Manual

Conners 4 Manual

Chapter 6: Development, Tables

Table 6.1. Demographic Characteristics of Rated Youth: Conners 4 Pilot Study General Population Sample

Demographic		Parent		Teacher		Self-Report
Demographic		N	%	N	%	N	%
Age (in years)	6 to 7	85	16.4	79	16.1	—	—
	8 to 9	85	16.4	81	16.5	74	19.1
	10 to 11	91	17.6	82	16.7	76	19.6
	12 to 13	85	16.4	83	16.9	79	20.4
	14 to 15	90	17.4	83	16.9	77	19.8
	16 to 18	82	15.8	82	16.7	82	21.1
Gender	Male	261	50.4	243	49.6	197	50.8
Gender	Female	257	49.6	247	50.4	191	49.2
U.S. Race/Ethnicity	Hispanic	116	22.4	117	23.9	95	24.5
	Asian	24	4.6	26	5.3	21	5.4
	Black	69	13.3	63	12.9	53	13.7
	White	283	54.6	258	52.7	197	50.8
	Other	26	5.0	26	5.3	22	5.7
U.S. Region	Northeast	90	17.4	77	15.7	56	14.4
	Midwest	119	23.0	108	22.0	86	22.2
	South	180	34.7	168	34.3	142	36.6
	West	129	24.9	137	28.0	104	26.8
Parental Education Level	High school diploma or lower	167	32.2	—	—	153	39.4
	Some college or associate’s degree	174	33.6	—	—	120	30.9
	Bachelor’s degree or higher	177	34.2	—	—	115	29.6
Total		518	100.0	490	100.0	388	100.0

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Table 6.2. Demographic Characteristics of Raters: Conners 4 Pilot Study General Population Sample

Rater Demographic		Parent		Teacher
Rater Demographic		N	%	N	%
Gender	Male	206	39.8	133	27.1
Gender	Female	312	60.2	357	72.9
U.S. Race/Ethnicity	Hispanic	115	22.2	42	8.6
	Asian	28	5.4	23	4.7
	Black	70	13.5	21	4.3
	White	289	55.8	389	79.4
	Other	16	3.1	15	3.1
Relation to Youth Being Rated	Biological mother	291	56.2	—	—
	Biological father	185	35.7	—	—
	Non-biological mother	11	2.1	—	—
	Non-biological father	11	2.1	—	—
	Other relative	17	3.3	—	—
	Other guardian	3	0.6	—	—
Length of Relationship	1–5 months	—	—	181	36.9
	6–11 months	—	—	96	19.6
	More than 12 months	—	—	213	43.5
How well does the teacher know the student being rated?	Moderately well	—	—	223	45.5
How well does the teacher know the student being rated?	Very well	—	—	267	54.5
How often does the teacher interact with the student being rated?	Less than weekly	—	—	15	3.1
	Weekly	—	—	88	18.0
	Almost daily	—	—	387	79.0
Age in years M (SD)		41.9 (9.3)		48.7 (13.1)
Total		518	100.0	490	100.0

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Table 6.3. Demographic Characteristics of Rated Youth: Conners 4 Pilot Study Clinical Sample

