Manual

CAARS 2 Manual

Chapter 9: Validity, Tables

Table 9.1. Alternative Models Tested for the CAARS 2 Scale Structure

CAARS 2 Content	4-Factor Model	5-Factor Model	6-Factor Model
Inattention	Inattention/Executive Dysfunction	Inattention/Executive Dysfunction	Inattention
Executive Dysfunction	Inattention/Executive Dysfunction	Inattention/Executive Dysfunction	Executive Dysfunction
Hyperactivity	Hyperactivity/Impulsivity	Hyperactivity	Hyperactivity
Impulsivity	Hyperactivity/Impulsivity	Impulsivity	Impulsivity
Emotional Dysregulation	Emotional Dysregulation	Emotional Dysregulation	Emotional Dysregulation
Negative Self-Concept	Negative Self-Concept	Negative Self-Concept	Negative Self-Concept

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Table 9.2. Fit Indices for Confirmatory Factor Analysis Models: CAARS 2 Content Scales

Form	Model	χ²	df	CFI	TLI	SRMR	RMSEA	RMSEA Confidence Interval
Self-Report	4-factor	15621.08	2478	.949	.947	.044	.049	.049, .050
	5-factor	14321.28	2474	.953	.951	.042	.047	.047, .048
	6-factor	12875.15	2469	.957	.956	.041	.045	.045, .046
Observer	4-factor	17910.77	2478	.940	.938	.051	.051	.050, .051
	5-factor	16013.27	2474	.945	.943	.048	.049	.048, .049
	6-factor	13388.60	2469	.953	.951	.044	.045	.044, .046

Note. CFI = Comparative Fit Index; TLI = Tucker-Lewis Index; SRMR = Standardized root mean square residual; RMSEA = Root mean square error of approximation. All χ² values are significant, p < .01.

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Table 9.3. Comparison of Nested Confirmatory Factor Analysis Models: CAARS 2 Content Scales

Form	Models Compared	χ²	df	p	ΔCFI
Self-Report	4-factor vs. 5-factor	108.47	4	< .01	.004
Self-Report	5-factor vs. 6-factor	135.32	5	< .01	.008
Observer	4-factor vs. 5-factor	72.40	4	< .01	.005
Observer	5-factor vs. 6-factor	132.77	5	< .01	.013

Note. ΔCFI = change in Comparative Fit Index value. All χ² values are significant, p < .01.

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Table 9.4. Five-Factor Model Inter-Factor Correlations: CAARS 2 Self-Report Content Scales

Scale	Inattention/Executive Dysfunction	Hyperactivity	Impulsivity	Emotional Dysregulation	Negative Self-Concept
Inattention/Executive Dysfunction	—	—	—	—	—
Hyperactivity	.818	—	—	—	—
Impulsivity	.877	.910	—	—	—
Emotional Dysregulation	.777	.765	.873	—	—
Negative Self-Concept	.774	.621	.664	.738	—

Note. N = 2,226. Guidelines for interpreting |r|: very weak < .20, weak = .20 to .39, moderate = .40 to .59, strong = .60 to .79, very strong ≥ .80.

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Table 9.5. Five-Factor Model Inter-Factor Correlations: CAARS 2 Observer Content Scales

Scale	Inattention/Executive Dysfunction	Hyperactivity	Impulsivity	Emotional Dysregulation	Negative Self-Concept
Inattention/Executive Dysfunction	—	—	—	—	—
Hyperactivity	.778	—	—	—	—
Impulsivity	.838	.897	—	—	—
Emotional Dysregulation	.738	.729	.871	—	—
Negative Self-Concept	.695	.480	.544	.634	—

Note. N = 2,150. Guidelines for interpreting |r|: very weak < .20, weak = .20 to .39, moderate = .40 to .59, strong = .60 to .79, very strong ≥ .80.

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Table 9.6a. Correlations between CAARS 2 and CAARS: Self-Report

CAARS 2 Scale		CAARS Scale	Obtained r	Corrected r	CAARS 2			CAARS
CAARS 2 Scale		CAARS Scale	Obtained r	Corrected r	M	Mdn	SD	M	Mdn	SD
Content Scales	Inattention/Executive Dysfunction	Inattention/Memory Problems	.72	.82	74.2	74	7.4	73.6	75	9.9
	Hyperactivity	Hyperactivity/Restlessness	.82	.72	67.2	67	12.2	59.2	59	11.2
	Impulsivity	Impulsivity/Emotional Lability	.75	.65	68.7	68	10.5	61.9	61	12.6
	Emotional Dysregulation	Impulsivity/Emotional Lability	.80	.72	63.4	64	10.1	61.9	61	12.6
	Negative Self-Concept	Problems with Self-Concept	.83	.80	63.0	64	10.1	66.1	66	10.9
DSM Symptom Scales	ADHD Inattentive Symptoms	ADHD Inattentive Symptoms	.79	.79	72.6	72	7.9	82.7	83	12.5
	ADHD Hyperactive/Impulsive Symptoms	ADHD Hyperactive-Impulsive Symptoms	.88	.73	68.8	67	12.4	63.9	64	13.8
	Total ADHD Symptoms	ADHD Symptoms Total	.84	.80	72.1	71	9.3	76.6	77	12.6

Note. N = 103. All correlations significant, p < .001. Guidelines for interpreting |r|: very weak < .20, weak = .20 to .39, moderate = .40 to .59, strong = .60 to .79, very strong ≥ .80.

