Manual

CAARS 2 Manual

Appendix A: Items by Scale, Tables

Table A.1a. Negative Impression Index: CAARS 2 Self-Report (6 items)

Item #	SR Item Text [In general…]
2	I try to follow the rules. (R)
18	I am unable to control my behavior.
35	One minute is the longest I can focus on anything.
50	I still throw tantrums.
55	I offer help when someone needs it. (R)
71	I grab things from other people without asking.

Click to expand

Table A.1b. Negative Impression Index: CAARS 2 Observer (6 items)

Item #	OBS Item Text [In general, this person…]
2	tries to follow the rules. (R)
18	is unable to control their own behavior.
35	is unable to focus on anything for longer than one minute.
50	throws tantrums.
55	is unable to pay attention to anything.
71	finds it impossible to get things done because they forget how to do them.

Click to expand

Table A.2. Inconsistency Index: CAARS 2 Self-Report (7 item pairs)

Pair	SR Item #	SR Item Text [In general…]	SR Item #	SR Item Text [In general…]
1	32	I feel like a failure.	36	My past failures make it hard for me to believe in myself.
2	65	I fidget.	72	I tap my hands or feet.
3	17	It’s hard for me to stay focused.	31	It’s hard for me to pay attention.
4	66	I’m easily irritated.	76	I am easily frustrated.
5	52	I feel restless.	78	I feel restless inside even if I am sitting still.
6	21	I have difficulty prioritizing the things I need to do.	23	I have problems organizing my tasks and activities.
7	5	I feel like other people are better than me.	13	I lack confidence in myself.

Click to expand

Table A.3. Inconsistency Index: CAARS 2 Observer (7 item pairs)

Pair	OBS Item #	[In general, this person…]	OBS Item #	[In general, this person…]
1	31	has difficulty paying attention.	41	is easily distracted.
2	21	has difficulty prioritizing the things they need to do.	64	has trouble finishing tasks at home, work, or school.
3	32	feels like a failure.	36	expresses lack of confidence in self because of past failures.
4	13	lacks confidence in themself.	59	believes in themself. (R)
5	66	is irritable.	76	is easily frustrated.
6	68	has a hard time doing things that have multiple steps.	79	has difficulty paying close attention to details.
7	39	forgets to do things.	47	is forgetful

Click to expand

Table A.4. Associated Clinical Concern Items: CAARS 2 (4 items)

Item #	SR Item Text	OBS Item Text
	[In general…]	[In general, this person…]
42	I feel anxious or worried.	seems anxious or worried.
74	I feel sad or empty.	seems sad.
	[Think about your entire life, then answer the following item.]	[Think about this person’s entire life, then answer the following item.]
89	I have thought about or attempted suicide.	has tried to kill themself or expressed thoughts about killing themself.
90	I have deliberately harmed my body (for example, by cutting or burning myself).	has deliberately harmed their body (for example, by cutting or burning).

Click to expand

Table A.5. Inattention/Executive Dysfunction: CAARS 2 (30 items)

Item #	SR Item Text [In general…]	OBS Item Text [In general, this person…]
1	I lose or misplace things that I need.	loses or misplaces things that they need.
3	It’s hard for me to shift my focus when needed.	has difficulty shifting their focus when needed.
6	I can only concentrate on things that are interesting to me.	seems to concentrate only on things that are interesting to them.
8	I need a deadline to get things done.	needs a deadline to get things done.
15	I’m late for things like meetings, appointments, or social events.	is late for things like meetings, appointments, or social events.
17	It’s hard for me to stay focused.	has difficulty staying focused.
19	I waste time.	wastes time.
21	I have difficulty prioritizing the things I need to do.	has difficulty prioritizing the things they need to do.
23	I have problems organizing my tasks and activities.	has problems organizing tasks and activities.
25	I need reminders to get things done.	needs reminders to get things done.
27	I procrastinate.	procrastinates.
29	I make careless mistakes.	makes careless mistakes.
31	It’s hard for me to pay attention.	has difficulty paying attention.
33	It’s hard for me to plan ahead.	has a hard time planning ahead.
37	I miss deadlines or due dates.	misses deadlines or due dates.
39	I forget to do things.	forgets to do things.
41	I am easily distracted.	is easily distracted.
43	It’s hard for me to follow through on instructions.	has trouble following through on instructions.
45	I am inconsistent.	is inconsistent.
47	I am forgetful.	is forgetful.
49	I am inattentive.	is inattentive.
51	I forget to check things (like my calendar, to-do list, or due dates).	forgets to check things (like their calendar, to-do list, or due dates).
58	Sometimes my attention narrows so much that I’m oblivious to everything else; other times it’s so broad that everything distracts me.	sometimes overfocuses on details; at other times appears distracted by everything going on around them.
60	I lose focus during conversations.	loses focus during conversations.
64	I have trouble finishing tasks at home, work, or school.	has trouble finishing tasks at home, work, or school.
68	Tasks that involve multiple steps are hard for me.	has a hard time doing things that have multiple steps.
70	I dislike having to stay focused for a long time.	seems to dislike having to stay focused for a long time.
73	I have trouble listening to what people say to me.	has trouble listening to what people say to them.
77	I have trouble getting started on a task.	has trouble getting started on a task.
79	It’s hard for me to pay close attention to details.	has difficulty paying close attention to details.