Demographic		Parent		Teacher		Self-Report
Demographic		N	%	N	%	N	%
Age (in years)	6 to 7	39	11.2	15	6.2	—	—
	8 to 9	61	17.5	38	15.7	41	16.7
	10 to 11	69	19.8	40	16.5	45	18.4
	12 to 13	57	16.3	38	15.7	39	15.9
	14 to 15	58	16.6	45	18.6	49	20.0
	16 to 18	65	18.6	66	27.3	71	29.0
Gender	Male	188	53.9	129	53.3	114	46.5
Gender	Female	161	46.1	113	46.7	131	53.5
U.S. Race/Ethnicity	Hispanic	43	12.3	13	5.4	22	9.0
	Asian	5	1.4	2	0.8	2	0.8
	Black	34	9.7	35	14.5	32	13.1
	White	254	72.8	181	74.8	174	71.0
	Other	13	3.7	11	4.5	15	6.1
U.S. Region	Northeast	49	14.0	77	31.8	35	14.3
	Midwest	132	37.8	94	38.8	113	46.1
	South	139	39.8	61	25.2	96	39.2
	West	7	2.0	7	2.9	0	0.0
Parental Education Level	High school diploma or lower	86	24.6	—	—	89	36.3
	Some college or associate’s degree	92	26.4	—	—	49	20.0
	Bachelor’s degree or higher	170	48.7	—	—	106	43.3
Diagnosis	ADHD Inattentive	60	17.2	46	19.0	50	20.4
	ADHD Hyperactive/Impulsive	11	3.2	4	1.7	7	2.9
	ADHD Combined	89	25.5	58	24.0	43	17.6
	Disruptive Disorders	28	8.0	22	9.1	24	9.8
	Generalized Anxiety Disorder	68	19.5	40	16.5	58	23.7
	Major Depressive Disorder	41	11.7	24	9.9	38	15.5
	Other Diagnoses	52	14.9	48	19.8	25	10.2
Total		349	100.0	242	100.0	245	100.0

Note. There were 21 omitted responses for U.S. Region and 1 omitted response for parental educational level (Parent form). There were 3 omitted responses for U.S. Region (Teacher form). Disruptive Disorders include Oppositional Defiant Disorder and Conduct Disorder.

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Table 6.4. Demographic Characteristics of Raters: Conners 4 Pilot Study Clinical Sample

Rater Demographic		Parent		Teacher
Rater Demographic		N	%	N	%
Gender	Male	31	8.9	67	27.7
Gender	Female	318	91.1	175	72.3
U.S. Race/Ethnicity	Hispanic	40	11.5	11	4.5
	Asian	4	1.1	1	0.4
	Black	35	10.0	24	9.9
	White	248	71.1	202	83.5
	Other	0	0.0	1	0.4
Canadian Race/Ethnicity	Not visible minority	21	6.0	3	1.2
Canadian Race/Ethnicity	Visible minority	1	0.3	0	0.0
Relation to Youth Being Rated	Biological mother	286	81.9	—	—
	Biological father	28	8.0	—	—
	Non-biological mother	15	4.3	—	—
	Non-biological father	1	0.3	—	—
	Other relative	11	3.2	—	—
	Other guardian	7	2.0	—	—
Length of Relationship	1–5 months	—	—	43	17.8
	6–11 months	—	—	118	48.8
	More than 12 months	—	—	81	33.5
How well does the teacher know the student being rated?	Not very well	—	—	9	3.7
	Moderately well	—	—	113	46.7
	Very well	—	—	120	49.6
How often does the teacher interact with the student being rated?	Less than weekly	—	—	4	1.7
	Weekly	—	—	32	13.2
	Almost daily	—	—	205	84.7
Age in years M (SD)		42.0 (8.0)		40.3 (9.3)
Total		349	100.0	242	100.0

Note. There was 1 omitted response for “relation to youth being rated” (Parent form) and 1 omitted response for “how often does the teacher interact with the student being rated” (Teacher form).

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Table 6.5. Demographic Characteristics of Rated Youth: Conners 4 Total Samples