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Table 9.6b. Correlations Between CAARS 2 and CAARS Scales: Observer

CAARS 2 Scale		CAARS Scale	Obtained r	Corrected r	CAARS 2			CAARS
CAARS 2 Scale		CAARS Scale	Obtained r	Corrected r	M	Mdn	SD	M	Mdn	SD
Content Scales	Inattention/Executive Dysfunction	Inattention/Memory Problems	.91	.87	66.9	67	10.4	64.8	65	12.3
	Hyperactivity	Hyperactivity/Restlessness	.66	.68	61.3	61	9.6	55.2	55	9.7
	Impulsivity	Impulsivity/Emotional Lability	.78	.71	58.9	58	11.2	56.3	56	11.0
	Emotional Dysregulation	Impulsivity/Emotional Lability	.84	.79	59.8	61	11.2	56.3	56	11.0
	Negative Self-Concept	Problems with Self-Concept	.93	.83	64.3	65	13.0	60.9	61	12.8
DSM Symptom Scales	ADHD Inattentive Symptoms	ADHD Inattentive Symptoms	.90	.87	66.4	65	11.0	63.0	65	10.9
	ADHD Hyperactive/Impulsive Symptoms	ADHD Hyperactive-Impulsive Symptoms	.84	.82	60.9	61	10.2	57.1	57	10.7
	Total ADHD Symptoms	ADHD Symptoms Total	.90	.90	64.5	62	9.8	61.5	61	10.1

Note. N = 63. All correlations significant, p < .001. Guidelines for interpreting |r|: very weak < .20, weak = .20 to .39, moderate = .40 to .59, strong = .60 to .79, very strong ≥ .80

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Table 9.7a. Correlations between CAARS 2 and CEFI Adult Scales: Self-Report

CAARS 2 Scale		CEFI Adult Scale	Obtained r	Corrected r	CAARS 2			CEFI Adult
CAARS 2 Scale		CEFI Adult Scale	Obtained r	Corrected r	M	Mdn	SD	M	Mdn	SD
Content Scales	Inattention/Executive Dysfunction	Attention	-0.71	-0.87	74.2	74	7.3	73.8	73	12.0
		Initiation	-0.59	-0.71	74.2	74	7.3	74.8	73	14.8
		Organization	-0.65	-0.80	74.2	74	7.3	72.1	70	13.5
		Planning	-0.67	-0.81	74.2	74	7.3	78.2	76	13.5
		Working Memory	-0.70	-0.80	74.2	74	7.3	75.9	75	15.0
	Impulsivity	Inhibitory Control	-0.69	-0.67	69.3	69	10.5	84.0	82	14.9
	Emotional Dysregulation	Emotion Regulation	-0.73	-0.68	63.4	64	10.1	87.1	86	17.3
DSM Symptom Scales	Total ADHD Symptoms	Full Scale	-0.59	-0.68	72.4	72	9.2	76.8	74	12.9

Note. N = 107. All correlations significant, p < .001. Negative correlations are in the expected direction. Guidelines for interpreting |r|: very weak < .20, weak = .20 to .39, moderate = .40 to .59, strong = .60 to .79, very strong ≥ .80.

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Table 9.7b. Correlations between CAARS 2 and CEFI Adult Scales: Observer

CAARS 2 Scale		CEFI Adult Scale	Obtained r	Corrected r	CAARS 2			CEFI Adult
CAARS 2 Scale		CEFI Adult Scale	Obtained r	Corrected r	M	Mdn	SD	M	Mdn	SD
Content Scales	Inattention/Executive Dysfunction	Attention	-0.71	-0.77	67.7	67	10.2	81.7	80	12.4
		Initiation	-0.67	-0.61	67.7	67	10.2	82.3	81	17.4
		Organization	-0.78	-0.79	67.7	67	10.2	81.4	78	14.5
		Planning	-0.72	-0.73	67.7	67	10.2	85.4	85	14.4
		Working Memory	-0.75	-0.76	67.7	67	10.2	83.8	81	14.4
	Impulsivity	Inhibitory Control	-0.77	-0.75	58.8	58	11.4	92.8	90	14.2
	Emotional Dysregulation	Emotion Regulation	-0.72	-0.64	59.1	61	11.0	92.9	91	16.8
DSM Symptom Scales	Total ADHD Symptoms	Full Scale	-0.65	-0.70	64.5	63	10.2	85.3	83	12.8

Note. N = 56. All correlations significant, p < .001. Negative correlations are in the expected direction. Guidelines for interpreting |r|: very weak < .20, weak = .20 to .39, moderate = .40 to .59, strong = .60 to .79, very strong ≥ .80.

