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C. Keith Conners, Ph.D.
DSM-5 UPDATE
™
Contact MHS1-800-456-3003 (U.S.) 1-800-268-6011 (Canada) +1-416-492-2627 (International) [email protected] www.mhs.com
This update was edited and typeset by David Wiechorek using InDesign CS6 and Microsoft Word 2010, using the Times New Roman, Arial, Verdana, and Myriad Pro fonts. The cover was designed by Dyan Buerano using Adobe InDesign CS6 and Adobe Illustrator CS6.
Conners Comprehensive Behavior Rating Scales and Conners CBRS are trademarks of Multi-Health Systems Inc.
DSM, DSM-IV, DSM-IV-TR, and DSM-5 are trademarks of the American Psychiatric Association.
Copyright © 2014 Multi-Health Systems Inc. All rights reserved. No part of this technical report, or any related materials protected by copyrights are to be printed or otherwise reproduced by any means, including electronic storage within a computer program or database, without the permission of the publisher. These materials may not be translated into a natural or computer language without permission. This copyright is protected through the laws of the United States, Canada, and other countries. Persons who violate the copyrights on these materials may be liable to prosecution. Ethical codes of various professional associations to which users are likely to belong specifically prohibit both illegal behaviors and actions that would deny other parties fair compensation for their work. Persons who violate professional ethical codes related to inappropriate and unfair use of these materials may be brought before the relevant professional associations to which they belong. The information included in this technical report does not constitute, and shall not be considered, the advice, recommendation, assessment, or endorsement of MHS. To the extent permitted by law, any statutory or implied warranty of merchantability or fitness for a particular purpose is completely denied and disclaimed. MHS shall not be liable for any third party claims, lost profits, lost savings, loss of information, or any other incidental damages or other economic consequential damages resulting from the use of the technical report.
Published in Canada by Multi-Health Systems Inc.
Printed in Canada.
July, 2014
Conners Comprehensive Behavior Rating Scales™ (Conners CBRS™)
DSM-5 Update
C. Keith Conners, Ph.D.
OverviewThe Conners Comprehensive Behavior Rating Scales™ (Conners CBRS™) features direct links between scale content on the full-length forms (i.e., Conners CBRS Parent [Conners CBRS–P], Conners CBRS Teacher [Conners CBRS–T], and Conners CBRS Self-Report [Conners CBRS–SR]), and symptom criteria in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR; American Psychiatric Association, 2000). The symptom criteria assessed on the Conners CBRS correspond to the following disorders: Attention-Deficit/Hyperactivity Disorder (ADHD), Conduct Disorder (CD), Oppositional Defiant Disorder (ODD), Major Depressive Episode, Manic Episode, Generalized Anxiety Disorder (GAD), Separation Anxiety Disorder, Social Phobia, Obsessive-Compulsive Disorder (OCD), Autistic Disorder, and Asperger’s Disorder. Items on the Conners CBRS DSM Symptom Scales approximate symptom-level criteria from the DSM; diagnostic criteria (e.g., course, age of onset, differential diagnosis, level of impairment, and pervasive-ness) are not represented in its entirety. (See the DSM for full diagnostic criteria.)
The American Psychiatric Association released a new edition of the DSM in May, 2013: The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5; APA, 2013). As a result, the Conners CBRS was reviewed to evaluate essential changes to scoring and interpretation of the assessment, including updates to software and online components (e.g., the Assessment, Progress, and Compara-tive reports). A few minor changes bring scoring and inter-pretation of the DSM Symptom Scales on the Conners CBRS in line with new diagnostic criteria. One substantial update in the DSM-5, the reconceptualization of the Pervasive Devel-opmental Disorders, informed scoring and interpretation of a new DSM Symptom Scale for Autism Spectrum Disorder (ASD); however, essentially the same items comprise this scale as were represented on the Conners CBRS for Autistic Disorder and Asperger’s Disorder (with the exception of items related to delayed communication, which is no longer a criterion of ASD; see Table 1 for details).
Changes to the Conners CBRS Corresponding to DSM-5 Criteria Updates The main source for administration, scoring, and interpretation information is still the Conners CBRS Manual. Updates to symptom criteria for ADHD, ODD, Major Depressive Episode, Manic Episode, Social Phobia, Obsessive-Compulsive Disorder (OCD), Autistic Disorder, and Asperger’s Disorder are outlined in this update, as are changes made to scoring and interpretative considerations in the Conners CBRS (see Table 1 for a summary of changes; see Tables 2a to 13 for DSM-5 criteria, the associated Conners CBRS form items, and the response choices for when symptoms are Indicated, May be Indicated, or Not Indicated). Psychometric properties for any of the DSM Symptom Scales with items that were added or deleted (i.e., Major Depressive Episode, Social Anxiety Disorder [Social Phobia]), OCD, and ASD) are also provided in this update (see Standardization and Reliability of the Conners CBRS DSM-5 Symptom Scales). Symptom criteria covered by the Conners CBRS for CD, GAD, and Separation Anxiety Disorder did not change (see Tables 3, 9 and 10).
A DSM scoring option is now included among the report options to allow the assessor to choose either DSM-IV-TR scoring or DSM-5 scoring:
• Selecting the DSM-IV-TR scoring option will produce reports identical to the original Conners CBRS reports.
• Selecting the DSM-5 scoring option will produce reports that include DSM-5 raw scores, T-scores, Symptom Counts and interpretative considerations.
The DSM-5 scoring option includes the following changes:
i. An update to the ADHD Symptom Count for 17- to 18-year-olds.
ii. An amendment to the order of ODD Criterion A symptoms, as well as to the symptom count requirements on the self-report form for ODD Criterion A8 (Note: parent and teacher forms were not impacted by the modification to Criterion A8).
1
Conners Comprehensive Behavior Rating Scales™ (Conners CBRS™)
2
iii. An additional item for Major Depressive Episode, Criterion A1, and feedback on the “With mixed features” specifier for Major Depressive Episode.
iv. A change to the symptom count requirements for Manic Episode, Criterion A, and feedback on the “With mixed features” specifier for Manic Episode.
v. Reworking of symptom count requirements for Social Anxiety Disorder (Social Phobia), including the deletion of two items, as well as the addition of one item to Criterion B.
vi. Fewer and reorganized items on the OCD Symptom Scale.
vii. Restructured and integrated symptom count requirements for Autistic Disorder and Asperger’s Disorder, resulting in a single ASD scale.
All scoring and structural changes to the DSM Symptom Scales are outlined in Table 1. As with the original DSM-IV-TR Symptom Scales, several interpretive notes are provided in the computerized reports to further enhance the interpretation of the Conners CBRS results. The bolded notes under Tables 2a to 13 provide the updated DSM-5 interpretative considerations.
Table 1. Changes to the DSM Symptom Scales
Symptom Scale Change to DSM-5 Change to Conners CBRS
Attention-Deficit/Hyperactivity Disorder
Fewer symptoms (5 rather than 6) are required for older adolescents and adults (17 years and older).
For individuals aged 17 years and older, and for both ADHD Predominantly Inattentive Presentation, and ADHD Predominantly Hyperactive-Impulsive Presentation, the Symptom Count is probably met when 5 or more symptoms are endorsed. ADHD Combined Presentation requires 5 or more symptoms from each of inattentive and hyperactive-impulsive symptom criteria.
ADHD subtypes are reclassified as presentations.
The DSM-5 ADHD Symptom Scales are renamed: ADHD Predominantly Inattentive Presentation, ADHD Predominantly Hyperactive-Impulsive Presentation, and ADHD Combined Presentation.
Oppositional Defiant Disorder
Criterion A symptoms are reorganized into three categories: Angry/Irritable Mood, Argumentative/Defiant Behavior, and Vindictiveness.
Any tables in the Conners CBRS reports that present ODD symptom criteria and/or corresponding items on the DSM-5 ODD Symptom Scale are reorganized with subheadings. Symptom criteria are reordered accordingly.
A frequency qualifier of no less than twice in 6 months is added to Criterion A8, spiteful or vindictive behavior.
Symptom Count scoring criteria for the parent and teacher forms account for this frequency of spiteful or vindictive behavior; a score of 1 (Just a little true; Occasionally) is used to reflect the frequency expressed in the DSM-5. Criterion status score requirements are updated on the Conners CBRS–SR; a score of 1 now also contributes to the Symptom Count.
Major Depressive Episode
Criterion A1 includes hopelessness among the examples of subjective report of depressed mood.1
An existing Conners CBRS item that accounts for a hopeless manifestation of depressed mood has been assigned to the Symptom Count, raw score, and T-score.
Manic Episode Increased goal-directed activity or increased energy is a symptom covered by Criterion A.
An existing Conners CBRS item for Criterion B6 (i.e., increase in goal-directed activity or psychomotor agitation) has been integrated into the Symptom Count for Criterion A (see Table 7). The raw score formula that is used to calculate the Manic Episode T-score is unaffected by this addition (i.e., the item is summed only once in calculating the raw score for Manic Episode).
Table continued next page...
DSM-5 Update
3
Table 1. (continued) Changes to the DSM Symptom Scales
Symptom Scale Change to DSM-5 Change to Conners CBRS
Mixed Episode Mixed Episode is removed from the DSM-5 Bipolar and Related Disorders section and has been replaced with:• a “With mixed features” specifier that
outlines manic symptoms that would lead to a classification of Depressive Episode, with mixed features
• a “With mixed features” specifier that outlines depressive symptoms that would lead to a classification of Manic Episode, with mixed features.
The Mixed Episode section of the Conners CBRS reports has been removed.
When the Symptom Count is probably met for Major Depressive Episode, a note beneath the DSM-5 Manic Episode Symptom Table in the Conners CBRS reports highlights the manic symptoms that comprise mixed features and details which of these symptoms are Indicated, May be Indicated, or Not Indicated. Interpretative considerations are outlined in a separate section of the Assessment report labeled Mixed Features.
When the Manic Episode Symptom Count is probably met, a note appears below the DSM-5 Major Depressive Episode Symptom Table in the Conners CBRS reports. This note highlights the depressive symptoms that are Indicated, May be Indicated, or Not Indicated for the mixed features specifier. A separate Mixed Features section in the Assessment report outlines interpretative considerations related to this specifier.
Social Anxiety Disorder (Social Phobia)
All of Criteria A, B, C, and D are required. For the Symptom Count to be probably met, the Conners CBRS item responses must result in all of the criteria being designated as Indicated/May be Indicated.
Criterion A no longer requires evidence of the capacity for age appropriate social relationships.
The Conners CBRS item, “Is unable to develop peer relationships” (parent and teacher form), “I get along with people once I am comfortable with them” (self-report form), has been dropped from the Symptom Count for Social Phobia.
DSM-IV-TR, Criterion A is split into two components: (1) the feared social situation (Criterion A); and (2) the feared reaction or behavior (Criterion B).
• Conners CBRS items measuring these different components were consequently reapplied to the appropriate criterion (see Table 11).
• To cover the new emphasis in Criterion B on fear of negative evaluation, the item “Worries about what others think of him/her” was added to the Symptom Count (see Table 11).
• Criterion C qualifies Criterion A, stating that “the social situations almost always provoke fear or anxiety.”
• Criterion C specifies how fear or anxiety may be expressed in children (i.e., “by crying, tantrums, freezing, clinging, shrinking, or failing to speak in social situations”).
• The same item on the Conners CBRS applies both to Criterion A and C (“Panics about social situations or when doing things in front of other people”), addressing the feared social situation component, as well as the qualification that fear or anxiety almost always occurs in response to the feared social situation.
• An item that measures these child-specific expressions of fear or anxiety (i.e., “Cries, throws tantrums, avoids, or freezes in social situations with unfamiliar people”) contributes to symptoms for Criterion C.
Obsessive-Compulsive Disorder
• Two symptom criteria (DSM-IV-TR A2 and A4) are removed from Obsessions, Criterion A.
• Wording for Criterion A1 has been modified such that the obsessions cause marked anxiety or distress in most individuals.
The item that measured the DSM-IV-TR Obsessions, Criterion A2 symptom (“Worries about things that are not real life problems”), has been deleted from the OCD Symptom Count. The item that formerly measured the DSM-IV-TR Obsessions, Criterion A4 symptom (“Creates thoughts or pictures that get stuck in his/her mind” [parent and teacher report] or “I create upsetting thoughts or pictures that get stuck in my mind” [self-report]) has been repurposed in the DSM-5 scale to measure Obsessions, Criterion A1 (see Table 12). That is, to account for the change in language to Criterion A1 (that obsessions cause marked anxiety or distress in most individuals), an item was added that measures obsessions, separate from the upsetting reaction to these thoughts, urges, or images. The parent and teacher version of this item does not require that obsessive thoughts are anxiety-provoking or cause distress, thus accounting for the qualifier that only “in most individuals” is distress associated with obsessions. Because the equivalent item on the self-report includes the term “upsetting,” if Criterion A1 (item 94 or 31) is not endorsed on the self-report, follow-up is recommended to determine if the individual has obsessive thoughts that do not cause anxiety or distress.
Table continued next page...
Conners Comprehensive Behavior Rating Scales™ (Conners CBRS™)
4
Table 1. (continued) Changes to the DSM Symptom Scales
Symptom Scale Change to DSM-5 Change to Conners CBRS
Autism Spectrum Disorder
The Pervasive Developmental Disorders, including Autistic Disorder and Asperger’s Disorder, are reorganized into one all-encompassing classification: ASD.
DSM Symptom Scales for Autistic Disorder and Asperger’s Disorder are reorganized into a DSM-5 Symptom Scale for ASD, which assesses (1) deficits in social communication and social interaction, and (2) restricted repetitive patterns of behavior, interests, and activities. Items on the Conners CBRS are restructured accordingly. Two items—“Was a late talker” on the parent form, and “Uses spoken language to communicate” on the teacher form—no longer apply to symptom criteria and are neither included in the Symptom Count, nor in the raw score and T-score calculations.
Criteria regarding the absence of “spontaneous make-believe or social imitative play,” and “persistent preoccupation with parts of objects” are removed.
Items covering these concepts (i.e., “Lacks varied, spontaneous make-believe play” and “Is over-focused or over-interested in one part of an object or toy”) do not contribute to the Symptom Count for ASD, because this count is based on direct association of items to symptom criteria in the DSM-5.2
1 Not all behavioral examples noted in the DSM symptom criteria are represented on the Conners CBRS DSM Symptom Scales. Expert review of DSM-5 criteria led to the determination that because hopelessness is a main feature of the cognitive theory of depression (Beck, Rush, Shaw, & Emery, 1979), and cognitive-behavioral therapy is “currently the treatment of choice for anxiety and depressive disorders in children and adoles-cents” (Compton, March, Brent, Albano, Weersing, & Curry, 2004, p. 930), it is important to measure this concept on the Conners CBRS.2 Expert review of changes to diagnostic criteria for ASD drove the determination that although the language of these items no longer directly corresponds to DSM-5 symptom criteria, the concepts covered by the items represent core aspects of the disorder. The absence of social-imitative play is a symptom that is related to the broad category of deficits in social communication and social interaction, and captures an important devel-opmental precursor to the types of behaviors assessed by ASD, Criterion A (e.g., Fuchs, 2013; Gallese & Goldman, 1998; Rizzolatti & Craighero, 2004; Toth, Munson, Meltzoff, & Dawson, 2006). Similarly, a focus on parts of objects applies broadly to the different areas covered by ASD, Criterion B, restricted repetitive patterns of behaviors, interests, or activities: A child that becomes focused on one part of an object or toy may be doing so due to the stereotyped or repetitive use of it (Criterion B1), the ritualized pattern or sense of sameness provided by it (Criterion B2), a preoccupation with the object itself (Criterion B3), or the smell or feel of the object (Criterion B4). As such, these two items are included in the raw score (and therefore, T-score) calculation for ASD.
DSM-5 Update
5
Tabl
e 2a
. D
SM-5
Sym
ptom
Cou
nt a
nd C
riter
ion
Stat
us S
core
Req
uire
men
ts fo
r AD
HD
D
SM-5
Sym
ptom
Cou
nt R
equi
rem
ents
:•ADHDPredominantlyInattentivePresentation:Atleast6ofthe9sym
ptom
sforindividuals≤16yearsofage;atleast5ofthe9sym
ptom
sforindividuals≥17yearsofage.
•ADHDCom
binedPresentation:Meetscriteriaforb
othInattentiveandHyperactive-Impulsivepresentations.
DS
M-5
Cri
teri
on A
Form
Item
Item
#
Indicated
May be Indicated
Not Indicated
Oft
en f
ails
to
giv
e cl
ose
atte
nti
on t
o d
etai
ls o
r m
akes
car
eles
s m
ista
kes
in s
choo
lwor
k, a
t w
ork,
or
du
rin
g o
ther
act
ivit
ies
(e.g
.,
over
look
s or
mis
ses
det
ails
, w
ork
is in
accu
rate
).1a
PD
oesn
’t pa
y at
tent
ion
to d
etai
ls; m
akes
car
eles
s mis
take
s.12
3, 2
–1,
0
TD
oesn
’t pa
y at
tent
ion
to d
etai
ls; m
akes
car
eles
s mis
take
s.5
3, 2
–1,
0
SRIt
is h
ard
for m
e to
pay
atte
ntio
n to
det
ails
.81 -o
r- 37
3, 2
-or- 3
–1,
0-a
nd-
1, 0
I mak
e m
ista
kes b
y ac
cide
nt.
2
Oft
en h
as d
ifficu
lty
sust
ain
ing
att
enti
on in
tas
ks o
r p
lay
acti
viti
es (
e.g
., h
as d
ifficu
lty
rem
ain
ing
foc
use
d d
uri
ng
lect
ure
s,
con
vers
atio
ns,
or
len
gth
y re
adin
g).
1bP
Has
trou
ble
keep
ing
his/
her m
ind
on w
ork
or o
n pl
ay fo
r lon
g.13
63,
2–
1, 0
TH
as tr
oubl
e ke
epin
g hi
s/he
r min
d on
wor
k or
pla
y fo
r lon
g.44
3, 2
–1,
0SR
I hav
e tro
uble
kee
ping
my
min
d on
wha
t I a
m d
oing
.10
13,
2–
1, 0
Oft
en d
oes
not
see
m t
o lis
ten
wh
en s
pok
en t
o d
irec
tly
(e.g
., m
ind
se
ems
else
wh
ere,
eve
n in
th
e ab
sen
ce o
f an
y ob
viou
s d
istr
acti
on).
1cP
Doe
s not
seem
to li
sten
to w
hat i
s bei
ng sa
id to
him
/her
.86
3, 2
–1,
0T
Doe
s not
seem
to li
sten
to w
hat i
s bei
ng sa
id to
him
/her
.11
73,
2–
1, 0
SRI h
ave
troub
le k
eepi
ng m
y m
ind
on w
hat p
eopl
e ar
e sa
ying
to m
e.9
3, 2
–1,
0
Oft
en d
oes
not
fol
low
th
rou
gh
on
inst
ruct
ion
s an
d f
ails
to
fin
ish
sc
hoo
lwor
k, c
hor
es,
or d
uti
es in
th
e w
orkp
lace
(e.
g.,
sta
rts
task
s b
ut
qu
ickl
y lo
ses
focu
s an
d is
eas
ily s
idet
rack
ed).
1d
P
Doe
s not
follo
w th
roug
h on
inst
ruct
ions
(eve
n w
hen
he/s
he u
nder
-st
ands
and
is tr
ying
to c
oope
rate
).65 -and
-8
3, 2
-and
-3,
2
–1,
0-o
r-1,
0Fa
ils to
com
plet
e sc
hool
wor
k, c
hore
s, or
task
s (ev
en w
hen
he/s
he
unde
rsta
nds a
nd is
tryi
ng to
coo
pera
te).
–
T
Doe
s not
follo
w th
roug
h on
inst
ruct
ions
(eve
n w
hen
he/s
he
unde
rsta
nds a
nd is
tryi
ng to
coo
pera
te).
109
-and
-20
3, 2
-and
-3,
2
–1,
0-o
r-1,
0Fa
ils to
com
plet
e sc
hool
wor
k or
task
s (ev
en w
hen
he/s
he
unde
rsta
nds a
nd is
tryi
ng to
coo
pera
te).
–
SRI h
ave
troub
le fo
llow
ing
inst
ruct
ions
.12
9-a
nd-
103
3, 2
-and
-3,
2
–1,
0-o
r-1,
0I h
ave
troub
le fi
nish
ing
thin
gs.
–
Oft
en h
as d
ifficu
lty
org
aniz
ing
tas
ks a
nd
act
ivit
ies
(e.g
., d
ifficu
lty
man
agin
g s
equ
enti
al t
asks
; d
ifficu
lty
keep
ing
mat
eria
ls a
nd
b
elon
gin
gs
in o
rder
; m
essy
, d
isor
gan
ized
, w
ork;
has
poo
r ti
me
man
agem
ent;
fai
ls t
o m
eet
dea
dlin
es).
1e
PH
as tr
oubl
e or
gani
zing
task
s or a
ctiv
ities
.23
3, 2
−1,
0
TH
as d
ifficu
lty o
rgan
izin
g ta
sks o
r act
iviti
es.