Demographic		Parent		Teacher		Self-Report
Demographic		N	%	N	%	N	%
Gender	Male	1,710	52.5	1,474	51.2	788	49.6
	Female	1,541	47.3	1,406	48.8	797	50.2
	Other	6	0.2	1	< 0.1	4	0.3
U.S. Race/Ethnicity	Hispanic	520	16.0	411	14.3	286	18.0
	Asian	135	4.1	98	3.4	55	3.5
	Black	313	9.6	376	13.1	171	10.8
	White	1,731	53.1	1,546	53.7	791	49.8
	Other	172	5.3	146	5.1	86	5.4
Canadian Race/Ethnicity	Not visible minority	275	8.4	213	7.4	137	8.6
Canadian Race/Ethnicity	Visible minority	111	3.4	90	3.1	63	4.0
U.S. Region	Northeast	499	15.3	595	20.7	245	15.4
	Midwest	687	21.1	571	19.8	343	21.6
	South	1,132	34.8	1,013	35.2	530	33.4
	West	553	17.0	398	13.8	271	17.1
Canadian Region	East	33	1.0	27	0.9	14	0.9
	Central	242	7.4	184	6.4	130	8.2
	West	111	3.4	93	3.2	56	3.5
Parental Education Level	No high school diploma	255	7.9	—	—	160	10.1
	High school diploma/GED	602	18.5	—	—	371	23.3
	Some college or associate’s degree	957	29.5	—	—	426	26.8
	Bachelor’s degree	861	26.5	—	—	354	22.3
	Graduate or professional degree	572	17.6	—	—	278	17.5
Diagnosis	General Population (no diagnosis)	2,518	77.3	2,379	82.6	1,247	78.5
	ADHD	560	17.2	321	11.1	229	14.4
	Other Diagnoses	179	5.5	181	6.3	113	7.1
Age in years M (SD)		11.7 (3.5)		11.8 (3.6)		12.8 (3.0)
Total		3,257	100.0	2,881	100.0	1,589	100.0

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Table 6.6. Demographic Characteristics of Raters: Conners 4 Total Samples

Rater Demographic		Parent		Teacher
Rater Demographic		N	%	N	%
Gender	Male	914	28.1	690	24.0
	Female	2,342	71.9	2,190	76.0
	Other	1	< 0.1	1	< 0.1
U.S. Race/Ethnicity	Hispanic	466	14.3	174	6.0
	Asian	1,858	57.0	2,118	73.5
	Black	327	10.0	152	5.3
	White	142	4.4	67	2.3
	Other	78	2.4	67	2.3
Canadian Race/Ethnicity	Not visible minority	280	8.6	258	9.0
Canadian Race/Ethnicity	Visible minority	106	3.3	45	1.6
Relation to Youth Being Rated	Biological mother	2,181	67.0	—	—
	Biological father	844	25.9	—	—
	Non-biological mother	101	3.1	—	—
	Non-biological father	42	1.3	—	—
	Other relative	89	2.7	—	—
Length of Relationship	1–5 months	—	—	0	0.0
	6–11 months	—	—	532	18.5
	1–3 years	—	—	1,129	39.2
	More than 3 years	—	—	1,220	42.3
How well does the teacher know the student being rated?	Moderately well	—	—	1,319	45.8
How well does the teacher know the student being rated?	Very well	—	—	1,562	54.2
How often does the teacher interact with the student being rated?	Monthly	—	—	22	0.8
	Weekly	—	—	429	14.9
	Daily	—	—	2,430	84.3
Age in years M (SD)		42.2 (8.4)		42.3 (11.5)
Total		3,527	100.0	2,881	100.0

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Table 6.7a. Classification Accuracy Statistics: Conners 4 Parent Negative Impression Index

Classification Accuracy Statistic	Fake ADHD vs. Honest Responders	Fake ADHD vs. Genuine ADHD	Fake Bad vs. Honest Responders
Overall Correct Classification (%)	94.4	90.7	94.8
Sensitivity (%)	54.4	54.5	72.7
Specificity (%)	95.3	95.7	95.3
Positive Predictive Value (%)	21.5	63.6	26.8
Negative Predictive Value (%)	98.9	93.9	99.3
Kappa	.29	.54	.37

Note. Honest Responders = General Population, ADHD, and other clinical samples (N = 3,255); Genuine ADHD = ADHD Reference Sample (N = 560); Fake ADHD = individuals from the Fake ADHD simulation study (N = 77); Fake Bad = individuals from the Fake Bad simulation study (N = 77).