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Table 9.8. Correlations between CAARS 2 Self-Report Impairment & Functional Outcome Items and WFIRS-S Domains

CAARS 2 Impairment & Functional Outcome Item Stem	WFIRS Self-Report Domain	r	N
Problems in romantic relationships	Family	.40	228
Problems in relationships with family	Family	.49	252
Neglects household or family duties	Family	.47	253
Problems at work and/or school	Work	.54	192
Problems at work and/or school	School	.54	60
Sleep problems	Life Skills	.47	255
Money management problems	Life Skills	.54	255
Problems with time spent online	Life Skills	.56	255
Problems in romantic relationships	Social	.40	230
Problems in relationships with family	Social	.49	254
Problems with friends, co-workers, or neighbors	Social	.49	252
Risky driving	Risk	.51	244
Problems interfere with life	Overall Score	.41	255
Has a harder time with things than others do	Overall Score	.28	255

Note. All correlations significant, p < .001. Guidelines for interpreting |r|: very weak < .20, weak = .20 to .39, moderate = .40 to .59, strong = .60 to .79, very strong ≥ .80. Sample sizes vary between correlations because the WFIRS Self-Report items include a “Not Applicable” response option. Respondents who endorse the “Not Applicable” response option across an entire WFIRS Self-Report domain thereby do not have a valid numerical domain score that can be correlated with the corresponding CAARS 2 impairment items. Additionally, the correlation with the WFIRS Self-Report Work domain was conducted only on individuals who noted that they are currently working, and the correlation with the WFIRS Self-Report School domain was conducted only on individuals who noted that they are currently in school.

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Table 9.9a. Differences between General Population and ADHD Groups: CAARS 2 Self-Report

Scale			GenPop (N = 197)	ADHDin (N = 96)	ADHDc (N = 101)	F (2, 391)	η²	Tukey’s HSD Post-Hoc Tests
Content Scales	Inattention/Executive Dysfunction	M	48.8	70.9	73.1	372.75	.66	ADHDc, ADHDin > GenPop
		SD	8.3	9.2	8.1
	Hyperactivity	M	48.9	59.3	72.6	219.96	.53	ADHDc > ADHDin > GenPop
		SD	8.6	10.0	9.8
	Impulsivity	M	48.9	62.2	71.8	203.68	.51	ADHDc > ADHDin > GenPop
		SD	8.8	10.7	10.0
	Emotional Dysregulation	M	48.3	57.9	65.4	111.79	.36	ADHDc > ADHDin > GenPop
		SD	9.3	10.6	9.1
	Negative Self-Concept	M	49.4	59.9	62.6	65.88	.25	ADHDc, ADHDin > GenPop
		SD	10.4	9.7	10.9
DSM Symptom Scales	ADHD Inattentive Symptoms	M	48.8	69.4	72.7	336.88	.63	ADHDc, ADHDin > GenPop
		SD	8.2	9.5	8.3
	ADHD Hyperactive/Impulsive Symptoms	M	49.1	60.9	73.3	220.66	.53	ADHDc > ADHDin > GenPop
		SD	8.6	10.7	10.3
	Total ADHD Symptoms	M	48.9	66.2	74.4	340.02	.64	ADHDc > ADHDin > GenPop
		SD	8.2	8.8	8.8

Note. All F tests statistically significant, p < .001. GenPop = individuals from the general population; ADHDin = individuals diagnosed with ADHD Predominantly Inattentive Presentation; ADHDc = individuals diagnosed with ADHD Combined Presentation. Guidelines for interpreting η²: negligible effect size < .01; small effect size = .01 to .059; medium effect size = .06 to .13; large effect size ≥ .14. The > symbol indicates that the post-hoc difference is statistically significant at p < .01, and a comma indicates no significant difference between groups.

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Table 9.9b. Differences between General Population and ADHD Groups: CAARS 2 Self-Report Effect Sizes

Scale		GenPop vs. ADHDin	GenPop vs. ADHDc	ADHDin vs. ADHDc
Content Scales	Inattention/Executive Dysfunction	2.57	2.97	0.26
	Hyperactivity	1.15	2.63	1.35
	Impulsivity	1.42	2.50	0.93
	Emotional Dysregulation	0.99	1.86	0.76
	Negative Self-Concept	1.03	1.25	0.27
DSM Symptom Scales	ADHD Inattentive Symptoms	2.40	2.90	0.36
	ADHD Hyperactive/Impulsive Symptoms	1.28	2.65	1.19
	Total ADHD Symptoms	2.08	3.05	0.93

Note. GenPop = individuals from the general population (N = 197); ADHDin = individuals diagnosed with ADHD Predominantly Inattentive Presentation (N = 96); ADHDc = individuals diagnosed with ADHD Combined Presentation (N = 101). Values presented are Cohen’s d effect sizes; guidelines for interpreting Cohen’s |d|: negligible effect size < 0.20; small effect size = 0.20 to 0.49; medium effect size = 0.50 to 0.79; large effect size ≥ 0.80. Cohen’s d values for which the corresponding post-hoc test was statistically significant (p < .01) are shaded in gray. A positive Cohen’s d value indicates that the second group listed scored higher than the first group listed.