503,
2−
1, 0
SRI h
ave
troub
le k
eepi
ng m
ysel
f org
aniz
ed.
323
21,
0
Oft
en a
void
s, d
islik
es,
or is
rel
uct
ant
to e
ng
age
in t
asks
th
at
req
uir
e su
stai
ned
men
tal e
ffor
t (e
.g.,
sch
oolw
ork
or h
omew
ork;
for
ol
der
ad
oles
cen
ts a
nd
ad
ult
s, p
rep
arin
g r
epor
ts,
com
ple
tin
g f
orm
s,
revi
ewin
g le
ng
thy
pap
ers)
.
1f
PAv
oids
or d
islik
es th
ings
that
take
a lo
t of e
ffort
and
are
not f
un.
833
21,
0
TAv
oids
or d
islik
es th
ings
that
take
a lo
t of e
ffort
and
are
not f
un.
423
21,
0
SRI d
on’t
like
doin
g th
ings
that
mak
e m
e th
ink
hard
.28
32
1, 0
Oft
en lo
ses
thin
gs
nec
essa
ry f
or t
asks
or
acti
viti
es (
e.g
., s
choo
l m
ater
ials
, p
enci
ls,
boo
ks,
tool
s, w
alle
ts,
keys
, p
aper
wor
k,
eyeg
lass
es,
mob
ile t
elep
hon
es).
1gP
Lose
s thi
ngs (
for e
xam
ple,
scho
olw
ork,
pen
cils
, boo
ks, t
ools
, or
toys
).96
3, 2
−1,
0
TLo
ses t
hing
s (e.
g., s
choo
lwor
k, p
enci
ls, b
ooks
, too
ls, o
r toy
s).
823,
2−
1, 0
SRI l
ose
stuf
f tha
t I n
eed.
116
3, 2
−1,
0Ta
ble
cont
inue
d ne
xt p
age.
..
Conners Comprehensive Behavior Rating Scales™ (Conners CBRS™)
6
Tabl
e 2a
. (
cont
inue
d) D
SM-5
Sym
ptom
Cou
nt a
nd C
riter
ion
Stat
us S
core
Req
uire
men
ts fo
r AD
HD
DS
M-5
Cri
teri
on A
Form
Item
Item
#
Indicated
May be Indicated
Not Indicated
Is o
ften
eas
ily d
istr
acte
d b
y ex
tran
eou
s st
imu
li (f
or o
lder
ad
oles
cen
ts a
nd
ad
ult
s, m
ay in
clu
de
un
rela
ted
th
oug
hts
).1h
a
PIs
eas
ily d
istra
cted
by
sigh
ts o
r sou
nds.
154
3, 2
−1,
0T
Is e
asily
dis
tract
ed b
y si
ghts
or s
ound
s.60
3, 2
−1,
0SR
I get
dis
tract
ed b
y th
ings
that
are
goi
ng o
n ar
ound
me.
653
21,
0
Is o
ften
for
get
ful i
n d
aily
act
ivit
ies
(e.g
., d
oin
g c
hor
es,
run
nin
g
erra
nd
s; f
or o
lder
ad
oles
cen
ts a
nd
ad
ult
s, r
etu
rnin
g c
alls
, p
ayin
g
bill
s, a
nd
kee
pin
g a
pp
oin
tmen
ts).
1iP
Is fo
rget
ful i
n da
ily a
ctiv
ities
.1
3, 2
−1,
0T
Is fo
rget
ful i
n da
ily a
ctiv
ities
.15
13,
2−
1, 0
SRI f
orge
t stu
ff.15
43
21,
0
DSM
-5 D
iagn
ostic
Crit
eria
is re
prin
ted
with
per
mis
sion
from
the
Dia
gnos
tic a
nd S
tatis
tical
Man
ual o
f Men
tal D
isor
ders
, Fift
h Ed
ition
™, (
Cop
yrig
ht ©
201
3). A
mer
ican
Psy
chia
tric A
ssoc
iatio
n.
All
Rig
hts R
eser
ved.
The
Am
eric
an P
sych
iatri
c Ass
ocia
tion
is n
ot a
ffilia
ted
with
and
is n
ot e
ndor
sing
this
pro
duct
.
Not
es:
P =
pare
nt; T
= te
ache
r; SR
= se
lf-re
port.
The
follo
win
g re
spon
se k
ey a
pplie
s to
the
crite
rion
stat
us sc
ore
requ
irem
ents
not
ed in
the
Indi
cate
d, M
ay b
e In
dica
ted,
and
Not
Indi
cate
d co
lum
ns:
0 =
Not
true
at a
ll (N
ever
, Sel
dom
); 1
= Ju
st a
littl
e tru
e (O
ccas
iona
lly);
2 =
Pret
ty m
uch
true
(Ofte
n, Q
uite
a b
it); 3
= V
ery
muc
h tru
e (V
ery
ofte
n, V
ery
freq
uent
ly).
Inte
rpre
tativ
e C
onsi
dera
tions
: W
hen
cons
ider
ing
DSM
-5 sy
mpt
om c
rite
ria
for A
DH
D, t
he a
sses
sor
need
s to
ensu
re th
at th
e sy
mpt
oms a
re n
ot so
lely
a m
anife
stat
ion
of o
ppos
ition
al b
ehav
ior,
defia
nce,
hos
tility
, or
failu
re to
und
er-
stan
d ta
sks o
r in
stru
ctio
ns.
a Cri
teri
on A
1h st
ates
that
in o
lder
ado
lesc
ents
, the
tend
ency
to b
e ea
sily
dis
trac
ted
by e
xtra
neou
s sti
mul
i may
incl
ude
unre
late
d th
ough
ts a
s the
sour
ce o
f dis
trac
tion.
Fol
low
-up
is r
ecom
men
ded
to
che
ck if
Cri
teri
on A
1h h
as b
een
met
.
DSM-5 Update
7
Tabl
e 2b
. D
SM-5
Sym
ptom
Cou
nt a
nd C
riter
ion
Stat
us S
core
Req
uire
men
ts fo
r AD
HD
D
SM-5
Sym
ptom
Cou
nt R
equi
rem
ents
: •ADHDPredominantlyHyperactive-ImpulsivePresentation:Atleast6ofthe9sym
ptom
sforindividuals≤16yearsofage;atleast5ofthe9sym
ptom
sforthose≥17yearsofage.
•ADHDCom
binedPresentation:Meetscriteriaforb
othInattentiveandHyperactive-Impulsivepresentations.
DS
M-5
Cri
teri
on A
Form
Item
Item
#
Indicated
May be Indicated
Not Indicated
Oft
en fi
dg
ets
wit
h o
r ta
ps
han
ds
or f
eet
or s
qu
irm
s in
sea
t.2a
PFi
dget
s or s
quirm
s in
seat
.11
73,
2−
1, 0
TFi
dget
s or s
quirm
s in
seat
.86
3, 2
−1,
0SR
It is
har
d fo
r me
to si
t stil
l.51
32
1, 0
Oft
en le
aves
sea
t in
sit
uat
ion
s w
hen
rem
ain
ing
sea
ted
is e
xpec
ted
(e
.g.,
leav
es h
is o
r h
er p
lace
in t
he
clas
sroo
m,
in t
he
office
or
oth
er
wor
kpla
ce,
or in
oth
er s
itu
atio
ns
that
req
uir
e re
mai
nin
g in
pla
ce).
2bP
Leav
es se
at w
hen
he/s
he sh
ould
stay
seat
ed.
283,
2−
1, 0
TLe
aves
seat
whe
n he
/she
shou
ld st
ay se
ated
.11
23,
2−
1, 0
SRI g
et o
ut o
f my
seat
whe
n I a
m n
ot su
ppos
ed to
.11
03,
2−
1, 0
Oft
en r
un
s ab
out
or c
limb
s in
sit
uat
ion
s w
her
e it
is in
app
rop
riat
e.
(Not
e: I
n a
dol
esce
nts
or
adu
lts,
may
be
limit
ed t
o fe
elin
g r
estl
ess.
)2c
a
PR
uns o
r clim
bs w
hen
he/s
he is
not
supp
osed
to.
32 -or- 89
3, 2
-or-
3, 2
1 -or- 1
0-a
nd-
0R
estle
ss o
r ove
ract
ive.
TR
uns o
r clim
bs w
hen
he/s
he is
not
supp
osed
to.
51 -or-
139
3, 2
-or-
3, 2
1 -or- 1
0-a
nd-
0R
estle
ss o
r ove
ract
ive.
SRI r
un o
r clim
b ev
en w
hen
I am
not
supp
osed
to.
114
-or- 86
3, 2
-or-
3, 2
–1,
0-a
nd-
1,0
I am
rest
less
.–
Oft
en u
nab
le t
o p
lay
or e
ng
age
in le
isu
re a
ctiv
itie
s q
uie
tly.
2dP
Is n
oisy
and
loud
whe
n pl
ayin
g or
usi
ng fr
ee ti
me.
148
3, 2
−1,
0T
Is n
oisy
and
loud
whe
n pl
ayin
g or
usi
ng fr
ee ti
me.
103,
2−
1, 0
SRI h
ave
troub
le p
layi
ng o
r doi
ng th
ings
qui
etly
.82
3, 2
−1,
0
Is o
ften
“on
th
e g
o,”
acti
ng
as
if “
dri
ven
by
a m
otor
” (e
.g.,
is
un
able
to
be
or u
nco
mfo
rtab
le b
ein
g s
till
for
exte
nd
ed t
ime,
as
in r
esta
ura
nts
, m
eeti
ng
s; m
ay b
e ex
per
ien
ced
by
oth
ers
as b
ein
g
rest
less
or
diffi
cult
to
keep
up
wit
h).
2e
PA
cts a
s if d
riven
by
a m
otor
.18
0-o
r- 16
3, 2
-or-
3, 2
1 -or- 1
0-a
nd-
0Is
con
stan
tly m
ovin
g
TA
cts a
s if d
riven
by
a m
otor
.6 -or- 49
3, 2
-or-
3, 2
1 -or- 1
0-a
nd-
0Is
con
stan
tly m
ovin
g.
SRI f
eel l
ike
I am
driv
en b
y a
mot
or.
29 -or- 71
3, 2
-or- 3
1 -or- 2
0-a
nd-
1,0
I lik
e to
be
on th
e go
rath
er th
an b
eing
in o
ne p
lace
.
Oft
en t
alks
exc
essi
vely
.2f
PTa
lks t
oo m
uch.
104
3, 2
−1,
0T
Talk
s too
muc
h.16
43,
2−
1, 0
SRI t
alk
too
muc
h.76
3, 2
−1,
0
Tabl
e co
ntin
ued
next
pag
e...
Conners Comprehensive Behavior Rating Scales™ (Conners CBRS™)
8
Tabl
e 2b
. (
cont
inue
d) D
SM-5
Sym
ptom
Cou
nt a
nd C
riter
ion
Stat
us S
core
Req
uire
men
ts fo
r AD
HD
DS
M-5
Cri
teri
on A
Form
Item
Item
#
Indicated
May be Indicated
Not Indicated
Oft
en b
lurt
s ou
t an
an
swer
bef
ore
a q
ues
tion
has
bee
n c
omp
lete
d
(e.g
., c
omp
lete
s p
eop
le's
sen
ten
ces;
can
not
wai
t fo
r tu
rn in
co
nve
rsat
ion
).2g
PB
lurts
out
ans
wer
s bef
ore
the
ques
tion
has b
een
com
plet
ed.
193,
2−
1, 0
TB
lurts
out
ans
wer
s bef
ore
the
ques
tion
has b
een
com
plet
ed.
333,
2−
1, 0
SRI b
lurt
out t
he a
nsw
er b
efor
e th
e qu
estio
n is
fini
shed
.25
3, 2
−1,
0
Oft
en h
as d
ifficu
lty
wai
tin
g h
is o
r h
er t
urn
(e.
g.,
wh
ile w
aiti
ng
in
line)
.2h
PH
as d
ifficu
lty w
aitin
g fo
r his
/her
turn
.99
3, 2
−1,
0T
Has
diffi
culty
wai
ting
for h
is/h
er tu
rn.
185
3, 2
−1,
0SR
I hav
e tro
uble
wai
ting
for m
y tu
rn.
993,
2−
1, 0
Oft
en in
terr
up
ts o
r in
tru
des
on
oth
ers
(e.g
., b
utt
s in
to
con
vers
atio
ns,
gam
es,
or a
ctiv
itie
s; m
ay s
tart
usi
ng
oth
er p
eop
le’s
th
ing
s w
ith
out
aski
ng
or
rece
ivin
g p
erm
issi
on;
for
adol
esce
nts
an
d
adu
lts,
may
intr
ud
e in
to o
r ta
ke o
ver
wh
at o
ther
s ar
e d
oin
g).
2iP
Inte
rrup
ts o
ther
s (fo
r exa
mpl
e, b
utts
into
con
vers
atio
ns o
r gam
es).
169
3, 2
−1,
0T
Inte
rrup
ts o
ther
s (e.
g., b
utts
into
con
vers
atio
ns o
r gam
es).
145
3, 2
−1,
0SR
I int
erru
pt o
ther
peo
ple.
173,
2−
1, 0
DSM
-5 D
iagn
ostic
Crit
eria
is re
prin
ted
with
per
mis
sion
from
the
Dia
gnos
tic a
nd S
tatis
tical
Man
ual o
f Men
tal D
isor
ders
, Fif
th E
ditio
n ™
, (C
opyr
ight
©20
13).
Am
eric
an P
sych
iatr
ic A
ssoc
iatio
n.
All
Rig
hts R
eser
ved.
The
Am
eric
an P
sych
iatr
ic A
ssoc
iatio
n is
not
affi
liate
d w
ith a
nd is
not
end
orsi
ng th
is p
rodu
ct.
Not
es:
P =
pare
nt; T
= te
ache
r; SR
= se
lf-re
port.
The
follo
win
g re
spon
se k
ey a
pplie
s to
the
crite
rion
stat
us sc
ore
requ
irem
ents
not
ed in
the
Indi
cate
d, M
ay b
e In
dica
ted,
and
Not
Indi
cate
d co
lum
ns: 0
= N
ot tr
ue a
t al
l (N
ever
, Sel
dom
); 1
= Ju
st a
littl
e tru
e (O
ccas
iona
lly);
2 =
Pret
ty m
uch
true
(Ofte
n, Q
uite
a b
it); 3
= V
ery
muc
h tru
e (V
ery
ofte
n, V
ery
freq
uent
ly).
Inte
rpre
tativ
e C
onsi
dera
tions
:
Whe
n co
nsid
erin
g D
SM-5
sym
ptom
cri
teri
a fo
r AD
HD
, the
ass
esso
r ne
eds t
o en
sure
that
the
sym
ptom
s are
not
sole
ly a
man
ifest
atio
n of
opp
ositi
onal
beh
avio
r, de
fianc
e, h
ostil
ity, o
r fa
ilure
to u
nder
-st
and
task
s or
inst
ruct
ions
.a C
riter
ion
A2c
stat
es th
at in
ado
lesc
ents
, ove
ract
ivity
may
be
expe
rienc
ed a
s sub
ject
ive
feel
ings
of r
estle
ssne
ss. F
ollo
w-u
p is
reco
mm
ende
d to
ens
ure
crite
rion
A2c
has
bee
n m
et fo
r you
nger
chi
ldre
n.
DSM-5 Update
9
Tabl
e 3.
D
SM-5
Sym
ptom
Cou
nt a
nd C
riter
ion
Stat
us S
core
Req
uire
men
ts fo
r CD
DSM
-5Sym
ptom
CountRequirements:A
tleast3ofthe15symptom
s.
DS
M-5
Cri
teri
on A
Form
Item
Item
#
Indicated
May be Indicated
Not Indicated
Ag
gre
ssio
n t
o P
eop
le a
nd
An
imal
s
Oft
en b
ulli
es,
thre
aten
s, o
r in
tim
idat
es o
ther
s.1
PB
ullie
s, th
reat
ens,
or sc
ares
oth
ers.
177
3, 2
10
TB
ullie
s, th
reat
ens,
or sc
ares
oth
ers.
733,
21
0SR
I bul
ly o
r thr
eate
n ot
her p
eopl
e.6
3, 2
10
Oft
en in
itia
tes
ph
ysic
al fi
gh
ts.
2P
Star
ts fi
ghts
with
oth
ers o
n pu
rpos
e.69
3, 2
10
TIn
tent
iona
lly st
arts
figh
ts w
ith o
ther
s.14
83,
21
0SR
I sta
rt fig
hts w
ith o
ther
peo
ple.
853,
21
0
Has
use
d a
wea
pon
th
at c
an c
ause
ser
iou
s p
hys
ical
har
m t
o ot
her
s (e
.g.,
a b
at,
bri
ck,
bro
ken
bot
tle,
kn
ife,
gu
n).
3
PU
ses a
wea
pon
(for
exa
mpl
e, a
bat
, bric
k, b
roke
n bo
ttle,
kni
fe, o
r gu
n).
122
3, 2
, 1−
0
TU
ses a
wea
pon
(e.g
., a
bat,
bric
k, b
roke
n bo
ttle,
kni
fe, o
r gun
).10
13,
2, 1
−0
SRI u
se a
wea
pon
(like
a b
at, b
rick,
bro
ken
glas
s, kn
ife, o
r gun
) to
scar
e or
hur
t peo
ple.
170
3, 2
, 1−
0
Has
bee
n p
hys
ical
ly c
ruel
to
peo
ple
.4
PPh
ysic
ally
hur
ts p
eopl
e.14
43,
2, 1
−0
TPh
ysic
ally
hur
ts p
eopl
e.52
3, 2
, 1−
0SR
I do
thin
gs to
hur
t peo
ple.
144
3, 2
, 1−
0
Has
bee
n p
hys
ical
ly c
ruel
to
anim
als.
5P
Is c
ruel
to a
nim
als.
161
3, 2
, 1−
0T
Is c
ruel
to a
nim
als.
115
3, 2
, 1−
0SR
I am
mea
n to
ani
mal
s.11
23,
2, 1
−0
Has
sto
len
wh
ile c
onfr
onti
ng
a v
icti
m (
e.g
., m
ug
gin
g,
pu
rse
snat
chin
g,
exto
rtio
n,
arm
ed r
obb
ery)
.6
PSt
eals
whi
le c
onfr
ontin
g a
pers
on (f
or e
xam
ple,
mug
ging
, pur
se
snat
chin
g or
arm
ed ro
bber
y).
116
3, 2
, 1−
0
TSt
eals
whi
le c
onfr
ontin
g a
pers
on (e
.g.,
mug
ging
, pur
se sn
atch
ing,
or
arm
ed ro
bber
y).
553,
2, 1
−0
SRI s
teal
from
oth
er p
eopl
e (b
y m
uggi
ng, p
urse
snat
chin
g, o
r arm
ed
robb
ery)
.60
3, 2
, 1−
0
Has
for
ced
som
eon
e in
to s
exu
al a
ctiv
ity.
7a
PH
as fo
rced
som
eone
into
sexu
al a
ctiv
ity.
983,
2, 1
−0
TH
as fo
rced
som
eone
into
sexu
al a
ctiv
ity.
106
3, 2
, 1−
0SR
––
––
–D
estr
uct
ion
of
Pro
per
ty
Has
del
iber
atel
y en
gag
ed in
fire
set
tin
g w
ith
th
e in
ten
tion
of
cau
sin
g s
erio
us
dam
age.
8b
PH
as in
tent
iona
lly se
t fire
s for
the
purp
ose
of c
ausi
ng d
amag
e.90
3, 2
, 1−
0T
Has
inte
ntio
nally
set fi
res f
or th
e pu
rpos
e of
cau
sing
dam
age.
127
3, 2
, 1−
0SR
I lik
e to
set t
hing
s on
fire.
623,
21
0
Has
del
iber
atel
y d
estr
oyed
oth
ers'
pro
per
ty (
oth
er t
han
by
fire
se
ttin
g).
9b
PIn
tent
iona
lly d
amag
es o
r des
troys
thin
gs th
at b
elon
g to
oth
ers.
179
3, 2
, 1−
0T
Inte
ntio
nally
dam
ages
or d
estro
ys th
ings
that
bel
ong
to o
ther
s.16
33,
2, 1
−0
SRI d
estro
y st
uff t
hat b
elon
gs to
oth
er p
eopl
e.48
3, 2
, 1−
0Ta
ble
cont
inue
d ne
xt p
age.
..
Conners Comprehensive Behavior Rating Scales™ (Conners CBRS™)
10
Tabl
e 3.
(c
ontin
ued)
DSM
-5 S
ympt
om C
ount
and
Crit
erio
n St
atus
Sco
re R
equi
rem
ents
for C
D
DS
M-5
Cri
teri
on A
Form
Item
Item
#
Indicated
May be Indicated
Not Indicated
Dec
eitf
uln
ess
or T
hef
t
Has
bro
ken
into
som
eon
e el
se's
hou
se,
bu
ildin
g,
or c
ar.
