CAARS 2 Manual Appendix F: Response Distributions — Associated Clinical Concern Items and Impairment & Functional Outcome Items

Appendix F: Response Distributions — Associated Clinical Concern Items and Impairment & Functional Outcome Items

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• Ages 18–24 Years
  • Table F.1a. Associated Clinical Concern Items Response Distributions: CAARS 2 Self-Report 18–24 Years
  • Table F.1b. Impairment & Functional Outcome Items Response Distributions: CAARS 2 Self-Report 18–24 Years
  • Table F.2a. Associated Clinical Concern Items Response Distributions: CAARS 2 Observer 18–24 Years
  • Table F.2b. Impairment & Functional Outcome Items Response Distributions: CAARS 2 Observer 18–24 Years
  
  
• Ages 25–29 Years
  • Table F.3a. Associated Clinical Concern Items Response Distributions: CAARS 2 Self-Report 25–29 Years
  • Table F.3b. Impairment & Functional Outcome Items Response Distributions: CAARS 2 Self-Report 25–29 Years
  • Table F.4a. Associated Clinical Concern Items Response Distributions: CAARS 2 Observer 25–29 Years
  • Table F.4b. Impairment & Functional Outcome Items Response Distributions: CAARS 2 Observer 25–29 Years
  
  
• Ages 30–39 Years
  • Table F.5a. Associated Clinical Concern Items Response Distributions: CAARS 2 Self-Report 30–39 Years
  • Table F.5b. Impairment & Functional Outcome Items Response Distributions: CAARS 2 Self-Report 30–39 Years
  • Table F.6a. Associated Clinical Concern Items Response Distributions: CAARS 2 Observer 30–39 Years
  • Table F.6b. Impairment & Functional Outcome Items Response Distributions: CAARS 2 Observer 30–39 Years
  
  
• Ages 40–49 Years
  • Table F.7a. Associated Clinical Concern Items Response Distributions: CAARS 2 Self-Report 40–49 Years
  • Table F.7b. Impairment & Functional Outcome Items Response Distributions: CAARS 2 Self-Report 40–49 Years
  • Table F.8a. Associated Clinical Concern Items Response Distributions: CAARS 2 Observer 40–49 Years
  • Table F.8b. Impairment & Functional Outcome Items Response Distributions: CAARS 2 Observer 40–49 Years
  
  
• Ages 50–59 Years
  • Table F.9a. Associated Clinical Concern Items Response Distributions: CAARS 2 Self-Report 50–59 Years
  • Table F.9b. Impairment & Functional Outcome Items Response Distributions: CAARS 2 Self-Report 50–59 Years
  • Table F.10a. Associated Clinical Concern Items Response Distributions: CAARS 2 Observer 50–59 Years
  • Table F.10b. Impairment & Functional Outcome Items Response Distributions: CAARS 2 Observer 50–59 Years
  
  
• Ages 60–69 Years
  • Table F.11a. Associated Clinical Concern Items Response Distributions: CAARS 2 Self-Report 60–69 Years
  • Table F.11b. Impairment & Functional Outcome Items Response Distributions: CAARS 2 Self-Report 60–69 Years
  • Table F.12a. Associated Clinical Concern Items Response Distributions: CAARS 2 Observer 60–69 Years
  • Table F.12b. Impairment & Functional Outcome Items Response Distributions: CAARS 2 Observer 60–69 Years
  
  
• Ages 70+ Years
  • Table F.13a. Associated Clinical Concern Items Response Distributions: CAARS 2 Self-Report 70+ Years
  • Table F.13b. Impairment & Functional Outcome Items Response Distributions: CAARS 2 Self-Report 70+ Years
  • Table F.14a. Associated Clinical Concern Items Response Distributions: CAARS 2 Observer 70+ Years
  • Table F.14b. Impairment & Functional Outcome Items Response Distributions: CAARS 2 Observer 70+ Years

This appendix provides the distribution (frequency) of responses for the Associated Clinical Concern Items and for the Impairment & Functional Outcome Items of the Conners Adult ADHD Rating Scales 2nd Edition (CAARS™ 2). These items are part of the full-length CAARS 2 and are not available on the CAARS™ 2–Short or CAARS™ 2–ADHD Index forms. As described in chapter 4, Interpretation, these response distributions can help with the interpretation of scores.