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Table 9.10a. Differences between General Population and ADHD Groups: CAARS 2 Observer

Scale			GenPop (N = 139)	ADHDin (N = 63)	ADHDc (N = 76)	F (2, 275)	η²	Tukey’s HSD Post-Hoc Tests
Content Scales	Inattention/Executive Dysfunction	M	48.6	66.9	65.6	125.97	.48	ADHDc, ADHDin > GenPop
		SD	8.1	9.4	10.8
	Hyperactivity	M	49.5	58.2	63.3	44.40	.24	ADHDc, ADHDin > GenPop
		SD	9.4	13.1	10.6
	Impulsivity	M	50.2	55.0	59.7	20.78	.13	ADHDc, ADHDin > GenPop
		SD	9.7	10.2	11.7
	Emotional Dysregulation	M	50.1	56.1	59.7	21.04	.13	ADHDc, ADHDin > GenPop
		SD	10.1	11.1	11.6
	Negative Self-Concept	M	49.4	63.1	61.9	48.36	.26	ADHDc, ADHDin > GenPop
		SD	9.2	13.0	12.5
DSM Symptom Scales	ADHD Inattentive Symptoms	M	48.7	66.1	65.7	116.17	.46	ADHDc, ADHDin > GenPop
		SD	8.2	9.8	11.0
	ADHD Hyperactive/ Impulsive Symptoms	M	49.8	57.0	62.2	36.75	.21	ADHDc > ADHDin > GenPop
		SD	9.6	12.0	10.5
	Total ADHD Symptoms	M	49.2	62.4	64.8	87.26	.39	ADHDc, ADHDin > GenPop
		SD	8.7	9.7	9.7

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Table 9.10b. Differences between General Population and ADHD Groups: Observer Effect Sizes

Scale		GenPop vs. ADHDin	GenPop vs. ADHDc	ADHDin vs. ADHDc
Content Scales	Inattention/Executive Dysfunction	2.14	1.86	-0.13
	Hyperactivity	0.81	1.41	0.44
	Impulsivity	0.49	0.91	0.43
	Emotional Dysregulation	0.58	0.91	0.32
	Negative Self-Concept	1.32	1.20	-0.10
DSM Symptom Scales	ADHD Inattentive Symptoms	2.00	1.84	-0.04
	ADHD Hyperactive/Impulsive Symptoms	0.69	1.26	0.47
	Total ADHD Symptoms	1.46	1.73	0.26

Note. GenPop = individuals from the general population (N = 139); ADHDin = individuals diagnosed with ADHD Predominantly Inattentive Presentation (N = 63); ADHDc = individuals diagnosed with ADHD Combined Presentation (N = 76). Values presented are Cohen’s d effect sizes; guidelines for interpreting Cohen’s |d|: negligible effect size < 0.20; small effect size = 0.20 to 0.49; medium effect size = 0.50 to 0.79; large effect size ≥ 0.80. Cohen’s d values for which the corresponding post-hoc test was statistically significant (p < .01) are shaded in grey. A positive Cohen’s d value indicates that the second group listed scored higher than the first group listed.

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Table 9.11. Differences between General Population and ADHD: CAARS 2 Associated Clinical Concern Items

Form	Associated Clinical Concern Item Stem	% Endorsed			Cliff’s d
Form	Associated Clinical Concern Item Stem	GenPop	ADHDin	ADHDc	GenPop vs. ADHDin	GenPop vs. ADHDc	ADHDin vs. ADHDc
Self-Report	Suicidal thoughts/attempts	29.0	58.3	81.2	.33	.56	.23
	Self-injury	18.0	28.1	41.6	.09	.22	.12
	Sadness/emptiness	20.3	46.9	47.5	.40	.50	.11
	Anxiety/worry	27.3	59.4	77.2	.38	.59	.27
Observer	Suicidal thoughts/attempts	13.0	37.7	41.7	.25	.29	.01
	Self-injury	6.6	13.6	15.7	.06	.07	-.05
	Sadness	4.3	38.1	35.5	.58	.48	-.08
	Anxiety/worry	9.4	60.3	59.2	.62	.60	.02

Note. GenPop = individuals from the general population; ADHDin = individuals diagnosed with ADHD Predominantly Inattentive Presentation; ADHDc = individuals diagnosed with ADHD Combined Presentation. Guidelines for interpreting Cliff’s |d|: negligible effect size < .15; small effect size = .15 to .32; medium effect size = .33 to .46; large effect size ≥ .47. Positive values indicate that the group listed second in the heading provided higher ratings than the group listed first. Differences are statistically significant for all |d| ≥ .16.

