C. Keith Conners, Ph.D. DSM-5 UPDATE
C. Keith Conners, Ph.D.DSM-5 UPDATE
Contact MHS1-800-456-3003 (U.S.)1-800-268-6011 (Canada) 1-416-492-2627 his 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 areto be printed or otherwise reproduced by any means, including electronic storage within a computer program or database, without the permission ofthe publisher. These materials may not be translated into a natural or computer language without permission. This copyright is protected through thelaws of the United States, Canada, and other countries. Persons who violate the copyrights on these materials may be liable to prosecution. Ethicalcodes of various professional associations to which users are likely to belong specifically prohibit both illegal behaviors and actions that woulddeny other parties fair compensation for their work. Persons who violate professional ethical codes related to inappropriate and unfair use of thesematerials may be brought before the relevant professional associations to which they belong. The information included in this technical report doesnot constitute, and shall not be considered, the advice, recommendation, assessment, or endorsement of MHS. To the extent permitted by law, anystatutory or implied warranty of merchantability or fitness for a particular purpose is completely denied and disclaimed. MHS shall not be liablefor any third party claims, lost profits, lost savings, loss of information, or any other incidental damages or other economic consequential damagesresulting 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 UpdateC. Keith ConnersOverviewThe Conners 3rd Edition (Conners 3 ), a revision of theConners’ Rating Scales–Revised (CRS–R; Conners, 1997),included a number of new features. One of these new featureswas direct links between scale content on the full-lengthforms (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 andStatistical Manual of Mental Disorders, Fourth Edition, TextRevision (DSM-IV-TR; American Psychiatric Association[APA], 2000), for Attention-Deficit/Hyperactivity Disorder(ADHD), and its most common comorbid disorders, ConductDisorder (CD) and Oppositional Defiant Disorder (ODD).A new edition of the DSM was released in May, 2013: TheDiagnostic and Statistical Manual of Mental Disorders, FifthEdition (DSM-5; APA, 2013). Accordingly, a review of theConners 3 Manual and associated materials, including the fulllength QuikScore forms, the Conners 3 Software Program,and online components (e.g., the Assessment, Progress, andComparative Reports) was undertaken in order to determinethe changes required to scoring and interpretation.This update outlines the revisions to symptom criteria forADHD, CD, and ODD made in the DSM-5, as well asany changes made to forms, scoring, and interpretativeconsiderations in the Conners 3. Much of what is requiredfor administration, scoring, and interpretation of thisassessment is still found in the Conners 3 Manual. The maincomputerized scoring update to the Conners 3 assessment isa report option featuring DSM-5 scoring. Correspondingly,for hand-scoring, DSM Symptom Scales on the Conners 3QuikScore forms are updated with DSM-5 criteria. TheDSM-5 scoring option incorporates the following:i.An update to the ADHD Symptom Count for 17- to18-year-olds;ii. An amendment to the order of ODD Criterion Asymptoms; andiii. A change to the symptom count requirements on theself-report form for ODD Criterion A8 (Note: symptomcount requirements on the parent and teacher formswere not impacted by the modification to Criterion A8).Any revisions or additions to interpretative considerationsin the Conners 3 Manual and Assessment Reports (seeAppendix E, Scoring DSM-IV-TR Symptom Scales in theConners 3 Manual) are outlined in this update and printedin bold below Tables 1a through 3 (Note: The originalinterpretative considerations are included in this update tofacilitate scoring and interpretation of the DSM-5 