c. keith conners, ph.d. dsm-5 update...the conners 3rd edition (conners 3 ), a revision of the...

™

C. Keith Conners, Ph.D.

DSM-5 UPDATE

Contact MHS1-800-456-3003 (U.S.) 1-800-268-6011 (Canada) +1-416-492-2627 (International) [email protected] www.mhs.com

This update was edited and typeset by David Wiechorek using InDesign CS6 and Microsoft Word 2010, using the Times New Roman, Arial, Verdana, and Myriad Pro fonts. The cover was designed by Dyan Buerano using Adobe InDesign CS6 and Adobe Illustrator CS6.

Conners 3rd Edition, Conners 3, CRS–R, and QuikScore 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.

January, 2014

Conners 3rd Edition™ (Conners 3™) DSM-5 Update

C. Keith Conners

OverviewThe Conners 3rd Edition™ (Conners 3™), a revision of the Conners’ Rating Scales–Revised (CRS–R; Conners, 1997), included a number of new features. One of these new features was direct links between scale content on the full-length forms (i.e., Conners 3–Parent [Conners 3–P], Conners 3 –Teacher [Conners 3–T], and Conners 3–Self-Report [Conners 3–SR]) and symptom criteria in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR; American Psychiatric Association [APA], 2000), for Attention-Deficit/Hyperactivity Disorder (ADHD), and its most common comorbid disorders, Conduct Disorder (CD) and Oppositional Defiant Disorder (ODD).

A new edition of the DSM was released in May, 2013: The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5; APA, 2013). Accordingly, a review of the Conners 3 Manual and associated materials, including the full-length QuikScore™ forms, the Conners 3 Software Program, and online components (e.g., the Assessment, Progress, and Comparative Reports) was undertaken in order to determine the changes required to scoring and interpretation.

This update outlines the revisions to symptom criteria for ADHD, CD, and ODD made in the DSM-5, as well as any changes made to forms, scoring, and interpretative considerations in the Conners 3. Much of what is required for administration, scoring, and interpretation of this assessment is still found in the Conners 3 Manual. The main computerized scoring update to the Conners 3 assessment is a report option featuring DSM-5 scoring. Correspondingly, for hand-scoring, DSM Symptom Scales on the Conners 3 QuikScore forms are updated with DSM-5 criteria. The DSM-5 scoring option incorporates the following:

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; and

iii. A change to the symptom count requirements on the self-report form for ODD Criterion A8 (Note: symptom count requirements on the parent and teacher forms were not impacted by the modification to Criterion A8).

Any revisions or additions to interpretative considerations in the Conners 3 Manual and Assessment Reports (see Appendix E, Scoring DSM-IV-TR Symptom Scales in the Conners 3 Manual) are outlined in this update and printed in bold below Tables 1a through 3 (Note: The original interpretative considerations are included in this update to facilitate scoring and interpretation of the DSM-5 Symptom Scales). Further, interpretative considerations appear where relevant as notes in the Assessment Reports.

Changes to the Conners 3 Corresponding to DSM Criteria Updates Conners 3 DSM Scales are comprised of items that approximate symptom-level criteria from the DSM; full diagnostic criteria (e.g., course, age of onset, differential diagnosis, level of impairment, and pervasiveness) are not represented. (See the DSM-5 for full diagnostic criteria.) The itemized list of changes provided in this update details only those changes in the DSM-5 to ADHD, CD, and ODD symptom criteria that are measured, scored, and interpreted on the Conners 3. (Note: None of the changes to diagnostic criteria for CD impact scoring or interpretation of the Conners 3.)

Only the Conners 3 full-length forms include the DSM-IV-TR Symptom Scales. As a result, any changes to scoring involve only the Conners 3 full-length forms (i.e., Conners 3–Parent [Conners 3–P], Conners 3–Teacher [Conners 3–T], and Conners 3–Self-Report [Conners 3–SR]). These can be scored by hand, software, or online (see the Conners 3 Manual for further information about scoring). For hand-scoring, the DSM Symptom Scales on the Conners 3 QuikScore forms are updated with DSM-5 criteria. With respect to computerized scoring, a DSM scoring option is now included that allows the assessor to choose either DSM-IV-TR scoring or DSM-5 scoring:

• Reports produced using the DSM-IV-TR scoring option are identical to the original Conners 3 reports.

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Conners 3rd Edition™ (Conners 3™)

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Conduct Disorder

DSM-5 Criterion

ItemNumber

Item Score

Required Score ()May be

IndicatedIndicated

A1 98 1 2 3

A2 105 1 2 3

A3 14 1 2 3

A4 35 1 2 3

A5 21 1 2 3

A6 27 1 2 3

A7 33 1 2 3

A8 61 1 2 3

A9 10 1 2 3

A10 90 1 2 3

A11 40 2 3

A12 31 1 2 3

A15 54 1 2 3

Total Symptom Count (sum all checkmarks)

Symptom criteria probably met if Total Symptom Count ≥ 3NOTE: The Conners 3–T does not assess Criterion A13 (staying out at night without permission) or Criterion A14 (running away from home). These criteria have been intentionally omitted, as most teachers do not have the opportunity to observe these infractions.

Conners 3 ADHD IndexInstructions: 1. For each item listed below, transfer the circled score from the Scoring Grid into the Item Score row.2. Transpose each score by following the Transposing Rule and enter the score into each Transposed Score box. 3. Sum the transposed scores to obtain the Total Transposed Score, then circle this score in the Probability Score table. 4. Determine the probability of a classification of ADHD by circling the corresponding Probability score.

Item4

Item7

Item13

Item23

Item44

Item57

Item60

Item69

Item97

Item100

Item Score

Transposing Rule

0, 1 2 3 0, 1 2 3 0, 1 2 3 0, 1 2 3 0, 1 2 3 0, 1 2 3 0, 1 2 3 0, 1 2 3 0, 1 2 3 0, 1 2 3 0 1 2 0 1 2 0 1 2 0 1 2 0 1 2 0 1 2 0 1 2 0 1 2 0 1 2 0 1 2

Transposed Score + + + + + + + + + =

Total Transposed

Score

DSM-5 Symptom CountsInstructions: 1. For each item number listed below, transfer the circled score from the Scoring Grid into the Item Score column. 2. If the Item Score is equal to a number in either Required Score column, circle that number in the May be Indicated or Indicated column. NOTE: Do not circle anything if the Item Score does not match any number in either Required Score column or if the item has been omitted. 3. Insert a checkmark in the () column if a score has been circled in either Required Score column. a) For ADHD Inattentive Criterion A1d, insert a checkmark only if a Required Score has been circled for both items 73 and 57. b) For ADHD Hyperactive-Impulsive Criterion A2c, insert a checkmark if a Required Score has been circled for either (or both) items 24 or 7. c) For ADHD Hyperactive-Impulsive Criterion A2e, insert a checkmark if a Required Score has been circled for either (or both) items 17 or 78.4. Count all checkmarks and write the sum in the Total Symptom Count box. 5. Insert a checkmark in the box at the bottom of the table if the symptom criteria is probably met.

NOTE: Please refer to the Conners 3 Manual and DSM-5 Update for exceptions that may alter the Total Symptom Count.