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Table 9.12. Differences between General Population and ADHD Groups: CAARS 2 Self-Report Impairment & Functional Outcome Items

Impairment & Functional Outcome Item Stem	% Elevated			Cliff’s d
Impairment & Functional Outcome Item Stem	GenPop	ADHDin	ADHDc	GenPop vs. ADHDin	GenPop vs. ADHDc	ADHDin vs. ADHDc
Bothered by the things endorsed on the CAARS 2	11.7	68.8	82.2	.69	.81	.25
Things endorsed on the CAARS 2 interfere with life	6.6	68.8	65.3	.81	.84	.09
Problems in romantic/marital relationship(s)	16.8	47.9	62.4	.41	.48	-.07
Problems in relationships with family members	8.6	37.5	60.4	.44	.63	.27
Problems in relationships with friends, coworkers, or neighbors	8.6	31.3	39.6	.43	.58	.17
Problems at work and/or school	11.2	64.6	71.3	.62	.70	.01
Has a harder time with things than other people do	12.7	62.5	72.3	.68	.72	.09
Underachiever	10.7	38.5	44.6	.33	.45	.12
Sleep problems	16.8	40.6	55.4	.37	.53	.18
Problems with money management	19.8	53.1	66.3	.36	.60	.24
Neglects family or household responsibilities	8.6	44.8	56.4	.59	.70	.11
Risky driving	10.7	44.8	44.6	.38	.39	.03
Problems due to time spent online	13.2	54.2	50.5	.53	.59	.07

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Table 9.13. Differences between General Population and ADHD Groups: CAARS 2 Observer Impairment & Functional Outcome Items

Impairment & Functional Outcome Item Stem	% Elevated			Cliff’s d
Impairment & Functional Outcome Item Stem	GenPop	ADHDin	ADHDc	GenPop vs. ADHDin	GenPop vs. ADHDc	ADHDin vs. ADHDc
Bothered by the things endorsed on the CAARS 2	15.8	84.1	57.9	.71	.56	-.25
Things endorsed on the CAARS 2 interfere with life	12.9	88.9	73.7	.81	.67	-.12
Problems in romantic/marital relationship(s)	16.5	31.7	32.9	.31	.22	-.24
Problems in relationships with family members	10.8	34.9	42.1	.43	.47	.06
Problems in relationships with friends, coworkers, or neighbors	6.5	11.1	17.1	.29	.35	.07
Problems at work and/or school	7.2	41.3	30.3	.53	.41	-.20
Has a harder time with things than other people do	2.2	42.9	46.1	.69	.66	.00
Underachiever	7.9	20.6	18.4	.27	.16	-.09
Sleep problems	7.2	44.4	52.6	.50	.57	.01
Problems with money management	21.6	36.5	43.4	.23	.34	.09
Neglects family or household responsibilities	7.2	31.7	28.9	.46	.37	-.09
Risky driving	6.5	15.9	21.1	.19	.14	-.12
Problems due to time spent online	18.0	47.6	35.5	.53	.59	.07

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Table 9.14a. Differences between ADHD, Depression/Anxiety, and General Population Groups: CAARS 2 Self-Report

Scale			GenPop (N = 245)	ADHD (N = 122)	Dep/Anx (N = 123)	F (2, 541)	η²	Tukey’s HSD Post-Hoc Tests
Content Scales	Inattention/Executive Dysfunction	M	49.4	71.0	56.5	222.70	.48	ADHD > Dep/Anx > GenPop
		SD	9.2	8.9	9.6
	Hyperactivity	M	49.0	64.4	53.6	85.77	.26	ADHD > Dep/Anx > GenPop
		SD	9.8	12.1	10.7
	Impulsivity	M	49.0	66.1	53.8	110.55	.31	ADHD > Dep/Anx > GenPop
		SD	9.5	11.8	10.6
	Emotional Dysregulation	M	48.8	60.0	57.0	55.82	.19	ADHD, Dep/Anx > GenPop
		SD	9.6	10.7	11.7
	Negative Self-Concept	M	49.7	59.8	60.8	61.59	.20	ADHD, Dep/Anx > GenPop
		SD	10.1	11.3	11.0
DSM Symptom Scales	ADHD Inattentive Symptoms	M	49.6	70.0	56.2	199.13	.45	ADHD > Dep/Anx > GenPop
		SD	9.1	9.3	9.5
	ADHD Hyperactive/ Impulsive Symptoms	M	49.0	65.7	54.0	99.92	.29	ADHD > Dep/Anx > GenPop
		SD	9.6	12.3	10.8
	Total ADHD Symptoms	M	49.2	69.0	55.4	176.26	.42	ADHD > Dep/Anx > GenPop
		SD	9.4	9.7	9.5

Note. All F tests statistically significant, p < .001. GenPop = individuals from the general population; ADHD = individuals diagnosed with any ADHD presentation (no diagnosis of anxiety or mood disorder); Dep/Anx = individuals diagnosed with a Depressive and/or Anxiety Disorder (no diagnosis of ADHD). Guidelines for interpreting η²: negligible effect size < .01; small effect size = .01 to .59; medium effect size = .06 to .13; large effect size ≥ .14. The > symbol indicates that the post-hoc difference is statistically significant at p < .01, and a comma indicates no significant difference between groups.

