

552.

412.

512.

532.

202.

532.

402.

372.

972.

652.

682.

782.

662.

362.

772.

66

Obs

essi

ve-

Com

puls

ive

Dis

orde

rM

0.37

0.60

0.46

0.35

0.56

0.46

0.33

0.60

0.44

0.21

0.62

0.43

0.29

0.64

0.41

0.26

0.66

0.44

SD0.

901.

231.

070.

881.

030.

970.

861.

231.

140.

851.

221.

130.

821.

201.

120.

811.

171.

10

Aut

ism

Spe

ctru

m

Dis

orde

rM

3.77

3.62

3.92

4.35

3.67

3.95

4.23

3.72

3.96

4.19

3.78

3.97

4.13

3.86

3.98

4.04

3.94

3.97

SD3.

163.

353.

243.

643.

383.

553.

543.

433.

533.

413.

483.

493.

553.

553.

443.

033.

623.

37

Not

e: M

= M

ale,

F =

Fem

ale,

T =

Tot

al.

DSM-5 Update

31

Tabl

e 16

. C

onne

rs C

BR

S−T

Nor

mat

ive

Sam

ple

Mea

ns a

nd S

tand

ard

Dev

iatio

ns fo

r the

DSM

-5 S

ympt

om S

cale

s (A

ges

6 to

18)

Sca

leA

ge

6A

ge

7A

ge

8A

ge

9A

ge

10

Ag

e 1

1M

FT

MF

TM

FT

MF

TM

FT

MF

T

Maj

or D

epre

ssiv

e Ep

isod

eM

1.22

1.09

1.16

1.22

0.99

1.11

1.23

0.91

1.07

1.24

0.85

1.04

1.35

0.95

1.21

1.35

0.81

1.04

SD2.

122.

592.

322.

232.

762.

342.

052.

012.

042.

391.

902.

193.

182.

783.

012.

932.

132.

61

Soci

al A

nxie

ty

Dis

orde

rM

2.11

1.99

2.05

1.96

1.78

1.87

1.84

1.64

1.74

1.75

1.57

1.67

1.69

1.56

1.64

1.67

1.62

1.67

SD2.

852.

312.

612.

252.

502.

432.

492.

262.

302.

431.

962.

242.

522.

262.

482.

562.

282.

39

Obs

essi

ve-

Com

puls

ive

Dis

orde

rM

0.42

0.37

0.39

0.38

0.34

0.36

0.35

0.32

0.33

0.33

0.29

0.30

0.31

0.27

0.27

0.29

0.22

0.25

SD0.

970.

931.

100.

991.

421.

341.

011.

051.

070.

870.

770.

841.

340.

931.

231.

010.

600.

83

Aut

ism

Spe

ctru

m

Dis

orde

rM

5.33

4.33

4.98

4.90

4.21

4.70

4.91

3.96

4.44

4.67

3.73

4.20

4.67

3.51

3.99

4.30

3.31

3.81

SD4.

373.

374.

143.

894.

574.

203.

383.

553.

433.

693.

083.

583.

603.

183.

433.

522.

883.

30

Sca

leA

ge

12

Ag

e 1

3A

ge

14

Ag

e 1

5A

ge

16

Ag

e 1

7/

18

MF

TM

FT

MF

TM

FT

MF

TM

FT

Maj

or D

epre

ssiv

e Ep

isod

eM

1.28

0.83

1.06

1.31

0.87

1.09

1.15

1.28

1.13

1.21

1.02

1.19

1.40

1.13

1.27

1.44

1.27

1.36

SD2.

051.

551.

882.

521.

652.

231.

963.

222.

822.

482.

152.

402.

441.

732.

392.

602.

292.

37

Soci

al A

nxie

ty

Dis

orde

rM

1.69

1.75

1.75

1.74

1.52

1.88

1.60

2.22

2.06

1.93

2.55

2.30

2.08

2.95

2.58

2.27

3.32

2.81

SD2.

352.

312.

412.

372.

002.

351.

973.

132.

762.

312.

472.

572.

542.

552.

652.

632.

642.

74

Obs

essi

ve-

Com

puls

ive

Dis

orde

rM

0.25

0.23

0.22

0.27

0.21

0.20

0.26

0.20

0.18

0.26

0.18

0.17

0.27

0.17

0.15

0.27

0.16

0.14

SD0.

670.

810.

811.

390.

751.

150.

701.

010.

870.

900.

630.

831.

090.

500.

770.

700.