10P
Has
bro
ken
into
som
eone
els
e's h
ouse
, bui
ldin
g, o
r car
.39
3, 2
, 1−
0T
Has
bro
ken
into
som
eone
els
e's h
ouse
, bui
ldin
g, o
r car
.64
3, 2
, 1−
0SR
I bre
ak in
to h
ouse
s, bu
ildin
gs, o
r car
s.87
3, 2
, 1−
0
Oft
en li
es t
o ob
tain
goo
ds
or f
avor
s or
to
avoi
d o
blig
atio
ns
(i
.e.,
"co
ns"
oth
ers)
.11
PLi
es to
avo
id h
avin
g to
do
som
ethi
ng o
r to
get t
hing
s.14
93,
2−
1, 0
TLi
es to
avo
id h
avin
g to
do
som
ethi
ng o
r to
get t
hing
s.97
3, 2
−1,
0SR
I tel
l lie
s to
get o
ut o
f doi
ng th
ings
or t
o ge
t stu
ff.96
3, 2
−1,
0
Has
sto
len
item
s of
non
triv
ial v
alu
e w
ith
out
con
fron
tin
g a
vic
tim
(e
.g.,
sh
oplif
tin
g,
bu
t w
ith
out
bre
akin
g a
nd
en
teri
ng
; fo
rger
y).
12P
Stea
ls se
cret
ly (f
or e
xam
ple,
shop
liftin
g or
forg
ery)
.12
03,
2, 1
−0
TSt
eals
secr
etly
(e.g
., sh
oplif
ting
or fo
rger
y).
141
3, 2
, 1−
0SR
I ste
al im
porta
nt th
ings
whe
n no
one
is w
atch
ing.
433,
2, 1
−0
Ser
iou
s V
iola
tion
s of
Ru
les
Oft
en s
tays
ou
t at
nig
ht
des
pit
e p
aren
tal p
roh
ibit
ion
s, b
egin
nin
g
bef
ore
age
13
yea
rs.
13c,
d
PG
oes o
ut a
t nig
ht e
ven
thou
gh it
bre
aks t
he ru
les.
147
3, 2
10
T−
−−
−−
SRI g
o ou
t at n
ight
eve
n w
hen
I am
supp
osed
to b
e at
hom
e.16
23,
21
0
Has
ru
n a
way
fro
m h
ome
over
nig
ht
at le
ast
twic
e w
hile
livi
ng
in
the
par
enta
l or
par
enta
l su
rrog
ate
hom
e, o
r on
ce w
ith
out
retu
rnin
g
for
a le
ng
thy
per
iod
.14
c
PR
uns a
way
from
hom
e fo
r at l
east
one
nig
ht.
103,
2, 1
−0
T−
−−
−−
SRI r
un a
way
from
hom
e.64
3, 2
, 1−
0
Is o
ften
tru
ant
from
sch
ool,
beg
inn
ing
bef
ore
age
13
yea
rs.
15e
PSk
ips c
lass
es.
107
3, 2
10
TSk
ips c
lass
es.
160
3, 2
10
SRI s
kip
clas
ses.
673,
21
0
DSM
-5 D
iagn
ostic
Crit
eria
is re
prin
ted
with
per
mis
sion
from
the
Dia
gnos
tic a
nd S
tatis
tical
Man
ual o
f Men
tal D
isor
ders
, Fift
h Ed
ition
™, (
Cop
yrig
ht ©
2013
). A
mer
ican
Psy
chia
tric A
ssoc
iatio
n.
All
Rig
hts R
eser
ved.
The
Am
eric
an P
sych
iatri
c Ass
ocia
tion
is n
ot a
ffilia
ted
with
and
is n
ot e
ndor
sing
this
pro
duct
.
Not
es:
P =
pare
nt; T
= te
ache
r; SR
= se
lf-re
port.
The
follo
win
g re
spon
se k
ey a
pplie
s to
the
crite
rion
stat
us sc
ore
requ
irem
ents
not
ed in
the
Indi
cate
d, M
ay b
e In
dica
ted,
and
Not
Indi
cate
d co
lum
ns:
0 =
Not
true
at a
ll (N
ever
, Sel
dom
); 1
= Ju
st a
littl
e tru
e (O
ccas
iona
lly);
2 =
Pret
ty m
uch
true
(Ofte
n, Q
uite
a b
it); 3
= V
ery
muc
h tru
e (V
ery
ofte
n, V
ery
freq
uent
ly).
Inte
rpre
tativ
e C
onsi
dera
tions
: a
The
Con
ners
CB
RS−
SR d
oes n
ot a
sses
s Crit
erio
n A
7 (f
orce
d se
xual
act
ivity
) due
to th
e se
nsiti
ve n
atur
e of
this
crit
erio
n.b
If b
oth
Crit
erio
n A
8 (fi
re-s
ettin
g) a
nd A
9 (d
estru
ctio
n of
pro
perty
) are
indi
cate
d, th
e as
sess
or m
ust c
onfir
m th
at p
rope
rty w
as d
estro
yed
othe
r tha
n by
fire
-set
ting
in o
rder
to m
eet C
riter
ion
A9.
c Th
e C
onne
rs C
BR
S−T
does
not
ass
ess C
riter
ion
A13
(sta
ying
out
at n
ight
with
out p
erm
issi
on) o
r Crit
erio
n A
14 (r
unni
ng a
way
from
hom
e), a
s tea
cher
s gen
eral
ly w
ould
not
be
dire
ctly
aw
are
of th
ese
infr
actio
ns.
d In
ord
er fo
r DSM
-5 C
riter
ion
A13
(sta
ying
out
at n
ight
) to
be in
dica
ted,
the
asse
ssor
nee
ds to
ens
ure
this
crit
erio
n oc
curr
ed b
efor
e th
e ag
e of
13
year
s.e
In o
rder
for D
SM-5
Crit
erio
n A
15 (t
ruan
cy) t
o be
indi
cate
d, th
e as
sess
or n
eeds
to e
nsur
e th
at th
e tru
ancy
occ
urre
d be
fore
the
age
of 1
3 ye
ars.
DSM-5 Update
11
Tabl
e 4.
D
SM-5
Sym
ptom
Cou
nt a
nd C
riter
ion
Stat
us S
core
Req
uire
men
ts fo
r OD
D
DSM
-5Sym
ptom
CountRequirements:A
tleast4ofthe8sym
ptom
s.
DS
M-5
Cri
teri
on A
Form
Item
Item
#
Indicated
May be Indicated
Not Indicated
An
gry
/Ir
rita
ble
Moo
d
Oft
en lo
ses
tem
per
.1
PLo
ses t
empe
r.45
3, 2
−1,
0
TLo
ses t
empe
r.3
3, 2
10
SRI l
ose
my
tem
per.
583
21,
0
Is o
ften
tou
chy
or e
asily
an
noy
ed.
2
PIs
irrit
able
and
eas
ily a
nnoy
ed b
y ot
hers
.10
83,
2−
1, 0
TIs
irrit
able
and
eas
ily a
nnoy
ed b
y ot
hers
.17
43,
21
0
SRI a
m e
asily
ann
oyed
by
othe
rs.
148
3, 2
−1,
0
Is o
ften
an
gry
an
d r
esen
tfu
l.3
PIs
ang
ry a
nd re
sent
ful.
823,
21
0
TIs
ang
ry a
nd re
sent
ful.
135
3, 2
10
SRPe
ople
mak
e m
e an
gry.
143
3, 2
−1,
0
Arg
um
enta
tive
/D
efian
t B
ehav
ior
Oft
en a
rgu
es w
ith
au
thor
ity
fig
ure
s or
, fo
r ch
ildre
n a
nd
ad
oles
cen
ts,
wit
h a
du
lts.
4
PA
rgue
s with
adu
lts.
703,
2−
1, 0
TA
rgue
s with
adu
lts.
192
3, 2
−1,
0
SRI a
rgue
with
adu
lts.
117
3, 2
−1,
0
Oft
en a
ctiv
ely
defi
es o
r re
fuse
s to
com
ply
wit
h r
equ
ests
fro
m
auth
orit
y fi
gu
res
or w
ith
ru
les.
5
PA
ctiv
ely
refu
ses t
o do
wha
t adu
lts te
ll hi
m/h
er to
do.
127
3, 2
−1,
0
TA
ctiv
ely
refu
ses t
o do
wha
t adu
lts te
ll hi
m/h
er to
do.
126
3, 2
10
SRI d
o w
hat m
y pa
rent
s or o
ther
adu
lts a
sk m
e to
do.
(R)
33 (R
)3
21,
0
Oft
en d
elib
erat
ely
ann
oys
oth
ers.
6
PA
nnoy
s oth
er p
eopl
e on
pur
pose
.16
33,
2−
1, 0
TA
nnoy
s oth
er p
eopl
e on
pur
pose
.12
83,
2−
1, 0
SRI t
ry to
ann
oy o
ther
peo
ple.
134
3, 2
−1,
0
Oft
en b
lam
es o
ther
s fo
r h
is o
r h
er m
ista
kes
or m
isb
ehav
ior.
7
PB
lam
es o
ther
s for
his
/her
mis
take
s or m
isbe
havi
or.
134
3, 2
−1,
0
TB
lam
es o
ther
s for
his
/her
mis
take
s or m
isbe
havi
or.
143
3, 2
10
SRI b
lam
e ot
hers
for t
hing
s I d
o w
rong
.88
3, 2
−1,
0
Tabl
e co
ntin
ued
next
pag
e...
Conners Comprehensive Behavior Rating Scales™ (Conners CBRS™)
12
Tabl
e 4.
(c
ontin
ued)
DSM
-5 S
ympt
om C
ount
and
Crit
erio
n St
atus
Sco
re R
equi
rem
ents
for O
DD
DS
M-5
Cri
teri
on A
Form
Item
Item
#
Indicated
May be Indicated
Not Indicated
Vin
dic
tive
nes
s
Has
bee
n s
pit
efu
l or
vin
dic
tive
at
leas
t tw
ice
wit
hin
th
e p
ast
6
mon
ths.
8
PTr
ies t
o ge
t eve
n w
ith p
eopl
e.54
3, 2
10
TTr
ies t
o ge
t eve
n w
ith p
eopl
e.18
23,
21
0
SRW
hen
I get
mad
at s
omeo
ne, I
get
eve
n w
ith th
em.
203,
21
0
DSM
-5 D
iagn
ostic
Crit
eria
is re
prin
ted
with
per
mis
sion
from
the
Dia
gnos
tic a
nd S
tatis
tical
Man
ual o
f Men
tal D
isor
ders
, Fift
h Ed
ition
™, (
Cop
yrig
ht ©
2013
). A
mer
ican
Psy
chia
tric A
ssoc
iatio
n.
All
Rig
hts R
eser
ved.
The
Am
eric
an P
sych
iatri
c Ass
ocia
tion
is n
ot a
ffilia
ted
with
and
is n
ot e
ndor
sing
this
pro
duct
.
Not
es:
(R) =
Item
is re
vers
e sc
ored
.P
= pa
rent
; T =
teac
her;
SR =
self-
repo
rt. T
he fo
llow
ing
resp
onse
key
app
lies t
o th
e cr
iterio
n st
atus
scor
e re
quire
men
ts n
oted
in th
e In
dica
ted,
May
be
Indi
cate
d, a
nd N
ot In
dica
ted
colu
mns
: 0
= N
ot tr
ue a
t all
(Nev
er, S
eldo
m);
1 =
Just
a li
ttle
true
(Occ
asio
nally
); 2
= Pr
etty
muc
h tru
e (O
ften,
Qui
te a
bit)
; 3 =
Ver
y m
uch
true
(Ver
y of
ten,
Ver
y fr
eque
ntly
).
Inte
rpre
tativ
e C
onsi
dera
tions
:W
hen
cons
ider
ing
DSM
-5 sy
mpt
om c
rite
ria
for
OD
D, t
he a
sses
sor
need
s to
ensu
re th
at th
e sy
mpt
oms a
re e
xhib
ited
duri
ng in
tera
ctio
n w
ith a
t lea
st o
ne in
divi
dual
who
is n
ot a
sibl
ing.
DSM-5 Update
13
Tabl
e 5.
D
SM-5
Sym
ptom
Cou
nt a
nd C
riter
ion
Stat
us S
core
Req
uire
men
ts fo
r Maj
or D
epre
ssiv
e Ep
isod
e DSM
-5Sym
ptom
CountRequirements:A
tleast5ofthe9sym
ptom
s,includingA1
orA
2.
DS
M-5
Cri
teri
on A
Form
Item
Item
#
Indicated
May be Indicated
Not Indicated
Dep
ress
ed m
ood
mos
t of
th
e d
ay,
nea
rly
ever
y d
ay,
as in
dic
ated
b
y ei
ther
su
bje
ctiv
e re
por
t (e
.g.,
fee
ls s
ad,
emp
ty,
or h
opel
ess)
or
ob
serv
atio
n m
ade
by
oth
ers
(e.g
., a
pp
ears
tea
rfu
l).
(Not
e: I
n
child
ren
an
d a
dol
esce
nts
, ca
n b
e ir
rita
ble
moo
d.)
1
PIs
sad,
glo
omy,
or i
rrita
ble
for m
any
days
at a
tim
e.94
*-o
r-13
7
3, 2
-or-
3, 2
, 1
10
-and
-0
Seem
s hop
eles
s abo
ut th
e fu
ture
.−
TIs
sad,
glo
omy,
or i
rrita
ble
for m
any
days
at a
tim
e.19
3*-o
r-11
6
3, 2
-or-
3, 2
, 1
10
-and
-0
Seem
s hop
eles
s abo
ut th
e fu
ture
.−
SRI f
eel s
ad, g
loom
y, o
r irr
itabl
e fo
r man
y da
ys a
t a ti
me.
115*
-or- 16
3, 2
-or-
3, 2
, 1
10
-and
-0
The
futu
re se
ems h
opel
ess t
o m
e.−
Mar
ked
ly d
imin
ish
ed in
tere
st o
r p
leas
ure
in a
ll, o
r al
mos
t al
l,
acti
viti
es m
ost
of t
he
day
, n
earl
y ev
ery
day
(as
ind
icat
ed b
y ei
ther
su
bje
ctiv
e ac
cou
nt
or o
bse
rvat
ion
).2
PH
as lo
st in
tere
st o
r ple
asur
e in
act
iviti
es.
53*
3, 2
10
TH
as lo
st in
tere
st o
r ple
asur
e in
act
iviti
es.
46*
3, 2
10
SRI d
on’t
feel
like
doi
ng th
ings
that
I us
ed to
enj
oy.
93*
3, 2
−1,
0
Sig
nifi
can
t w
eig
ht
loss
wh
en n
ot d
ieti
ng
or
wei
gh
t g
ain
(e.
g.,
a
chan
ge
of m
ore
than
5%
of
bod
y w
eig
ht
in a
mon
th),
or
dec
reas
e or
incr
ease
in a
pp
etit
e n
earl
y ev
ery
day
. (N
ote:
In
ch
ildre
n,
con
sid
er f
ailu
re t
o m
ake
exp
ecte
d w
eig
ht
gai
n.)
3a
PA
ppet
ite o
r wei
ght h
as c
hang
ed a
lot.
433,
2, 1
−0
TA
ppet
ite o
r wei
ght h
as c
hang
ed a
lot.
162
3, 2
, 1−
0
SRM
y ap
petit
e or
wei
ght h
as c
hang
ed a
lot.
83,
2−
1, 0
Inso
mn
ia o
r h
yper
som
nia
nea
rly
ever
y d
ay.
4b
P
Slee
ps to
o m
uch.
59 -or-
126
-or-
181
-or-
110
3, 2
-or-
3, 2
-or-
3, 2
-or-
3, 2
−1,
0-a
nd-
1, 0
-and
-1,
0-a
nd-
1, 0
Has
trou
ble
falli
ng a
slee
p.−
Wak
es u
p to
o ea
rly.
−
Wak
es u
p du
ring
the
nigh
t, th
en h
as tr
oubl
e fa
lling
bac
k to
slee
p.−
TFa
lls a
slee
p in
cla
ss.
181
3, 2
10
SR
I sle
ep to
o m
uch.
125
-or- 70 -or-
158
-or- 1
3, 2
-or-
3, 2
-or-
3, 2
-or-
3, 2
−1,
0-a
nd-
1, 0
-and
-1,
0-a
nd-
1, 0
I hav
e tro
uble
falli
ng a
slee
p.−
I wak
e up
too
early
(and
not
just
bec
ause
of t
he a
larm
clo
ck o
r my
pare
nts)
.−
I wak
e up
dur
ing
the
nigh
t and
hav
e tro
uble
falli
ng b
ack
to sl
eep.
−
Psy
chom
otor
ag
itat
ion
or
reta
rdat
ion
nea
rly
ever
y d
ay (
obse
rvab
le
by
oth
ers;
not
mer
ely
sub
ject
ive
feel
ing
s of
res
tles
snes
s or
bei
ng
sl
owed
dow
n).
5
PIs
agi
tate
d in
the
rest
less
sens
e.35 -o
r-10
3*
3, 2
-or-
3, 2
1 -or- 1
0-a
nd-
0Se
ems p
hysi
cally
slow
ed d
own.
TIs
agi
tate
d in
the
rest
less
sens
e.83 -o
r-13
6*
3, 2
-or-
3, 2
1 -or- 1
0-a
nd-
0Se
ems p
hysi
cally
slow
ed d
own.
SRI a
m re
stle
ss.
86 -or-
26*
3, 2
-or-
3, 2
−1,
0-a
nd-
0I f
eel v
ery
slow
ed d
own
in m
y m
ovem
ents
.1
Tabl
e co
ntin
ued
next
pag
e...
Conners Comprehensive Behavior Rating Scales™ (Conners CBRS™)
14
DS
M-5
Cri
teri
on A
Form
Item
Item
#
Indicated
May be Indicated
Not Indicated
Fati
gu
e or
loss
of
ener
gy
nea
rly
ever
y d
ay.
6c
PSe
ems t
ired;
has
low
ene
rgy.
171*
3, 2
−1,
0
TSe
ems t
ired;
has
low
ene
rgy.
122*
3, 2
−1,
0
SRI f
eel t
ired,
like
I do
n’t h
ave
enou
gh e
nerg
y.13
7*3,
2−
1, 0
Feel
ing
s of
wor
thle
ssn
ess
or e
xces
sive
or
inap
pro
pri
ate
gu
ilt
(wh
ich
may
be
del
usi
onal
) n
earl
y ev
ery
day
(n
ot m
erel
y se
lf-
rep
roac
h o
r g
uilt
ab
out
bei
ng
sic
k).
7
PFe
els i
napp
ropr
iate
ly g
uilty
.12
4*-o
r- 6*
3, 2
-or-
3, 2
1 -or- 1
0-a
nd-
0Fe
els w
orth
less
.
TFe
els i
napp
ropr
iate
ly g
uilty
.16
9*-o
r-16
6*
3, 2
-or-
3, 2
1 -or- 1
0-a
nd-
0Fe
els w
orth
less
.
SRI f
eel m
ore
guilt
y th
an I
shou
ld.
118*
-or-
135*
3, 2
-or-
3, 2
−1,
0-a
nd-
0I f
eel w
orth
less
.1
Dim
inis
hed
ab
ility
to
thin
k or
con
cen
trat
e, o
r in
dec
isiv
enes
s, n
earl
y ev
ery
day
(ei
ther
by
sub
ject
ive
acco
un
t or
as
obse
rved
by
oth
ers)
.8
PH
as lo
st th
e ab
ility
to th
ink,
con
cent
rate
, or m
ake
deci
sion
s.49
3, 2
10
TH
as lo
st th
e ab
ility
to th
ink,
con
cent
rate
, or m
ake
deci
sion
s.90
3, 2
10
SRI c
an’t
mak
e up
my
min
d ab
out t
hing
s any
mor
e.12 -o
r-14
7
3, 2
-or-
3, 2
−1,
0-a
nd-
1, 0
I am
no
long
er a
ble
to k
eep
my
min
d on
one
thin
g.−
Rec
urr
ent
thou
gh
ts o
f d
eath
(n
ot j
ust
fea
r of
dyi
ng
), r
ecu
rren
t su
icid
al id
eati
on w
ith
out
a sp
ecifi
c p
lan
, or
a s
uic
ide
atte
mp
t or
a
spec
ific
pla
n f
or c
omm
itti
ng
su
icid
e.9d
PH
as ta
lked
abo
ut, t
ried,
or p
lann
ed to
com
mit
suic
ide.
138*
-or-
168*
3, 2
, 1-o
r-3,
2, 1
−0
-and
-0
Has
repe
ated
thou
ghts
of d
eath
or d
ying
.−
TH
as ta
lked
abo
ut, t
ried,
or p
lann
ed to
com
mit
suic
ide.
58*
-or-
191*
3, 2
, 1-o
r-3,
2, 1
−0
-and
-0
Has
repe
ated
thou
ghts
of d
eath
or d
ying
.−
SRI t
hink
abo
ut h
urtin
g m
ysel
f.14
6*3,
2, 1
−0
DSM
-5 D
iagn
ostic
Crit
eria
is re
prin
ted
with
per
mis
sion
from
the
Dia
gnos
tic a
nd S
tatis
tical
Man
ual o
f Men
tal D
isor
ders
, Fift
h Ed
ition
™, (
Cop
yrig
ht ©
2013
). A
mer
ican
Psy
chia
tric A
ssoc
iatio
n.