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Table 9.14b. Differences between ADHD, Depression/Anxiety, and General Population Groups: CAARS 2 Self-Report Effect Sizes

Scale		GenPop vs. ADHD	GenPop vs. Dep/Anx	ADHD vs. Dep/Anx
Content Scales	Inattention/Executive Dysfunction	2.38	0.76	1.57
	Hyperactivity	1.46	0.45	0.95
	Impulsivity	1.66	0.48	1.10
	Emotional Dysregulation	1.13	0.80	0.27
	Negative Self-Concept	0.97	1.07	-0.09
DSM Symptom Scales	ADHD Inattentive Symptoms	2.23	0.72	1.48
	ADHD Hyperactive/Impulsive Symptoms	1.58	0.50	1.01
	Total ADHD Symptoms	2.09	0.66	1.42

Note. GenPop = individuals from the general population (N = 245); ADHD = individuals with a diagnosis of ADHD (N = 122); Dep/Anx = individuals with a diagnosis of a Depressive Disorder or an Anxiety Disorder (N = 121). Values presented are Cohen’s d effect sizes; guidelines for interpreting Cohen’s |d|: negligible effect size < 0.20; small effect size = 0.20 to 0.49; medium effect size = 0.50 to 0.79; large effect size ≥ 0.80. Cohen’s d values for which the corresponding post-hoc test was statistically significant (p < .01) are shaded in grey. A positive Cohen’s d value indicates that the second group listed scored higher than the first group listed.

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Table 9.15a. Group Differences between ADHD, Depression/Anxiety, and General Population Samples: CAARS 2 Observer

Scale			GenPop (N = 177)	ADHD (N = 79)	Dep/Anx (N = 98)	F (2, 351)	η²	Tukey’s HSD Post-Hoc Tests
Content Scales	Inattention/Executive Dysfunction	M	48.0	67.7	55.0	122.05	.41	ADHD > Dep/Anx > GenPop
		SD	8.2	9.6	10.8
	Hyperactivity	M	49.1	61.8	51.7	47.19	.21	ADHD > Dep/Anx, GenPop
		SD	8.6	11.8	9.9
	Impulsivity	M	49.4	59.2	50.7	27.26	.13	ADHD > Dep/Anx, GenPop
		SD	8.9	11.9	10.2
	Emotional Dysregulation	M	49.6	58.0	55.7	20.25	.10	ADHD, Dep/Anx > GenPop
		SD	10.4	11.1	11.3
	Negative Self-Concept	M	48.8	60.5	63.1	61.09	.26	ADHD, Dep/Anx > GenPop
		SD	9.6	12.7	12.9
DSM Symptom Scales	ADHD Inattentive Symptoms	M	48.0	67.9	55.4	122.92	.41	ADHD > Dep/Anx > GenPop
		SD	8.1	10.1	11.0
	ADHD Hyperactive/ Impulsive Symptoms	M	49.2	60.8	51.7	39.59	.18	ADHD > Dep/Anx, GenPop
		SD	8.6	11.6	10.0
	Total ADHD Symptoms	M	48.5	65.3	53.8	93.92	.35	ADHD > Dep/Anx > GenPop
		SD	8.2	9.6	10.0

Note. GenPop = individuals from the general population; ADHD = individuals diagnosed with any ADHD presentation (no diagnosis of anxiety or mood disorder); Dep/Anx = individuals diagnosed with a Depressive and/or Anxiety Disorder (no diagnosis of ADHD). Guidelines for interpreting η²: small effect size = .01; medium effect size = .06; large effect size = .14. The > symbol indicates that the post-hoc difference is statistically significant at p < .01. The > symbol indicates that the post-hoc difference is statistically significant at p < .01, and a comma indicates no significant difference between groups.

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Table 9.15b. Differences between ADHD, Depression/Anxiety, and General Population Groups: CAARS 2 Observer Effect Sizes

Scale		GenPop vs. ADHD	GenPop vs. Dep/Anx	ADHD vs. Dep/Anx
Content Scales	Inattention/Executive Dysfunction	2.27	0.77	1.23
	Hyperactivity	1.32	0.29	0.94
	Impulsivity	0.99	0.14	0.78
	Emotional Dysregulation	0.79	0.57	0.21
	Negative Self-Concept	1.11	1.32	-0.20
DSM Symptom Scales	ADHD Inattentive Symptoms	2.29	0.81	1.19
	ADHD Hyperactive/Impulsive Symptoms	1.21	0.27	0.86
	Total ADHD Symptoms	1.94	0.60	1.18

Note. GenPop = individuals from the general population (N = 177); ADHD = individuals with an ADHD diagnosis (N = 79); Dep/Anx = individuals with a diagnosis of a Depressive Disorder or an Anxiety Disorder (N = 97). Values presented are Cohen’s d effect sizes; guidelines for interpreting Cohen’s |d|: negligible effect size < 0.20; small effect size = 0.20 to 0.49; medium effect size = 0.50 to 0.79; large effect size ≥ 0.80. Cohen's d values for which the corresponding post-hoc test was statistically significant (p < .01) are shaded in grey. A positive Cohen’s d value indicates that the second group listed scored higher than the first group listed.