SymptomScales). Further, interpretative considerations appear whererelevant as notes in the Assessment Reports.Changes to the Conners 3Corresponding to DSMCriteria UpdatesConners 3 DSM Scales are comprised of items thatapproximate symptom-level criteria from the DSM; fulldiagnostic criteria (e.g., course, age of onset, differentialdiagnosis, level of impairment, and pervasiveness) are notrepresented. (See the DSM-5 for full diagnostic criteria.)The itemized list of changes provided in this update detailsonly those changes in the DSM-5 to ADHD, CD, and ODDsymptom criteria that are measured, scored, and interpretedon the Conners 3. (Note: None of the changes to diagnosticcriteria for CD impact scoring or interpretation of theConners 3.)Only the Conners 3 full-length forms include the DSM-IV-TRSymptom Scales. As a result, any changes to scoring involveonly the Conners 3 full-length forms (i.e., Conners 3–Parent[Conners 3–P], Conners 3–Teacher [Conners 3–T], andConners 3–Self-Report [Conners 3–SR]). These can bescored by hand, software, or online (see the Conners 3Manual for further information about scoring). For handscoring, the DSM Symptom Scales on the Conners 3QuikScore forms are updated with DSM-5 criteria. Withrespect to computerized scoring, a DSM scoring optionis now included that allows the assessor to choose eitherDSM-IV-TR scoring or DSM-5 scoring: Reports produced using the DSM-IV-TR scoring optionare identical to the original Conners 3 reports.1
Conners 3rd Edition (Conners 3 )Interpretative Considerations: Reports produced using the DSM-5 scoring optioninclude DSM-5 Symptom Counts and interpretativeconsiderations. Inattentive, Hyperactive-Impulsive, and Combinedsubtypes were reclassified as presentations in theDSM‑5.ADHDThe following is a list of changes made in the DSM-5 to thediagnostic criteria for ADHD that required correspondingupdates to the Conners 3 assessment. Tables 1a and 1b showthe DSM-5 criteria for ADHD, the associated Conners 3form items, and the response choices for when symptomsare Indicated, May be Indicated, or Not Indicated.Response Style Analysis CONNERS 3 –TeacherScoringand ReportingAdjustments:InconsistencyIndex The names of the Conners 3 DSM Scales for ADHDwere updated to reflect this reclassification. A statement was added in the DSM-5 to the pre-amblefor both ADHD Predominantly Inattentive Presentation(Criterion A1) and ADHD Predominantly HyperactiveImpulsive Presentation (Criterion A2) that explicitlyStudent's Name/ID:requires the diagnostician to rule out “oppositionalbehavior, defiance, hostility, or failure to understandGender: MF Teacher's Name/ID:(Circle One)tasks or instructions,” as the primary causes of ADHDsymptoms. Instructions:In the DSM-5, the symptom count was reduced for1. For each of the following items, transfer the circled scores from the Scoring Grid into the appropriate boxes, below.Conduct Disorder Tobelowaddress2.olderFor eachadolescentspair of items, subtractthe lowervalue(17from thehigher andvalue andwrite the difference in the box directlyeach pair.the differential diagnosis considerationandadultsyearsolder),3. Sum the Absolute Differences to get the Inconsistency Index Total (box A).Required ScoreItemItemadded to Criterion A1 and Criterion A2, ifDSM-5the4.fromWrite theabsolute differencesthat areequalofto 2Inattentiveor 3 in box B.6numberto 5 ofsymptomsfromeachand/orMay beIndicCriterionNumberScore5. Insert a checkmark in the box provided if a possible inconsistent response style is indicated.IndicatedSymptom Count is probably met for any of theHyperactive-Impulsive presentations.12A1Item ItemItem ItemItem ItemItem ItemItem ItemItem ItemItem Item ADHDItem Itempresentations,Item ItemItem theItem assessor must ruleout 98971005263477262998105255723443489477112A2105 ItemThe changeto thesymptomcount7 for13 olderthese behaviors as the primary cause of theA3ADHD 14Score1 2adolescents (17–18-year-olds) is incorporated intoAbsolutesymptoms.considerationA41 