All
Rig
hts R
eser
ved.
The
Am
eric
an P
sych
iatri
c Ass
ocia
tion
is n
ot a
ffilia
ted
with
and
is n
ot e
ndor
sing
this
pro
duct
.
Not
es:
P =
pare
nt; T
= te
ache
r; SR
= se
lf-re
port;
* =
dep
ress
ive
sym
ptom
s rep
rese
ntin
g th
e m
ixed
feat
ures
spec
ifier
for M
anic
Epi
sode
(see
Tab
le 8
). Th
e fo
llow
ing
resp
onse
key
app
lies t
o th
e cr
iterio
n st
atus
scor
e re
quire
men
ts n
oted
in th
e In
dica
ted,
May
be
Indi
cate
d, a
nd N
ot In
dica
ted
colu
mns
: 0 =
Not
true
at a
ll (N
ever
, Sel
dom
); 1
= Ju
st a
littl
e tru
e (O
ccas
iona
lly);
2 =
Pret
ty m
uch
true
(Ofte
n, Q
uite
a b
it);
3 =
Very
muc
h tru
e (V
ery
ofte
n, V
ery
freq
uent
ly).
Inte
rpre
tativ
e C
onsi
dera
tions
:•
Whe
n co
nsid
erin
g D
SM-5
sym
ptom
cri
teri
a fo
r M
ajor
Dep
ress
ive
Epi
sode
, the
ass
esso
r ne
eds t
o en
sure
the
yout
h ex
peri
ence
s the
se sy
mpt
oms n
earl
y ev
ery
day,
and
that
the
sym
ptom
s rep
rese
nt a
ch
ange
from
pre
viou
s fun
ctio
ning
.•
Pres
ence
of a
cur
rent
Maj
or D
epre
ssiv
e E
piso
de su
gges
ts c
onsi
dera
tion
of M
ajor
Dep
ress
ive
Dis
orde
r, as
wel
l as i
nves
tigat
ion
of p
ast M
anic
or
Hyp
oman
ic E
piso
des t
o de
term
ine
if B
ipol
ar I
Dis
orde
r or
Bip
olar
II D
isor
der
mig
ht b
e ap
prop
riat
e.a
If n
o ch
ange
in w
eigh
t or a
ppet
ite is
repo
rted
(Crit
erio
n A
3), f
ollo
w-u
p is
reco
mm
ende
d to
exa
min
e po
ssib
le fa
ilure
to m
ake
expe
cted
wei
ght g
ains
.b
Crit
erio
n A
4 is
ass
esse
d in
dire
ctly
(i.e
., “F
alls
asl
eep
in c
lass
”), a
s mos
t tea
cher
s do
not h
ave
the
oppo
rtun
ity to
obs
erve
the
yout
h’s s
leep
hab
its a
t nig
ht. F
ollo
w-u
p is
reco
mm
ende
d to
obt
ain
addi
tiona
l inf
or-
mat
ion
abou
t sle
ep p
robl
ems.
c In
vest
igat
ion
by th
e as
sess
or is
reco
mm
ende
d to
det
erm
ine
whe
ther
tire
dnes
s or l
ow e
nerg
y re
pres
ents
a c
hang
e fr
om ty
pica
l ene
rgy
leve
ls (C
riter
ion
A6)
.d
In o
rder
to fu
lly a
sses
s Crit
erio
n A
9 fo
r Con
ners
CBR
S−SR
, fol
low
-up
is re
com
men
ded
to d
eter
min
e if
ther
e ha
ve b
een
recu
rren
t tho
ught
s of d
eath
or s
uici
de, i
f a su
icid
e pl
an h
as b
een
mad
e, o
r if t
here
has
be
en a
suic
ide
atte
mpt
.
Tabl
e 5.
(c
ontin
ued)
DSM
-5 S
ympt
om C
ount
and
Crit
erio
n St
atus
Sco
re R
equi
rem
ents
for M
ajor
Dep
ress
ive
Epis
ode
DSM-5 Update
15
Tabl
e 6.
D
SM-5
Sym
ptom
Cou
nt a
nd C
riter
ion
Stat
us S
core
Req
uire
men
ts fo
r Dep
ress
ive
Epis
ode,
with
mix
ed fe
atur
es
DSM
-5 S
ympt
om C
ount
Req
uire
men
ts:
•Fu
ll cr
iteria
met
for M
ajor
Dep
ress
ive
Epis
ode
•Atleast3ofthe7manic/hypom
anicsym
ptom
s
DS
M-5
Cri
teri
on A
Form
Item
Item
#
Indicated
May be Indicated
Not Indicated
Elev
ated
, ex
pan
sive
moo
d.
1P
Seem
s abn
orm
ally
hap
py fo
r at l
east
one
wee
k.11
13,
2, 1
−0
TSe
ems a
bnor
mal
ly h
appy
for a
t lea
st o
ne w
eek.
114
3, 2
, 1−
0SR
I bec
ome
unus
ually
hap
py o
r irr
itabl
e fo
r a w
eek
or lo
nger
.89
3, 2
10
Infl
ated
sel
f-es
teem
or
gra
nd
iosi
ty.
2
PTh
inks
he/
she
is b
ette
r tha
n ev
eryo
ne a
nd c
an d
o an
ythi
ng.
743,
21
0T
Thin
ks h
e/sh
e is
bet
ter t
han
ever
yone
and
can
do
anyt
hing
.27
3, 2
10
SRI f
eel r
eally
goo
d, li
ke I’
m b
ette
r tha
n ev
eryo
ne e
lse
and
I can
do
anyt
hing
.17
13,
2−
1, 0
Mor
e ta
lkat
ive
than
usu
al o
r p
ress
ure
to
keep
tal
kin
g.
3P
Has
per
iods
of f
ast,
non-
stop
spee
ch.
713,
21
0T
Has
per
iods
of f
ast,
non-
stop
spee
ch.
253,
21
0SR
I fee
l lik
e I c
an't
stop
talk
ing.
633,
2−
1, 0
Flig
ht
of id
eas
or s
ub
ject
ive
exp
erie
nce
th
at t
hou
gh
ts a
re r
acin
g.
4P
Says
thou
ghts
are
raci
ng, o
r com
ing
too
fast
.10
93,
2, 1
−0
TSa
ys th
ough
ts a
re ra
cing
, or c
omin
g to
o fa
st.
152
3, 2
, 1−
0SR
My
thou
ghts
com
e so
fast
that
it is
har
d to
kee
p up
with
them
.27
3, 2
−1,
0
Incr
ease
in e
ner
gy
or g
oal-
dir
ecte
d a
ctiv
ity
(eit
her
soc
ially
, at
w
ork
or s
choo
l, o
r se
xual
ly).
5P
Has
show
n an
unu
sual
incr
ease
in so
cial
, sch
ool,
or se
xual
act
iviti
es.
913,
2, 1
−0
TH
as sh
own
an u
nusu
al in
crea
se in
soci
al, s
choo
l, or
sexu
al a
ctiv
ities
.14
23,
2, 1
−0
SRI s
udde
nly
have
man
y m
ore
plan
s and
act
iviti
es th
an I
used
to.
149
32
1, 0
Incr
ease
d o
r ex
cess
ive
invo
lvem
ent
in a
ctiv
itie
s th
at h
ave
a h
igh
p
oten
tial
for
pai
nfu
l con
seq
uen
ces
(e.g
., e
ng
agin
g in
un
rest
rain
ed
bu
yin
g s
pre
es,
sexu
al in
dis
cret
ion
s, o
r fo
olis
h b
usi
nes
s in
vest
men
ts).
6
PSe
eks p
leas
ure
with
out c
arin
g ab
out w
hat b
ad th
ings
cou
ld h
appe
n.19
83,
2, 1
−0
TSe
eks p
leas
ure
with
out c
arin
g ab
out w
hat b
ad th
ings
cou
ld h
appe
n.15
43,
2, 1
−0
SRI d
o th
ings
that
feel
goo
d, n
o m
atte
r wha
t bad
thin
gs m
ight
hap
pen
afte
rwar
ds.
166
3, 2
−1,
0
Dec
reas
ed n
eed
for
sle
ep (
feel
ing
res
ted
des
pit
e sl
eep
ing
less
th
an
usu
al;
to b
e co
ntr
aste
d w
ith
inso
mn
ia).
7P
Slee
ps m
uch
less
than
he/
she
used
to, b
ut d
oes n
ot se
em ti
red.
253,
21
0T
−−
−−
−SR
I sle
ep m
uch
less
than
I us
ed to
but
I do
n't f
eel t
ired.
108
3, 2
−1,
0D
SM-5
Dia
gnos
tic C
riter
ia is
repr
inte
d w
ith p
erm
issi
on fr
om th
e D
iagn
ostic
and
Sta
tistic
al M
anua
l of M
enta
l Dis
orde
rs, F
ifth
Editi
on™
, (C
opyr
ight
©20
13).
Am
eric
an P
sych
iatri
c Ass
ocia
tion.
A
ll R
ight
s Res
erve
d. T
he A
mer
ican
Psy
chia
tric A
ssoc
iatio
n is
not
affi
liate
d w
ith a
nd is
not
end
orsi
ng th
is p
rodu
ct.
Not
es:
P =
pare
nt; T
= te
ache
r; SR
= se
lf-re
port.
Th
e fo
llow
ing
resp
onse
key
app
lies t
o th
e cr
iterio
n st
atus
scor
e re
quire
men
ts n
oted
in th
e In
dica
ted,
May
be
Indi
cate
d, a
nd N
ot In
dica
ted
colu
mns
: 0 =
Not
true
at a
ll (N
ever
, Sel
dom
);
1 =
Just
a li
ttle
true
(Occ
asio
nally
); 2
= Pr
etty
muc
h tru
e (O
ften,
Qui
te a
bit)
; 3 =
Ver
y m
uch
true
(Ver
y of
ten,
Ver
y fr
eque
ntly
).
Inte
rpre
tativ
e C
onsi
dera
tions
:•
Mix
ed fe
atur
es a
ssoc
iate
d w
ith a
Maj
or D
epre
ssiv
e E
piso
de h
ave
been
foun
d to
be
a si
gnifi
cant
ris
k fa
ctor
for
the
deve
lopm
ent o
f Bip
olar
I D
isor
der,
or B
ipol
ar II
Dis
orde
r.•
Whe
n co
nsid
erin
g D
SM-5
sym
ptom
cri
teri
a fo
r M
ajor
Dep
ress
ive
Epi
sode
, with
mix
ed fe
atur
es, t
he a
sses
sor
need
s to
ensu
re th
at th
e m
ixed
sym
ptom
s are
pre
sent
dur
ing
the
maj
ority
of d
ays o
f the
cu
rren
t or
mos
t rec
ent e
piso
de o
f dep
ress
ion,
and
that
the
mix
ed sy
mpt
oms r
epre
sent
a c
hang
e fr
om th
e pe
rson
’s u
sual
beh
avio
r.In
terp
reta
tive
cons
ider
atio
ns fo
r man
ic sy
mpt
oms w
ith a
n as
teris
k in
Tab
le 7
app
ly to
man
ic sy
mpt
oms a
sses
sed
for t
he D
epre
ssiv
e Ep
isod
e, w
ith m
ixed
feat
ures
spec
ifier
.
Conners Comprehensive Behavior Rating Scales™ (Conners CBRS™)
16
Tabl
e 7.
D
SM-5
Sym
ptom
Cou
nt a
nd C
riter
ion
Stat
us S
core
Req
uire
men
ts fo
r Man
ic E
piso
de
DSM
-5 S
ympt
om C
ount
Req
uire
men
ts:
•CriterionAElevatedMoodandIncreasedGoal-D
irectedActivityorE
nergyandatleast3ofthe7CriterionBsymptom
s.
- or -
•CriterionAIrritableMoodandIncreasedGoal-D
irectedActivityorE
nergyandatleast4ofthe7CriterionBsymptom
s.
DS
M-5
Cri
teri
a A
, B
Form
Item
Item
#
Indicated
May be Indicated
Not Indicated
A d
isti
nct
per
iod
of
abn
orm
ally
an
d p
ersi
sten
tly
elev
ated
, ex
pan
sive
, or
irri
tab
le m
ood
an
d a
bn
orm
ally
an
d p
ersi
sten
tly
incr
ease
d g
oal-
dir
ecte
d a
ctiv
ity
or e
ner
gy,
last
ing
at
leas
t 1
wee
k an
d p
rese
nt
mos
t of
th
e d
ay,
nea
rly
ever
y d
ay (
or a
ny
du
rati
on if
h
osp
ital
izat
ion
is n
eces
sary
).
Aa,
b, c
P
Seem
s abn
orm
ally
hap
py fo
r at l
east
one
wee
k.11
1*-o
r-16
6-a
nd-
91
3, 2
, 1-o
r-3,
2, 1
-and
-3,
2, 1
−0
-and
-0 -or- 0
Has
per
iods
of i
rrita
bilit
y la
stin
g fo
r at l
east
one
wee
k.−
Has
show
n an
unu
sual
incr
ease
in so
cial
, sch
ool,
or se
xual
act
iviti
es.
−
T
Seem
s abn
orm
ally
hap
py fo
r at l
east
one
wee
k.11
4*-o
r- 89 -and
-14
2
3, 2
, 1-o
r-3,
2, 1
-and
-3,
2, 1
−0
-and
-0 -or- 0
Has
per
iods
of i
rrita
bilit
y la
stin
g fo
r at l
east
one
wee
k.−
Has
show
n an
unu
sual
incr
ease
in so
cial
, sch
ool,
or se
xual
act
iviti
es.
−
SRI b
ecom
e un
usua
lly h
appy
or i
rrita
ble
for a
wee
k or
long
er.
89*
-and
-14
9
3, 2
-and
-3
10 -or-
1, 0
I sud
denl
y ha
ve m
any
mor
e pl
ans a
nd a
ctiv
ities
than
I us
ed to
.2
Infl
ated
sel
f-es
teem
or
gra
nd
iosi
ty.
B1
PTh
inks
he/
she
is b
ette
r tha
n ev
eryo
ne a
nd c
an d
o an
ythi
ng.
74*
3, 2
10
TTh
inks
he/
she
is b
ette
r tha
n ev
eryo
ne a
nd c
an d
o an
ythi
ng.
27*
3, 2
10
SRI f
eel r
eally
goo
d, li
ke I’
m b
ette
r tha
n ev
eryo
ne e
lse
and
I can
do
anyt
hing
.17
1*3,
2−
1, 0
Dec
reas
ed n
eed
for
sle
ep (
e.g
., f
eels
res
ted
aft
er o
nly
3 h
ours
of
slee
p).
B2d
PSl
eeps
muc
h le
ss th
an h
e/sh
e us
ed to
, but
doe
s not
seem
tire
d.25
*3,
21
0
T−
−−
−−
SRI s
leep
muc
h le
ss th
an I
used
to b
ut I
don'
t fee
l tire
d.10
8*3,
2−
1, 0
Mor
e ta
lkat
ive
than
usu
al o
r p
ress
ure
to
keep
tal
kin
g.
B3
PH
as p
erio
ds o
f fas
t, no
n-st
op sp
eech
.71
*3,
21
0
TH
as p
erio
ds o
f fas
t, no
n-st
op sp
eech
.25
*3,
21
0
SRI f
eel l
ike
I can
't st
op ta
lkin
g.63
*3,
2−
1, 0
Flig
ht
of id
eas
or s
ub
ject
ive
exp
erie
nce
th
at t
hou
gh
ts a
re r
acin
g.
B4
PSa
ys th
ough
ts ar
e ra
cing
, or c
omin
g to
o fa
st.10
9*3,
2, 1
−0
TSa
ys th
ough
ts ar
e ra
cing
, or c
omin
g to
o fa
st.15
2*3,
2, 1
−0
SRM
y th
ough
ts c
ome
so fa
st th
at it
is h
ard
to k
eep
up w
ith th
em.
27*
3, 2
−1,
0
Tabl
e co
ntin
ued
next
pag
e...
DSM-5 Update
17
DS
M-5
Cri
teri
a A
, B
Form
Item
Item
#
Indicated
May be Indicated
Not Indicated
Dis
trac
tib
ility
(i.
e.,
atte
nti
on t
oo e
asily
dra
wn
to
un
imp
orta
nt
or
irre
leva
nt
exte
rnal
sti
mu
li),
as r
epor
ted
or
obse
rved
.B
5
PA
ttent
ion
too
easil
y dr
awn
to u
nim
porta
nt o
r irre
leva
nt th
ings
.87
3, 2
−1,
0
TA
ttent
ion
too
easil
y dr
awn
to u
nim
porta
nt o
r irre
leva
nt th
ings
.91
3, 2
−1,
0
SRI g
et d
istra
cted
by
thin
gs th
at a
re n
ot im
porta
nt.
126
32
1, 0
Incr
ease
in g
oal-
dir
ecte
d a
ctiv
ity
(eit
her
soc
ially
, at
wor
k or
sc
hoo
l, o
r se
xual
ly)
or p
sych
omot
or a
git
atio
n (
i.e.
, p
urp
osel
ess
non
-goa
l-d
irec
ted
act
ivit
y).
B6
PH
as sh
own
an u
nusu
al in
crea
se in
soci
al, s
choo
l, or
sexu
al a
ctiv
i-tie
s.91
*-o
r- 35
3, 2
, 1-o
r-3,
2
−0
-and
-0
Is a
gita
ted
in th
e re
stle
ss se
nse.
1
TH
as sh
own
an u
nusu
al in
crea
se in
soci
al, s
choo
l, or
sexu
al a
ctiv
i-tie
s.14
2*-o
r- 83
3, 2
, 1-o
r-3,
2
−0
-and
-0
Is a
gita
ted
in th
e re
stle
ss se
nse.
1
SRI s
udde
nly
have
man
y m
ore
plan
s and
act
iviti
es th
an I
used
to.
149*
-or- 86
3 -or-
3, 2
21,
0
-and
-1,
0I a
m re
stle
ss.
−
Exce
ssiv
e in
volv
emen
t in
act
ivit
ies
that
hav
e a
hig
h p
oten
tial
fo
r p
ain
ful c
onse
qu
ence
s (e
.g.,
en
gag
ing
in u
nre
stra
ined
bu
yin
g
spre
es,
sexu
al in
dis
cret
ion
s, o
r fo
olis
h b
usi
nes
s in
vest
men
ts).
B7c
PSe
eks p
leas
ure
with
out c
arin
g ab
out w
hat b
ad th
ings
cou
ld h
ap-
pen.
198*
3, 2
, 1−
0
TSe
eks p
leas
ure
with
out c
arin
g ab
out w
hat b
ad th
ings
cou
ld h
ap-
pen.
154*
3, 2
, 1−
0
SRI d
o th
ings
that
feel
goo
d, n
o m
atte
r wha
t bad
thin
gs m
ight
ha
ppen
afte
rwar
ds.
166*
3, 2
−1,
0
DSM
-5 D
iagn
ostic
Crit
eria
is re
prin
ted
with
per
mis
sion
from
the
Dia
gnos
tic a
nd S
tatis
tical
Man
ual o
f Men
tal D
isor
ders
, Fift
h Ed
ition
™, (
Cop
yrig
ht ©
2013
). A
mer
ican
Psy
chia
tric A
ssoc
iatio
n.
All
Rig
hts R
eser
ved.
The
Am
eric
an P
sych
iatri
c Ass
ocia
tion
is n
ot a
ffilia
ted
with
and
is n
ot e
ndor
sing
this
pro
duct
.
Not
es:
P =
pare
nt; T
= te
ache
r; SR
= se
lf-re
port;
* =
man
ic sy
mpt
oms r
epre
sent
ing
the
mix
ed fe
atur
es sp
ecifi
er fo
r Maj
or D
epre
ssiv
e Ep
isod
e (s
ee T
able
6).
The
follo
win
g re
spon
se k
ey a
pplie
s to
the
crite
rion
stat
us sc
ore
requ
irem
ents
not
ed in
the
Indi
cate
d, M
ay b
e In
dica
ted,
and
Not
Indi
cate
d co
lum
ns: 0
= N
ot tr
ue a
t all
(Nev
er, S
eldo
m);
1 =
Just
a li
ttle
true
(Occ
asio
nally
); 2
= Pr
etty
muc
h tru
e (O
ften,
Qui
te a
bit)
; 3
= Ve
ry m
uch
true
(Ver
y of
ten,
Ver
y fr
eque
ntly
).