ADHD Hyperactive-Impulsive

DSM-5 Criterion

ItemNumber

Item Score

Required Score()May be

Indicated Indicated

A2a 4 2 3

A2b 1 2 3

A2c24 1 2 3 EITHER item

circled

7 1 2 3

A2d 32 2 3

A2e17 1 2 3 EITHER item

circled

78 1 2 3

A2f 50 2 3

A2g 9 2 3

A2h 76 2 3

A2i 29 2 3


Age < 16; Symptom criteria probably met if Total Symptom Count > 6

Age > 17; Symptom criteria probably met if Total Symptom Count > 5

ADHD Inattentive

DSM-5 Criterion

ItemNumber

Item Score


Indicated Indicated

A1a 37 2 3

A1b 111 2 3

A1c 69 2 3

A1d73 2 3 BOTH items

circled

57 2 3

A1e 103 2 3

A1f 60 2 3

A1g 92 2 3

A1h 23 2 3

A1i 88 2 3




Oppositional Defiant Disorder

DSM-5 Criterion

ItemNumber

Item Score


IndicatedIndicated

A1 62 1 2 3

A2 56 1 2 3

A3 38 1 2 3

A4 47 2 3

A5 71 1 2 3

A6 59 2 3

A7 64 1 2 3

A8 51 1 2 3


Symptom criteria probably met if Total Symptom Count ≥ 4

Response Style Analysis Inconsistency IndexInstructions: 1. For each of the following items, transfer the circled scores from the Scoring Grid into the appropriate boxes, below.2. For each pair of items, subtract the lower value from the higher value and write the difference in the box directly below each pair. 3. Sum the Absolute Differences to get the Inconsistency Index Total (box A).4. Write the number of absolute differences that are equal to 2 or 3 in box B.5. Insert a checkmark in the box provided if a possible inconsistent response style is indicated.

Item 97

Item 100

Item 52

Item 63

Item 4

Item 77

Item 7

Item 13

Item 26

Item 29

Item 98

Item 105

Item 25

Item 57

Item 23

Item 44

Item 34

Item 89

Item 47

Item 71

ItemScore

Absolute Difference + + + + + + + + + = A

Inconsistency Index Total (A)

Number of Absolute Differences = 2 or 3 (B) B Possible inconsistent response style indicated

if A ≥ 6 and B ≥ 2

PI and NI Scale GuidelinesInstructions: 1. Transfer the Total Raw Scores for both the Positive Impression (PI) and Negative Impression (NI) Scales from the Scoring Grid into the Raw Score column of the table, below.2. Insert a checkmark in the Interpretive Guideline box if the response style is indicated.

Raw Score Interpretive Guideline

Positive Impression (PI) Possible positive response style indicated if Raw Score ≥ 5.

Negative Impression (NI) Possible negative response style indicated if Raw Score ≥ 5.

ImpairmentInstructions: For each item listed in the Impairment table below, refer to the Scoring Grid and circle the score.

Impairment

ItemNot true at all/

neverJust a little true/

occasionallyPretty much true/

oftenVery much true/

very often

112. The student’s problems seriously affect schoolwork or grades. 0 1 2 3

113. The student’s problems seriously affect friendships and relationships. 0 1 2 3

ADHD Combined Symptom criteria probably met if symptom criteria probably met for ADHD Inattentive and ADHD Hyperactive-Impulsive

Conners 3 ADHD Index Probability ScoreTotal Transposed Score 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20

Probability (%) 19 39 51 52 58 64 69 73 77 81 84 87 89 91 92 93 95 96 97 98 99

Student's Name/ID: ________________________________________ Age: ______ ______ Years Months

Grade: ______ Birth Date: ______/______/________ Month Day Year

Gender: M F (Circle One) Teacher's Name/ID: _________________________ Time Known Student: ______

MonthsAdministration Date: ______/______/________

Month Day Year

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• Reports produced using the DSM-5 scoring option include DSM-5 Symptom Counts and interpretative considerations.

ADHDThe following is a list of changes made in the DSM-5 to the diagnostic criteria for ADHD that required corresponding updates to the Conners 3 assessment. Tables 1a and 1b show the DSM-5 criteria for ADHD, the associated Conners 3 form items, and the response choices for when symptoms are Indicated, May be Indicated, or Not Indicated.

Scoring and Reporting Adjustments:• In the DSM-5, the symptom count was reduced for

older adolescents and adults (17 years and older), from 6 to 5 symptoms from each of Inattentive and/or Hyperactive-Impulsive presentations.

• The change to the symptom count for older adolescents (17–18-year-olds) is incorporated into scoring algorithms for the Conners 3 reports, such that 5 symptoms are required for the Symptom Count to be probably met for ADHD Predominantly Inattentive Presentation and ADHD Predominantly Hyperactive-Impulsive Presentation. ADHD Combined Presentation requires 5 symptoms each from inattentive and hyperactive-impulsive symptom criteria. For hand-scoring, the QuikScore forms are updated to note the different symptom count requirements for individuals 16 years of age and younger, versus those 17 years of age and older (see Figure 1).

Interpretative Considerations:• Inattentive, Hyperactive-Impulsive, and Combined

subtypes were reclassified as presentations in the DSM-5.

• The names of the Conners 3 DSM Scales for ADHD were updated to reflect this reclassification.

• A statement was added in the DSM-5 to the pre-amble for both ADHD Predominantly Inattentive Presentation (Criterion A1) and ADHD Predominantly Hyperactive-Impulsive Presentation (Criterion A2) that explicitly requires the diagnostician to rule out “oppositional behavior, defiance, hostility, or failure to understand tasks or instructions,” as the primary causes of ADHD symptoms.

• To address the differential diagnosis consideration added to Criterion A1 and Criterion A2, if the Symptom Count is probably met for any of the ADHD presentations, the assessor must rule out these behaviors as the primary cause of the ADHD symptoms. This interpretative consideration automatically appears in the Conners 3 Assessment Reports when the Symptom Count is probably met for any of the ADHD presentations (see the Interpretative Considerations for Table 1a and 1b, DSM-5 Symptom Count and Criterion Status Score Requirements for ADHD).

• A lifespan-specific example was added to Criterion A1h in the DSM-5, illustrating how the symptom of distraction may present in older adolescents.

• An interpretative consideration is included in the Conners 3 Assessment Report to account for this change (see Interpretative Considerations for Table 1a).

Statements for determining if the Total Symptom Count is probably met.

Figure 1. Conners 3–Teacher QuikScore Form - Symptom Count Requirements

DSM-5 Update

3

CDRevisions made in the DSM-5 to the diagnostic criteria for CD did not impact Criterion A symptoms (those symptoms assessed by the Conners 3); they are essentially identical to those printed in the DSM-IV-TR. Table 2 shows the DSM-5 criteria for CD, the associated Conners 3 form items, and the response choices for when symptoms are Indicated, May be Indicated, or Not Indicated.

Scoring and Reporting Adjustments:None.

Interpretative Considerations:No changes were made to the interpretative considerations for CD. Table 2 includes interpretative considerations for CD that apply to the DSM-5 Symptom Scales; however, these notes are identical to the interpretative considerations for the DSM-IV-TR Symptom Scales. The notes are provided in this supplement to facilitate interpretation of the Symptom Count for DSM-5 scoring.

ODDTable 3 shows the DSM-5 criteria for ODD, the associated Conners 3 form items, and the response choices for when symptoms are Indicated, May be Indicated, or Not Indicated. There are two changes that affected the reporting and scoring of the Conners 3 scales, and some other interpretative considerations.