Click to expand

Table A.6. Hyperactivity: CAARS 2 (13 items)

Item #	SR Item Text [In general…]	OBS Item Text [In general, this person…]
4	I talk too much.	talks too much.
11	I am overactive.	is overactive.
20	It’s hard for me to stay still.	appears to have difficulty staying still.
22	I move around even when I should be still.	moves around even when they should be still.
28	It’s hard for me to be quiet.	has difficulty being quiet.
40	I have trouble doing leisure activities quietly.	has trouble doing leisure activities quietly.
46	I leave my seat when I should stay seated.	leaves their seat when they should stay seated.
52	I feel restless.	seems restless.
57	I talk when I should be quiet, like during movies, lectures, or performances.	talks when they should be quiet, like during movies, lectures, or performances.
63	I am distracting to other people.	distracts people.
65	I fidget.	fidgets.
72	I tap my hands or feet.	taps their hands or feet.
78	I feel restless inside even if I am sitting still.	appears to be restless even when sitting still.

Click to expand

Table A.7. Impulsivity: CAARS 2 (13 items)

Item #	SR Item Text [In general…]	OBS Item Text [In general, this person…]
9	I give answers before questions have been completed.	gives answers before questions have been completed.
12	I have difficulty waiting to speak in conversations.	has difficulty waiting to speak in conversations.
16	I annoy other people without meaning to.	annoys other people without meaning to.
24	I’d rather get a small reward right away instead of waiting for a big reward later.	would rather get a small reward right away instead of waiting for a big reward later.
30	I do risky things without thinking.	does risky things without thinking.
38	I say things without thinking.	says things without thinking.
44	I interrupt people.	interrupts people.
48	I intrude on others’ activities.	intrudes on others’ activities.
53	It’s hard to wait for my turn.	has difficulty waiting for their turn.
56	I am impatient.	seems impatient.
62	I rush through things.	rushes through things.
67	I act before I think.	acts before thinking.
75	I am impulsive.	is impulsive.

Click to expand

Table A.8. Emotional Dysregulation: CAARS 2 (9 items)

Item #	SR Item Text [In general…]	OBS Item Text [In general, this person…]
7	It’s hard for me to calm down.	has a hard time calming down.
10	It’s hard to control my anger.	has difficulty controlling their anger.
14	It’s hard for me to hide my emotions.	has trouble hiding their emotions.
26	Controlling my emotions is hard for me.	has difficulty controlling their emotions.
34	When I’m upset, I say things that I shouldn’t.	says things that they shouldn’t when upset.
61	My moods change quickly.	has moods that change quickly.
66	I’m easily irritated.	is irritable.
76	I am easily frustrated.	is easily frustrated.
80	I overreact.	overreacts.

Click to expand

Table A.9. Negative Self-Concept: CAARS 2 (7 items)

Item #	SR Item Text [In general…]	OBS Item Text [In general, this person…]
5	I feel like other people are better than me.	sees themself as inferior to others.
13	I lack confidence in myself.	lacks confidence in themself.
32	I feel like a failure.	feels like a failure.
36	My past failures make it hard for me to believe in myself.	expresses lack of confidence in self because of past failures.
54	I am self-critical.	is self-critical.
59	I believe in myself. (R)	believes in themself. (R)
69	I avoid new challenges because I lack confidence.	avoids new challenges because they lack confidence.