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Table 6.7b. Classification Accuracy Statistics: Conners 4 Teacher Negative Impression Index

Classification Accuracy Statistic	Fake ADHD vs. Honest Responders	Fake ADHD vs. Genuine ADHD	Fake Bad vs. Honest Responders
Overall Correct Classification (%)	94.1	82.1	93.8
Sensitivity (%)	52.1	52.1	48.1
Specificity (%)	95.5	90.9	95.5
Positive Predictive Value (%)	27.4	62.8	28.2
Negative Predictive Value (%)	98.4	86.6	98.0
Kappa	.33	.46	.33

Note. Honest Responders = General Population, ADHD, and other clinical samples (N = 2,879); Genuine ADHD = ADHD Reference Sample (N = 320); Fake ADHD = individuals from the Fake ADHD simulation study (N = 94); Fake Bad = individuals from the Fake Bad simulation study (N = 106).

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Table 6.7c. Classification Accuracy Statistics: Conners 4 Self-Report Negative Impression Index

Classification Accuracy Statistic	Fake ADHD vs. Honest Responders	Fake ADHD vs. Genuine ADHD	Fake Bad vs. Honest Responders
Overall Correct Classification (%)	96.3	90.2	96.6
Sensitivity (%)	62.5	62.5	80.0
Specificity (%)	97.2	95.1	97.0
Positive Predictive Value (%)	35.7	69.4	36.8
Negative Predictive Value (%)	99.0	93.4	99.5
Kappa	.44	.60	.49

Note. Honest Responders = General Population, ADHD, and other clinical samples (N = 1,592 for adolescents aged 13 to 18 years); Genuine ADHD = ADHD Reference Sample (N = 224 for adolescents aged 13 to 18 years); Fake ADHD = individuals from the Fake ADHD simulation study (N = 40 for adolescents aged 13 to 18 years); Fake Bad = individuals from the Fake Bad simulation study (N = 35 for adolescents aged 13 to 18 years).

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Table 6.8. Classification Accuracy Adjusted for Base Rate: Conners 4 Negative Impression Index

Study	Rater	10% Base Rate		60% Base Rate		70% Base Rate		80% Base Rate
Study	Rater	PPV (%)	NPV (%)	PPV (%)	NPV (%)	PPV (%)	NPV (%)	PPV (%)	NPV (%)
Fake ADHD vs. Honest Responders	Parent	69.9	91.3	93.3	63.6	94.2	60.0	94.9	56.7
	Teacher	69.8	90.1	93.3	62.4	94.2	58.8	95.5	55.5
	Self-Report	81.5	92.8	96.4	68.4	96.9	64.9	97.2	61.8
Fake ADHD vs. Genuine ADHD	Parent	71.8	91.3	93.9	63.7	94.7	60.1	95.7	95.3
	Teacher	53.5	90.5	87.4	61.3	89.0	57.6	90.2	54.3
	Self-Report	71.8	92.7	93.9	67.9	94.7	64.4	95.3	61.3
Fake Bad vs. Honest Responders	Parent	75.6	94.6	94.9	74.4	95.6	71.4	96.1	68.6
	Teacher	68.1	90.2	92.8	60.5	93.7	56.8	94.5	53.5
	Self-Report	84.1	96.0	97.0	80.2	97.4	77.6	97.7	75.2

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

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Table 6.9. Classification Accuracy Statistics: Conners 4 Parent and Teacher Negative Impression Index Validation Study

Classification Accuracy Statistic	Parent		Teacher
Classification Accuracy Statistic	Fake ADHD vs. Honest Responders	Fake ADHD vs. Genuine ADHD	Fake ADHD vs. Honest Responders	Fake ADHD vs. Genuine ADHD
Overall Correct Classification (%)	87.8	94.1	82.0	94.3
Sensitivity (%)	52.1	52.1	58.3	58.3
Specificity (%)	93.9	95.3	89.1	95.5
Positive Predictive Value (%)	59.5	24.6	61.5	30.1
Negative Predictive Value (%)	92.0	98.5	87.7	98.6
Kappa	.49	.31	.48	.37

Note. Honest Responders = General Population, ADHD, and other clinical samples (N = 3,255 for Parent; N = 2,879 for Teacher). Genuine ADHD = ADHD Reference Sample (N = 560 for Parent; N = 320 for Teacher). Fake ADHD N = 47 for Parent; N = 47 for Teacher.