235 This interpretative ADifferencescoring algorithms for the Conners 3 reports, such that1 2automatically appears in theConners 3 AssessmentA521InconsistencyIndex Total (A)5 symptoms are required for the Symptom Count to1 2A627Reports when the Symptom Count is probablyPossible inconsistent response style indicatedNumber of Absolute1 2be probably met for ADHD PredominantlyInattentive A733Bmet for any of the ADHD presentations (see theDifferences 2 or 3 (B)if A 6 and B 21 2A861Presentation and ADHD Predominantly HyperactiveInterpretative Considerations for Table 1a and1b, 101 2A9Presentation.ADHD Combined PresentationPI Impulsiveand NI ScaleGuidelinesDSM-5 Symptom Count and Criterion Status1 2A10 Score 90Instructions:requires 5 symptoms each from inattentive and2Requirementsfor ADHD).A11401. Transfer the Total Raw Scores for both the Positive Impression (PI) and Negative Impression (NI) Scales from the ScoringGrid into the Raw Scorecolumn of the table, below.hyperactive-impulsivesymptomForhand2. Inserta checkmark in the Interpretive Guidelinebox if thecriteria.response styleis indicated.1 2A1231 A lifespan-specific example was added to CriterionScoreInterpretiveGuideline12scoring, the QuikScore Rawformsare updatedto notetheA1554A1hin theDSM-5,Total Symptom CPositiveImpression(PI)differentsymptomcount requirements forPossibleindividualspositive response styleindicatedif RawScore 5. illustrating how the symptom ofdistractionmay present in older adolescents.16 yearsof age17 yearsof response styleNegativeImpression(NI) and younger, versus those Possiblenegativeindicated if Raw Score 5. Symptom criteria probably met if Total Symptage and older (see Figure 1). An interpretative consideration is includedNOTE:in ThetheConners 3–T does not assess Criterion A13 (staying out at n(sum all checDSM-5 Symptom Countsor Criterion A14 (running away from home). These criteria have been intmost teachers do not have the opportunity to observe these infractions.Conners 3 Assessment Report to account forthisInstructions:change (see Interpretative Considerations for Table 1a).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.ImpairmentInstructions:For each item listed in the Impairment table below, refer to theFigure1. referConners3–TeacherQuikScoreForm -thatSymptomRequirementsNOTE: Pleaseto the Conners3 Manual and DSM-5Update for exceptionsmay alter the CountTotal SymptomCount.ADHD InattentiveC. Keith Conners, Ph.D.DSM-5CriterionItemNumberItemScoreRequired ScoreMay beIndicated( )IndicatedDSM-5CriterionItemNumberItemScore113. The student’s problems seriously affect f60A1g9223A1h2323A1i8823A1d2BOTH itemscircled3Total Symptom Count(sum all checkmarks) Age 16; Symptom criteria probably met if Total Symptom Count 6 Age 17; Symptom criteria probably met if Total Symptom Count 5ADHD Combined 2923A2eA2f( )IndicatedA1b69112. The student’s problems seriously affect schoolwoRequired ScoreMay beIndicatedA1aA1c2ItemADHD Hyperactive-ImpulsiveEITHER itemcircledEITHER itemcircledTotal Symptom CountConners 3 ADHD IndeInstructions:1. For each item listed below, transfer the circled score from th2. Transpose each score by following the Transposing Rule an3. Sum the transposed scores to obtain the Total Transposed4. Determine the probability of a classification of ADHD by circItem4Item7Item130, 1 2 3 0 1 20, 1 2 3 0 1 2StatementsforItem Scoredetermining if 0,the1 2TotalTransposingSymptom Rule0 1Countis probablyTransposedmet. Score3 2Total Transposed Score012345Probability (%)19395152586 0 (sum all checkmarks) Age 16; Symptom criteria probably met if Total Symptom Count 6 Age 17; Symptom criteria probably met if Total Symptom Count 5Symptom criteria probably met if symptom criteria probably met for ADHD Inattentive andADHD Hyperactive-ImpulsiveConners 3