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Table 9.16. Differences between General Population, ADHD, and Depression/Anxiety: CAARS 2 Associated Clinical Concern Items

Form	Associated Clinical Concern Item Stem	% Endorsement			Cliff’s d
Form	Associated Clinical Concern Item Stem	GenPop	ADHD	Dep/Anx	GenPop vs. ADHD	GenPop vs. Dep/Anx	ADHD vs. Dep/Anx
Self-Report	Suicidal thoughts/attempts	29.0	65.6	65.0	.36	.40	-.10
	Self-injury	18.0	25.4	33.3	.07	.17	-.12
	Sadness/emptiness	21.2	38.5	57.7	.34	.51	-.24
	Anxiety/worry	27.3	38.5	56.1	.39	.68	-.36
Observer	Suicidal thoughts/attempts	11.4	32.1	48.9	.21	.39	-.24
	Self-injury	8.0	9.2	21.5	.01	.13	-.17
	Sadness	7.3	25.3	41.8	.38	.62	-.26
	Anxiety/worry	9.0	51.9	71.4	.55	.74	-.21

Note. GenPop = individuals from the general population; ADHD = individuals diagnosed with any ADHD presentation (no diagnosis of anxiety or mood disorder); Dep/Anx = individuals diagnosed with a Depressive and/or Anxiety Disorder (no diagnosis of ADHD). Guidelines for interpreting Cliff’s |d|: negligible effect size < .15; small effect size = .15 to .32; medium effect size = .33 to .46; large effect size ≥ .47. Positive values indicate that the group listed second in the heading provided higher ratings than the group listed first. Differences are statistically significant for all |d| ≥ .16.

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Table 9.17. Differences between General Population, ADHD, and Depression/Anxiety: CAARS 2 Self-Report Impairment & Functional Outcome Items

Impairment & Functional Outcome Item Stem	% Endorsement			Cliff’s d
Impairment & Functional Outcome Item Stem	GenPop	ADHD	Dep/Anx	GenPop vs. ADHD	GenPop vs. Dep/Anx	ADHD vs. Dep/Anx
Bothered by the things endorsed on the CAARS 2	12.2	71.3	49.6	.68	.48	.23
Things endorsed on the CAARS 2 interfere with life	9.0	64.8	31.7	.77	.58	.33
Problems in romantic/marital relationship(s)	15.9	59.0	39.8	.45	.32	.01
Problems in relationships with family members	11.0	50.8	41.5	.51	.43	.05
Problems in relationships with friends, coworkers, or neighbors	7.8	36.9	26.0	.49	.33	.17
Problems at work and/or school	13.5	68.0	38.2	.57	.26	.32
Has a harder time with things than other people do	11.8	65.6	33.3	.67	.42	.35
Underachiever	11.4	38.5	21.1	.35	.07	.26
Sleep problems	16.3	45.1	47.2	.43	.52	-.10
Problems with money management	17.6	60.7	37.4	.52	.28	.27
Neglects family or household responsibilities	9.0	46.7	26.0	.57	.30	.28
Risky driving	11.8	41.8	22.8	.26	.08	.11
Problems due to time spent online	15.5	51.6	23.6	.48	.18	.31

Note. GenPop = individuals from the general population; ADHD = individuals diagnosed with any ADHD presentation (no diagnosis of anxiety or mood disorder); Dep/Anx = individuals diagnosed with a Depressive and/or Anxiety Disorder (no diagnosis of ADHD). Guidelines for interpreting Cliff’s |d|: negligible effect size < .15; small effect size = .15 to .32; medium effect size = .33 to .46; large effect size ≥ .47. Positive values indicate that the group listed second in the heading provided higher ratings than the group listed first. Differences are statistically significant for all |d| ≥ .16.

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Table 9.18. Differences between General Population, ADHD, and Depression/Anxiety: CAARS 2 Observer Impairment & Functional Outcome Items

Impairment & Functional Outcome Item Stem	% Endorsement			Cliff’s d
Impairment & Functional Outcome Item Stem	GenPop	ADHD	Dep/Anx	GenPop vs. ADHD	GenPop vs. Dep/Anx	ADHD vs. Dep/Anx
Bothered by the things endorsed on the CAARS 2	13.0	69.6	52.0	.66	.56	.16
Things endorsed on the CAARS 2 interfere with life	13.0	79.7	58.2	.74	.59	.22
Problems in romantic/marital relationship(s)	15.3	34.2	36.7	.27	.31	-.14
Problems in relationships with family members	15.8	38.0	27.6	.38	.31	.05
Problems in relationships with friends, coworkers, or neighbors	7.3	17.7	19.4	.36	.34	-.02
Problems at work and/or school	5.6	34.2	20.4	.48	.29	.07
Has a harder time with things than other people do	3.4	49.4	22.4	.72	.53	.30
Underachiever	8.5	20.3	19.4	.25	.19	.06
Sleep problems	7.9	48.1	46.9	.55	.49	.00
Problems with money management	18.6	41.8	32.7	.38	.22	.14
Neglects family or household responsibilities	7.9	34.2	20.4	.43	.23	.22
Risky driving	7.3	25.3	5.1	.27	.00	.24
Problems due to time spent online	16.9	36.7	29.6	.32	.16	.15

Note. GenPop = individuals from the general population; ADHD = individuals diagnosed with any ADHD presentation (no diagnosis of anxiety or mood disorder); Dep/Anx = individuals diagnosed with a Depressive and/or Anxiety Disorder (no diagnosis of ADHD). Guidelines for interpreting Cliff’s |d|: negligible effect size < .15; small effect size = .15 to .32; medium effect size = .33 to .46; large effect size ≥ .47. Positive values indicate that the group listed second in the heading provided higher ratings than the group listed first. Differences are statistically significant for all |d| ≥ .16.