Inte
rpre
tativ
e C
onsi
dera
tions
:•
Pres
ence
of a
cur
rent
Man
ic E
piso
de su
gges
ts c
onsi
dera
tion
of B
ipol
ar I
Dis
orde
r.•
Whe
n co
nsid
erin
g D
SM-5
sym
ptom
cri
teri
a fo
r M
anic
Epi
sode
, the
ass
esso
r ne
eds t
o en
sure
the
yout
h ex
peri
ence
s the
Cri
teri
on A
sym
ptom
s nea
rly
ever
y da
y, a
nd th
at th
e C
rite
rion
B sy
mpt
oms
repr
esen
t a n
otic
eabl
e ch
ange
from
usu
al b
ehav
ior.
a C
rite
rion
A r
equi
res i
ncre
ased
goa
l-di
rect
ed a
ctiv
ity o
r in
crea
sed
ener
gy. I
ncre
ased
ene
rgy
is n
ot a
sses
sed
on th
e C
onne
rs C
BR
S. F
ollo
w-u
p is
rec
omm
ende
d to
che
ck if
ther
e ha
s bee
n an
incr
ease
in
ene
rgy.
b If
the
indi
vidu
al w
as h
ospi
taliz
ed fo
r th
e sy
mpt
oms o
f Man
ic E
piso
de, h
e/sh
e is
seve
re e
noug
h to
war
rant
con
side
ratio
n fo
r th
is d
iagn
osis
(eve
n if
sym
ptom
s did
not
per
sist
for
one
wee
k pr
ior
to
hosp
italiz
atio
n).
c If
Crit
erio
n A
May
be
Indi
cate
d or
is In
dica
ted
on th
e C
onne
rs C
BRS−
SR (i
tem
#89
), fo
llow
-up
is re
quire
d to
det
erm
ine
whe
ther
the
yout
h’s m
ood
is e
leva
ted,
exp
ansi
ve, o
r irr
itabl
e.d
The
Con
ners
CBR
S−T
does
not
ass
ess C
riter
ion
B2 (i
.e.,
decr
ease
d ne
ed fo
r sle
ep),
as m
ost t
each
ers d
o no
t hav
e th
e op
port
unity
to o
bser
ve th
is sy
mpt
om.
e C
rite
rion
B7
(exc
essi
ve in
volv
emen
t in
activ
ities
that
hav
e a
high
pot
enti
al fo
r pa
infu
l con
sequ
ence
s) is
ass
esse
d w
ith th
e ite
m “
Seek
s ple
asur
e w
ithou
t car
ing
abou
t wha
t bad
thin
gs c
ould
hap
pen”
[P
, T],
or “
I do
thin
gs th
at fe
el g
ood,
no
mat
ter
wha
t bad
thin
gs m
ight
hap
pen
afte
rwar
ds”
[SR
]. T
he sy
mpt
om c
rite
rion
des
crib
es a
ctiv
ities
ass
ocia
ted
with
shor
t-te
rm p
leas
ure
and
long
-ter
m c
on-
sequ
ence
s (e.
g., s
hopp
ing
spre
es, s
exua
l ind
iscr
etio
ns, r
isky
bus
ines
s inv
estm
ents
), bu
t “pl
easu
re”
or “
feel
ing
good
” is
not
spec
ified
in th
e D
SM-5
. Fur
ther
inve
stig
atio
n is
war
rant
ed to
det
erm
ine
if th
e in
divi
dual
is e
ngag
ed in
hig
h-ri
sk a
ctiv
ities
.
Tabl
e 7.
(c
ontin
ued)
DSM
-5 S
ympt
om C
ount
and
Crit
erio
n St
atus
Sco
re R
equi
rem
ents
for M
anic
Epi
sode
Conners Comprehensive Behavior Rating Scales™ (Conners CBRS™)
18
Tabl
e 8.
D
SM-5
Sym
ptom
Cou
nt a
nd C
riter
ion
Stat
us S
core
Req
uire
men
ts fo
r Man
ic E
piso
de, w
ith m
ixed
feat
ures
D
SM-5
Sym
ptom
Cou
nt R
equi
rem
ents
:•
Full
crite
ria m
et fo
r Man
ic E
piso
de•
At le
ast 3
of t
he 6
Crit
erio
n A
sym
ptom
s
DS
M-5
Cri
teri
on A
Form
Item
Item
#
Indicated
May be Indicated
Not Indicated
Pro
min
ent
dys
ph
oria
or
dep
ress
ed m
ood
as
ind
icat
ed b
y ei
ther
su
bje
ctiv
e re
por
t (e
.g.,
fee
ls s
ad o
r em
pty
) or
ob
serv
atio
n m
ade
by
oth
ers
(e.g
., a
pp
ears
tea
rfu
l).
1a
PIs
sad,
glo
omy,
or i
rrita
ble
for m
any
days
at a
tim
e.94
3, 2
10
TIs
sad,
glo
omy,
or i
rrita
ble
for m
any
days
at a
tim
e.19
33,
21
0
SRI f
eel s
ad, g
loom
y, o
r irr
itabl
e fo
r man
y da
ys a
t a ti
me.
115
3, 2
10
Dim
inis
hed
inte
rest
or
ple
asu
re in
all,
or
alm
ost
all,
act
ivit
ies
(as
ind
icat
ed b
y ei
ther
su
bje
ctiv
e ac
cou
nt
or o
bse
rvat
ion
mad
e b
y ot
her
s).
2
PH
as lo
st in
tere
st o
r ple
asur
e in
act
iviti
es.
533,
21
0
TH
as lo
st in
tere
st o
r ple
asur
e in
act
iviti
es.
463,
21
0
SRI d
on’t
feel
like
doi
ng th
ings
that
I us
ed to
enj
oy.
933,
2−
1, 0
Psy
chom
otor
ret
ard
atio
n n
earl
y ev
ery
day
(ob
serv
able
by
oth
ers;
n
ot m
erel
y su
bje
ctiv
e fe
elin
gs
of b
ein
g s
low
ed d
own
).3
PSe
ems p
hysi
cally
slow
ed d
own.
103
3, 2
10
TSe
ems p
hysi
cally
slow
ed d
own.
136
3, 2
10
SRI f
eel v
ery
slow
ed d
own
in m
y m
ovem
ents
.26
3, 2
10
Fati
gu
e or
loss
of
ener
gy.
4
PSe
ems t
ired;
has
low
ene
rgy.
171
3, 2
−1,
0
TSe
ems t
ired;
has
low
ene
rgy.
122
3, 2
−1,
0
SRI f
eel t
ired,
like
I do
n’t h
ave
enou
gh e
nerg
y.13
73,
2−
1, 0
Feel
ing
s of
wor
thle
ssn
ess
or e
xces
sive
or
inap
pro
pri
ate
gu
ilt (
not
m
erel
y se
lf-r
epro
ach
or
gu
ilt a
bou
t b
ein
g s
ick)
.5
PFe
els i
napp
ropr
iate
ly g
uilty
.12
4-o
r- 6
3, 2
-or-
3, 2
1 -or- 1
0-a
nd-
0Fe
els w
orth
less
.
TFe
els i
napp
ropr
iate
ly g
uilty
.16
9-o
r-16
6
3, 2
-or-
3, 2
1 -or- 1
0-a
nd-
0Fe
els w
orth
less
.
SRI f
eel m
ore
guilt
y th
an I
shou
ld.
118
-or-
135
3, 2
-or-
3, 2
− 1
1, 0
-and
-0
I fee
l wor
thle
ss.
Tabl
e co
ntin
ued
next
pag
e...
DSM-5 Update
19
DS
M-5
Cri
teri
on A
Form
Item
Item
#
Indicated
May be Indicated
Not Indicated
Rec
urr
ent
thou
gh
ts o
f d
eath
(n
ot j
ust
fea
r of
dyi
ng
), r
ecu
rren
t su
icid
al id
eati
on w
ith
out
a sp
ecifi
c p
lan
, or
a s
uic
ide
atte
mp
t or
a
spec
ific
pla
n f
or c
omm
itti
ng
su
icid
e.6
PH
as ta
lked
abo
ut, t
ried,
or p
lann
ed to
com
mit
suic
ide.
138
-or-
168
3, 2
, 1-o
r-3,
2, 1
−0
-and
-0
Has
repe
ated
thou
ghts
of d
eath
or d
ying
.−
TH
as ta
lked
abo
ut, t
ried,
or p
lann
ed to
com
mit
suic
ide.
58 -or-
191
3, 2
, 1-o
r-3,
2, 1
−0
-and
-0
Has
repe
ated
thou
ghts
of d
eath
or d
ying
.−
SRI t
hink
abo
ut h
urtin
g m
ysel
f.14
63,
2, 1
−0
DSM
-5 D
iagn
ostic
Crit
eria
is re
prin
ted
with
per
mis
sion
from
the
Dia
gnos
tic a
nd S
tatis
tical
Man
ual o
f Men
tal D
isor
ders
, Fift
h Ed
ition
™, (
Cop
yrig
ht ©
2013
). A
mer
ican
Psy
chia
tric A
ssoc
iatio
n.
All
Rig
hts R
eser
ved.
The
Am
eric
an P
sych
iatri
c Ass
ocia
tion
is n
ot a
ffilia
ted
with
and
is n
ot e
ndor
sing
this
pro
duct
.
Not
es:
P =
pare
nt; T
= te
ache
r; SR
= se
lf-re
port.
The
follo
win
g re
spon
se k
ey a
pplie
s to
the
crite
rion
stat
us sc
ore
requ
irem
ents
not
ed in
the
Indi
cate
d, M
ay b
e In
dica
ted,
and
Not
Indi
cate
d co
lum
ns: 0
= N
ot tr
ue a
t al
l (N
ever
, Sel
dom
); 1
= Ju
st a
littl
e tru
e (O
ccas
iona
lly);
2 =
Pret
ty m
uch
true
(Ofte
n, Q
uite
a b
it); 3
= V
ery
muc
h tru
e (V
ery
ofte
n, V
ery
freq
uent
ly).
Inte
rpre
tativ
e C
onsi
dera
tions
:•
Pres
ence
of a
cur
rent
Man
ic E
piso
de, w
ith m
ixed
feat
ures
sugg
ests
con
side
ratio
n of
Bip
olar
I D
isor
der.
• W
hen
cons
ider
ing
DSM
-5 sy
mpt
om c
rite
ria
for
Man
ic E
piso
de, w
ith m
ixed
feat
ures
, the
ass
esso
r ne
eds t
o en
sure
that
the
mix
ed sy
mpt
oms a
re p
rese
nt d
urin
g th
e m
ajor
ity o
f day
s of t
he c
urre
nt o
r m
ost r
ecen
t epi
sode
of m
ania
, and
that
the
mix
ed sy
mpt
oms r
epre
sent
a c
hang
e fr
om th
e pe
rson
’s u
sual
beh
avio
r.a
The
DSM
-5 n
o lo
nger
incl
udes
irri
tabi
lity
in C
rite
rion
A1
for
mix
ed fe
atur
es.
Inte
rpre
tativ
e co
nsid
erat
ions
for d
epre
ssiv
e sy
mpt
oms w
ith a
n as
teris
k in
Tab
le 5
app
ly to
dep
ress
ive
sym
ptom
s ass
esse
d fo
r the
Man
ic E
piso
de, w
ith m
ixed
feat
ures
spec
ifier
.
Tabl
e 8.
(c
ontin
ued)
DSM
-5 S
ympt
om C
ount
and
Crit
erio
n St
atus
Sco
re R
equi
rem
ents
for M
anic
Epi
sode
, with
mix
ed fe
atur
es
Conners Comprehensive Behavior Rating Scales™ (Conners CBRS™)
20
Tabl
e 9.
D
SM-5
Sym
ptom
Cou
nt a
nd C
riter
ion
Stat
us S
core
Req
uire
men
ts fo
r Gen
eral
ized
Anx
iety
Dis
orde
r D
SM-5
Sym
ptom
Cou
nt R
equi
rem
ents
:•CriteriaAandB
•Atleast1ofthe6CriterionCsym
ptom
sa
DS
M-5
Cri
teri
a A
, B
, C
Form
Item
Item
#
Indicated
May be Indicated
Not Indicated
Exce
ssiv
e an
xiet
y an
d w
orry
(ap
pre
hen
sive
exp
ecta
tion
), o
ccu
rrin
g
mor
e d
ays
than
not
for
at
leas
t 6
mon
ths,
ab
out
a n
um
ber
of
even
ts o
r ac
tivi
ties
(su
ch a
s w
ork
or s
choo
l per
form
ance
).A
PW
orrie
s abo
ut m
any
thin
gs.
683,
2−
1, 0
TW
orrie
s abo
ut m
any
thin
gs.
593,
2−
1, 0
SRI w
orry
abo
ut lo
ts o
f thi
ngs.
783,
2−
1, 0
The
ind
ivid
ual
fin
ds
it d
ifficu
lt t
o co
ntr
ol t
he
wor
ry.
B
PH
as tr
oubl
e co
ntro
lling
his
/her
wor
ries.
153
3, 2
10
TH
as tr
oubl
e co
ntro
lling
his
/her
wor
ries.
186
3, 2
10
SRI h
ave
troub
le c
ontro
lling
my
wor
ries.
383,
2−
1, 0
Res
tles
snes
s or
fee
ling
key
ed u
p o
r on
ed
ge.
C1
PA
ppea
rs “
on e
dge,
” ne
rvou
s, or
jum
py.
42 -or- 89
3, 2
-or-
3, 2
1 -or- 1
0-a
nd-
0R
estle
ss o
r ove
ract
ive.
TA
ppea
rs “
on e
dge,
” ne
rvou
s, or
jum
py.
194
-or-
139
3, 2
-or-
3, 2
1 -or- 1
0-a
nd-
0R
estle
ss o
r ove
ract
ive.
SRI f
eel n
ervo
us o
r jum
py.
3 -or- 86
3, 2
-or-
3, 2
−1,
0-a
nd-
1, 0
I am
rest
less
.−
Bei
ng
eas
ily f
atig
ued
.C
2
PSe
ems t
ired;
has
low
ene
rgy.
171
-or- 50
3, 2
-or-
3, 2
, 1
−1,
0-a
nd-
0G
ets w
orn
out w
ith w
orry
ing.
−
TSe
ems t
ired;
has
low
ene
rgy.
122
-or- 7
3, 2
-or-
3, 2
, 1
−1,
0-a
nd-
0G
ets w
orn
out w
ith w
orry
ing.
−
SRI f
eel t
ired,
like
I do
n't h
ave
enou
gh e
nerg
y.13
7-o
r- 35
3, 2
-or-
3, 2
−1,
0-a
nd-
1, 0
I get
wor
n ou
t with
wor
ryin
g.−
Diffi
cult
y co
nce
ntr
atin
g o
r m
ind
goi
ng
bla
nk.
C3
PH
as tr
oubl
e co
ncen
tratin
g.4
3, 2
−1,
0
TH
as tr
oubl
e co
ncen
tratin
g.19
93,
2−
1, 0
SRI h
ave
troub
le k
eepi
ng m
y m
ind
on th
ings
.11
33,
2−
1, 0
Irri
tab
ility
.C
4
PB
ecom
es ir
ritab
le w
hen
anxi
ous.
196
-or-
108
3, 2
-or-
3, 2
−1,
0-a
nd-
1, 0
Is ir
ritab
le a
nd e
asily
ann
oyed
by
othe
rs.
−
TB
ecom
es ir
ritab
le w
hen
anxi
ous.
35 -or-
174
3, 2
-or-
3, 2
−1,
0-a
nd-
0Is
irrit
able
and
eas
ily a
nnoy
ed b
y ot
hers
.1
SRW
hen
I fee
l ner
vous
, thi
ngs i
rrita
te m
e.14
23,
2−
1, 0
Tabl
e co
ntin
ued
next
pag
e...
DSM-5 Update
21
DS
M-5
Cri
teri
a A
, B
, C
Form
Item
Item
#
Indicated
May be Indicated
Not Indicated
Mu
scle
ten
sion
.C
5
PM
uscl
es g
et te
nse
whe
n w
orrie
d ab
out s
omet
hing
.7
3, 2
−1,
0
TM
uscl
es g
et te
nse
whe
n w
orrie
d ab
out s
omet
hing
.19
53,
21
0
SRM
y m
uscl
es g
et te
nse
whe
n I a
m w
orrie
d ab
out s
omet
hing
.13
3, 2
−1,
0
Sle
ep d
istu
rban
ce (
diffi
cult
y fa
llin
g o
r st
ayin
g a
slee
p,
or r
estl
ess,
u
nsa
tisf
yin
g s
leep
).C
6b
P
Wor
ries s
o m
uch
that
he/
she
has t
roub
le sl
eepi
ng.
119
-or-
110
-or-
126
-or-
181
3. 2
-or-
3, 2
-or-
3, 2
-or-
3, 2
10
-and
-1,
0-a
nd-
1, 0
-and
-1,
0
Wak
es u
p du
ring
the
nigh
t, th
en h
as tr
oubl
e fa
lling
bac
k to
slee
p.−
Has
trou
ble
falli
ng a
slee
p.−
Wak
es u
p to
o ea
rly.
−
TFa
lls a
slee
p in
cla
ss.
181
3, 2
, 1−
0
SR
I hav
e tro
uble
slee
ping
bec
ause
I am
wor
ryin
g ab
out s
tuff.
10 -or- 1 -or- 70 -or-
158
3, 2
-or-
3, 2
-or-
3, 2 or 3, 2
−1,
0-a
nd-
1, 0
-and
-1,
0-a
nd-
1, 0
I wak
e up
dur
ing
the
nigh
t and
hav
e tro
uble
falli
ng b
ack
to sl
eep.
−
I hav
e tro
uble
falli
ng a
slee
p.−
I wak
e up
too
early
(and
not
just
bec
ause
of t
he a
larm
clo
ck o
r my
pare
nts)
.−
DSM
-5 D
iagn
ostic
Crit
eria
is re
prin
ted
with
per
mis
sion
from
the
Dia
gnos
tic a
nd S
tatis
tical
Man
ual o
f Men
tal D
isor
ders
, Fift
h Ed
ition
™, (
Cop
yrig
ht ©
2013
). A
mer
ican
Psy
chia
tric A
ssoc
iatio
n.
All
Rig
hts R
eser
ved.
The
Am
eric
an P
sych
iatri
c Ass
ocia
tion
is n
ot a
ffilia
ted
with
and
is n
ot e
ndor
sing
this
pro
duct
.
Not
es:
P =
pare
nt; T
= te
ache
r; SR
= se
lf-re
port.
The
follo
win
g re
spon
se k
ey a
pplie
s to
the
crite
rion
stat
us sc
ore
requ
irem
ents
not
ed in
the
Indi
cate
d, M
ay b
e In
dica
ted,
and
Not
Indi
cate
d co
lum
ns: 0
= N
ot tr
ue a
t al
l (N
ever
, Sel
dom
); 1
= Ju
st a
littl
e tru
e (O
ccas
iona
lly);
2 =
Pret
ty m
uch
true
(Ofte
n, Q
uite
a b
it); 3
= V
ery
muc
h tru
e (V
ery
ofte
n, V
ery
freq
uent
ly).
Inte
rpre
tativ
e C
onsi
dera
tions
:a
The
DSM
-5 r
equi
res a
t lea
st o
ne o
f six
cri
teri
on C
sym
ptom
s for
chi
ldre
n; a
t lea
st th
ree
out o
f the
six
sym
ptom
s are
req
uire
d fo
r ad
ults
(no
clar
ifica
tion
is p
rovi
ded
rega
rdin
g “a
dole
scen
ts”)
. The
C
onne
rs C
BR
S Sy
mpt
om C
ount
is b
ased
on
the
DSM
-5 c
rite
ria
for
child
ren.
b C
riter
ion
C6
is a
sses
sed
indi
rect
ly (i
.e.,
“Fal
ls a
slee
p in
cla
ss”)
, as m
ost t
each
ers d
o no
t hav
e th
e op
port
unity
to o
bser
ve th
e yo
uth’
s sle
ep h
abits
at n
ight
. Fol
low
-up
is re
com
men
ded
to o
btai
n ad
ditio
nal i
nfor
-m
atio
n re
gard
ing
slee
p pr
oble
ms.
Tabl
e 9.
(c
ontin
ued)
DSM
-5 S
ympt
om C
ount
and
Crit
erio
n St
atus
Sco
re R
equi
rem
ents
for G
ener
aliz
ed A
nxie
ty D
isor
der
Conners Comprehensive Behavior Rating Scales™ (Conners CBRS™)
22
Tabl
e 10
. D
SM-5
Sym
ptom
Cou
nt a
nd C
riter
ion
Stat
us S
core
Req
uire
men
ts fo
r Sep
arat
ion
Anx
iety
Dis
orde
r DSM
-5Sym
ptom
CountRequirements:A
tleast3ofthe8sym
ptom
s.
DS
M-5
Cri
teri
on A
Form
Item
Item
#
Indicated
May be Indicated
Not Indicated
Rec
urr
ent
exce
ssiv
e d
istr
ess
wh
en a
nti
cip
atin
g o
r ex
per
ien
cin
g
sep
arat
ion
fro
m h
ome
or f
rom
maj
or a
ttac
hm
ent
fig
ure
s.1
PIs
wor
ried
or d
istre
ssed
abo
ut b
eing
sepa
rate
d fr
om c
areg
iver
s.76
3, 2
10
TSe
ems w
orrie
d or
dist
ress
ed a
bout
bei
ng se
para
ted
from
car
egiv
ers.