510.

72

Aut

ism

Spe

ctru

m

Dis

orde

rM

4.16

3.13

3.65

4.16

2.97

3.51

3.62

2.83

3.39

3.45

2.70

3.30

3.92

2.42

3.24

4.05

2.50

3.44

SD3.

462.

693.

194.

152.

333.

492.

812.

533.

023.

322.

762.

963.

292.

152.

923.

272.

072.

89

Not

e: M

= M

ale,

F =

Fem

ale,

T =

Tot

al.


32

Tabl

e 17

. C

onne

rs C

BR

S−SR

Nor

mat

ive

Sam

ple

Mea

ns a

nd S

tand

ard

Dev

iatio

ns fo

r the

DSM

-5 S

ympt

om S

cale

s (A

ges

8 to

18)

Sca

leA

ge

8A

ge

9A

ge

10

Ag

e 1

1M

FT

MF

TM

FT

MF

T

Maj

or D

epre

ssiv

e Ep

isod

eM

5.04

6.42

5.41

5.50

6.75

6.22

5.41

6.46

5.88

5.46

5.44

5.54

SD5.

325.

705.

445.

446.

776.

495.

376.

275.

875.

355.

055.

33

Soci

al A

nxie

ty D

isor

der

M2.

813.

713.

573.

363.

703.

633.

403.

743.

713.

423.

843.

82

SD2.

902.

962.

902.

903.

283.

032.

772.

872.

923.

043.

112.

96

Obs

essi

ve-C

ompu

lsiv

e D

isor

der

M2.

282.

862.

392.

482.

792.

652.

382.

542.

492.

302.

392.

32

SD2.

443.

092.

813.

003.

403.

193.

082.

592.

832.

512.

682.

58

Sca

leA

ge

12

Ag

e 1

3A

ge

14

Ag

e 1

5A

ge

16

Ag

e 1

7/

18

MF

TM

FT

MF

TM

FT

MF

TM

FT

Maj

or D

epre

ssiv

e Ep

isod

eM

5.64

5.97

5.86

5.95

5.44

6.05

6.18

6.77

6.41

5.75

7.15

6.32

5.85

8.06

6.69

7.52

10.5

18.

33

SD5.

386.

806.

215.

175.

055.

335.

577.

066.

445.

387.

346.

305.

946.

826.

515.

927.

416.

70

Soci

al A

nxie

ty

Dis

orde

rM

3.43

4.00

3.95

3.43

4.21

4.10

3.42

4.06

3.86

3.39

4.20

3.90

3.36

4.30

3.87

3.31

5.02

4.15

SD2.

543.

133.

022.

772.

982.

942.

913.

043.

073.

113.

143.

303.

012.

783.

023.

252.

853.

44

Obs

essi

ve-

Com

puls

ive

Dis

orde

rM

2.73

2.20

2.71

2.18

1.95

2.20

2.14

2.39

2.38

1.87

2.34

2.20

2.12

2.32

2.41

2.13

3.18

2.81

SD3.

323.

143.

252.

362.

692.

532.

393.

533.

022.

253.

172.

683.

272.

793.

022.

302.

912.

70

Not

e: M

= M

ale,

F =

Fem

ale,

T =

Tot

al.