Scoring and Reporting Adjustments:• Criterion A in the DSM-5 divides ODD symptom

criteria into three types of behaviors, including Angry/Irritable Mood, Argumentative/Defiant Behavior, and Vindictiveness. As a result of this change, diagnostic criteria for ODD were reordered as follows:

• Criterion A1 in the DSM-5 is in the same order it was in the DSM-IV-TR

• Criterion A2 in the DSM-5 was Criterion A6 in the DSM-IV-TR






• Criterion A8 in the DSM-5 is in the same order it was in the DSM-IV-TR

• In the Conners 3, symptom criteria are reordered and labeled as they are in the DSM-5 (i.e., Angry/Irritable Mood, Argumentative/Defiant Behavior, and Vindictiveness; see Figure 2) in all of the ODD tables in the reports. Similarly, the change to the order of symptom criteria for ODD is incorporated into the ODD table in the DSM-5 Symptom Counts section of the QuikScore forms (see Figure 3).

Figure 2. Conners 3–Teacher Assessment Report - DSM-5 Symptom Table

DSM-5 Conduct Disorder

¹Both Criterion A8 (fire setting) and Criterion A9 (destruction of property) were indicated. In order to meet Criterion A9, the assessor must confirm that property was destroyed other than by fire-setting (Criterion A8).

²In order for Criterion A15 (truancy) to be indicated the assessor needs to ensure this criterion occurred before the age of 13 years.

Note: The Conners 3–T does not assess Criterion A13 (staying out at night without permission) or Criterion A14 (running away from home), as most teachers do not have the opportunity to observe these infractions.

Criterion StatusItemDSM-5 Symptoms: Criterion A Teacher's Rating0 1 2 3 ?Number

Aggression to People and AnimalsIndicated98A1. üIndicated105A2. üIndicated14A3. üIndicated35A4. üIndicated21A5. üIndicated27A6. üIndicated33A7. ü

Destruction of PropertyIndicated¹61A8. üIndicated¹10A9. ü

Deceitfulness or TheftIndicated90A10. üIndicated40A11. üIndicated31A12. ü

Serious Violations of RulesIndicated²54A15. ü

DSM-5 Oppositional Defiant DisorderCriterion StatusItemDSM-5 Symptoms: Criterion A Teacher's Rating

0 1 2 3 ?NumberAngry/Irritable Mood

Indicated62A1. üIndicated56A2. üIndicated38A3. ü

Argumentative/Defiant BehaviorIndicated47A4. üIndicated71A5. üIndicated59A6. üIndicated64A7. ü

VindictivenessIndicated51A8. ü

Conners 3–T Assessment Report for Test Admin Date: 11/11/2013

Page 11

Copyright © 2008, 2013 Multi-Health Systems Inc. All rights reserved.

Symptom criteria reordered and labeled.


4

• In the DSM-5, a frequency qualifier was added to Criterion A8 of “at least twice within the past 6 months,” for spiteful or vindictive behavior.

• Criterion status score requirements are updated on the Conners 3–SR to accommodate the frequency qualifier added to Criterion A8 (see Figure 3). Specifically, for the symptom of spiteful or vindictive behavior to be classified as May be Indicated on the Conners 3–SR, a response of 1 [Just a little true (Occasionally)] is required. Previously, a response of 1 was classified as Not Indicated. However, it was determined that the frequency of “Just a little true (Occasionally)” applies better to a behavior that meets symptom criteria if it occurs at least twice within the past 6 months. Symptom count requirements did not change on the Conners 3–P and Conners 3–T; existing criterion status score requirements account for this frequency of spiteful or vindictive behavior.

Interpretative Considerations:• Criterion A now states that the symptoms that define

ODD must be “exhibited during interaction with at least one individual who is not a sibling.”

• To address this change, the following interpretative consideration should be taken into account when the Symptom Count is probably met for ODD: “ODD Criterion A states that symptoms must be exhibited during interaction with at least one individual who is not a sibling. If the Symptom Count is probably met for ODD, follow-up is recommended to ensure this requirement is satisfied” (see Interpretative Considerations for Table 3). This interpretative consideration automatically appears in the Conners 3 Assessment Reports when the Symptom Count is probably met.

SummaryWith the release of the DSM-5, it was necessary to review the Conners 3 Manual and associated materials (i.e., the QuikScore forms, Conners 3 Software Program, and online components, including reports) to assess the need to update the DSM Symptom Scales. This review led to the determination that with some small modifications scoring and interpretation of the DSM Symptom Scales could be aligned with the diagnostic criteria in the DSM-5. The Conners 3 Manual contains most of the material required to administer, score, and interpret the assessment. This update details reporting and scoring changes, and interpretative considerations that need to be taken into account when using DSM-5 symptom criteria to score and interpret the DSM Symptom Scales on the Conners 3.

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Name/ID: _______________________________________________ Age: ______ ______ Years Months

Birth Date: ______/______/________ Month Day Year

Gender: M F(Circle One)

Grade: ______ Administration Date: ______/______/________ Month Day Year

Conduct Disorder

DSM-5 Criterion

ItemNumber

Item Score


IndicatedIndicated

A1 25 1 2 3

A2 38 1 2 3

A3 59 1 2 3

A4 86 1 2 3

A5 47 1 2 3

A6 13 1 2 3

A8 72 1 2 3

A9 82 1 2 3

A10 78 1 2 3

A11 16 2 3

A12 52 1 2 3

A13 91 1 2 3

A14 8 1 2 3

A15 33 1 2 3


Symptom criteria probably met if Total Symptom Count ≥ 3NOTE: The Conners 3–SR does not assess Criterion A7 (forced sexual activity). This criterion has been intentionally omitted due to the sensitive nature of this criterion.


Item6

Item9

Item15

Item21

Item34

Item35

Item43

Item50

Item61

Item63

Item Score

Transposing Rule0, 1 2 3 0, 1 2 3 0, 1 2 3 0, 1 2 3 0, 1 2, 3 0, 1 2, 3 0, 1 2 3 0, 1 2, 3 0, 1 2, 3 0, 1 2 3 0 1 2 0 1 2 0 1 2 0 1 2 0 1 0 2 0 1 2 0 1 0 2 0 1 2


Total Transposed

Score

DSM-5 Symptom CountsInstructions: 1. For each item number listed below, transfer the circled score from the Scoring Grid into the Item Score column. 2. If the Item Score is equal to a number in either Required Score column, circle that number in the May be Indicated or Indicated column. NOTE: Do not circle anything if the Item Score does not match any number in either Required Score column or if the item has been omitted. 3. Insert a checkmark in the () column if a score has been circled in either Required Score column. a) For ADHD Inattentive Criterion A1a, insert a checkmark only if a Required Score has been circled for either (or both) items 31 or 39. b) For ADHD Inattentive Criterion A1d, insert a checkmark only if a Required Score has been circled for both items 61 and 17. c) For ADHD Hyperactive-Impulsive Criterion A2c, insert a checkmark if a Required Score has been circled for either (or both) items 20 or 7. d) For ADHD Hyperactive-Impulsive Criterion A2e, insert a checkmark if a Required Score has been circled for either (or both) items 66 or 55.4. Count all checkmarks and write the sum in the Total Symptom Count box. 5. Insert a checkmark in the box at the bottom of the table if the symptom criteria is probably met.

NOTE: Please refer to the Conners 3 Manual and DSM-5 Update for exceptions that may alter the Total Symptom Count.


