Manual

Conners 4 Manual

Appendix D: DSM Symptom Scales Scoring Criteria

Appendix D: DSM Symptom Scales Scoring Criteria

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This appendix outlines the scoring criteria used for the Conners 4 (Conners 4®) DSM Symptom Scales. The following information is contained in Tables D.1 to D.3:

  • The DSM Symptom Count requirement for ADHD, Oppositional Defiant Disorder, and Conduct Disorder.

  • The Conners 4 items corresponding to the DSM1 symptom criteria for these disorders.

  • The criterion status requirements (i.e., the item score(s) that contributes to the Symptom Count for the scale).

  • The relevant interpretive considerations for each DSM Symptom scale.

The following response key applies to the criterion status score requirements noted in the Contributes to Symptom Count column for each table:

DO NOT COPY

                      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)


These items and scales are provided to aid use and interpretation of the tool, but the contents of this appendix are copyrighted/trade secret material that are not intended for public disclosure.


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Tables D.1a. DSM Symptom Count and Criterion Status Score Requirements for DSM ADHD Inattentive Symptoms

DSM Symptom Count Requirements: At least 6 of the 9 symptoms for youth ≤ 16 years of age; at least 5 of the 9 symptoms for youth
≥ 17 years of age.

DSM Criterion A

Parent Item #

Teacher Item #

Parent/Teacher Item Text

Self-Report Item #

Self-Report Item Text

Item Score that Contributes to Symptom Count

1a

62

55

Fails to pay close attention to details.

66

It is hard for me to pay attention to details.

2,3 

-or-

-or-

-or-

-or-

-or-

-or-

66

59

Makes careless mistakes in schoolwork or other activities.

69

I make careless mistakes.

2,3

1b

107

98

Has trouble staying focused on work or play for a long time.

108

I have trouble focusing for a long time.

2,3

1c

15

13

Doesn’t seem to listen to what people are saying to them.

18

People don’t think I’m listening to them.

2,3

1d

19

17

Doesn’t finish schoolwork, work, or other tasks.

22

I don’t finish things I start, like schoolwork, work, or other tasks.

One item score = 2,3

-and-

-and-

-and-

-and-

-and-

-and-

32

29

Fails to follow through on instructions.

35

I have trouble following instructions.

other item score = 1,2,3

1e

57

52

Has trouble organizing tasks or activities.

60

I have trouble keeping my things organized.

2,3

1f

5

5

Avoids or dislikes things that take a lot of effort and are not fun.

6

I don’t like doing things that make me think hard for a long time.

2,3

 -or-

 -or-

-or-

-or-

-or-

-or-

n/a

n/a

n/a

92

I avoid doing things that make me think hard for a long time.

2,3

1g

79

73

Loses or misplaces things that they need.

81

I lose things that I need.

2,3

1ha

10

10

Is easily distracted.

14

I am easily distracted.

2,3

1i

2

2

Is forgetful in daily activities.

2

I forget to do things.

2,3

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Tables D.1b. DSM Symptom Count and Criterion Status Score Requirements for DSM ADHD Hyperactive/Impulsive Symptoms

DSM Symptom Count Requirements: At least 6 of the 9 symptoms for youth ≤ 16 years of age; at least 5 of the 9 symptoms for youth
≥ 17 years of age.

DSM Criterion A

Parent Item #

Teacher Item #

Parent/Teacher Item Text

Self-Report Item #

Self-Report Item Text

Item Score that Contributes to Symptom Count

2a

86

80

Has trouble sitting still.

88

It’s hard for me to sit still.

2,3

-or-

-or-

-or-

-or-

-or-

-or-

108

99

Fidgets or squirms in their seat.

109

I fidget or squirm in my seat.

2,3

2b

3

3

Leaves their seat when they should stay seated.

3

I get out of my seat when I am not supposed to.

2,3

2cb

51

47

Runs or climbs when they are not supposed to.

52

I run or climb even when I am not supposed to.

2,3

-or-

-or-

-or-

-or-

-or-

-or-

111

102

Is restless.

112

I feel restless.

2,3

2d

60

54

Is unable to be quiet when playing or using free time.

64

I can’t play or do things quietly.

2,3

2e

14

12

Needs to be moving around.

17

I feel like I need to be moving around.

2,3

-or-

-or-

-or-

-or-

-or-

-or-

95

89

Acts as if driven by a motor.

98

I feel like I am driven by a motor.

2,3

2f

47

42

Talks too much.

47

I talk too much.

2,3

2g

106

97

Blurts out answers before the question has been completed.

107

I blurt out the answer before the question is finished.

2,3

2h

50

45

Has difficulty waiting for their turn.

50

I have trouble waiting for my turn.

2,3

2i

55

50

Interrupts other people’s conversations, games, or activities.

57

I interrupt people when they are talking or playing games.