Click to expand

Table A.10. DSM ADHD Inattentive Symptoms: CAARS 2 (11 items)

Item #	SR Item Text [In general…]	OBS Item Text [In general, this person…]
1	I lose or misplace things that I need.	loses or misplaces things that they need.
17	It’s hard for me to stay focused.	has difficulty staying focused.
23	I have problems organizing my tasks and activities.	has problems organizing tasks and activities.
29	I make careless mistakes.	makes careless mistakes.
39	I forget to do things.	forgets to do things.
41	I am easily distracted.	is easily distracted.
43	It’s hard for me to follow through on instructions.	has trouble following through on instructions.
64	I have trouble finishing tasks at home, work, or school.	has trouble finishing tasks at home, work, or school.
70	I dislike having to stay focused for a long time.	seems to dislike having to stay focused for a long time.
73	I have trouble listening to what people say to me.	has trouble listening to what people say to them.
79	It’s hard for me to pay close attention to details.	has difficulty paying close attention to details.

Note. DSM Total ADHD Symptoms Scale consists of all items from the DSM ADHD Inattentive Symptoms and DSM ADHD Hyperactive/impulsive Symptoms Scales. Please see appendix G for a list of DSM Symptom Criteria and corresponding CAARS 2 items for both rater forms.

Click to expand

Table A.11. DSM ADHD Hyperactive/Impulsive Symptoms: CAARS 2 (12 items)

Item #	SR Item Text [In general…]	OBS Item Text [In general, this person…]
4	I talk too much.	talks too much.
9	I give answers before questions have been completed.	gives answers before questions have been completed.
20	It’s hard for me to stay still.	appears to have difficulty staying still.
22	I move around even when I should be still.	moves around even when they should be still.
40	I have trouble doing leisure activities quietly.	has trouble doing leisure activities quietly.
44	I interrupt people.	interrupts people.
46	I leave my seat when I should stay seated.	leaves their seat when they should stay seated.
48	I intrude on others’ activities.	intrudes on others’ activities.
52	I feel restless.	seems restless.
53	It’s hard to wait for my turn.	has difficulty waiting for their turn.
65	I fidget.	fidgets.
72	I tap my hands or feet.	taps their hands or feet.

Click to expand

Table A.12. ADHD Index: CAARS 2 Self-Report

SR Item #	SR Item Text [In general…]
1	I lose or misplace things that I need.
4	I talk too much.
6	I can only concentrate on things that are interesting to me.
8	I need a deadline to get things done.
17	It’s hard for me to stay focused.
25	I need reminders to get things done.
31	It’s hard for me to pay attention.
41	I am easily distracted.
44	I interrupt people.
58	Sometimes my attention narrows so much that I’m oblivious to everything else; other times it’s so broad that everything distracts me.
64	I have trouble finishing tasks at home, work, or school.
65	I fidget.

Click to expand

Table A.13. ADHD Index: CAARS 2 Observer

OBS Item #	OBS Item Text [In general, this person…]
13	lacks confidence in themself.
17	has difficulty staying focused.
21	has difficulty prioritizing the things they need to do.
25	needs reminders to get things done.
27	procrastinates.
31	has difficulty paying attention.
41	is easily distracted.
54	is self-critical.
57	talks when they should be quiet, like during movies, lectures, or performances.
58	sometimes overfocuses on details; at other times appears distracted by everything going on around them.
75	is impulsive.
87	has a harder time with things than other people do.