DSM-5 Criterion

ItemNumber

Item Score


IndicatedIndicated

A2a 60 2 3A2b 64 2 3

A2c20 2 3 EITHER item

circled

7 2 3A2d 84 2 3


circled

55 2 3A2f 34 2 3A2g 9 2 3A2h 27 2 3A2i 6 2 3




ADHD Inattentive

DSM-5 Criterion

ItemNumber

Item Score


IndicatedIndicated

A1a31 2 3 EITHER item

circled

39 2 3A1b 63 2 3A1c 42 2 3


circled

17 2 3A1e 21 2 3A1f 51 2 3A1g 5 2 3A1h 77 2 3A1i 32 2 3





DSM-5 Criterion

ItemNumber

Item Score


IndicatedIndicated

A1 67 2 3

A2 74 2 3

A3 87 2 3

A4 24 2 3

A5 1 2 3

A6 3 2 3

A7 62 2 3

A8 94 1 2 3




Item 73

Item 85

Item 50

Item 60

Item 81

Item 79

Item 46

Item 90

Item 17

Item 30

Item 56

Item 70

Item 42

Item 63

Item 69

Item 83

Item 43

Item 61

Item 25

Item 38

ItemScore




if A ≥ 9 and B ≥ 2






Impairment





very often

95. I have problems that make school really hard for me. 0 1 2 3

96. I have problems that make friendships really hard for me. 0 1 2 3

97. I have problems that make things really hard for me at home. 0 1 2 3


Conners 3 ADHD Index Probability ScoreTotal Transposed Score 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18

Probability (%) 26 35 44 52 59 66 73 78 83 87 91 94 96 97 98 98 99 99 99

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Figure 3. Conners 3–Self-Report QuikScore Form Change to Order of Symptom Criteria and Criterion Status Score Requirements

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Name/ID: _______________________________________________ Age: ______ ______ Years Months

Birth Date: ______/______/________ Month Day Year

Gender: M F(Circle One)

Grade: ______ Administration Date: ______/______/________ Month Day Year

Conduct Disorder

DSM-IV-TR Criterion

ItemNumber

Item Score


IndicatedIndicated

A1 25 1 2 3

A2 38 1 2 3

A3 59 1 2 3

A4 86 1 2 3

A5 47 1 2 3

A6 13 1 2 3

A8 72 1 2 3

A9 82 1 2 3

A10 78 1 2 3

A11 16 2 3

A12 52 1 2 3

A13 91 1 2 3

A14 8 1 2 3

A15 33 1 2 3


Symptom criteria probably met if Total Symptom Count ≥ 3NOTE: The Conners 3–SR does not assess Criterion A7 (forced sexual activity). This criterion has been intentionally omitted due to the sensitive nature of this criterion.


Item6

Item9

Item15

Item21

Item34

Item35

Item43

Item50

Item61

Item63

Item Score

Transposing Rule0, 1 2 3 0, 1 2 3 0, 1 2 3 0, 1 2 3 0, 1 2, 3 0, 1 2, 3 0, 1 2 3 0, 1 2, 3 0, 1 2, 3 0, 1 2 3 0 1 2 0 1 2 0 1 2 0 1 2 0 1 0 2 0 1 2 0 1 0 2 0 1 2


Total Transposed

Score

DSM-IV-TR Symptom CountsInstructions: 1. For each item number listed below, transfer the circled score from the Scoring Grid into the Item Score column. 2. If the Item Score is equal to a number in either Required Score column, circle that number in the May be Indicated or Indicated column. NOTE: Do not circle anything if the Item Score does not match any number in either Required Score column or if the item has been omitted. 3. Insert a checkmark in the () column if a score has been circled in either Required Score column. a) For ADHD Inattentive Criterion A1a, insert a checkmark only if a Required Score has been circled for either (or both) items 31 or 39. b) For ADHD Inattentive Criterion A1d, insert a checkmark only if a Required Score has been circled for both items 61 and 17. c) For ADHD Hyperactive-Impulsive Criterion A2c, insert a checkmark if a Required Score has been circled for either (or both) items 20 or 7. d) For ADHD Hyperactive-Impulsive Criterion A2e, insert a checkmark if a Required Score has been circled for either (or both) items 66 or 55.4. Count all checkmarks and write the sum in the Total Symptom Count box. 5. Insert a checkmark in the box at the bottom of the table if the symptom criteria is probably met.

NOTE: Please refer to the Conners 3 Manual for exceptions that may alter the Total Symptom Count.


DSM-IV-TR Criterion

ItemNumber

Item Score


IndicatedIndicated

A2a 60 2 3

A2b 64 2 3

A2c20 2 3 EITHER item

circled

7 2 3

A2d 84 2 3


circled

55 2 3

A2f 34 2 3

A2g 9 2 3

A2h 27 2 3

A2i 6 2 3



ADHD Inattentive

DSM-IV-TR Criterion

ItemNumber

Item Score


IndicatedIndicated

A1a31 2 3 EITHER item

circled

39 2 3

A1b 63 2 3

A1c 42 2 3


circled

17 2 3

A1e 21 2 3

A1f 51 2 3

A1g 5 2 3

A1h 77 2 3

A1i 32 2 3




DSM-IV-TR Criterion

ItemNumber

Item Score


IndicatedIndicated

A1 67 2 3

A2 24 2 3

A3 1 2 3

A4 3 2 3

A5 62 2 3

A6 74 2 3

A7 87 2 3

A8 94 2 3




Item 73

Item 85

Item 50

Item 60

Item 81

Item 79

Item 46

Item 90

Item 17

Item 30

Item 56

Item 70

Item 42

Item 63

Item 69

Item 83

Item 43

Item 61

Item 25

Item 38

ItemScore




if A ≥ 9 and B ≥ 2






Impairment





very often

95. I have problems that make school really hard for me. 0 1 2 3

96. I have problems that make friendships really hard for me. 0 1 2 3

97. I have problems that make things really hard for me at home. 0 1 2 3


Conners 3 ADHD Index Probability ScoreTotal Transposed Score 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18

Probability (%) 26 35 44 52 59 66 73 78 83 87 91 94 96 97 98 98 99 99 99

Trim

par

ts 2

, 3, 4

& 5

to

17.

125

in.

(a) DSM-IV-TR Symptom Scale (b) DSM-5 Symptom Scale

Change to criterion status score requirements for ODD Criterion A8.

Change to order of criteria. [Note: There are different item numbers for criteria A2 to A7 in table (a) vs. (b)].

DSM-5 Update

5

Tabl

e 1a

. 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 S

ympt

om C

ount

Req

uire

men

ts:

•ADHDPredominantlyInattentivePresentation:Atleast6ofthe9sym

ptom

sforindividuals≤16yearsofage;atleast5ofthe9sym

ptom

sforindividuals≥17yearsofage.

•A

DH

D C

ombi

ned

Pre

sent

atio

n: M

eets

crit

eria

for b

oth

Inat

tent

ive

and

Hyp

erac

tive-

Impu

lsiv

e pr

esen

tatio

ns.

DS

M-5

Cri

teri

on

AFo

rmIt

em

Item

#

Indicated

May be Indicated

Not Indicated

Oft

en

fails

to g

ive c

lose

att

en

tio

n t

o d

eta

ils

or

makes

care

less

m

ista

kes

in s

cho

olw

ork

, at

wo

rk,

or

du

rin

g o

ther

act

ivit

ies

(e.g

.,

overl

oo

ks

or

mis

ses

deta

ils,

wo

rk is

inacc

ura

te).