13,
21
0
SRI w
orry
abo
ut b
eing
apa
rt fr
om m
y fa
mily
.61
3, 2
−1,
0
Per
sist
ent
and
exc
essi
ve w
orry
ab
out
losi
ng
maj
or a
ttac
hm
ent
fig
ure
s or
ab
out
pos
sib
le h
arm
to
them
, su
ch a
s ill
nes
s, in
jury
, d
isas
ters
, or
dea
th.
2
PW
orrie
s abo
ut so
met
hing
bad
hap
peni
ng to
fam
ily m
embe
rs.
313,
2−
1, 0
TSe
ems w
orrie
d ab
out s
omet
hing
bad
hap
peni
ng to
fam
ily m
embe
rs.
170
3, 2
10
SRI w
orry
that
som
ethi
ng b
ad m
ight
hap
pen
to m
y fa
mily
.24
32
1, 0
Per
sist
ent
and
exc
essi
ve w
orry
ab
out
exp
erie
nci
ng
an
un
tow
ard
ev
ent
(e.g
., g
etti
ng
lost
, b
ein
g k
idn
app
ed,
hav
ing
an
acc
iden
t,
bec
omin
g il
l) t
hat
cau
ses
sep
arat
ion
fro
m a
maj
or a
ttac
hm
ent
fig
ure
.
3
PW
orrie
s abo
ut g
ettin
g lo
st o
r bei
ng k
idna
pped
.88
3, 2
10
TSe
ems w
orrie
d ab
out g
ettin
g lo
st o
r bei
ng k
idna
pped
.68
3, 2
10
SRI w
orry
abo
ut g
ettin
g lo
st o
r bei
ng k
idna
pped
.14
53,
2−
1, 0
Per
sist
ent
relu
ctan
ce o
r re
fusa
l to
go
out,
aw
ay f
rom
hom
e, t
o sc
hoo
l, t
o w
ork,
or
else
wh
ere
bec
ause
of
fear
of
sep
arat
ion
.4
PR
efus
es to
go
to sc
hool
or o
ther
pla
ces f
or fe
ar o
f bei
ng se
para
ted
from
fam
ily m
embe
rs.
443,
21
0
TM
akes
exc
uses
in o
rder
to se
e hi
s/her
fam
ily d
urin
g th
e sc
hool
day
.18
93,
21
0
SRI d
on’t
like
goin
g to
scho
ol o
r oth
er p
lace
s whe
re I
am a
way
from
m
y fa
mily
.15
13,
21
0
Per
sist
ent
and
exc
essi
ve f
ear
of o
r re
luct
ance
ab
out
bei
ng
alo
ne
or
wit
hou
t m
ajor
att
ach
men
t fi
gu
res
at h
ome
or in
oth
er s
etti
ng
s.5
PIs
afr
aid
of b
eing
alo
ne w
ithou
t fam
ily o
r oth
er fa
mili
ar a
dults
.41 -o
r- 58
3, 2
-or-
3, 2
−1,
0-a
nd-
1, 0
Is a
frai
d of
bei
ng a
lone
.−
TIs
afr
aid
of b
eing
alo
ne w
ithou
t fam
ily o
r oth
er fa
mili
ar a
dults
.26
3, 2
10
SRI g
et sc
ared
if I’
m n
ot w
ith m
y fa
mily
or o
ther
adu
lts I
know
wel
l.14 -o
r-14
0
3, 2
-or-
3, 2
−1,
0-a
nd-
1, 0
I wor
ry a
bout
bei
ng a
lone
.−
Per
sist
ent
relu
ctan
ce o
r re
fusa
l to
slee
p a
way
fro
m h
ome
or t
o g
o to
sle
ep w
ith
out
bei
ng
nea
r a
maj
or a
ttac
hm
ent
fig
ure
.6a
PIs
afr
aid
to g
o to
slee
p w
ithou
t a fa
mily
mem
ber n
earb
y.16
03,
21
0
T −
−−
−−
SRI’
m a
frai
d to
go
to sl
eep
if m
y fa
mily
is n
ot n
ear m
e.12
73,
21
0
Rep
eate
d n
igh
tmar
es in
volv
ing
th
e th
eme
of s
epar
atio
n.
7a
PH
as n
ight
mar
es a
bout
bei
ng se
para
ted
from
fam
ily.
813,
2, 1
−0
T −
−−
−−
SRI h
ave
bad
drea
ms a
bout
bei
ng a
way
from
my
fam
ily.
493,
21
0
Tabl
e co
ntin
ued
next
pag
e...
DSM-5 Update
23
DS
M-5
Cri
teri
on A
Form
Item
Item
#
Indicated
May be Indicated
Not Indicated
Rep
eate
d c
omp
lain
ts o
f p
hys
ical
sym
pto
ms
(e.g
., h
ead
ach
es,
stom
ach
ach
es,
nau
sea,
vom
itin
g)
wh
en s
epar
atio
n f
rom
maj
or
atta
chm
ent
fig
ure
s oc
curs
or
is a
nti
cip
ated
.8
PC
ompl
ains
of a
ches
and
pai
ns w
hen
wor
ried
abou
t bei
ng se
para
ted
from
fam
ily.
184
3, 2
, 1−
0
TC
ompl
ains
of a
ches
and
pai
ns w
hen
wor
ried
abou
t bei
ng se
para
ted
from
fam
ily.
111
3, 2
, 1−
0
SRI g
et a
ches
and
pai
ns w
hen
I thi
nk a
bout
bei
ng a
way
from
my
fam
ily.
523,
21
0
DSM
-5 D
iagn
ostic
Crit
eria
is re
prin
ted
with
per
mis
sion
from
the
Dia
gnos
tic a
nd S
tatis
tical
Man
ual o
f Men
tal D
isor
ders
, Fift
h Ed
ition
™, (
Cop
yrig
ht ©
2013
). A
mer
ican
Psy
chia
tric A
ssoc
iatio
n.
All
Rig
hts R
eser
ved.
The
Am
eric
an P
sych
iatri
c Ass
ocia
tion
is n
ot a
ffilia
ted
with
and
is n
ot e
ndor
sing
this
pro
duct
.
Not
es:
P =
pare
nt; T
= te
ache
r; SR
= se
lf-re
port.
The
follo
win
g re
spon
se k
ey a
pplie
s to
the
crite
rion
stat
us sc
ore
requ
irem
ents
not
ed in
the
Indi
cate
d, M
ay b
e In
dica
ted,
and
Not
Indi
cate
d co
lum
ns: 0
= N
ot tr
ue a
t al
l (N
ever
, Sel
dom
); 1
= Ju
st a
littl
e tru
e (O
ccas
iona
lly);
2 =
Pret
ty m
uch
true
(Ofte
n, Q
uite
a b
it); 3
= V
ery
muc
h tru
e (V
ery
ofte
n, V
ery
freq
uent
ly).
Inte
rpre
tativ
e C
onsi
dera
tions
:a
The
Con
ners
CBR
S−T
does
not
ass
ess C
riter
ion
A6
(relu
ctan
ce o
r ref
usal
to sl
eep
away
from
his
/her
hom
e, o
r to
go to
slee
p w
ithou
t an
atta
chm
ent fi
gure
) or C
riter
ion
A7
(has
nig
htm
ares
abo
ut se
para
tion)
, as
mos
t tea
cher
s do
not h
ave
the
oppo
rtun
ity to
obs
erve
thes
e sy
mpt
oms.
Tabl
e 10
. (
cont
inue
d) D
SM-5
Sym
ptom
Cou
nt a
nd C
riter
ion
Stat
us S
core
Req
uire
men
ts fo
r Sep
arat
ion
Anx
iety
Dis
orde
r
Conners Comprehensive Behavior Rating Scales™ (Conners CBRS™)
24
Tabl
e 11
. D
SM-5
Sym
ptom
Cou
nt a
nd C
riter
ion
Stat
us S
core
Req
uire
men
ts fo
r Soc
ial A
nxie
ty D
isor
der (
Soci
al P
hobi
a)
DSM-5Sym
ptom
CountRequirements:C
riteriaA,B
,C,andD.
DS
M-5
Cri
teri
on A
, B
, C
, D
Form
Item
Item
#
Indicated
May be Indicated
Not Indicated
Mar
ked
fea
r or
an
xiet
y ab
out
one
or m
ore
soci
al s
itu
atio
ns
in w
hic
h
the
ind
ivid
ual
is e
xpos
ed t
o p
ossi
ble
scr
uti
ny
by
oth
ers.
Exa
mp
les
incl
ud
e so
cial
inte
ract
ion
s (e
.g.,
hav
ing
a c
onve
rsat
ion
, m
eeti
ng
u
nfa
mili
ar p
eop
le),
bei
ng
ob
serv
ed (
e.g
., e
atin
g o
r d
rin
kin
g),
an
d p
erfo
rmin
g in
fro
nt
of o
ther
s (e
.g.,
giv
ing
a s
pee
ch).
Not
e:
In c
hild
ren
, th
e an
xiet
y m
ust
occ
ur
in p
eer
sett
ing
s an
d n
ot j
ust
d
uri
ng
inte
ract
ion
s w
ith
ad
ult
s.
Aa
PPa
nics
abo
ut so
cial
situ
atio
ns o
r whe
n do
ing
thin
gs in
fron
t of
peop
le.
223,
2−
1, 0
TPa
nics
abo
ut so
cial
situ
atio
ns o
r whe
n do
ing
thin
gs in
fron
t of
peop
le.
200
3, 2
10
SRI g
et p
anic
ky w
hen
I hav
e to
do
thin
gs in
fron
t of o
ther
peo
ple
(like
ans
wer
que
stio
ns o
r giv
e a
talk
).46
32
1, 0
The
ind
ivid
ual
fea
rs t
hat
he
or s
he
will
act
in a
way
or
show
an
xiet
y sy
mp
tom
s th
at w
ill b
e n
egat
ivel
y ev
alu
ated
(i.
e.,
will
b
e h
um
iliat
ing
or
emb
arra
ssin
g;
will
lead
to
reje
ctio
n o
r off
end
ot
her
s).
B
PFe
ars b
eing
em
barr
asse
d or
hum
iliat
ed in
fron
t of p
eers
.18
7-o
r- 63
3 -or- 3
2 -or- 2
1, 0
-and
-1,
0W
orrie
s abo
ut w
hat o
ther
s thi
nk o
f him
/her
.
TFe
ars b
eing
em
barr
asse
d or
hum
iliat
ed in
fron
t of p
eers
.34 -o
r- 17
3 -or- 3
2 -or- 2
1, 0
-and
-1,
0W
orrie
s abo
ut w
hat o
ther
s thi
nk o
f him
/her
.
SRI w
orry
that
oth
er p
eopl
e m
ight
laug
h at
me
or m
ake
fun
of m
e.44 -o
r-16
1
3 -or- 3
2 -or- 2
1, 0
-and
-1,
0I w
orry
abo
ut w
hat o
ther
s thi
nk o
f me.
The
soci
al s
itu
atio
ns
alm
ost
alw
ays
pro
voke
fea
r or
an
xiet
y.
Not
e: I
n c
hild
ren
, th
e fe
ar o
r an
xiet
y m
ay b
e ex
pre
ssed
by
cryi
ng
, ta
ntr
um
s, f
reez
ing
, cl
ing
ing
, sh
rin
kin
g,
or f
ailin
g t
o sp
eak
in s
ocia
l si
tuat
ion
s.
Ca,
b, c
P
Pani
cs a
bout
soci
al si
tuat
ions
or w
hen
doin
g th
ings
in fr
ont o
f pe
ople
.22 -o
r- 56
3 -or- 3
2 -or- 2
1, 0
-and
-1,
0C
ries,
thro
ws t
antru
ms,
avoi
ds, o
r fre
ezes
in so
cial
situ
atio
ns w
ith
unfa
mili
ar p
eopl
e.
T
Pani
cs a
bout
soci
al si
tuat
ions
or w
hen
doin
g th
ings
in fr
ont o
f pe
ople
.20
0-o
r-19
7
3 -or- 3
2 -or- 2
1, 0
-and
-1,
0C
ries,
thro
ws t
antru
ms,
avoi
ds, o
r fre
ezes
in so
cial
situ
atio
ns w
ith
unfa
mili
ar p
eopl
e.
SRI g
et p
anic
ky w
hen
I hav
e to
do
thin
gs in
fron
t of o
ther
peo
ple
(like
ans
wer
que
stio
ns o
r giv
e a
talk
).46
32
1, 0
Tabl
e co
ntin
ued
next
pag
e...
DSM-5 Update
25
DS
M-5
Cri
teri
on A
, B
, C
, D
Form
Item
Item
#
Indicated
May be Indicated
Not Indicated
The
soci
al s
itu
atio
ns
are
avoi
ded
or
end
ure
d w
ith
inte
nse
fea
r or
an
xiet
y.D
P
Avoi
ds o
r bec
omes
dis
tress
ed a
bout
doi
ng th
ings
in fr
ont o
f pe
ople
.92 -o
r-17
6
3, 2
-or-
3, 2
−1,
0-a
nd-
0Av
oids
soci
al si
tuat
ions
, or b
ecom
es d
istre
ssed
whe
n re
quire
d to
pa
rtici
pate
.1
T
Avoi
ds o
r bec
omes
dis
tress
ed a
bout
doi
ng th
ings
in fr
ont o
f pe
ople
.24 -o
r-17
1
3, 2
-or-
3, 2
−1,
0-a
nd-
0Av
oids
soci
al si
tuat
ions
, or b
ecom
es d
istre
ssed
whe
n re
quire
d to
pa
rtici
pate
.1
SR
I avo
id o
r get
real
ly st
ress
ed o
ut a
bout
doi
ng th
ings
in fr
ont o
f ot
her p
eopl
e.74 -o
r- 84
3, 2
-or-
3, 2
−1,
0-a
nd-
1, 0
I avo
id o
r get
real
ly st
ress
ed o
ut b
y ta
lkin
g to
unf
amili
ar p
eopl
e.−
DSM
-5 D
iagn
ostic
Crit
eria
is re
prin
ted
with
per
mis
sion
from
the
Dia
gnos
tic a
nd S
tatis
tical
Man
ual o
f Men
tal D
isor
ders
, Fift
h Ed
ition
™, (
Cop
yrig
ht ©
2013
). A
mer
ican
Psy
chia
tric A
ssoc
iatio
n.
All
Rig
hts R
eser
ved.
The
Am
eric
an P
sych
iatri
c Ass
ocia
tion
is n
ot a
ffilia
ted
with
and
is n
ot e
ndor
sing
this
pro
duct
.
Not
es:
P =
pare
nt; T
= te
ache
r; SR
= se
lf-re
port.
The
follo
win
g re
spon
se k
ey a
pplie
s to
the
crite
rion
stat
us sc
ore
requ
irem
ents
not
ed in
the
Indi
cate
d, M
ay b
e In
dica
ted,
and
Not
Indi
cate
d co
lum
ns: 0
= N
ot tr
ue a
t al
l (N
ever
, Sel
dom
); 1
= Ju
st a
littl
e tru
e (O
ccas
iona
lly);
2 =
Pret
ty m
uch
true
(Ofte
n, Q
uite
a b
it); 3
= V
ery
muc
h tru
e (V
ery
ofte
n, V
ery
freq
uent
ly).
Inte
rpre
tativ
e C
onsi
dera
tions
:So
cial
Anx
iety
Dis
orde
r (S
ocia
l Pho
bia)
Cri
teri
on E
stat
es th
at fe
ar o
r an
xiet
y ab
out s
ocia
l situ
atio
ns is
out
of p
ropo
rtio
n to
the
actu
al th
reat
pos
ed b
y th
e so
cial
situ
atio
n an
d to
the
soci
ocul
tura
l con
-te
xt. I
f the
Sym
ptom
Cou
nt is
pro
babl
y m
et fo
r So
cial
Anx
iety
Dis
orde
r, fo
llow
-up
is r
ecom
men
ded
to e
nsur
e th
is r
equi
rem
ent i
s sat
isfie
d.a
Cri
teri
on A
(fea
r or
anx
iety
abo
ut si
tuat
ions
that
invo
lve
poss
ibly
scru
tiny
by
othe
rs) a
nd C
(alw
ays e
xper
ienc
es fe
ar o
r an
xiet
y in
rel
evan
t soc
ial s
ituat
ions
) foc
us o
n fe
ar o
r an
xiet
y, r
athe
r th
an
pani
c. F
urth
er in
vest
igat
ion
is w
arra
nted
to d
eter
min
e if
ther
e is
mar
ked
fear
or
anxi
ety
in so
cial
situ
atio
ns.
b C
rite
rion
C d
oes n
ot li
mit
anxi
ety-
prov
okin
g so
cial
situ
atio
ns to
thos
e th
at in
volv
e un
fam
iliar
peo
ple.
Fur
ther
inve
stig
atio
n is
war
rant
ed to
det
erm
ine
if fe
ar o
r an
xiet
y is
exp
ress
ed in
soci
al si
tua-
tions
with
fam
iliar
peo
ple.
c T
he C
onne
rs C
BR
S−SR
item
for
Cri
teri
on C
focu
ses o
n pe
rfor
man
ce r
athe
r th
an so
cial
situ
atio
ns a
nd d
oes n
ot in
clud
e po
ssib
le c
hild
exp
ress
ions
of f
ear
or a
nxie
ty. F
urth
er in
vest
igat
ion
is w
ar-
rant
ed to
det
erm
ine
if th
ere
is m
arke
d fe
ar o
r an
xiet
y, e
xpre
ssed
via
chi
ld e
xpre
ssio
ns o
r ot
herw
ise,
in o
ne o
r m
ore
soci
al si
tuat
ions
.
Tabl
e 11
. (
cont
inue
d) D
SM-5
Sym
ptom
Cou
nt a
nd C
riter
ion
Stat
us S
core
Req
uire
men
ts fo
r Soc
ial A
nxie
ty D
isor
der (
Soci
al P
hobi
a)
Conners Comprehensive Behavior Rating Scales™ (Conners CBRS™)
26
Tabl
e 12
. D
SM-5
Sym
ptom
Cou
nt a
nd C
riter
ion
Stat
us S
core
Req
uire
men
ts fo
r Obs
essi
ve-C
ompu
lsiv
e D
isor
der
DS
M-5
Sym
ptom
Cou
nt R
equi
rem
ents
:•Bo
thObsessionssymptom
s -o
r-•Bo
thCom
pulsionssym
ptom
s DS
M-5
Cri
teri
on A
Form
Item
Item
#
Indicated
May be Indicated
Not Indicated
Ob
sess
ion
s
Rec
urr
ent
and
per
sist
ent
thou
gh
ts,
urg
es,
or im
ages
th
at a
re
exp
erie
nce
d,
at s
ome
tim
e d
uri
ng
th
e d
istu
rban
ce,
as in
tru
sive
an
d
un
wan
ted
, an
d t
hat
in m
ost
ind
ivid
ual
s ca
use
mar
ked
an
xiet
y or
d
istr
ess.
A1
PG
ets s
tuck
on
thou
ghts,
urg
es, o
r men
tal p
ictu
res t
hat a
re u
pset
ting.
159
-or-
183
3, 2
-or-
3, 2
, 1
10
-and
-0
Cre
ates
thou
ghts
or p
ictu
res t
hat g
et st
uck
in h
is/h
er m
ind.
−
TG
ets s
tuck
on
thou
ghts,
urg
es, o
r men
tal p
ictu
res t
hat a
re u
pset
ting.
9 -or-
158
3, 2
-or-
3, 2
, 1
10
-and
-0
Cre
ates
thou
ghts
or p
ictu
res t
hat g
et st
uck
in h
is/h
er m
ind.
−
SRU
pset
ting
thou
ghts
or p
ictu
res g
et st
uck
in m
y m
ind
and
it's h
ard
to m
ake
them
go
away
.94 -o
r- 31
3, 2
-or-
3, 2
−1,
0-a
nd-
1, 0
I cre
ate
upse
tting
thou
ghts
or p
ictu
res t
hat g
et st
uck
in m
y m
ind.
−
The
ind
ivid
ual
att
emp
ts t
o ig
nor
e or
su
pp
ress
su
ch t
hou
gh
ts,
urg
es,
or im
ages
, or
to
neu
tral
ize
them
wit
h s
ome
oth
er t
hou
gh
t or
ac
tion
(i.
e.,
by
per
form
ing
a c
omp
uls
ion
).A
2
PH
as u
pset
ting
thou
ghts
, urg
es, o
r men
tal p
ictu
res t
hat h
e/sh
e tri
es
to m
ake
go a
way
.84
3, 2
, 1−
0
TH
as u
pset
ting
thou
ghts
, urg
es, o
r men
tal p
ictu
res t
hat h
e/sh
e tri
es
to m
ake
go a
way
.53
3, 2
, 1−
0
SRU
pset
ting
thou
ghts
or p
ictu
res g
et st
uck
in m
y m
ind
and
I try
to
mak
e th
em g
o aw
ay.
223,
2−
1, 0
Com
pu
lsio
ns
Rep
etit
ive
beh
avio
rs (
e.g
., h
and
was
hin
g,
ord
erin
g,
chec
kin
g)
or
men
tal a
cts
(e.g
., p
rayi
ng
, co
un
tin
g,
rep
eati
ng
wor
ds
sile
ntl
y) t
hat
th
e in
div
idu
al f
eels
dri
ven
to
per
form
in r
esp
onse
to
an o
bse
ssio
n
or a
ccor
din
g t
o ru
les
that
mu
st b
e ap
plie
d r
igid
ly.