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Table 6.10. Inconsistency Index Item Pairs: Conners 4 Parent

Item Stem 1	Item Stem 2	r
34. Making impulsive decisions	109. Being impulsive	.87
14. Needing to move around	86. Having trouble sitting still	.83
28. Creating stress for the family	88. Creating chaos for the family	.83
16. Refusing to follow the rules	83. Refusing to do what they are told	.77
40. Forgetting to turn in work	64. Handing things in late	.76
55. Interrupting others	97. Talking out of turn	.76
73. People don’t want to be friends with them	100. Having trouble making or keeping friends	.75

Note. All correlation coefficients (r) are significant, p < .001.

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Table 6.11. Inconsistency Index Item Pairs: Conners 4 Teacher

Item Stem 1	Item Stem 2	r
31. Making impulsive decisions	100. Being impulsive	.87
4. Losing their temper	60. Trouble controlling their temper	.86
17. Having trouble finishing tasks	32. Failing to finish things they start	.85
77. Talking before others are finished	90. Talking out of turn	.79
80. Having trouble sitting still	99. Fidgeting	.81
37. Forgetting to turn in work	22. Not knowing where or what their homework is	.77
34. Feeling angry and resentful	104. Having trouble controlling their anger	.77

Note. All correlation coefficients (r) are significant, p < .001.

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Table 6.12. Inconsistency Index Item Pairs: Conners 4 Self-Report

Item Stem 1	Item Stem 2	r
46. Worrying so much they get tired	75. Worrying too much	.73
8. Having too much energy to sit still	88. Having trouble sitting still	.72
12. Feeling sad, gloomy, or irritable	111. Feeling helpless	.70
68. Getting really angry	114. Having trouble controlling their anger	.64
48. Having trouble concentrating	58. Having trouble completing work	.64
7. Having trouble sleeping because of worry	26. Having trouble controlling their worries	.62
31. Creating stress for the family	89. Causing problems for family	.59
46. Worrying so much they get tired	75. Worrying too much	.56

Note. All correlation coefficients (r) are significant, p < .001.

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Table 6.13. Classification Accuracy Statistics: Conners 4 Inconsistency Index

Classification Accuracy Statistic	Parent		Teacher		Self-Report
Classification Accuracy Statistic	Random Responses vs.Best Effort Responders	Random Responses vs. ADHD	Random Responses vs. Best Effort Responders	Random Responses vs. ADHD	Random Responses vs. Best Effort Responders	Random Responses vs. ADHD
Overall Correct Classification (%)	88.6	83.7	88.8	82.6	88.7	87.9
Sensitivity (%)	81.6	81.6	80.8	80.8	88.4	88.4
Specificity (%)	95.8	98.2	97.4	99.1	89.1	84.8
Positive Predictive Value (%)	95.2	99.7	97.1	99.9	89.7	97.6
Negative Predictive Value (%)	83.3	43.6	82.6	36.5	87.7	51.3
Kappa	.77	.52	.78	.45	.77	.57

Note. Best Effort Responders = General Population and ADHD samples. ADHD = ADHD Reference Sample.

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Table 6.14. Breakdown of Unchanged, Modified, and New Content from the Conners 3 to Conners 4