1a

PD

oesn

’t pa

y at

tent

ion

to d

etai

ls; m

akes

car

eles

s mis

take

s.47

3, 2

–1,

0

TD

oesn

’t pa

y at

tent

ion

to d

etai

ls; m

akes

car

eles

s mis

take

s.37

3, 2

–1,

0

SRIt

is h

ard

for m

e to

pay

atte

ntio

n to

det

ails

.31 -o

r- 39

3, 2

-or- 3

–1,

0-a

nd-

1, 0

I mak

e m

ista

kes b

y ac

cide

nt.

2

Oft

en

has

dif

ficu

lty s

ust

ain

ing

att

en

tio

n in

task

s o

r p

lay

act

ivit

ies

(e.g

., h

as

dif

ficu

lty r

em

ain

ing

fo

cuse

d d

uri

ng

lect

ure

s,

con

vers

ati

on

s, o

r le

ng

thy r

ead

ing

).1b

PH

as tr

oubl

e ke

epin

g hi

s/he

r min

d on

wor

k or

on

play

for l

ong.

953,

2–

1, 0

TH

as tr

oubl

e ke

epin

g hi

s/he

r min

d on

wor

k or

pla

y fo

r lon

g.11

13,

2–

1, 0

SRI h

ave

troub

le k

eepi

ng m

y m

ind

on w

hat I

am

doi

ng.

633,

2–

1, 0

Oft

en

do

es

no

t se

em

to

lis

ten

wh

en

sp

oken

to

dir

ect

ly (

e.g

., m

ind

se

em

s els

ew

here

, even

in

th

e a

bse

nce

of

an

y o

bvio

us

dis

tract

ion

).1c

PD

oes n

ot se

em to

list

en to

wha

t is b

eing

said

to h

im/h

er.

353,

2–

1, 0

TD

oes n

ot se

em to

list

en to

wha

t is b

eing

said

to h

im/h

er.

693,

2–

1, 0

SRI h

ave

troub

le k

eepi

ng m

y m

ind

on w

hat p

eopl

e ar

e sa

ying

to m

e.42

3, 2

–1,

0

Oft

en

do

es

no

t fo

llo

w t

hro

ug

h o

n in

stru

ctio

ns

an

d f

ail

s to

fin

ish

sc

ho

olw

ork

, ch

ore

s, o

r d

uti

es

in t

he w

ork

pla

ce (

e.g

., s

tart

s ta

sks

bu

t q

uic

kly

lo

ses

focu

s an

d is

easi

ly s

idetr

ack

ed

).1d

P

Doe

s not

follo

w th

roug

h on

inst

ruct

ions

(eve

n w

hen

he/s

he u

nder

-st

ands

and

is tr

ying

to c

oope

rate

).68 -and

-79

3, 2

-and

-3.

2

–1,

0-o

r-1,

0Fa

ils to

com

plet

e sc

hool

wor

k, c

hore

s, or

task

s (ev

en w

hen

he/s

he

unde

rsta

nds a

nd is

tryi

ng to

coo

pera

te).

–

T

Doe

s not

follo

w th

roug

h on

inst

ruct

ions

(eve

n w

hen

he/s

he

unde

rsta

nds a

nd is

tryi

ng to

coo

pera

te).

73 -and

-57

3, 2

-and

-3.

2

–1,

0-o

r-1,

0Fa

ils to

com

plet

e sc

hool

wor

k or

task

s (ev

en w

hen

he/s

he

unde

rsta

nds a

nd is

tryi

ng to

coo

pera

te).

–

SRI h

ave

troub

le fo

llow

ing

inst

ruct

ions

.61 -and

-17

3, 2

-and

-3.

2

–1,

0-o

r-1,

0I h

ave

troub

le fi

nish

ing

thin

gs.

–

Oft

en

has

dif

ficu

lty o

rgan

izin

g t

ask

s an

d a

ctiv

itie

s (e

.g.,

dif

ficu

lty

man

ag

ing

seq

uen

tial ta

sks;

dif

ficu

lty k

eep

ing

mate

rials

an

d

belo

ng

ing

s in

ord

er;

mess

y,

dis

org

an

ized

, w

ork

; h

as

po

or

tim

e

man

ag

em

en

t; f

ails

to m

eet

dead

lin

es)

.

1e

PH

as tr

oubl

e or

gani

zing

task

s or a

ctiv

ities

.84

3, 2

–1,

0

TH

as d

ifficu

lty o

rgan

izin

g ta

sks o

r act

iviti

es.

103

3, 2

–1,

0

SRI h

ave

troub

le k

eepi

ng m

ysel

f org

aniz

ed.

213

21,

0

Oft

en

avo

ids,

dis

likes,

or

is r

elu

ctan

t to

en

gag

e in

task

s th

at

req

uir

e s

ust

ain

ed

men

tal eff

ort

(e.g

., s

cho

olw

ork

or

ho

mew

ork

; fo

r o

lder

ad

ole

scen

ts a

nd

ad

ult

s, p

rep

ari

ng

rep

ort

s, c

om

ple

tin

g f

orm

s,

revie

win

g len

gth

y p

ap

ers

).

1f

PAv

oids

or d

islik

es th

ings

that

take

a lo

t of e

ffort

and

are

not f

un.

283

21,

0

TAv

oids

or d

islik

es th

ings

that

take

a lo

t of e

ffort

and

are

not f

un.

603

21,

0

SRI d

on’t

like

doin

g th

ings

that

mak

e m

e th

ink

hard

.51

32

1, 0

Oft

en

lo

ses

thin

gs

nece

ssary

fo

r ta

sks

or

act

ivit

ies

(e.g

., s

cho

ol

mate

rials

, p

en

cils

, b

oo

ks,

to

ols

, w

allets

, keys,

pap

erw

ork

, eyeg

lass

es,

mo

bile t

ele

ph

on

es)

.1g

PLo

ses t

hing

s (fo

r exa

mpl

e, sc

hool

wor

k, p

enci

ls, b

ooks

, too

ls, o

r to

ys).

973,

2–

1, 0

TLo

ses t

hing

s (e.

g., s

choo

lwor

k, p

enci

ls, b

ooks

, too

ls, o

r toy

s).

923,

2–

1, 0

SRI l

ose

stuf

f tha

t I n

eed.

53,

2–

1, 0

Tabl

e co

ntin

ued

next

pag

e...


6

Tabl

e 1a

. (C

ontin

ued)

DSM

-5 S

ympt

om C

ount

and

Crit

erio

n St

atus

Sco

re R

equi

rem

ents

for A

DH

D

DS

M-5

Cri

teri

on

AFo

rmIt

em

Item

#

Indicated

May be Indicated

Not Indicated

Is o

ften

easi

ly d

istr

act

ed

by e

xtr

an

eo

us

stim

uli (

for

old

er

ad

ole

scen

ts a

nd

ad

ult

s, m

ay in

clu

de u

nre

late

d t

ho

ug

hts

).1h

a

PIs

eas

ily d

istra

cted

by

sigh

ts o

r sou

nds.

101

3, 2

–1,

0T

Is e

asily

dis

tract

ed b

y si

ghts

or s

ound

s.23

3, 2

–1,

0SR

I get

dis

tract

ed b

y th

ings

that

are

goi

ng o

n ar

ound

me.

773

21,

0

Is o

ften

fo

rgetf

ul in

daily a

ctiv

itie

s (e

.g.,

do

ing

ch

ore

s, r

un

nin

g

err

an

ds;

fo

r o

lder

ad

ole

scen

ts a

nd

ad

ult

s, r

etu

rnin

g c

all

s, p

ayin

g

bil

ls,

an

d k

eep

ing

ap

po

intm

en

ts).