2,3

-or-

-or-

-or-

-or-

-or-

-or-

75

70

Intrudes on or takes over what others are doing.

n/a

n/a

2,3

Interpretative Considerations for Tables D.1a and D.1b:

ADHD Criterion A states that the symptoms indicated by the rater must: (a) have persisted for at least 6 months, (b) not be consistent with developmental level, and (c) have direct negative impact on the youth’s social and academic/occupational activities.

ADHD Criterion A states that “…the symptoms are not solely a manifestation of oppositional behavior, defiance, hostility, or failure to understand tasks or instructions” (p.69, APA, 2022).

a Criterion A1h states that in older adolescents, the tendency to be easily distracted by extraneous stimuli may include unrelated thoughts as the source of distraction. Follow-up is recommended to check if Criterion A1h has been met for older adolescents.

b Criterion A2c states that in adolescents, overactivity may be experienced as subjective feelings of restlessness. Follow-up is recommended to ensure Criterion A2c has been met for the self-report of adolescents.

DSM Symptom Count Requirements for ADHD Combined Presentation: Meets symptom count criteria for both Inattentive and Hyperactive-Impulsive presentations.


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Interpretative Considerations:

Oppositional Defiant Disorder Criterion A requires that the patterns of angry/irritable mood, argumentative/defiant behavior, or vindictiveness be present for at least 6 months.

Oppositional Defiant Disorder Criterion A states that symptoms must be “exhibited during interaction with at least one individual who is not a sibling” (p. 522; APA, 2022).

a In order for Criterion A8 (vindictiveness) to be indicated, the assessor needs to ensure this criterion occurred twice within the past 6 months.


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Table D.3. DSM Symptom Count and Criterion Status Score Requirements for DSM Conduct Disorder Symptoms

DSM Symptom Count Requirements: At least 3 of the 15 symptoms.

DSM Criterion A

Parent Item #

Teacher Item #

Parent/Teacher Item Text

Self-Report Item #

Self-Report Item Text

Item Score that Contributes to Symptom Count

Aggression to People and Animals

1

33

30

Bullies, threatens, or scares others.

36

I bully, threaten, or scare others.

2,3

2

21

19

Starts fights with people.

24

I start fights with other people.

2,3

3

84

79

Uses a weapon to scare or hurt people.

87

I use a weapon to scare or hurt people.

1,2,3

4

6

6

Physically hurts people.

10

I hurt people by doing things like punching, kicking, or scratching.

1,2,3

5

70

65

Is cruel to animals.

73

I do things to hurt animals.

1,2,3

6

17

15

Steals while confronting a person (for example, mugging, purse snatching, or armed robbery).

20

I steal from people by robbing them.

1,2,3

7

101

94

Has forced someone into sexual activity.

103

I made someone do something sexual against their will.

1,2,3

Destruction of Property

8

29

26

Has intentionally set fires for the purpose of causing damage.

32

I set things on fire to cause damage.

1,2,3

9a

81

75

Intentionally damages or destroys things that belong to others.

83

I destroy things on purpose that belong to others.

1,2,3

Deceitfulness or Theft

10

44

39

Has broken into someone else’s house, building, or car.

44

I’ve broken into houses, buildings, or cars.

1,2,3

11

68

62

Lies to avoid having to do something or to get things.

71

I tell lies to get out of doing things or to get stuff.

2,3

12

27

25

Steals valuable things secretly (for example, through shoplifting or forgery).

30

I steal valuable things when no one is watching.

1,2,3

Serious Violations of Rules

13b,c

61

 n/a

Stays out at night, even though it breaks the rules.

65

I stay out at night, even though it breaks the rules.

2,3

14b,d

104

 n/a

Has run away from home for at least one night.

105

I have run away from home for at least one night.

1,2,3

15e

90

84

Skips classes.

93

I skip classes.

2,3

Interpretative Considerations:

Conduct Disorder Criterion A states that a repetitive and persistent pattern of behavior where the basic rights of others or major age-appropriate societal norms or rules are violated is shown in the past 12 months from any of the categories (aggression to people and animals, destruction of property, deceitfulness or theft, or serious violation of rules), with at least one criterion present in the past 6 months.

a If both Criterion A8 (fire setting) and A9 (destruction of property) are indicated, in order to meet Criterion A9, the assessor must confirm that property was destroyed other than by fire-setting.

b The Conners 4 Teacher does not assess Criterion A13 (staying out at night without permission) or Criterion A14 (running away from home), as teachers generally would not be directly aware of these infractions.

c In order for DSM Criterion A13 (staying out at night without permission) to be indicated, the assessor must ensure that behavior had occurred before the age of 13 years.

d In order for DSM Criterion A14 (running away from home) to be indicated, the assessor must ensure that the behavior occurred at least twice while living in the parental or parental surrogate home, or once without returning for a lengthy period.

e In order for DSM Criterion A15 (truancy) to be indicated, the assessor must ensure that the truancy had occurred before the age of 13 years.


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


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