Click to expand

Table A.14. Impairment & Functional Outcome Items

Item #	SR Item Text	OBS Item Text
	[Think about your answers so far.]	[Think about your answers so far.]
81	How much do the things you described on this form bother you?	How much do the things you described on this form bother this person?
82	How much do the things you described on this form interfere with your life?	How much do the things you described on this form interfere with this person’s life?
	[In general…]	[In general, this person…]
83	I have problems in my romantic/marital relationship(s).	has problems in their romantic/marital relationship(s).
84	I have problems in my relationships with family members.	has problems in their relationships with family members.
85	I have problems in my relationships with friends, co-workers, or neighbors.	has problems in their relationships with friends, co-workers, or neighbors.
86	I have problems at work and/or school.	has problems at work and/or school.
87	Things are harder for me than they are for other people.	has a harder time with things than other people do.
88	I am an underachiever.	is an underachiever.
91	I have sleep problems (such as falling asleep, staying asleep, or feeling well-rested).	has sleep problems (such as falling asleep, staying asleep, or feeling well-rested).
92	I have problems managing money (like overspending, too much debt, or paying bills late).	has problems managing money (like overspending, too much debt, or paying bills late).
93	I neglect important family or household responsibilities.	neglects important family or household responsibilities.
94	I take risks when driving (for example, I speed or drive recklessly, I drive while under the influence or while texting).	takes risks when driving (for example, speeds or drives recklessly, drives while under the influence or while texting).
95	The time I spend online (for example, on social media, gaming, or gambling) makes it hard for me to get things done.	spends so much time online (for example, on social media, gaming, or gambling) that it’s hard for them to get things done.

Click to expand

Table A.15. Additional Questions: CAARS 2

Item #	SR Item Text	OBS Item Text
96	Please describe any other issues or problems.	Please describe any other issues or problems.
97	What are your main strengths or skills?	What strengths or skills does this person have?

Click to expand

Table A.16. Negative Impression Index: CAARS 2–Short Self-Report (6 items)

Item #	SR Item Text [In general…]
6	I try to follow the rules. (R)
10	I am unable to control my behavior.
22	I still throw tantrums.
32	One minute is the longest I can focus on anything.
35	I grab things from other people without asking.
46	I offer help when someone needs it. (R)

Click to expand

Table A.17. Negative Impression Index: CAARS 2–Short Observer (6 items)

Item #	OBS Item Text [In general, this person…]
1	tries to follow the rules. (R)
4	finds it impossible to get things done because they forget how to do them.
20	is unable to focus on anything for longer than one minute.
26	throws tantrums.
32	is unable to control their own behavior.
45	is unable to pay attention to anything.

Click to expand

Table A.18. Inattention/Executive Dysfunction: CAARS 2–Short (12 items)

SR Item #	SR Item Text [In general…]	OBS Item #	OBS Item Text [In general, this person…]
12	I have difficulty prioritizing the things I need to do.	6	has difficulty prioritizing the things they need to do.
14	I have problems organizing my tasks and activities.	9	has problems organizing tasks and activities.
16	I make careless mistakes.	14	makes careless mistakes.
18	I miss deadlines or due dates.		n/a
23	It’s hard for me to plan ahead.	18	has a hard time planning ahead.
25	I forget to do things.		n/a
27	I am easily distracted.	22	is easily distracted.
29	It’s hard for me to follow through on instructions.	49	has trouble following through on instructions.
31	I am inattentive.	25	is inattentive.
38	I lose focus during conversations.	37	loses focus during conversations.
43	Tasks that involve multiple steps are hard for me.	43	has a hard time doing things that have multiple steps.
51	It’s hard for me to pay close attention to details.	47	has difficulty paying close attention to details.
	n/a	27	forgets to check things (like their calendar, to-do list, or due dates).
	n/a	40	has trouble finishing tasks at home, work, or school.

Click to expand

Table A.19. Hyperactivity: CAARS 2–Short (7 items)

SR Item #	SR Item Text [In general…]	OBS Item #	OBS Item Text [In general, this person…]
11	It’s hard for me to stay still.	5	appears to have difficulty staying still.
17	It’s hard for me to be quiet.	41	has difficulty being quiet.
21	I move around even when I should be still.	34	moves around even when they should be still.
26	I leave my seat when I should stay seated.	24	leaves their seat when they should stay seated.
40	I am distracting to other people.	39	distracts people.
45	I tap my hands or feet.		n/a
50	I feel restless inside even if I am sitting still.		n/a
	n/a	12	fidgets.
	n/a	28	seems restless.