1iP

Is fo

rget

ful i

n da

ily a

ctiv

ities

.2

3, 2

–1,

0T

Is fo

rget

ful i

n da

ily a

ctiv

ities

.88

3, 2

–1,

0SR

I for

get s

tuff.

323

21,

0D

SM-5

Sym

ptom

Crit

eria

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, C

opyr

ight

, 201

3. A

mer

ican

Psy

chia

tric A

ssoc

iatio

n.

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 all

(Nev

er, S

eldo

m);

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

:

AD

HD

Cri

teri

on A

stat

es th

at 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

erst

and

task

s or

inst

ruct

ions

. If t

he S

ympt

om C

ount

is p

roba

bly

met

fo

r AD

HD

Pre

dom

inan

tly In

atte

ntiv

e, H

yper

activ

e-Im

puls

ive,

or

Com

bine

d Pr

esen

tatio

n, fo

llow

-up

is r

ecom

men

ded

to e

nsur

e th

is r

equi

rem

ent i

s sat

isfie

d.a C

rite

rion

A1h

stat

es th

at in

old

er a

dole

scen

ts, t

he te

nden

cy to

be

easi

ly d

istr

acte

d by

ext

rane

ous s

timul

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

chec

k if

Cri

teri

on A

1h h

as b

een

met

for

olde

r ad

oles

cent

s.

DSM-5 Update

7

Tabl

e 1b

. 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 S

ympt

om C

ount

Req

uire

men

ts:

•ADHDPredominantlyHyperactive-ImpulsivePresentation:Atleast6ofthe9sym

ptom

sforindividuals≤16yearsofage;atleast5ofthe9sym

ptom

sforthose≥17yearsofage.

•A

DH

D C

ombi

ned

Pre

sent

atio

n: M

eets

crit

eria

for b

oth

Inat

tent

ive

and

Hyp

erac

tive-

Impu

lsiv

e pr

esen

tatio

ns.

DS

M-5

Cri

teri

on

AFo

rmIt

em

Item

#

Indicated

May be Indicated

Not Indicated

Oft

en

fid

gets

wit

h o

r ta

ps

han

ds

or

feet

or

squ

irm

s in

seat.

2a

PFi

dget

s or s

quirm

s in

seat

.98

3, 2

–1,

0

TFi

dget

s or s

quirm

s in

seat

.4

3, 2

–1,

0

SRIt

is h

ard

for m

e to

sit s

till.

603

21,

0

Oft

en

leaves

seat

in s

itu

ati

on

s w

hen

rem

ain

ing

seate

d i

s exp

ect

ed

(e

.g.,

leaves

his

or

her

pla

ce in

th

e c

lass

roo

m,

in t

he o

ffice

or

oth

er

wo

rkp

lace

, o

r in

oth

er

situ

ati

on

s th

at

req

uir

e r

em

ain

ing

in

pla

ce).

2b

PLe

aves

seat

whe

n he

/she

shou

ld st

ay se

ated

.93

3, 2

–1,

0

TLe

aves

seat

whe

n he

/she

shou

ld st

ay se

ated

.1

3, 2

–1,

0

SRI g

et o

ut o

f my

seat

whe

n I a

m n

ot su

ppos

ed to

.64

3, 2

–1,

0

Oft

en

ru

ns

ab

ou

t o

r cl

imb

s in

sit

uati

on

s w

here

it

is i

nap

pro

pri

ate

. (N

ote

: In

ad

ole

scen

ts o

r ad

ult

s, m

ay b

e lim

ited

to

feeli

ng

rest

less

.)2c

a

PR

uns o

r clim

bs w

hen

he/s

he is

not

supp

osed

to.

69 -or- 99

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.

24 -or- 7

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.

20 -or- 7

3, 2

-or-

3, 2

–1,

0-a

nd-

1,0

I am

rest

less

.–

Oft

en

un

ab

le t

o p

lay o

r en

gag

e in

leis

ure

act

ivit

ies

qu

ietl

y.

2d

PIs

noi

sy a

nd lo

ud w

hen

play

ing

or u

sing

free

tim

e.71

3, 2

–1,

0

TIs

noi

sy a

nd lo

ud w

hen

play

ing

or u

sing

free

tim

e.32

3, 2

–1,

0

SRI h

ave

troub

le p

layi

ng o

r doi

ng th

ings

qui

etly

.84

3, 2

–1,

0

Is o

ften

“o

n t

he g

o,”

act

ing

as

if “

dri

ven

by a

mo

tor”

(e.g

., i

s u

nab

le t

o b

e o

r u

nco

mfo

rtab

le b

ein

g s

till f

or

exte

nd

ed

tim

e,

as

in r

est

au

ran

ts,

meeti

ng

s; m

ay b

e e

xp

eri

en

ced

by o

thers

as

bein

g

rest

less

or

dif

ficu

lt t

o k

eep

up

wit

h).

2e

PA

cts a

s if d

riven

by

a m

otor

.54 -o

r- 45

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

.17 -o

r- 78

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.

66 -or- 55

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

talk

s exce

ssiv

ely

.2f

PTa

lks t

oo m

uch.

33,

2–

1, 0

TTa

lks t

oo m

uch.

503,

2–

1, 0

SRI t

alk

too

muc

h.34

3, 2

–1,

0

Tabl

e co

ntin

ued

next

pag

e...


8

Tabl

e 1b

. (C

ontin

ued)

DSM

-5 S

ympt

om C

ount

and

Crit

erio

n St

atus

Sco

re R

equi

rem

ents

for A

DH

D

DS

M-5

Cri

teri

on

AFo

rmIt

em

Item

#

Indicated

May be Indicated

Not Indicated

Oft

en

blu

rts

ou

t an

an

swer

befo

re a

qu

est

ion

has

been

co

mp

lete

d

(e.g

., c

om

ple

tes

peo

ple

's s

en

ten

ces;

can

no

t w

ait

fo

r tu

rn i

n

con

vers

ati

on

).2g

PB

lurts

out

ans

wer

s bef

ore

the

ques

tion

has b

een

com

plet

ed.

433,

2–

1, 0

TB

lurts

out

ans

wer

s bef

ore

the

ques

tion

has b

een

com

plet

ed.

93,

2–

1, 0

SRI b

lurt

out t

he a

nsw

er b

efor

e th

e qu

estio

n is

fini

shed

.9

3, 2

–1,

0

Oft

en

has

dif

ficu

lty w

ait

ing

his

or

her

turn

(e.g

., w

hil

e w

ait

ing

in

li

ne).

2hP

Has

diffi

culty

wai

ting

for h

is/h

er tu

rn.

613,

2–

1, 0

TH

as d

ifficu

lty w

aitin

g fo

r his

/her

turn

.76

3, 2

–1,

0SR

I hav

e tro

uble

wai

ting

for m

y tu

rn.

273,

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

ati

on

s, g

am

es,

or

act

ivit

ies;

may s

tart

usi

ng

oth

er

peo

ple

’s

thin

gs

wit

ho

ut

ask

ing

or

rece

ivin

g p

erm

issi

on

; fo

r ad

ole

scen

ts a

nd

ad

ult

s, m

ay in

tru

de in

to o

r ta

ke o

ver

wh

at

oth

ers

are

do

ing

).