DSM-5 Update

33

Table 18. Cronbach’s Alpha: Conners CBRS−P Total Sample

Scale TotalMale Female

6−9 10−13 14−18 6−9 10−13 14−18

Major Depressive Episode .882 .840 .883 .863 .810 .885 .905

Social Anxiety Disorder .800 .790 .836 .771 .791 .783 .811

Obsessive-Compulsive Disorder .803 .838 .825 .772 .788 .819 .755

Autism Spectrum Disorder .794 .795 .811 .807 .728 .778 .798

Table 19. Cronbach’s Alpha: Conners CBRS−T Total Sample


6−9 10−13 14−18 6−9 10−13 14−18





Table 20. Cronbach’s Alpha: Conners CBRS−SR Total Sample


8−9 10−13 14−18 8−9 10−13 14−18




Table 21. Cronbach’s Alpha: Conners CBRS−P General Population Sample


6−9 10−13 14−18 6−9 10−13 14−18





Table 22. Cronbach’s Alpha: Conners CBRS−T General Population Sample


6−9 10−13 14−18 6−9 10−13 14−18





Table 23. Cronbach’s Alpha: Conners CBRS−SR General Population Sample


8−9 10−13 14−18 8−9 10−13 14−18





34

Table 24. Cronbach’s Alpha: Conners CBRS−P Clinical Sample


6−9 10−13 14−18 6−9 10−13 14−18





Table 25. Cronbach’s Alpha: Conners CBRS−T Clinical Sample


6−9 10−13 14−18 6−9 10−13 14−18





Table 26. Cronbach’s Alpha: Conners CBRS−SR Clinical Sample


8−9 10−13 14−18 8−9 10−13 14−18




Table 27. T-Score SEM1 for Conners CBRS DSM-5 Scales for the Total Sample

Form DSM-5 Symptom Scale Total Male Female

6−91 10−13 14−18 6−91 10−13 14−18

Parent

Major Depressive Episode 3.44 4.00 3.42 3.70 4.36 3.39 3.08

Social Anxiety Disorder 4.47 4.58 4.05 4.79 4.57 4.66 4.35

Obsessive-Compulsive Disorder 4.44 4.02 4.18 4.77 4.60 4.25 4.95

Autism Spectrum Disorder 4.54 4.53 4.35 4.39 5.22 4.71 4.49

Teacher





Self-Report



Obsessive-Compulsive Disorder 4.34 4.29 4.54 4.47 4.15 4.34 4.181 The age group for the self-report form is 8−9 years.

DSM-5 Update

35

Table 28. Raw Score SEM1 for Conners CBRS DSM-5 Scales for the Total Sample


6−91 10−13 14−18 6−91 10−13 14−18

Parent





Teacher





Self-Report




Table 29. T-Score SEM1 for Conners CBRS DSM-5 Symptom Scales for the General Population Sample


6−91 10−13 14−18 6−91 10−13 14−18

Parent





Teacher





Self-Report




Table 30. Raw Score SEM1 for Conners DSM-5 Symptom Scales for the General Population Sample


6−91 10−13 14−18 6−91 10−13 14−18

Parent





Teacher





Self-Report





36

Table 31. T-Score SEM1 for Conners CBRS DSM-5 Symptom Scales for the Clinical Sample


6−91 10−13 14−18 6−91 10−13 14−18

Parent





Teacher





Self-Report




Table 32. Raw Score SEM1 for Conners CBRS DSM-5 Symptom Scales for the Clinical Sample


6−91 10−13 14−18 6−91 10−13 14−18

Parent





Teacher





Self-Report




SummaryWith the release of the DSM-5, it was necessary to review the Conners CBRS Manual and associated materials (i.e., Conners CBRS Software Program and online components, including reports) to assess the need to update the DSM Symptom Scales. The changes outlined in this update align scoring and interpretation of the DSM Symptom Scales with diagnostic criteria in the DSM-5. This supplement details considerations that need to be taken into account when using the DSM-5 Scoring option to score and interpret the DSM Symptom Scales. Additionally, this supplement outlines the psychometric properties of the revised scales, namely, Major Depressive Episode, Social Anxiety Disorder (Social Phobia), Obsessive-Compulsive Disorder, and Autism Spectrum Disorder.

ReferencesAmerican Psychiatric Association. (2000). Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.).

Washington, DC: American Psychiatric Publishing.

American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.

Beck, A. T., Rush, A. J., Shaw, B. F., & Emery, G. (1979). Cognitive Therapy of Depression. New York, NY: The Guilford Press.

Compton, S. N., March, J. S., Brent, D., Albano, A. M., Weersing, R., & Curry, J. (2004). Cognitive-behavioral psychotherapy for anxiety and depressive disorders in children and adolescents: An evidence-based medicine review. Journal of the American Academy of Child and Adolescent Psychiatry, 43, 930−959.

Conners, C. K. (2008, 2010). Conners Comprehensive Behavior Rating Scales Manual. Toronto, Ontario, Canada: Multi-Health Systems.

Fuchs, T. (2013). The phenomenology and development of social perspectives. Phenomenology and the Cognitive Sciences, 12, 655−683.

Gallese, V., & Goldman, A. (1998). Mirror neurons and the simulation theory of mind-reading. Trends in Cognitive Sciences, 2, 493−501.

Rizzolatti, G., & Craighero, L. (2004). The mirror-neuron system. Annual Review of Neuroscience, 27, 169−192.

Toth, K., Munson, J., Meltzoff, A. N., & Dawson, G. (2006). Early predictors of communication development in young children with Autism Spectrum Disorder: Joint attention, imitation, and toy play. Journal of Autism and Developmental Disorders, 36, 993−1005.

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