A1
PD
oes t
hing
s ove
r and
ove
r aga
in (f
or e
xam
ple,
han
d w
ashi
ng,
doub
le-c
heck
ing,
or c
ount
ing)
.17
83,
21
0
TD
oes t
hing
s ove
r and
ove
r aga
in (f
or e
xam
ple,
han
d w
ashi
ng,
doub
le-c
heck
ing,
or c
ount
ing)
.12
13,
21
0
SRIt’
s har
d to
stop
mys
elf f
rom
doi
ng c
erta
in th
ings
ove
r and
ove
r ag
ain
(like
cou
ntin
g, c
heck
ing
lock
s or o
ther
thin
gs, o
r was
hing
m
y ha
nds)
.54
3, 2
−1,
0
The
beh
avio
rs o
r m
enta
l act
s ar
e ai
med
at
pre
ven
tin
g o
r re
du
cin
g
anxi
ety
or d
istr
ess,
or
pre
ven
tin
g s
ome
dre
aded
eve
nt
or s
itu
atio
n;
how
ever
, th
ese
beh
avio
rs o
r m
enta
l act
s ar
e n
ot c
onn
ecte
d in
a
real
isti
c w
ay w
ith
wh
at t
hey
are
des
ign
ed t
o n
eutr
aliz
e or
pre
ven
t,
or a
re c
lear
ly e
xces
sive
. N
ote:
You
ng
ch
ildre
n m
ay n
ot b
e ab
le t
o ar
ticu
late
th
e ai
ms
of t
hes
e b
ehav
iors
or
men
tal a
cts.
A2
PD
oes t
hing
s ove
r and
ove
r aga
in to
redu
ce a
nxie
ty, b
ut in
an
unre
-al
istic
or e
xces
sive
way
.17
53,
2, 1
−0
TD
oes t
hing
s ove
r and
ove
r aga
in to
redu
ce a
nxie
ty, b
ut in
an
unre
-al
istic
or e
xces
sive
way
.18
33,
2, 1
−0
SRD
oing
thin
gs o
ver a
nd o
ver a
gain
hel
ps m
e fe
el le
ss w
orrie
d.11
93,
2−
1, 0
DSM
-5 D
iagn
ostic
Crit
eria
is re
prin
ted
with
per
mis
sion
from
the
Dia
gnos
tic a
nd S
tatis
tical
Man
ual o
f Men
tal D
isor
ders
, Fift
h Ed
ition
™, (
Cop
yrig
ht ©
2013
). A
mer
ican
Psy
chia
tric A
ssoc
iatio
n.
All
Rig
hts R
eser
ved.
The
Am
eric
an P
sych
iatri
c Ass
ocia
tion
is n
ot a
ffilia
ted
with
and
is n
ot e
ndor
sing
this
pro
duct
.
Not
es:
P =
pare
nt; T
= te
ache
r; SR
= se
lf-re
port.
The
follo
win
g re
spon
se k
ey a
pplie
s to
the
crite
rion
stat
us sc
ore
requ
irem
ents
not
ed in
the
Indi
cate
d, M
ay b
e In
dica
ted,
and
Not
Indi
cate
d co
lum
ns: 0
= N
ot tr
ue a
t al
l (N
ever
, Sel
dom
); 1
= Ju
st a
littl
e tru
e (O
ccas
iona
lly);
2 =
Pret
ty m
uch
true
(Ofte
n, Q
uite
a b
it); 3
= V
ery
muc
h tru
e (V
ery
ofte
n, V
ery
freq
uent
ly).
DSM-5 Update
27
Tabl
e 13
. D
SM-5
Sym
ptom
Cou
nt a
nd C
riter
ion
Stat
us S
core
Req
uire
men
ts fo
r Aut
ism
Spe
ctru
m D
isor
der
DS
M-5
Sym
ptom
Cou
nt R
equi
rem
ents
: •CriterionA,includingA1,A2,andA3
•Atleast2ofthe4CriterionBsymptom
s
DS
M-5
Cri
teri
a A
, B
Form
Item
Item
#
Indicated
May be Indicated
Not Indicated
Defi
cits
in s
ocia
l-em
otio
nal
rec
ipro
city
, ra
ng
ing
, fo
r ex
amp
le,
from
ab
nor
mal
soc
ial a
pp
roac
h a
nd
fai
lure
of
nor
mal
bac
k-an
d-f
orth
co
nve
rsat
ion
; to
red
uce
d s
har
ing
of
inte
rest
s, e
mot
ion
s, o
r aff
ect;
to
fai
lure
to
init
iate
or
resp
ond
to
soci
al in
tera
ctio
ns.
A1
P
Doe
s not
reco
gniz
e or
reac
t app
ropr
iate
ly to
oth
er p
eopl
e’s m
oods
or
feel
ings
.85 -o
r-77
(R)
-or-
156
-or-
186
(R)
3 -or- 3 -or-
3, 2
-or- 3
21,
0-a
nd-
2, 1
, 0-a
nd-
1, 0
-and 1, 0
Is in
tere
sted
in o
ther
peo
ple,
or i
n w
hat t
hey
are
doin
g. (R
)−
Has
trou
ble
star
ting
a co
nver
satio
n or
kee
ping
a c
onve
rsat
ion
goin
g.−
Shar
es fe
elin
gs, i
nter
ests
, or a
chie
vem
ents
with
oth
ers.
(R)
2
T
Doe
s not
reco
gniz
e or
reac
t app
ropr
iate
ly to
oth
er p
eopl
e’s m
oods
or
feel
ings
.80 -o
r-76
(R)
-or- 48 -or-
2 (R
)
3 -or- 3 -or-
3, 2
-or- 3
21,
0-a
nd-
2, 1
, 0-a
nd-
1, 0
-and 1, 0
Is in
tere
sted
in o
ther
peo
ple,
or i
n w
hat t
hey
are
doin
g. (R
)−
Has
trou
ble
star
ting
a co
nver
satio
n or
kee
ping
a c
onve
rsat
ion
goin
g.−
Shar
es fe
elin
gs, i
nter
ests
, or a
chie
vem
ents
with
oth
ers.
(R)
2
Defi
cits
in n
onve
rbal
com
mu
nic
ativ
e b
ehav
iors
use
d f
or s
ocia
l in
tera
ctio
n,
ran
gin
g,
for
exam
ple
, fr
om p
oorl
y in
teg
rate
d v
erb
al
and
non
verb
al c
omm
un
icat
ion
; to
ab
nor
mal
itie
s in
eye
con
tact
an
d
bod
y la
ng
uag
e or
defi
cits
in u
nd
erst
and
ing
an
d u
se o
f g
estu
res;
to
a to
tal l
ack
of f
acia
l exp
ress
ion
s an
d n
onve
rbal
com
mu
nic
atio
n.
A2
PU
ses f
acia
l exp
ress
ions
, eye
con
tact
, and
han
d ge
stur
es
appr
opria
tely
. (R
)2
(R)
32
1, 0
TU
ses f
acia
l exp
ress
ions
, eye
con
tact
, and
han
d ge
stur
es
appr
opria
tely
. (R
)13
8 (R
)3
21,
0
Defi
cits
in d
evel
opin
g,
mai
nta
inin
g,
and
un
der
stan
din
g
rela
tion
ship
s, r
ang
ing
, fo
r ex
amp
le,
from
diffi
cult
ies
adju
stin
g
beh
avio
r to
su
it v
ario
us
soci
al c
onte
xts;
to
diffi
cult
ies
in s
har
ing
im
agin
ativ
e p
lay
or in
mak
ing
fri
end
s; t
o ab
sen
ce o
f in
tere
st in
p
eers
.
A3
PIs
una
ble
to d
evel
op p
eer r
elat
ions
hips
.64
32,
10
TIs
una
ble
to d
evel
op p
eer r
elat
ions
hips
.11
83
2, 1
0
Ste
reot
yped
or
rep
etit
ive
mot
or m
ovem
ents
, u
se o
f ob
ject
s, o
r sp
eech
(e.
g.,
sim
ple
mot
or s
tere
otyp
ies,
lin
ing
up
toy
s or
flip
pin
g
obje
cts,
ech
olal
ia,
idio
syn
crat
ic p
hra
ses)
.B
1
P
Rep
eats
bod
y m
ovem
ents
ove
r and
ove
r (fo
r exa
mpl
e, ro
ckin
g,
spin
ning
, or h
and
flapp
ing)
.18
8
-or- 48
3, 2
, 1
-or-
3, 2
, 1
−0
-and
-
0
Unu
sual
use
of l
angu
age
(for
exa
mpl
e, re
peat
s thi
ngs,
soun
ds
like
a ro
bot o
r a li
ttle
prof
esso
r, us
es a
hig
h-pi
tche
d vo
ice,
or u
ses
mad
e-up
wor
ds).
−
T
Rep
eats
bod
y m
ovem
ents
ove
r and
ove
r (fo
r exa
mpl
e, ro
ckin
g,
spin
ning
, or h
and
flapp
ing)
.13
2
-or- 69
3, 2
, 1
-or-
3, 2
, 1
−0
-and
-
0
Unu
sual
use
of l
angu
age
(e.g
., re
peat
s thi
ngs,
soun
ds li
ke a
robo
t or
a li
ttle
prof
esso
r, us
es a
hig
h-pi
tche
d vo
ice,
or u
ses m
ade-
up
wor
ds).
−
Tabl
e co
ntin
ued
next
pag
e...
Conners Comprehensive Behavior Rating Scales™ (Conners CBRS™)
28
DS
M-5
Cri
teri
a A
, B
Form
Item
Item
#
Indicated
May be Indicated
Not Indicated
Insi
sten
ce o
n s
amen
ess,
infl
exib
le a
dh
eren
ce t
o ro
uti
nes
, or
ri
tual
ized
pat
tern
s of
ver
bal
or
non
verb
al b
ehav
ior
(e.g
., e
xtre
me
dis
tres
s at
sm
all c
han
ges
, d
ifficu
ltie
s w
ith
tra
nsi
tion
s, r
igid
th
inki
ng
pat
tern
s, g
reet
ing
rit
ual
s, n
eed
to
take
sam
e ro
ute
or
eat
sam
e fo
od v
ery
day
).
B2
PH
as ri
tual
s or r
outin
es a
nd g
ets u
nusu
ally
ups
et if
thes
e ar
e in
ter-
rupt
ed o
r cha
nged
.97
3, 2
10
TH
as ri
tual
s or r
outin
es a
nd g
ets u
nusu
ally
ups
et if
thes
e ar
e in
ter-
rupt
ed o
r cha
nged
.94
3, 2
10
Hig
hly
res
tric
ted
, fi
xate
d in
tere
sts
that
are
ab
nor
mal
in in
ten
sity
or
foc
us
(e.g
., s
tron
g a
ttac
hm
ent
to o
r p
reoc
cup
atio
n w
ith
un
usu
al
obje
cts,
exc
essi
vely
cir
cum
scri
bed
or
per
seve
rati
ve in
tere
sts)
.B
3P
Has
lim
ited
inte
rest
s or g
ets s
tuck
on
one
thin
g.14
33,
2−
1, 0
TH
as li
mite
d in
tere
sts o
r get
s stu
ck o
n on
e th
ing.
183,
2−
1, 0
DSM
-5 D
iagn
ostic
Crit
eria
is re
prin
ted
with
per
mis
sion
from
the
Dia
gnos
tic a
nd S
tatis
tical
Man
ual o
f Men
tal D
isor
ders
, Fift
h Ed
ition
™, (
Cop
yrig
ht ©
2013
). A
mer
ican
Psy
chia
tric A
ssoc
iatio
n.
All
Rig
hts R
eser
ved.
The
Am
eric
an P
sych
iatri
c Ass
ocia
tion
is n
ot a
ffilia
ted
with
and
is n
ot e
ndor
sing
this
pro
duct
.
Not
es:
P =
pare
nt; T
= te
ache
r; SR
= se
lf-re
port.
The
follo
win
g re
spon
se k
ey a
pplie
s to
the
crite
rion
stat
us sc
ore
requ
irem
ents
not
ed in
the
Indi
cate
d, M
ay b
e In
dica
ted,
and
Not
Indi
cate
d co
lum
ns: 0
= N
ot tr
ue a
t al
l (N
ever
, Sel
dom
); 1
= Ju
st a
littl
e tru
e (O
ccas
iona
lly);
2 =
Pret
ty m
uch
true
(Ofte
n, Q
uite
a b
it); 3
= V
ery
muc
h tru
e (V
ery
ofte
n, V
ery
freq
uent
ly).
(R) =
Item
is re
vers
e sc
ored
.In
terp
reta
tive
Con
side
ratio
ns:
Cri
teri
on B
4 (h
yper
- or
hypo
reac
tivity
to se
nsor
y in
put o
r un
usua
l int
eres
t in
sens
ory
aspe
cts o
f the
env
iron
men
t) is
not
ass
esse
d on
the
Con
ners
CB
RS.
Tabl
e 13
. (
cont
inue
d) D
SM-5
Sym
ptom
Cou
nt a
nd C
riter
ion
Stat
us S
core
Req
uire
men
ts fo
r Aut
ism
Spe
ctru
m D
isor
der
DSM-5 Update
29
Standardization and Reliability of the Conners CBRS DSM-5 Symptom ScalesNorm Construction. The construction of the norms for the Conners CBRS DSM-5 Symptom Scales that changed (i.e., Major Depressive Episode, Social Anxiety Disorder, Obsessive Compulsive Disorder, and Autism Spectrum Disorder) was performed in the same fashion as for the original scales of the instrument using the same normative samples (see chapter 10 of the Conners CBRS Manual, Standardization). Actual construction of the norms was conducted by rater type (i.e., Parent, Teacher, and Self-Report) for each of the age and gender groups (see Tables 15 to 17 for the normative samples’ means and standard devia-tions, for scales that have changed from the DSM-IV-TR to the DSM-5. See Tables 10.34 to 10.45 in the Conners CBRS Manual for the means and standard deviations of the other Conners CBRS scales). Note that the means presented in these tables have been statistically smoothed (see chapter 10 in the Conners CBRS Manual for more information on the smoothing process). Standard scores (T-scores with a mean of 50 and standard deviation of 10) were computed for each norm group, as were empirical percentiles.
For scales that have changed, Pearson product-moment correlation coefficients between the DSM-5 Symptom Scales and the DSM-IV-TR Symptom Scales of the Conners CBRS were computed and are reported in Table 14. These values ranged from .909 to .998 across norm groups and rater versions.
Internal Consistency. Cronbach’s alpha coefficients for the DSM-5 Symptom Scales were calculated for each norm group using the same procedure as for the DSM-IV-TR Scale. Reliability coefficients were estimated for the total sample, as well as separately for the general population and clinical samples. Results are similar to the DSM-IV-TR Symptom Scales values for each respective rater version and norm group. The Conners CBRS−P, Conners CBRS−T, and Conners CBRS−SR were observed to demonstrate moderate-to-high levels of internal consistency for the vast majority of the revised scales. Reliability coefficients are shown in Tables 18 to 26 for scales that have changed from the DSM-IV-TR to the DSM-5. See Tables 11.2 to 11.4 in the Conners CBRS Manual for the reliability coefficients for the other Conners CBRS scales.
Standard Error of Measurement. The standard error of measurement (SEM) serves as another tool for measuring the stability of observed scores. SEM provides an indication of the amount of variability that may exist in the observed score, and how much that score may differ from a theoretical true score. More information about SEM can be found in chapter 11 of the Conners CBRS Manual, Reliability.
Tables 27 to 32 present the SEM values for scales that have changed due to changes in the DSM-5. Tables 27 to 28 display the SEM values for the total sample, and Tables 29 to 32 display the SEM values for the general population and clinical samples. For most purposes, SEM values for T-scores are sufficient; however, raw score values are provided for research purposes.
Table 14. Correlations between the Conners CBRS DSM-IV-TR and DSM-5 Symptom Scales
ScaleTotal Sample General Population Clinical Sample
Parent Teacher Self-Report Parent Teacher Self-
Report Parent Teacher Self-Report
Major Depressive Episode .998 .996 .997 .997 .996 .997 .997 .996 .997
Social Anxiety Disorder .939 .936 .963 .910 .909 .956 .960 .964 .970
Obsessive-Compulsive Disorder .973 .973 .979 .949 .952 .997 .979 .978 .980
DSM-5 Autism Spectrum Disorder vs. DSM-IV-TR Autistic Disorder .974 .968 n/a .964 .970 n/a .976 .977 n/a
DSM-5 Autism Spectrum Disorder vs. DSM-IV-TR Asperger’s Disorder .979 .973 n/a .977 .984 n/a .976 .971 n/a
N 2,276 2,360 2,055 1,575 1,690 1,359 704 670 698
Notes: n/a = not applicable (i.e., DSM-5 Autism Spectrum Disorder [as well as DSM-IV-TR Autistic Disorder and Asperger’s Disorder] are not assessed on the self-report form; see the Conners CBRS Manual for more information). All rs significant, p < .001.
Conners Comprehensive Behavior Rating Scales™ (Conners CBRS™)
30
Tabl
e 15
. C
onne
rs C
BR
S−P
Nor
mat
ive
Sam
ple
Mea
ns a
nd S
tand
ard
Dev
iatio
ns fo
r the
DSM
-5 S
ympt
om S
cale
s (A
ges
6 to
18)
Sca
leA
ge
6A
ge
7A
ge
8A
ge
9A
ge
10
Ag
e 1
1M
FT
MF
TM
FT
MF
TM
FT
MF
T
Maj
or D
epre
ssiv
e Ep
isod
eM
1.82
1.95
1.92
1.93
2.02
1.97
2.03
2.15
2.03
2.12
2.22
2.11
2.20
2.30
2.20
2.28
2.33
2.30
SD2.
443.
032.
583.
252.
903.
262.
442.
822.
553.
412.
813.
202.
752.
852.
953.
602.
963.
03
Soci
al A
nxie
ty
Dis
orde
rM
2.13
2.47
2.30
2.28
2.58
2.43
2.42
2.67
2.55
2.75
2.76
2.65
2.61
2.84
2.73
2.68
2.92
2.81
SD2.
822.
442.
652.
742.
512.
652.
392.
572.
462.
922.
472.
742.
162.
902.
652.
863.
022.
96
Obs
essi
ve-
Com
puls
ive
Dis
orde
rM
0.44
0.42
0.43
0.43
0.46
0.44
0.42
0.50
0.46
0.41
0.53
0.46
0.40
0.56
0.47
0.39
0.58
0.47
SD0.
970.
900.
941.
131.
341.
281.
010.
870.
921.
221.
001.
120.
811.
441.
290.
921.
211.
14
Aut
ism
Spe
ctru
m
Dis
orde
rM
3.55
3.58
3.67
4.15
3.56
3.85
4.00
3.35
3.78
4.25
3.55
3.95
4.00
3.57
3.86
4.21
3.59
3.90
SD3.
232.
942.
993.
834.
073.
963.
043.
063.
094.
193.
343.
853.
693.
593.
544.
003.
343.
56
Sca
leA
ge
12
Ag
e 1
3A
ge
14
Ag
e 1
5A
ge
16
Ag
e 1
7/
18
MF
TM
FT
MF
TM
FT
MF
TM
FT
Maj
or D
epre
ssiv
e Ep
isod
eM
2.05
2.50
2.42
2.41
2.60
2.55
2.46
2.95
2.70
2.50
3.00
2.86
2.54
3.54
3.03
2.57
4.02
3.22
SD2.
473.
133.
132.
713.
352.
903.
083.
643.
413.
533.
983.
593.
334.
394.
082.
994.
864.
01
Soci
al A
nxie
ty
Dis
orde
rM
2.71
2.99
2.87
2.73
2.75
2.91
2.72
2.80
2.94
2.68
3.17
2.96
2.63
3.21
2.96
2.54
3.26
2.95
SD2.
452.
742.
552.
412.
512.
532.
202.
532.
402.
372.
972.
652.
682.
782.
662.
362.
772.
66
Obs
essi
ve-
Com
puls
ive
Dis
orde
rM
0.37
0.60
0.46
0.35
0.56
0.46
0.33
0.60
0.44
0.21
0.62
0.43
0.29
0.64
0.41
0.26
0.66
0.44
SD0.
901.
231.
070.
881.
030.
970.
861.
231.
140.
851.
221.
130.
821.
201.
120.
811.
171.
10
Aut
ism
Spe
ctru
m
Dis
orde
rM
3.77
3.62
3.92
4.35
3.67
3.95
4.23
3.72
3.96
4.19
3.78
3.97
4.13
3.86
3.98
4.04
3.94
3.97
SD3.
163.
353.
243.
643.
383.
553.
543.
433.
533.
413.
483.
493.
553.
553.
443.
033.
623.
37
Not
e: M
= M
ale,
F =
Fem
ale,
T =
Tot
al.