2i

PIn

terr

upts

oth

ers (

for e

xam

ple,

but

ts in

to c

onve

rsat

ions

or g

ames

).10

43,

2–

1, 0

TIn

terr

upts

oth

ers (

e.g.

, but

ts in

to c

onve

rsat

ions

or g

ames

).29

3, 2

–1,

0

SRI i

nter

rupt

oth

er p

eopl

e.6

3, 2

–1,

0

DSM

-5 S

ympt

om C

riter

ia 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

, Cop

yrig

ht, 2

013.

Am

eric

an P

sych

iatri

c Ass

ocia

tion.

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 all

(Nev

er, S

eldo

m);

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

:

AD

HD

Cri

teri

on A

stat

es th

at 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

erst

and

task

s or

inst

ruct

ions

. If t

he S

ympt

om C

ount

is p

roba

bly

met

fo

r AD

HD

Pre

dom

inan

tly In

atte

ntiv

e, H

yper

activ

e-Im

puls

ive,

or

Com

bine

d Pr

esen

tatio

n, fo

llow

-up

is r

ecom

men

ded

to e

nsur

e th

is r

equi

rem

ent i

s sat

isfie

d.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 the

self-

repo

rt of

you

nger

ch

ildre

n.

DSM-5 Update

9

Tabl

e 2.

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

AFo

rmIt

em

Item

#

Indicated

May be Indicated

Not Indicated

Ag

gre

ssio

n t

o P

eo

ple

an

d A

nim

als

Oft

en

bu

llie

s, t

hre

ate

ns,

or

inti

mid

ate

s o

thers

.1

PB

ullie

s, th

reat

ens,

or sc

ares

oth

ers.

163,

21

0

TB

ullie

s, th

reat

ens,

or sc

ares

oth

ers.

983,

21

0

SRI b

ully

or t

hrea

ten

othe

r peo

ple.

253,

21

0

Oft

en

in

itia

tes

ph

ysi

cal fi

gh

ts.

2

PSt

arts

figh

ts w

ith o

ther

s on

purp

ose.

303,

21

0

TIn

tent

iona

lly st

arts

figh

ts w

ith o

ther

s.10

53,

21

0

SRI s

tart

fight

s with

oth

er p

eopl

e.38

3, 2

10

Has

use

d a

weap

on

th

at

can

cau

se s

eri

ou

s p

hysi

cal

harm

to

oth

ers

(e

.g.,

a b

at,

bri

ck,

bro

ken

bo

ttle

, 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).

273,

2, 1

–0

TU

ses a

wea

pon

(e.g

., a

bat,

bric

k, b

roke

n bo

ttle,

kni

fe, o

r gun

).14

3, 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.

593,

2, 1

–0

Has

been

ph

ysi

call

y c

ruel to

peo

ple

.4

PPh

ysic

ally

hur

ts p

eopl

e.39

3, 2

, 1–

0

TPh

ysic

ally

hur

ts p

eopl

e.35

3, 2

, 1–

0

SRI d

o th

ings

to h

urt p

eopl

e.86

3, 2

, 1–

0

Has

been

ph

ysi

call

y c

ruel to

an

imals

.5

PIs

cru

el to

ani

mal

s.41

3, 2

, 1–

0

TIs

cru

el to

ani

mal

s.21

3, 2

, 1–

0

SRI a

m m

ean

to a

nim

als.

473,

2, 1

–0

Has

sto

len

wh

ile c

on

fro

nti

ng

a v

icti

m (

e.g

., m

ug

gin

g,

pu

rse

snatc

hin

g,

exto

rtio

n,

arm

ed

ro

bb

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).

963,

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).

273,

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)

.13

3, 2

, 1–

0

Has

forc

ed

so

meo

ne in

to s

exu

al act

ivit

y.

7a

PH

as fo

rced

som

eone

into

sexu

al a

ctiv

ity.

113,

2, 1

–0

TH

as fo

rced

som

eone

into

sexu

al a

ctiv

ity.

333,

2, 1

–0

SR–

––

––

Dest

ruct

ion

of

Pro

pert

y

Has

delib

era

tely

en

gag

ed

in

fire

sett

ing

wit

h t

he in

ten

tio

n o

f ca

usi

ng

seri

ou

s d

am

ag

e.

8b

PH

as in

tent

iona

lly se

t fire

s for

the

purp

ose

of c

ausi

ng d

amag

e.78

3, 2

, 1–

0

TH

as in

tent

iona

lly se

t fire

s for

the

purp

ose

of c

ausi

ng d

amag

e.61

3, 2

, 1–

0

SRI l

ike

to se

t thi

ngs o

n fir

e.72

3, 2

10

Tabl

e co

ntin

ued

next

pag

e...


10

Tabl

e 2.

(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

AFo

rmIt

em

Item

#

Indicated

May be Indicated

Not Indicated

Has

delib

era

tely

dest

royed

oth

ers

' p

rop

ert

y (

oth

er

than

by fi

re

sett

ing

).9b

PIn

tent

iona

lly d

amag

es o

r des

troys

thin

gs th

at b

elon

g to

oth

ers.

653,

2, 1

–0

TIn

tent

iona

lly d

amag

es o

r des

troys

thin

gs th

at b

elon

g to

oth

ers.

103,

2, 1

–0

SRI d

estro

y st

uff t

hat b

elon

gs to

oth

er p

eopl

e.82

3, 2

, 1–

0

Dece

itfu

lness

or

Th

eft

Has

bro

ken

in

to s

om

eo

ne e

lse's

ho

use

, b

uild

ing

, o

r ca

r.10

PH

as b

roke

n in

to so

meo

ne e

lse's

hou

se, b

uild

ing,

or c

ar.

893,

2, 1

–0

TH

as b

roke

n in

to so

meo

ne e

lse's

hou

se, b

uild

ing,

or c

ar.

903,

2, 1

–0

SRI b

reak

into

hou

ses,

build

ings

, or c

ars.

783,

2, 1

–0

Oft

en

lie

s to

ob

tain

go

od

s o

r fa

vo

rs o

r to

avo

id o

blig

ati

on

s (i

.e.,

"c

on

s" o

thers

).11

PLi

es to

avo

id h

avin

g to

do

som

ethi

ng o

r to

get t

hing

s.56

3, 2

–1,

0

TLi

es to

avo

id h

avin

g to

do

som

ethi

ng o

r to

get t

hing

s.40

3, 2

–1,

0

SRI t

ell l

ies t

o ge

t out

of d

oing

thin

gs o

r to

get s

tuff.

163,

2–

1, 0

Has

sto

len

ite

ms

of

no

ntr

ivia

l valu

e w

ith

ou

t co

nfr

on

tin

g a

vic

tim

(e

.g.,

sh

op

lift

ing

, b

ut

wit

ho

ut

bre

akin

g a

nd

en

teri

ng

; fo

rgery

).12

PSt

eals

secr

etly

(for

exa

mpl

e, sh

oplif

ting

or fo

rger

y).

583,

2, 1

–0

TSt

eals

secr

etly

(e.g

., sh

oplif

ting

or fo

rger

y).

313,

2, 1

–0

SRI s

teal

impo

rtant

thin

gs w

hen

no o

ne is

wat

chin

g.52

3, 2

, 1–

0

Seri

ou

s V

iola

tio

ns

of

Ru

les

Oft

en

sta

ys

ou

t at

nig

ht

desp

ite p

are

nta

l p

roh

ibit

ion

s, b

eg

inn

ing

b

efo

re a

ge 1

3 y

ears

.13

c,d

PG

oes o

ut a

t nig

ht e

ven

thou

gh it

bre

aks t

he ru

les.