Click to expand

Table A.20. Impulsivity: CAARS 2–Short (7 items)

SR Item #	SR Item Text [In general…]	OBS Item #	OBS Item Text [In general, this person…]
13	I do risky things without thinking.	15	does risky things without thinking.
19	I intrude on others’ activities.		n/a
24	I say things without thinking.	21	says things without thinking.
30	I interrupt people.	23	interrupts people.
33	It’s hard to wait for my turn.	29	has difficulty waiting for their turn.
39	I rush through things.	38	rushes through things.
47	I am impulsive.	46	is impulsive.
	n/a	33	seems impatient.

Click to expand

Table A.21. Emotional Dysregulation: CAARS 2–Short (6 items)

SR Item #	SR Item Text [In general…]	OBS Item #	OBS Item Text [In general, this person…]
5	It’s hard for me to calm down.		n/a
7	It’s hard to control my anger.		n/a
15	Controlling my emotions is hard for me.	10	has difficulty controlling their emotions.
37	My moods change quickly.	36	has moods that change quickly.
49	I am easily frustrated.		n/a
52	I overreact.	48	overreacts.
	n/a	13	is easily frustrated.
	n/a	19	says things that they shouldn’t when upset.
	n/a	42	is irritable.

Click to expand

Table A.22. Negative Self-Concept: CAARS 2–Short (5 items)

SR Item #	SR Item Text [In general…]	OBS Item #	OBS Item Text [In general, this person…]
3	I feel like other people are better than me.	2	sees themself as inferior to others.
8	I lack confidence in myself.	7	lacks confidence in themself.
28	My past failures make it hard for me to believe in myself.	17	feels like a failure.
34	I am self-critical.	30	is self-critical.
44	I avoid new challenges because I lack confidence.	44	avoids new challenges because they lack confidence.

Click to expand

Table A.23. ADHD Index: CAARS 2–Short Self-Report

SR Item #	SR Item Text [In general…]
1	I lose or misplace things that I need.
2	I talk too much.
4	I can only concentrate on things that are interesting to me.
9	It’s hard for me to stay focused.
20	It’s hard for me to pay attention.
27	I am easily distracted.
30	I interrupt people.
36	Sometimes my attention narrows so much that I’m oblivious to everything else; other times it’s so broad that everything distracts me.
41	I have trouble finishing tasks at home, work, or school.
42	I fidget.
48	I need reminders to get things done.
53	I need a deadline to get things done.

Click to expand

Table A.24. ADHD Index: CAARS 2–Short Observer

OBS Item #	OBS Item Text [In general, this person…]
3	has difficulty staying focused.
6	has difficulty prioritizing the things they need to do.
7	lacks confidence in themself.
8	talks when they should be quiet, like during movies, lectures, or performances.
11	procrastinates.
16	has difficulty paying attention.
22	is easily distracted.
30	is self-critical.
31	needs reminders to get things done.
35	sometimes overfocuses on details; at other times appears distracted by everything going on around them.
46	is impulsive.
50	has a harder time with things than other people do.

Click to expand

Table A.25. Additional Questions: CAARS 2–Short

SR Item #	SR Item Text	OBS Item #	OBS Item Text
54	Please describe any other issues or problems.	51	Please describe any other issues or problems.
55	What are your main strengths or skills?	52	What strengths or skills does this person have?

Click to expand

Table A.26. CAARS 2–ADHD Index Self-Report

SR Item #	SR Item Text [In general…]
1	It’s hard for me to stay focused.
2	I lose or misplace things that I need.
3	I need reminders to get things done.
4	Sometimes my attention narrows so much that I’m oblivious to everything else; other times it’s so broad that everything distracts me.
5	I fidget.
6	I can only concentrate on things that are interesting to me.
7	I need a deadline to get things done.
8	It’s hard for me to pay attention.
9	I interrupt people.
10	I have trouble finishing tasks at home, work, or school.
11	I talk too much.
12	I am easily distracted.

Click to expand

Table A.27. CAARS 2–ADHD Index Observer

OBS Item #	OBS Item Text [In general, this person…]
1	has difficulty staying focused.
2	needs reminders to get things done.
3	has difficulty prioritizing the things they need to do.
4	is self-critical.
5	sometimes overfocuses on details; at other times appears distracted by everything going on around them.
6	procrastinates.
7	has a harder time with things than other people do.
8	is impulsive.
9	has difficulty paying attention.
10	talks when they should be quiet, like during movies, lectures, or performances.
11	is easily distracted.
12	lacks confidence in themself.