DSM-5 Update
31
Tabl
e 16
. C
onne
rs C
BR
S−T
Nor
mat
ive
Sam
ple
Mea
ns a
nd S
tand
ard
Dev
iatio
ns fo
r the
DSM
-5 S
ympt
om S
cale
s (A
ges
6 to
18)
Sca
leA
ge
6A
ge
7A
ge
8A
ge
9A
ge
10
Ag
e 1
1M
FT
MF
TM
FT
MF
TM
FT
MF
T
Maj
or D
epre
ssiv
e Ep
isod
eM
1.22
1.09
1.16
1.22
0.99
1.11
1.23
0.91
1.07
1.24
0.85
1.04
1.35
0.95
1.21
1.35
0.81
1.04
SD2.
122.
592.
322.
232.
762.
342.
052.
012.
042.
391.
902.
193.
182.
783.
012.
932.
132.
61
Soci
al A
nxie
ty
Dis
orde
rM
2.11
1.99
2.05
1.96
1.78
1.87
1.84
1.64
1.74
1.75
1.57
1.67
1.69
1.56
1.64
1.67
1.62
1.67
SD2.
852.
312.
612.
252.
502.
432.
492.
262.
302.
431.
962.
242.
522.
262.
482.
562.
282.
39
Obs
essi
ve-
Com
puls
ive
Dis
orde
rM
0.42
0.37
0.39
0.38
0.34
0.36
0.35
0.32
0.33
0.33
0.29
0.30
0.31
0.27
0.27
0.29
0.22
0.25
SD0.
970.
931.
100.
991.
421.
341.
011.
051.
070.
870.
770.
841.
340.
931.
231.
010.
600.
83
Aut
ism
Spe
ctru
m
Dis
orde
rM
5.33
4.33
4.98
4.90
4.21
4.70
4.91
3.96
4.44
4.67
3.73
4.20
4.67
3.51
3.99
4.30
3.31
3.81
SD4.
373.
374.
143.
894.
574.
203.
383.
553.
433.
693.
083.
583.
603.
183.
433.
522.
883.
30
Sca
leA
ge
12
Ag
e 1
3A
ge
14
Ag
e 1
5A
ge
16
Ag
e 1
7/
18
MF
TM
FT
MF
TM
FT
MF
TM
FT
Maj
or D
epre
ssiv
e Ep
isod
eM
1.28
0.83
1.06
1.31
0.87
1.09
1.15
1.28
1.13
1.21
1.02
1.19
1.40
1.13
1.27
1.44
1.27
1.36
SD2.
051.
551.
882.
521.
652.
231.
963.
222.
822.
482.
152.
402.
441.
732.
392.
602.
292.
37
Soci
al A
nxie
ty
Dis
orde
rM
1.69
1.75
1.75
1.74
1.52
1.88
1.60
2.22
2.06
1.93
2.55
2.30
2.08
2.95
2.58
2.27
3.32
2.81
SD2.
352.
312.
412.
372.
002.
351.
973.
132.
762.
312.
472.
572.
542.
552.
652.
632.
642.
74
Obs
essi
ve-
Com
puls
ive
Dis
orde
rM
0.25
0.23
0.22
0.27
0.21
0.20
0.26
0.20
0.18
0.26
0.18
0.17
0.27
0.17
0.15
0.27
0.16
0.14
SD0.
670.
810.
811.
390.
751.
150.
701.
010.
870.
900.
630.
831.
090.
500.
770.
700.
510.
72
Aut
ism
Spe
ctru
m
Dis
orde
rM
4.16
3.13
3.65
4.16
2.97
3.51
3.62
2.83
3.39
3.45
2.70
3.30
3.92
2.42
3.24
4.05
2.50
3.44
SD3.
462.
693.
194.
152.
333.
492.
812.
533.
023.
322.
762.
963.
292.
152.
923.
272.
072.
89
Not
e: M
= M
ale,
F =
Fem
ale,
T =
Tot
al.
Conners Comprehensive Behavior Rating Scales™ (Conners CBRS™)
32
Tabl
e 17
. C
onne
rs C
BR
S−SR
Nor
mat
ive
Sam
ple
Mea
ns a
nd S
tand
ard
Dev
iatio
ns fo
r the
DSM
-5 S
ympt
om S
cale
s (A
ges
8 to
18)
Sca
leA
ge
8A
ge
9A
ge
10
Ag
e 1
1M
FT
MF
TM
FT
MF
T
Maj
or D
epre
ssiv
e Ep
isod
eM
5.04
6.42
5.41
5.50
6.75
6.22
5.41
6.46
5.88
5.46
5.44
5.54
SD5.
325.
705.
445.
446.
776.
495.
376.
275.
875.
355.
055.
33
Soci
al A
nxie
ty D
isor
der
M2.
813.
713.
573.
363.
703.
633.
403.
743.
713.
423.
843.
82
SD2.
902.
962.
902.
903.
283.
032.
772.
872.
923.
043.
112.
96
Obs
essi
ve-C
ompu
lsiv
e D
isor
der
M2.
282.
862.
392.
482.
792.
652.
382.
542.
492.
302.
392.
32
SD2.
443.
092.
813.
003.
403.
193.
082.
592.
832.
512.
682.
58
Sca
leA
ge
12
Ag
e 1
3A
ge
14
Ag
e 1
5A
ge
16
Ag
e 1
7/
18
MF
TM
FT
MF
TM
FT
MF
TM
FT
Maj
or D
epre
ssiv
e Ep
isod
eM
5.64
5.97
5.86
5.95
5.44
6.05
6.18
6.77
6.41
5.75
7.15
6.32
5.85
8.06
6.69
7.52
10.5
18.
33
SD5.
386.
806.
215.
175.
055.
335.
577.
066.
445.
387.
346.
305.
946.
826.
515.
927.
416.
70
Soci
al A
nxie
ty
Dis
orde
rM
3.43
4.00
3.95
3.43
4.21
4.10
3.42
4.06
3.86
3.39
4.20
3.90
3.36
4.30
3.87
3.31
5.02
4.15
SD2.
543.
133.
022.
772.
982.
942.
913.
043.
073.
113.
143.
303.
012.
783.
023.
252.
853.
44
Obs
essi
ve-
Com
puls
ive
Dis
orde
rM
2.73
2.20
2.71
2.18
1.95
2.20
2.14
2.39
2.38
1.87
2.34
2.20
2.12
2.32
2.41
2.13
3.18
2.81
SD3.
323.
143.
252.
362.
692.
532.
393.
533.
022.
253.
172.
683.
272.
793.
022.
302.
912.
70
Not
e: M
= M
ale,
F =
Fem
ale,
T =
Tot
al.
DSM-5 Update
33
Table 18. Cronbach’s Alpha: Conners CBRS−P Total Sample
Scale TotalMale Female
6−9 10−13 14−18 6−9 10−13 14−18
Major Depressive Episode .882 .840 .883 .863 .810 .885 .905
Social Anxiety Disorder .800 .790 .836 .771 .791 .783 .811
Obsessive-Compulsive Disorder .803 .838 .825 .772 .788 .819 .755
Autism Spectrum Disorder .794 .795 .811 .807 .728 .778 .798
Table 19. Cronbach’s Alpha: Conners CBRS−T Total Sample
Scale TotalMale Female
6−9 10−13 14−18 6−9 10−13 14−18
Major Depressive Episode .851 .615 .838 .851 .823 .859 .896
Social Anxiety Disorder .825 .812 .850 .822 .779 .846 .812
Obsessive-Compulsive Disorder .827 .727 .803 .857 .843 .823 .856
Autism Spectrum Disorder .647 .657 .711 .693 .522 .530 .647
Table 20. Cronbach’s Alpha: Conners CBRS−SR Total Sample
Scale TotalMale Female
8−9 10−13 14−18 8−9 10−13 14−18
Major Depressive Episode .892 .885 .885 .877 .889 .887 .901
Social Anxiety Disorder .790 .773 .786 .799 .758 .753 .815
Obsessive-Compulsive Disorder .812 .816 .794 .800 .828 .812 .825
Table 21. Cronbach’s Alpha: Conners CBRS−P General Population Sample
Scale TotalMale Female
6−9 10−13 14−18 6−9 10−13 14−18
Major Depressive Episode .775 .750 .726 .794 .765 .719 .827
Social Anxiety Disorder .764 .804 .768 .714 .772 .762 .769
Obsessive-Compulsive Disorder .687 .711 .584 .715 .658 .730 .659
Autism Spectrum Disorder .679 .707 .635 .711 .692 .644 .684
Table 22. Cronbach’s Alpha: Conners CBRS−T General Population Sample
Scale TotalMale Female
6−9 10−13 14−18 6−9 10−13 14−18
Major Depressive Episode .805 .648 .844 .790 .787 .817 .847
Social Anxiety Disorder .789 .793 .844 .755 .769 .784 .782
Obsessive-Compulsive Disorder .732 .483 .834 .757 .741 .733 .689
Autism Spectrum Disorder .521 .462 .601 .544 .526 .475 .493
Table 23. Cronbach’s Alpha: Conners CBRS−SR General Population Sample
Scale TotalMale Female
8−9 10−13 14−18 8−9 10−13 14−18
Major Depressive Episode .871 .876 .821 .841 .865 .867 .898
Social Anxiety Disorder .754 .731 .726 .762 .721 .729 .798
Obsessive-Compulsive Disorder .786 .805 .755 .789 .771 .786 .806
Conners Comprehensive Behavior Rating Scales™ (Conners CBRS™)
34
Table 24. Cronbach’s Alpha: Conners CBRS−P Clinical Sample
Scale TotalMale Female
6−9 10−13 14−18 6−9 10−13 14−18
Major Depressive Episode .891 .872 .886 .863 .844 .903 .883
Social Anxiety Disorder .810 .749 .857 .814 .787 .773 .793
Obsessive-Compulsive Disorder .827 .885 .840 .769 .878 .842 .755
Autism Spectrum Disorder .826 .833 .837 .828 .763 .843 .803
Table 25. Cronbach’s Alpha: Conners CBRS−T Clinical Sample
Scale TotalMale Female
6−9 10−13 14−18 6−9 10−13 14−18
Major Depressive Episode .845 .529 .813 .853 .832 .845 .873
Social Anxiety Disorder .853 .841 .847 .878 .788 .865 .841
Obsessive-Compulsive Disorder .850 .833 .774 .878 .925 .839 .862
Autism Spectrum Disorder .748 .806 .785 .760 .577 .649 .706
Table 26. Cronbach’s Alpha: Conners CBRS−SR Clinical Sample
Scale TotalMale Female
8−9 10−13 14−18 8−9 10−13 14−18
Major Depressive Episode .898 .896 .902 .882 .920 .895 .876
Social Anxiety Disorder .819 .813 .827 .830 .786 .772 .813
Obsessive-Compulsive Disorder .834 .836 .820 .803 .904 .840 .832
Table 27. T-Score SEM1 for Conners CBRS DSM-5 Scales for the Total Sample
Form DSM-5 Symptom Scale Total Male Female
6−91 10−13 14−18 6−91 10−13 14−18
Parent
Major Depressive Episode 3.44 4.00 3.42 3.70 4.36 3.39 3.08
Social Anxiety Disorder 4.47 4.58 4.05 4.79 4.57 4.66 4.35
Obsessive-Compulsive Disorder 4.44 4.02 4.18 4.77 4.60 4.25 4.95
Autism Spectrum Disorder 4.54 4.53 4.35 4.39 5.22 4.71 4.49
Teacher
Major Depressive Episode 3.86 6.20 4.02 3.86 4.21 3.75 3.22
Social Anxiety Disorder 4.18 4.34 3.87 4.22 4.70 3.92 4.34
Obsessive-Compulsive Disorder 4.16 5.22 4.44 3.78 3.96 4.21 3.79
Autism Spectrum Disorder 5.94 5.86 5.38 5.54 6.91 6.86 5.94
Self-Report
Major Depressive Episode 3.29 3.39 3.39 3.51 3.33 3.36 3.15
Social Anxiety Disorder 4.58 4.76 4.63 4.48 4.92 4.97 4.30
Obsessive-Compulsive Disorder 4.34 4.29 4.54 4.47 4.15 4.34 4.181 The age group for the self-report form is 8−9 years.
DSM-5 Update
35
Table 28. Raw Score SEM1 for Conners CBRS DSM-5 Scales for the Total Sample
Form DSM-5 Symptom Scale Total Male Female
6−91 10−13 14−18 6−91 10−13 14−18
Parent
Major Depressive Episode 1.94 1.70 1.95 1.94 1.62 1.89 2.32
Social Anxiety Disorder 1.42 1.33 1.36 1.40 1.37 1.43 1.56
Obsessive-Compulsive Disorder 0.78 0.64 0.78 0.67 0.67 0.83 1.03
Autism Spectrum Disorder 2.14 2.13 2.27 2.11 1.97 2.09 2.17
Teacher
Major Depressive Episode 1.41 1.34 1.50 1.54 1.24 1.20 1.50
Social Anxiety Disorder 1.26 1.20 1.20 1.25 1.18 1.13 1.42
Obsessive-Compulsive Disorder 0.67 0.69 0.72 0.65 0.62 0.58 0.72
Autism Spectrum Disorder 2.16 2.39 2.33 2.10 2.29 1.92 1.88
Self-Report
Major Depressive Episode 2.53 2.49 2.46 2.54 2.50 2.37 2.75
Social Anxiety Disorder 1.58 1.57 1.54 1.48 1.75 1.63 1.59
Obsessive-Compulsive Disorder 1.41 1.43 1.47 1.32 1.45 1.36 1.481 The age group for the self-report form is 8−9 years.
Table 29. T-Score SEM1 for Conners CBRS DSM-5 Symptom Scales for the General Population Sample
Form DSM-5 Symptom Scale Total Male Female
6−91 10−13 14−18 6−91 10−13 14−18
Parent
Major Depressive Episode 4.74 5.00 5.23 4.54 4.85 5.30 4.16
Social Anxiety Disorder 4.86 4.43 4.82 5.35 4.77 4.88 4.81
Obsessive-Compulsive Disorder 5.59 5.38 6.45 5.34 5.85 5.20 5.84
Autism Spectrum Disorder 5.67 5.41 6.04 5.38 5.55 5.97 5.62
Teacher
Major Depressive Episode 4.42 5.93 3.95 4.58 4.62 4.28 3.91
Social Anxiety Disorder 4.59 4.55 3.95 4.95 4.81 4.65 4.67
Obsessive-Compulsive Disorder 5.18 7.19 4.07 4.93 5.09 5.17 5.58
Autism Spectrum Disorder 6.92 7.33 6.32 6.75 6.88 7.25 7.12
Self-Report
Major Depressive Episode 3.59 3.52 4.23 3.99 3.67 3.65 3.19
Social Anxiety Disorder 4.96 5.19 5.23 4.88 5.28 5.21 4.49
Obsessive-Compulsive Disorder 4.63 4.42 4.95 4.59 4.79 4.63 4.401 The age group for the self-report form is 8−9 years.
Table 30. Raw Score SEM1 for Conners DSM-5 Symptom Scales for the General Population Sample
Form DSM-5 Symptom Scale Total Male Female
6−91 10−13 14−18 6−91 10−13 14−18
Parent
Major Depressive Episode 1.57 1.47 1.42 1.60 1.47 1.57 1.82
Social Anxiety Disorder 1.29 1.20 1.21 1.31 1.27 1.32 1.37
Obsessive-Compulsive Disorder 0.61 0.57 0.51 0.48 0.60 0.66 0.81
Autism Spectrum Disorder 1.95 2.00 2.03 1.89 1.88 1.95 1.91
Teacher
Major Depressive Episode 1.08 1.00 1.51 1.18 1.03 0.86 1.08
Social Anxiety Disorder 1.19 1.11 1.31 1.34 1.12 1.02 1.36
Obsessive-Compulsive Disorder 0.50 0.47 0.51 0.48 0.59 0.38 0.42
Autism Spectrum Disorder 1.93 2.29 1.98 1.84 2.22 1.71 1.48
Self-Report
Major Depressive Episode 2.34 3.33 2.75 2.33 2.41 2.19 2.53
Social Anxiety Disorder 1.53 1.05 1.37 1.51 1.69 1.67 1.52
Obsessive-Compulsive Disorder 1.36 1.76 1.39 1.21 1.50 1.33 1.391 The age group for the self-report form is 8−9 years.
Conners Comprehensive Behavior Rating Scales™ (Conners CBRS™)
36
Table 31. T-Score SEM1 for Conners CBRS DSM-5 Symptom Scales for the Clinical Sample
Form DSM-5 Symptom Scale Total Male Female
6−91 10−13 14−18 6−91 10−13 14−18
Parent
Major Depressive Episode 3.30 3.58 3.38 3.70 3.95 3.11 3.42
Social Anxiety Disorder 4.36 5.01 3.78 4.31 4.62 4.76 4.55
Obsessive-Compulsive Disorder 4.16 3.39 4.00 4.81 3.49 3.97 4.95
Autism Spectrum Disorder 4.17 4.09 4.04 4.15 4.87 3.96 4.44
Teacher
Major Depressive Episode 3.94 6.86 4.32 3.83 4.10 3.94 3.56
Social Anxiety Disorder 3.83 3.99 3.91 3.49 4.60 3.67 3.99
Obsessive-Compulsive Disorder 3.87 4.09 4.75 3.49 2.74 4.01 3.71
Autism Spectrum Disorder 5.02 4.40 4.64 4.90 6.50 5.92 5.42
Self-Report
Major Depressive Episode 3.19 3.22 3.13 3.44 2.83 3.24 3.52
Social Anxiety Disorder 4.25 4.32 4.16 4.12 4.63 4.77 4.32
Obsessive-Compulsive Disorder 4.07 4.05 4.24 4.44 3.10 4.00 4.101 The age group for the self-report form is 8−9 years.
Table 32. Raw Score SEM1 for Conners CBRS DSM-5 Symptom Scales for the Clinical Sample
Form DSM-5 Symptom Scale Total Male Female
6−91 10−13 14−18 6−91 10−13 14−18
Parent
Major Depressive Episode 2.55 2.10 2.50 2.50 2.16 2.55 3.02
Social Anxiety Disorder 1.68 1.59 1.57 1.56 1.81 1.67 1.85
Obsessive-Compulsive Disorder 1.07 0.80 1.05 0.94 0.90 1.14 1.33
Autism Spectrum Disorder 2.49 2.41 2.56 2.46 2.33 2.37 2.58
Teacher
Major Depressive Episode 3.04 1.61 1.94 2.07 1.96 1.84 2.17
Social Anxiety Disorder 1.47 1.30 1.37 1.29 1.48 1.38 1.50
Obsessive-Compulsive Disorder 0.99 0.83 0.97 0.90 0.77 0.91 1.09
Autism Spectrum Disorder 3.00 2.51 2.61 2.47 2.42 2.25 2.46
Self-Report
Major Depressive Episode 2.88 2.68 2.77 3.01 2.74 2.73 3.10
Social Anxiety Disorder 1.68 1.62 1.59 1.64 1.93 1.71 1.71
Obsessive-Compulsive Disorder 1.51 1.39 1.55 1.52 1.36 1.42 1.621 The age group for the self-report form is 8−9 years.
SummaryWith the release of the DSM-5, it was necessary to review the Conners CBRS Manual and associated materials (i.e., Conners CBRS Software Program and online components, including reports) to assess the need to update the DSM Symptom Scales. The changes outlined in this update align scoring and interpretation of the DSM Symptom Scales with diagnostic criteria in the DSM-5. This supplement details considerations that need to be taken into account when using the DSM-5 Scoring option to score and interpret the DSM Symptom Scales. Additionally, this supplement outlines the psychometric properties of the revised scales, namely, Major Depressive Episode, Social Anxiety Disorder (Social Phobia), Obsessive-Compulsive Disorder, and Autism Spectrum Disorder.
ReferencesAmerican Psychiatric Association. (2000). Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.).
Washington, DC: American Psychiatric Publishing.
American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
Beck, A. T., Rush, A. J., Shaw, B. F., & Emery, G. (1979). Cognitive Therapy of Depression. New York, NY: The Guilford Press.
Compton, S. N., March, J. S., Brent, D., Albano, A. M., Weersing, R., & Curry, J. (2004). Cognitive-behavioral psychotherapy for anxiety and depressive disorders in children and adolescents: An evidence-based medicine review. Journal of the American Academy of Child and Adolescent Psychiatry, 43, 930−959.
Conners, C. K. (2008, 2010). Conners Comprehensive Behavior Rating Scales Manual. Toronto, Ontario, Canada: Multi-Health Systems.
Fuchs, T. (2013). The phenomenology and development of social perspectives. Phenomenology and the Cognitive Sciences, 12, 655−683.
Gallese, V., & Goldman, A. (1998). Mirror neurons and the simulation theory of mind-reading. Trends in Cognitive Sciences, 2, 493−501.
Rizzolatti, G., & Craighero, L. (2004). The mirror-neuron system. Annual Review of Neuroscience, 27, 169−192.
Toth, K., Munson, J., Meltzoff, A. N., & Dawson, G. (2006). Early predictors of communication development in young children with Autism Spectrum Disorder: Joint attention, imitation, and toy play. Journal of Autism and Developmental Disorders, 36, 993−1005.
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