Manual

CAARS 2 Manual

Chapter 4: Interpretation, Tables

Table 4.1. Interpretation Guidelines for Negative Impression Index

Negative Impression Index Raw Score		Interpretation Guidelines
Self-Report	Observer	Interpretation Guidelines
≥ 6	≥ 7	Warrants follow-up, as it may reflect an attempt to present an unfavorable impression. Review the Items by Scale of the report and other sources of information to determine if this score reflects unrealistically negative ratings, exaggerated description of problems, and/or accurate ratings of problems that rarely occur at the level endorsed.
0–5	0–6	Within the expected range and does not suggest unrealistically negative ratings or an exaggerated description of problems.

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Table 4.2. Interpretation Guidelines for Inconsistency Index

Inconsistency Index Raw Score		Interpretation Guidelines
Self-Report	Observer	Interpretation Guidelines
≥ 4	≥ 4	Warrants follow-up; review the Items by Scale and other sources of information to determine if this score reflects inconsistent, careless, or random responding; comprehension difficulties; or the rater’s interpretation of subtle wording differences within an item pair.
0–3	0–3	Within the expected range; does not suggest inconsistent, careless, or random responding.

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Table 4.3. Interpretation Guidelines for Pace (For Online Administration Only)

Pace (Average Number of Items Completed per Minute)		Interpretation Guidelines
Self-Report	Observer
≥ 15.0 items per minute		Warrants follow-up; this is an unusually fast pace, which could result from a variety of factors (e.g., reading items quickly, giving little consideration to responses, rushing).
1.0 to 14.9 items per minute		Within the expected range; this is a typical pace.
< 1.0 item per minute		Warrants follow-up; this is an unusually slow pace, which could result from a variety of factors (e.g., interruptions, comprehension difficulties, fatigue, extreme deliberation).

Note. Those using paper-and-pencil administration forms are not advised to hand-calculate Pace, as different response modalities can affect expectations regarding the typical speed of response.

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Table 4.4. Interpretation Guidelines for Associated Clinical Concern Items

Associated Clinical Concern Item Stem		Rating	Interpretation Guidelines
Critical Items¹	Suicidal thoughts/attempts	≥ 1	Immediate follow-up is strongly recommended.
Critical Items¹	Self-injury	≥ 1	Immediate follow-up is strongly recommended.
Screening Items²	Anxiety/worry	≥ 2	Follow-up is strongly recommended.
Screening Items²	Sadness/emptiness³	≥ 2 (ages 18–69) ≥ 1 (ages 70+)	Follow-up is strongly recommended.

¹ Critical Items ask about entire life and have a different set of response options: 0 (“Never”), 1 (“Rarely”), 2 (“Just a little/Occasionally”), 3 (“Often/Quite a bit”), and 4 (“Very often/Always”). The Observer form also includes a “Don’t Know” option because some observers may not have knowledge of suicidality or self-injury.

² Response options for the Screening Items are consistent with other CAARS 2 items.

³ The Self-Report form asks about sadness or emptiness; the Observer form asks about sadness.

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Table 4.5. Interpretation Guidelines for T-scores

T-score Range	Interpretation Guidelines
≥ 70	Very Elevated
65 to 69	Elevated
60 to 64	Slightly Elevated
< 60	Not Elevated

Note. These T-score Interpretation Guidelines are used for all CAARS 2 T-scores, including Content Scales and DSM Symptom Scales.

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Table 4.6. Interpretation Guidelines for ADHD Index Probability Score

Probability Score	Guideline	Interpretation
90% to 99%	Very High	Scores in this range have very high similarities to scores from individuals who have ADHD and are very dissimilar to scores from individuals in the general population.
60% to 89%	High	Scores in this range have high similarity to scores from individuals who have ADHD and are dissimilar to scores from individuals in the general population.
40% to 59%	Borderline	Scores in this range do not have clear similarities to scores from one group over the other (i.e., individuals who have ADHD versus individuals in the general population).
10% to 39%	Low	Scores in this range have low similarity to scores from individuals who have ADHD and are more similar to scores from individuals in the general population.
1% to 9%	Very Low	Scores in this range have very low similarity to scores from individuals who have ADHD and are much more similar to scores from individuals in the general population.

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Table 4.7. Interpretation Guidelines for Integrating DSM Symptom Scale Scores

T-score	Symptom Count	Interpretation Guidelines
≥ 65	≥ 5	Based on this pattern of results, clinically significant DSM symptoms of ADHD are prominent. A diagnosis of ADHD merits further consideration.¹
≥ 60	< 5	This pattern of results is inconclusive; however, a diagnosis of ADHD cannot be ruled out given that ratings on the DSM Symptoms scales exceeded what is typically reported by similarly-aged individuals (despite the number of endorsed symptoms being lower than the DSM threshold for adults). If other sources of information suggest the possibility of ADHD, a classification of ADHD Other Specified may merit further consideration provided that other disorders or contextual factors do not better account for the client’s presentation.¹
60-64	≥ 5	This pattern of results suggests the presence of DSM symptoms of ADHD. A possible ADHD diagnosis merits further consideration.¹
< 60	≥ 5	A DSM ADHD diagnosis appears unlikely; however, a diagnosis of ADHD cannot be ruled out given the endorsement of numerous ADHD symptoms (despite these symptoms not exceeding what is typically reported by similarly-aged individuals).¹
< 60	< 5	This pattern of results suggests symptoms of ADHD are not prominent. A DSM ADHD diagnosis appears unlikely. However, it is important to consider additional sources of information before ruling out a diagnosis.²

¹ It is essential to consider additional sources of information, to examine whether symptoms are present to an atypical degree, and to determine if both the symptomatic and the additional criteria specified in the DSM are met before assigning a diagnosis.

² In the special subthreshold case where the T-score falls just below the “Elevated” range (T-score = 55─59) and the Symptom Count is 4 (falling just below the DSM threshold for adults), a DSM ADHD diagnosis continues to appear unlikely; however, the endorsement of numerous symptoms of ADHD may warrant further investigation.