DSM-5 UpdateCDScoring and Reporting Adjustments: Criterion A in the DSM-5 divides ODD symptomRevisions made in the DSM-5 to the diagnostic criteria forcriteria into three types of behaviors, including Angry/CD did not impact Criterion A symptoms (those symptomsIrritable Mood, Argumentative/Defiant Behavior, andassessed by the Conners 3); they are essentially identical toVindictiveness. As a result of this change, diagnosticthoseprinted in the DSM-IV-TR. Table 2 shows the DSM-5Conners 3–T Assessment Report for TestAdmin Date:11/11/2013criteria for ODD were reorderedas follows:criteria for CD, the associated Conners 3 form items, and theresponsechoicesfor when symptomsare Indicated, May beDSM-5ConductDisorder Criterion A1 in the DSM-5 is in the same order it wasIndicated,or Not Indicated.the DSM-IV-TRDSM-5 Symptoms:Criterion AItemTeacher's inRatingCriterion StatusAggression to People and AnimalsNumber 012Scoring and Reporting siderations:35A4.A5.changes were made to the interpretative21considerationsNoforCD. Table 2 includes interpretative considerationsfor CDA6.27thatA7. apply to the DSM-5 Symptom Scales;33however, thesenotesare identicalto the interpretative considerations forDestructionof PropertytheDSM-IV-TRSymptomScales. The notesA8.61are provided inthissupplementtofacilitateinterpretationof the SymptomA9.10CountforDSM-5scoring.Deceitfulness or Theft3? Criterion A2 in the DSM-5 was Criterion A6 in theDSM-IV-TRIndicatedü CriterionA3inthe DSM-5 was Criterion A7 in theIndicatedüDSM-IV-TRIndicatedü CriterionA4inthe DSM-5 was Criterion A2 in theIndicatedüDSM-IV-TRIndicatedüIndicatedü CriterionA5 inthe DSM-5 was Criterion A3 in theDSM-IV-TRIndicatedü Criterion A6 in the DSM-5 was Criterion A4 in theIndicated¹üDSM-IV-TRIndicated¹ü Criterion A7 in the DSM-5 was Criterion A5 in theDSM-IV-TRA10.90Indicatedü Criterion A8 in the DSM-5 is in the same order it wasA11.40IndicatedüODDin the DSM-IV-TRA12.31IndicatedüTable 3 shows the DSM-5 criteria for ODD, the associated In the Conners 3, symptom criteria are reorderedSerious Violations of RulesConners 3 form items, and the response choices forand ülabeled as theyare in the DSM-5 (i.e., Angry/A15.54Indicated²when symptoms are Indicated, May be Indicated, or NotIrritable Mood, Argumentative/Defiant Behavior, and¹Both ctionwere indicated. In order to meet Criterion of property)Vindictiveness; see Figure 2) in all of the ODD tablesthe assessor must confirm that property was destroyed other than by fire-setting (Criterion A8).and scoring of the Conners 3 scales, and some otherin the reports. Similarly, the change to the order ofinterpretativeconsiderations.symptomcriteriafor ODDis incorporated²In order for CriterionA15 (truancy) to be indicated the assessor needsto ensurethis criterionoccurredbefore theintoagetheof 13 years.ODD table in the DSM-5 Symptom Counts section ofthe QuikScore forms (see Figure 3).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.Figure 2. Conners 3–Teacher Assessment Report - DSM-5 Symptom TableDSM-5 Oppositional Defiant DisorderDSM-5 Symptoms: Criterion AAngry/Irritable MoodItemNumber 0A1.62A2.56A3.38Teacher's tative/Defiant nessA8.Criterion dSymptom criteriareordered and labeled.3
Conners 3rd Edition (Conners 3 )Age:/ /Name/ID:Birth Date:(CircleOne)MonthDayYearConduct DisorderOppositional Defiant DisorderItem61Item25ItemNumberItemA138A2 A3A167A224 A1nt response style A4indicated 3A562A674e Raw Score column of the table, below.A787A894Score 4.w Score 5.t 325A359 286213A872A982A1078113347A6( ) May beIndicated338A4A5InconsistencyIndex Total (A)2DayYearMonthDayYear23233A1116 2A1252A1391 2A148A15332Oppositional Defiant DisorderRequiredScoreChange1( )toIndicatedorder ofcriteria.2 3[Note:Thereare2 3differentitem1 2 3numbersfor1 2 3criteriaA2to1 2 3A7in table (a)1 2 3vs. (b)].2 31231232 3 toChange1 2 3criterion12 score3status1 2 3requirementsfor ODD12 3CriterionTotal SymptomCount A8.33Total Symptom CountTrim parts 2, 3, 4 & 5 to 17.125 in.Item43Required ScoreItemItemItem DSM-5May ight 2008 Multi-Health Systems Inc. All rights reserved. In the United States, P.O. Box 950, North Tonawanda, NY 