913,

21

0

T–

––

––

SRI g

o ou

t at n

ight

eve

n w

hen

I am

supp

osed

to b

e at

hom

e.91

3, 2

10

Has

run

aw

ay f

rom

ho

me o

vern

igh

t at

least

tw

ice w

hil

e l

ivin

g i

n

the p

are

nta

l o

r p

are

nta

l su

rro

gate

ho

me,

or

on

ce w

ith

ou

t re

turn

ing

fo

r a len

gth

y p

eri

od

.14

c

PR

uns a

way

from

hom

e fo

r at l

east

one

nig

ht.

763,

2, 1

–0

T–

––

––

SRI r

un a

way

from

hom

e.8

3, 2

, 1–

0

Is o

ften

tru

an

t fr

om

sch

oo

l, b

eg

inn

ing

befo

re a

ge 1

3 y

ears

.15

e

PSk

ips c

lass

es.

63,

21

0

TSk

ips c

lass

es.

543,

21

0

SRI s

kip

clas

ses.

333,

21

0D

SM-5

Sym

ptom

Crit

eria

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, C

opyr

ight

, 201

3. A

mer

ican

Psy

chia

tric A

ssoc

iatio

n.N

otes

: 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

).In

terp

reta

tive

Con

side

ratio

ns:

a The

Con

ners

3–S

R 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

bot

h C

riter

ion

A8

(fire

setti

ng) a

nd A

9 (d

estru

ctio

n of

pro

perty

) are

indi

cate

d, in

ord

er to

mee

t Crit

erio

n A

9, 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.

c The

Con

ners

3–T

doe

s 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 o

rder

for D

SM-5

Crit

erio

n A

13 (s

tayi

ng o

ut a

t nig

ht) t

o be

indi

cate

d, th

e as

sess

or n

eeds

to e

nsur

e th

is c

riter

ion

occu

rred

bef

ore

the

age

of 1

3 ye

ars.

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 m

ust 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 3.

D

SM-5

Sym

ptom

Cou

nt a

nd C

riter

ion

Stat

us S

core

Req

uire

men

ts fo

r OD

D

DS

M-5

Sym

ptom

Cou

nt R

equi

rem

ents

: At l

east

4 o

f the

8 s

ympt

oms.

DS

M-5

Cri

teri

on

AFo

rmIt

em

Item

#

Indicated

May be Indicated

Not Indicated

An

gry

/Ir

rita

ble

Mo

od

Oft

en

lo

ses

tem

per.

1

PLo

ses t

empe

r.14

3, 2

–1,

0

TLo

ses t

empe

r.62

3, 2

10

SRI l

ose

my

tem

per.

673

21,

0

Is o

ften

to

uch

y o

r easi

ly a

nn

oyed

.2

PIs

irrit

able

and

eas

ily a

nnoy

ed b

y ot

hers

.73

3, 2

–1,

0

TIs

irrit

able

and

eas

ily a

nnoy

ed b

y ot

hers

.56

3, 2

10

SRI a

m e

asily

ann

oyed

by

othe

rs.

743,

2–

1, 0

Is o

ften

an

gry

an

d r

ese

ntf

ul.

3

PIs

ang

ry a

nd re

sent

ful.

483,

21

0

TIs

ang

ry a

nd re

sent

ful.

383,

21

0

SRPe

ople

mak

e m

e an

gry.

873,

2–

1, 0

Arg

um

en

tati

ve/

Defi

an

t B

eh

avio

r

Oft

en

arg

ues

wit

h a

uth

ori

ty fi

gu

res

or,

fo

r ch

ild

ren

an

d

ad

ole

scen

ts,

wit

h a

du

lts.

4

PA

rgue

s with

adu

lts.

102

3, 2

–1,

0

TA

rgue

s with

adu

lts.

473,

2–

1, 0

SRI a

rgue

with

adu

lts.

243,

2–

1, 0

Oft

en

act

ively

defi

es

or

refu

ses

to c

om

ply

wit

h r

eq

uest

s fr

om

au

tho

rity

fig

ure

s o

r 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.

943,

2–

1, 0

TA

ctiv

ely

refu

ses t

o do

wha

t adu

lts te

ll hi

m/h

er to

do.

713,

21

0

SRI d

o w

hat m

y pa

rent

s or o

ther

adu

lts a

sk m

e to

do.

(R)

1 (R

)3

21,

0

Oft

en

delib

era

tely

an

no

ys

oth

ers

.6

PA

nnoy

s oth

er p

eopl

e on

pur

pose

.59

3, 2

–1,

0

TA

nnoy

s oth

er p

eopl

e on

pur

pose

.59

3, 2

–1,

0

SRI t

ry to

ann

oy o

ther

peo

ple.

33,

2–

1, 0

Oft

en

bla

mes

oth

ers

fo

r h

is o

r h

er

mis

takes

or

mis

beh

avio

r.7

PB

lam

es o

ther

s for

his

/her

mis

take

s or m

isbe

havi

or.

213,

2–

1, 0

TB

lam

es o

ther

s for

his

/her

mis

take

s or m

isbe

havi

or.

643,

21

0

SRI b

lam

e ot

hers

for t

hing

s I d

o w

rong

.62

3, 2

–1,

0

Tabl

e co

ntin

ued

next

pag

e...


12

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 O

DD

DS

M-5

Cri

teri

on

AFo

rmIt

em

Item

#

Indicated

May be Indicated

Not Indicated

Vin

dic

tiven

ess

Has

been

sp

itefu

l o

r vin

dic

tive a

t le

ast

tw

ice w

ith

in t

he p

ast

6

mo

nth

s.8

PTr

ies t

o ge

t eve

n w

ith p

eopl

e.57

3, 2

10

TTr

ies t

o ge

t eve

n w

ith p

eopl

e.51

3, 2

10

SRW

hen

I get

mad

at s

omeo

ne, I

get

eve

n w

ith th

em.

943,

21

0

DSM

-5 S

ympt

om C

riter

ia 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

, Cop

yrig

ht, 2

013.

Am

eric

an P

sych

iatri

c Ass

ocia

tion.

Not

es:

(R) =

Item

is re

vers

e sc

ored

.

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 all

(Nev

er, S

eldo

m);

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

:

OD

D C

rite

rion

A st

ates

that

sym

ptom

s mus

t be

exhi

bite

d du

ring

inte

ract

ion

with

at l

east

one

indi

vidu

al w

ho is

not

a si

blin

g. If

the

Sym

ptom

Cou

nt is

pro

babl

y m

et fo

r O

DD

, fol

low

-up

is r

ecom

men

ded

to e

nsur

e th

is r

equi

rem

ent i

s sat

isfie

d.

References

American 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.

Conners, C. K. (1997). Conners’ Rating Scales–Revised Technical Manual. Toronto, Ontario, Canada: Multi-Health Systems.

Conners, C. K. (2008, 2010). Conners 3rd Edition Manual. Toronto, Ontario, Canada: Multi-Health Systems.

USAP.O. Box 950North Tonawanda, NY14120-0950Phone: 1.800.456.3003Fax: 1.888.540.4484

CANADA3770 Victoria Park Ave.Toronto, ON M2H 3M6Phone: 1.800.268.6011Fax: 1.888.540.4484

INTERNATIONALPhone: +1.416.492.2627Fax: +1.416.492.3343

WEBSITEwww.mhs.com/conners

[email protected]

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