Components		Parent				Teacher				Self-Report
Components		N items	% Unchanged	% Modified	% New	N items	% Unchanged	% Modified	% New	N items	% Unchanged	% Modified	% New
Negative Impression Index		8	0.0	12.5	87.5	7	0.0	14.3	85.7	8	0.0	0.0	100.0
Self-Harm Critical Items		2	0.0	0.0	100.0	2	0.0	0.0	100.0	3	0.0	0.0	100.0
Severe Conduct Critical Items		6	83.3	16.7	0.0	6	83.3	16.7	0.0	6	0.0	83.3	16,7
Content Scales	Inattention/Executive Dysfunction	20	30.0	45.0	25.0	20	30.0	45.0	25.0	20	20.0	40.0	40.0
	Hyperactivity	11	18.2	54.5	27.3	11	36.4	45.5	18.2	11	54.5	18.2	27.3
	Impulsivity	9	22.2	33.3	44.4	9	22.2	33.3	44.4	9	22.2	33.3	44.4
	Emotional Dysregulation	8	25.0	0.0	75.0	8	25.0	0.0	75.0	8	12.5	0.0	87.5
	Depressed Mood	6	16.7	50.0	33.3	6	16.7	33.3	50.0	6	50.0	0.0	50.0
	Anxious Thoughts	5	0.0	60.0	40.0	5	0.0	60.0	40.0	6	33.3	16.7	50.0
Impairment & Functional Outcome Scales	Schoolwork	6	16.7	0.0	83.3	6	16.7	0.0	83.3	7	0.0	14.3	85.7
	Peer Interactions	6	0.0	50.0	50.0	6	0.0	33.3	66.7	6	0.0	0.0	100.0
	Family Life	7	0.0	0.0	100.0	0	0.0	0.0	0.0	6	0.0	0.0	100.0
DSM Symptom Scales	ADHD Inattentive Symptoms	11	27.3	63.6	9.1	11	18.2	72.7	9.1	12	16.7	58.3	25.0
	ADHD Hyperactive/Impulsive Symptoms	13	23.1	61.5	15.4	13	30.8	53.8	15.4	12	58.3	16.7	25.0
	Oppositional Defiant Disorder Symptoms	10	50.0	30.0	20.0	10	60.0	20.0	20.0	10	40.0	30.0	30.0
	Conduct Disorder Symptoms	15	66.7	33.3	0.0	13	76.9	23.1	0.0	15	20.0	73.3	6.7
Total Test		117a	25.6	30.8	43.6	109a	30.3	28.4	41.3	118a	22.0	24.6	53.4

Note. The Inconsistency Index and ADHD Index are not listed above because the items in these scales are found, and thus accounted for, in the other scales.

^a The totals provided are not equal to the sum of the scale item counts because some items are found in multiple scales. The Total Test values represent the number of unique items within the test, including the additional questions .

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Table 6.15. Breakdown of Unchanged, Modified, and New Content from the Conners 3 Short Form to Conners 4-Short

Components		Parent				Teacher				Self-Report
Components		N items	% Unchanged	% Modified	% New	N items	% Unchanged	% Modified	% New	N items	% Unchanged	% Modified	% New
Negative Impression Index		8	0.0	12.5	87.5	7	0.0	14.3	85.7	8	0.0	0.0	100.0
Content Scales	Inattention/Executive Dysfunction	10	30.0	33.3	60.0	10	0.0	20.0	80.0	10	0.0	10.0	90.0
	Hyperactivity	5	0.0	40.0	60.0	5	0.0	40.0	60.0	5	20.0	40.0	40.0
	Impulsivity	5	0.0	0.0	100.0	5	0.0	0.0	100.0	5	0.0	0.0	100.0
	Emotional Dysregulation	4	0.0	0.0	100.0	4	0.0	0.0	100.0	4	0.0	0.0	100.0
Impairment & Functional Outcome Scales	Schoolwork	4	0.0	0.0	100.0	4	0.0	0.0	100.0	4	0.0	0.0	100.0
	Peer Interactions	4	0.0	25.0	75.0	4	0.0	25.0	75.0	4	0.0	0.0	100.0
	Family Life	4	0.0	0.0	100.0	0	0.0	0.0	0.0	4	0.0	0.0	100.0
ADHD Indexa		12	0.0	0.0	100.0	12	0.0	0.0	100.0	12	0.0	0.0	100.0
Total Test		53b	5.7	7.5	66.0	49b	0.0	12.2	75.5	51b	2.0	5.9	84.3

^a The ADHD Index is not part of the Conners 3 Short form so the items for this scale are all new for the Conners 4 – Short. However, because some of the items in this scale are found, and thus accounted for, in the other scales, only the unique items (i.e., not found in other scales) are counted towards the percentages.

^b The totals provided are not equal to the sum of the scale item counts because some items are found in multiple scales. The Total Test values represent the number of unique items within the test, including the additional questions .