14120-0950, 1-800-456-3003.In Canada, 3770 Victoria Park Ave., Toronto, ON M2H 3M6, 1-800-268-6011, 1-416-492-2627, Fax 1-416-492-3343.DSM-IV-TRCriterion( )Month/ /(b) DSM-5 Symptom Scale(a) DSM-IV-TR Symptom Scaleair.Birth Date: / /YearsMonthsMonthQuikScoreDayYearConners 3–Self-ReportFormFGrade:and Criterion Status Score RequirementsAdministration Date:AdministrationDate:ChangetoGender:OrderofM / /SymptomCriteriaRequired 8723A42423A51A6323A76223A89423May beIndicated2 metSymptomprobably Symptom criteria probablyif TotalcriteriaSymptomCountmet 4if Total Symptom Count 33231Total Symptom Count(sum all checkmarks)(sum all checkmarks)(sum all checkmarks)( )Indicated Symptom criteria probably met if Total Symptom Count 4NOTE: The Conners 3–SR does not assess Criterion A7 (forced sexual activity). This criterionhas been intentionally omitted due to the sensitive nature of this criterion.criterionSummary In the DSM-5, a frequency qualifier was added toCriterion A8 of “atImpairmentleast twice within the past 6Instructions:Withtheof the DSM-5, it was necessary to reviewmonths,”forspitefulor itemvindictivebehavior.items31 orFor eachlisted in the Impairmenttable below, refer to the Scoring Gridand circlethe releasescore.dh)andcirclethe39.score.1 and 17.the Conners 3 Manual and associated materials (i.e., the(or both) items 20 or 7. 55.Criterion status score requirements are updated on theImpairment(or both)items 66 orImpairmentQuikScoreforms, Conners 3 Software Program, andNot true at all/ Just a little true/ Pretty much true/ Very much true/Conners3–SRaccommodatefrequencyNot trueat all/ Justa l
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 ame
Conners 4-ADHD Index: Self-Report - 1.5 minutes, Parent - 1.5 minutes, Teacher - 1 minute What is the average administration time on . Conners 3 Online uses will have immediate access to Conners 4 within their account. Any unused Conners 3 uses can be substituted for Conners 4 uses. Uses will be
Conners‐3 & Conners CBRS Scoring Software (Conners 3rd Edition & Conners Comprehensive Behavior Rating Scales) 1 No Software Manual Available MHS Adobe (.pdf) Excel (.xls) Rich Text Format (.rtf) YES (ψ) YES Requires USB Key Access Via MHS Scoring Software Conners
The Conners CBRS is more than just a DSM based rating scale. It includes content scales as well as symptom scales to ensure the assessment is capturing a holistic view of a children's functionality. While some Conners products are specifically ADHD focused, such as the popular Conners 3 and Conners Adult ADHD Rating Scales, the Conners CBRS .
assessed by the Conners 3-Parent Short Form [Conners 3-P(S)]. This section of the report may be given to parents (caregivers) or to a third party upon parental consent. What is the Conners 3? The Conners 3 is a set of rating scales that are used to gather information about the behaviors and feelings of children and adolescents.
Conners 3 Index Scores According to ratings on the Conners 3 ADHD Index, a clinical classification of ADHD is: · indicated for 2 raters (Probability (%): Parent 71, Self-Report 78) According to ratings on the Conners 3 Global Index: · Conners 3GI Emotional Lability: The T-score was elevated for 1 rater (Parent 65).
Conners' Parent Rating Scale Revised-L (Conners' Parent) Conners' Teacher Rating Scale Revised-L (Conners' Teacher) Expressive Vocabulary Test-2 (EVT-2) Peabody Picture Vocabulary Test-4 (PPVT-4) Multiscore Depression Inventory for Children (MDI-C) Multidimensional Anxiety Scale for Children (MASC) Multidimensional School Anger Inventory (MSAI)
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The T-scores for the following Conners 3 Global Index scales were elevated (i.e., T-score 65 to 69), indicating more concerns than are typically reported: Conners 3GI: Emotional Lability (T 65) and Conners . (ADHD) and its most common co-morbid problems in children and adolescents aged 6 to 18 years old. When used in combination with .