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Table 9.19. Classification Accuracy Statistics: CAARS 2 Self-Report

Predictor Scales/Items	Target Groups	Overall Correct Classification Rate (%)	Sensitivity (%)	Specificity (%)	Positive Predictive Value (%)	Negative Predictive Value (%)	Kappa
Content Scales + Impairment & Functional Outcome Items	All ADHD Presentations	92.5	90.6	94.2	94.2	90.9	.85
Total ADHD Symptoms Scale + Impairment & Functional Outcome Items	All ADHD Presentations	89.7	90.0	89.4	89.4	89.9	.79
ADHD Inattentive Symptoms Scale + Impairment & Functional Outcome Items	ADHD Inattentive or ADHD Combined	92.3	91.6	92.9	92.8	91.7	.85
ADHD Hyperactive/Impulsive Symptoms Scale + Impairment & Functional Outcome Items	ADHD Hyperactive/Impulsive or ADHD Combined	92.0	90.4	93.6	93.4	90.7	.84

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Table 9.20. Positive and Negative Predictive Values by Base Rate for ADHD vs. General Population Comparisons: CAARS 2 Self-Report

Predictor Scales	Target Groups	10% Base Rate		60% Base Rate		70% Base Rate		80% Base Rate
Predictor Scales	Target Groups	PPV (%)	NPV (%)	PPV (%)	NPV (%)	PPV (%)	NPV (%)	PPV (%)	NPV (%)
Content Scales + Impairment & Functional Outcome Items	All ADHD Presentations	76.3	98.1	95.1	89.4	95.8	87.8	96.3	86.3
Total ADHD Symptoms Scale + Impairment & Functional Outcome Items	All ADHD Presentations	62.9	97.8	91.4	88.2	92.2	86.4	91.1	84.8
ADHD Inattentive Symptoms Scale + Impairment & Functional Outcome Items	ADHD Inattentive & ADHD Combined	72.1	98.2	93.9	90.2	94.8	88.8	95.4	87.4
ADHD Hyperactive/Impulsive Symptoms Scale + Impairment & Functional Outcome Items	ADHD Hyperactive/Impulsive & ADHD Combined	73.9	98.0	94.4	89.1	95.2	87.5	95.8	85.9

Note. PPV = Positive Predictive Value; NPV = Negative Predictive Value.

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Table 9.21. Classification Accuracy Statistics: CAARS 2 Observer

Predictor Scales/Items	Target Groups	Overall Correct Classification Rate (%)	Sensitivity (%)	Specificity (%)	Positive Predictive Value (%)	Negative Predictive Value (%)	Kappa
Content Scales + Impairment & Functional Outcome Items	All ADHD Presentations	91.7	92.9	90.5	90.7	92.7	.83
Total ADHD Symptoms Scale + Impairment & Functional Outcome Items	All ADHD Presentations	88.5	89.7	87.3	87.6	89.4	.77
ADHD Inattentive Symptom Scale + Impairment & Functional Outcome Items	ADHD Inattentive & ADHD Combined	87.3	89.3	85.3	85.8	88.9	.75
ADHD Hyperactive/Impulsive Symptom Scale + Impairment & Functional Outcome Items	ADHD Hyperactive/Impulsive & ADHD Combined	84.7	86.7	82.7	83.3	86.1	.69

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Table 9.22. ADHD vs. General Population Positive and Negative Predictive Values by Base Rate: CAARS 2 Observer

Predictor Scales	Target Groups	10% Base Rate		60% Base Rate		70% Base Rate		80% Base Rate
Predictor Scales	Target Groups	PPV (%)	NPV (%)	PPV (%)	NPV (%)	PPV (%)	NPV (%)	PPV (%)	NPV (%)
Content Scales + Impairment & Functional Outcome Items	All ADHD Presentations	66.1	98.5	92.1	91.3	93.2	90.0	93.9	88.8
Total ADHD Symptoms Scale + Impairment & Functional Outcome Items	All ADHD Presentations	58.6	97.7	89.5	87.6	90.8	85.8	91.9	84.1
ADHD Inattentive Symptoms Scale + Impairment & Functional Outcome Items	ADHD Inattentive & ADHD Combined	54.7	97.6	87.9	86.9	89.5	85.1	90.6	83.3
ADHD Hyperactive/Impulsive Symptoms Scale + Impairment & Functional Outcome Items	ADHD Hyperactive/Impulsive & ADHD Combined	50.0	96.9	85.7	83.8	87.5	81.6	88.9	79.5

Note. PPV = Positive Predictive Value; NPV = Negative Predictive Value.