Within the Associated Clinical Concern Items, there are different interpretation guidelines for Critical Items versus Screening Items. For the Critical Items (suicidal thoughts/attempts and self-injury), any endorsement greater than 0 (“Never”) indicates the need for follow-up. Response distributions can help with the interpretation of both Critical Items but should not limit follow-up. In the normative sample, some of these items were commonly endorsed at low levels. This indicates that mild levels of these concerns may be common in a particular population. For the Screening Items (anxiety/worry, sadness/emptiness¹), any endorsement of 2 (“Pretty much true; Often/Quite a bit”) or greater indicates the need for follow-up in most of the age groups. The one exception is individuals aged 70+ on the Self-Report form, where any rating of 1 (“Just a little true; Occasionally”) or higher requires follow-up.

Individual Impairment & Functional Outcome Items are flagged as “Elevated” in the Overview section of the report when they are endorsed at higher levels than expected for individuals in that age group (and gender, when the gender-specific reference group is selected). Specifically, any level of endorsement that falls in the top quartile of the response distribution is noted as an Elevated item (note that a small number of the item elevations were manually adjusted to take age trends into account and therefore, in rare instances, an item response may be described as Elevated even if it falls below the top quartile).

Response distributions for the Associated Clinical Concern Items and Impairment & Functional Outcome Items are provided in the following tables. The response distributions for a given item can be determined by following these steps:

1. Find the correct table, based on
   
   
   1. the age group of the individual being rated, and
      
      
   2. the rater type (Self-Report or Observer).
   
   
2. Select the appropriate column in the table, based on the gender group used for scoring (Combined Gender, Male, or Female).
   
   
3. Find the row that contains the item and refer to its corresponding response frequencies.
   
   

Consider the following examples for use of these tables:

• A 20-year-old woman responded, “Just a little true; Occasionally” (item score = 1) to the anxiety/worry item. The correct look-up table is Table F.1a (18-24 years, Self-Report). The clinician was interested in how her response compared with other women her age, so they chose the last set of columns (Female). They found the row for “Anxiety/worry” and saw that an item score of 1 had a response frequency of 45.5%. The clinician was able to interpret this data as, “For 18- to 24-year-old women, the anxiety/worry item was rated at least ‘Just a little true; Occasionally’ by 45.5% of the normative sample (based on age and gender). In other words, her rating is not an uncommon response to the item.”
  
  
• An Observer responded, “Completely true; Very often/Always” (item score = 3) to the underachievement item when rating a 37-year-old individual. Gender was not specified, so the clinician chose the default, Combined Gender, when selecting a Principal Reference Sample. The correct look-up table is Table F.6b (30-39 years, Observer). Being careful to use the “Combined Gender” columns and to track across the “Underachiever” row, the clinician found an item score of 3 had a response frequency of 6.4%. An appropriate interpretation of this data point is, “For Observer ratings of individuals in their 30s, it is unusual to see this level of endorsement for underachievement (i.e., a rating of “Completely true; Very often/Always” occurred in only 6.4% of the normative sample for individuals of the same age).”
  
  

The following response keys apply to all tables in this appendix (item numbers for Associated Clinical Concern Items and the Impairment & Functional Outcome Items are the same for both Self-Report and Observer).

Response Key for items 42, 74, 83‒88, 91‒95:
0 = Not true at all; Never/Rarely
1 = Just a little true; Occasionally
2 = Pretty much true; Often/Quite a bit
3 = Completely true; Very often/Always
n/a = Not Applicable (only available on items 83‒86 and 94)
DK = Don’t Know (only available on Observer form on items 83‒86 and 91‒95)

Response Key for items 81 and 82:
0 = Never/Rarely
1 = Just a little/Occasionally
2 = Often/Quite a bit
3 = Very often/Always

Response Key for items 89 and 90:
0 = Never
1 = Rarely
2 = Just a little/Occasionally
3 = Often/Quite a bit
4 = Very often/Always
DK = Don’t Know (only available on Observer form)

Ages 18–24 Years

Ages 25–29 Years

Ages 30–39 Years

Ages 40–49 Years

Ages 50–59 Years

Ages 60–69 Years

Ages 70+ Years

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