Manual

Conners 4 Manual

Appendix A: Omitted Responses


Appendix A: Omitted Responses

view all section tables | print this section

The Conners 4th Edition (Conners 4®) results will be less valuable and less accurate if responses are missing. If the allowable number of omitted responses has been exceeded for a given scale (see Table A.1), the scale cannot be scored and is marked as “?” in the digital reports. This question mark indicates that the scale cannot be scored due to too many omitted responses. However, if the maximum number of allowable omissions has not been exceeded, then scores will be prorated for the following scales: Content Scales, Impairment & Functional Outcome Scales, and DSM Symptom Scales (for the purposes of calculating T-scores), and the Conners 4®–ADHD Index. Raw scores for these scales are prorated with the following formula:



For example, a rater obtained a raw score of 10, but answered only 5 out of 6 items on a particular scale. The score may be prorated by multiplying the obtained raw score of 10 by the number of items (6) on the full scale (10 × 6 = 60). The obtained result is then divided by the number of completed items on the scale (5) to get the prorated raw score of 12 (60 ÷ 5). The prorated raw score takes into account the missing items and adjusts the total raw score based on how the rater answered the other items on the scale. Prorating is automatically implemented where applicable when using digital scoring.



Omissions are handled differently for the Negative Impression Index, the Inconsistency Index, and the DSM Symptom Counts. These are discussed in detail in the following sections.


Omitted Responses for the Negative Impression Index

The Negative Impression Index cannot be prorated. When Negative Impression Index item responses are missing, the following rules are applied in order:

  1. If the raw score (based on the items that were rated) is equal to, or higher than the cut-off (for values, see Table 4.2 in chapter 4, Interpretation), then the status of “An unrealistic or exaggerated presentation” is provided regardless of how many items have been omitted (see Example 1 in Table A.2).

  2. If the raw score (based on the items that were rated) plus the number of missing items multiplied by three is lower than the minimum cut-off, then the status of “No indication of exaggerated responding” is provided (see Example 2 in Table A.2). Note: The number of missing items is multiplied by three as this is the highest possible score for a Negative Impression Item.

  3. If neither of the above two conditions are met, then the status of the Negative Impression Index is “Cannot be determined” (see Example 3 in Table A.2).



Omitted Responses for the Inconsistency Index

When Inconsistency Index item responses are missing, the following rules are applied, in order:

  1. If the raw score (based on the item pairs that were rated) is equal to, or higher than the cut-off (for values, see Table 4.3 in chapter 4, Interpretation), then the status of “A high level of inconsistency” is provided, regardless of how many item pairs have been omitted (see Example 1 in Table A.3).

  2. If the raw score (based on the item pairs that were rated) plus the number of missing item pairs multiplied by three is lower than the minimum cut-off, then the status of “No indication of inconsistent responding” is provided (see Example 2 in Table A.3). Note: The number of missing item pairs is multiplied by three as this is the highest possible difference score for an Inconsistency Index item pair.

  3. If neither of the above two conditions are met, then the status of the Inconsistency index is “Cannot be determined” (see Example 3 in Table A.3).



Omitted Responses for the DSM Symptom Counts

The DSM Symptom Counts cannot be prorated in the same manner as raw scores. When item responses are omitted, one needs to determine if the symptom criteria outlined by the DSM1 is affected. If it is affected, then the symptom is omitted. It should be noted that in both “OR” criteria (i.e., endorsement of either item is required to count toward a criterion) and “AND” criteria (i.e., both items count toward a criterion), the symptom is considered omitted if both items are omitted or if one item is omitted and the other item is not endorsed (see appendix D for details about how Conners 4 items map onto DSM symptom criteria). The following rules are applied for DSM Symptom Counts:

  1. If the omitted item(s) impacts one of the DSM symptom criteria, the Symptom Count will be provided, with a note that the Symptom Count may be an underestimation because the rater did not respond to all of the symptom criteria (see Example 1 in Table A.4).

  2. If the omitted items impact more than one of the DSM symptom criteria, there are two possible scenarios:

    1. If the Symptom Count is below the DSM symptom count requirement, then the Symptom Count cannot be provided for the scale and is marked as “?” on digital reports to indicate that it cannot be scored due to too many omitted responses (see Example 2 in Table A.4).

    2. If the Symptom Count is at or above the DSM symptom count requirement, then the Symptom Count will be provided; however, a note will indicate that the obtained Symptom Count may be an underestimation of the actual Symptom Count because the rater did not respond to all the symptom criteria (see Example 3 in Table A.4).


Click to expand

Table A.4. DSM ADHD Inattentive Symptoms Scale Interpreted with Omitted Items: Conners 4 Parent Examples

Example

DSM ADHD Inattentive Symptoms Obtained Score

Number of Omitted Items

Symptom Count Reported

Meaning of Notation

1

1

1

1*/9

*Symptom Count(s) may be underestimated due to omitted item(s).

2

1

2

?

? = could not be scored due to omitted item(s).

3

8

2

8*/9

*Symptom Count(s) may be underestimated due to omitted item(s).

Note. The DSM requires at least 6/9 symptoms to be endorsed to meet Criterion A of the diagnostic criteria for ADHD for youth ≤ 16 years of age, and at least 5/9 symptoms for youth ≥ 17 years of age.




1 Throughout this manual, DSM refers to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR, 2022).


< Back Next >