Conners' Adult ADHD Rating Scales–Self-Report: Long

Version (CAARS–S:L)
By C. Keith Conners, Ph.D., Drew Erhardt, Ph.D., and Elizabeth Sparrow, Ph.D.

Interpretive Report

Copyright © 2002 Multi-Health Systems Inc. All rights reserved.

P.O. Box 950, North Tonawanda, NY 14120-0950
3770 Victoria Park Ave., Toronto, ON M2H 3M6
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Introduction
The Conners’ Adult ADHD Rating Scales–Self Report: Long Version (CAARS–S:L) is an assessment
that prompts an adult to provide valuable information about themselves. This instrument is helpful when
considering a diagnosis of ADHD or related problems. The normative sample includes 1026 adults. This
report provides information about the adult’s score, how he or she compares to other adults, and what
subscales are elevated. See the Conner’s Adult ADHD Rating Scales Technical Manual (published by
MHS) for more information about the instrument.
The computerized report is meant to act as an interpretive aid and should not be used as the sole basis
for clinical diagnosis or intervention. This report works best when combined with other sources of
relevant information. The CAARS results are based on the individual's current functioning and thus
cannot be used to establish the childhood onset of symptoms, which is necessary for diagnosis. The
report is based on an algorithm that produces the most common interpretations for the scores that have
been obtained. Test users should review the individual's responses to specific items to ensure that
these generic interpretations apply. Highly idiosyncratic response patterns must be explored in other
ways and on a case-by-case basis.

CAARS–S:L Subscale T-Scores

The following graph provides John's T-scores for each of the CAARS–S:L subscales.
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Summary of Subscale Scores

The following table summarizes John's subscale scores and gives general information about how he
compares to the nomative group. More interpretive data are provided later in this report.

Raw T- Common Characteristics of

Subscale Guideline
Score Score High Scorers
Inattention/Memory Problems 24 72 Markedly atypical Difficulties may include
(indicates significant trouble concentrating,
problem) difficulty planning or
completing tasks,
forgetfulness,
absent-mindedness, being
disorganized.
Hyperactivity/Restlessness 18 56 Slightly atypical Difficulties may include
(borderline: should problems with working at the
raise concern) same task for long periods of
time, feeling more restless
than others seems to be,
fidgeting.
Impulsivity/Emotional Lability 26 73 Markedly atypical Difficulties may include
(indicates significant engaging in more impulsive
problem) acts than others do, low
frustration tolerance, quick
and frequent mood changes,
feeling easily angered and
irritated by people.
Problems with Self-Concept 12 66 Moderately atypical Difficulties may include poor
(indicates significant social relationships, low
problem) self-esteem and self
confidence.
DSM-IV: Inattentive Symptoms 11 65 Mildly atypical Behave in a manner
(possible significant consistent with the Inattentive
problem) Subtype of ADHD, described
in the DSM-IV.
DSM-IV: Hyperactive-Impulsive 13 65 Mildly atypical Behave in a manner
Symptoms (possible significant consistent with the
problem) Hyperactive-Impulsive
Subtype of ADHD, described
in the DSM-IV.
DSM-IV: ADHD Symptoms 24 68 Moderately atypical Behave in a manner
Total (indicates significant consistent with the DSM-IV
problem) diagnostic criteria for
Combined type ADHD.
ADHD Index 22 70 Moderately atypical Identifies individuals 'at risk'
(indicates significant for ADHD
problem)
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Item Response Table

The following response values were entered for the items on CAARS–S:L.

Response Key
0 = Not at all, Never
1 = Just a little, Once in a while
2 = Pretty much, Often
3 = Very much, Very frequently
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DSM-IV Subscales: Elevated Responses

The following graph shows the number of items for which John answered " Very much, Very Frequently"
(3) or "Pretty much, Often" (2). The answers are grouped by DSM-IV subscale. The DSM-IV subscales
are interpreted in more detail later in this report.
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Validity Assessment
If the findings presented here conflict with other sources of information, then the reason(s) for the
conflicting information should be considered, and the results described in this report should be
interpreted with these reasons in mind.

If these results conflict with other information, then it is possible that the respondent is either
exaggerating current problems, or has denied the existence of problems previously. It is also possible,
however, that behavior and attitudes are situation specific. That is, behavior and attitudes at home may
be quite different than behavior and attitudes away from home (e.g., at work). Use of the CAARS
observer form is recommended to help resolve apparent inconsistencies.

An examination of the individual item responses reveals some possible inconsistencies. Quite different
responses were given to items with similar content. If possible, discrepancies in the responses to items
should be discussed with John. Some items may have been misunderstood, or perhaps he was
unwilling or unable to give a clear picture of his own behavior and attitudes.

The following item pairs reveal inconsistent responses that should be explored further.

Item pairs with Score

Response
similar content Differential
11. 2
49. 3 1
40. 2
44. 0 2
20. 1
25. 2 1
30. 3
47. 1 2
19. 3
23. 2 1
6. 2
37. 3 1
26. 3
63. 0 3

Examination of Subscale Scores

ADHD Index: T-Score = 70
Moderately elevated. This index consists of the best set of items on CAARS for identifying adults "at
risk" for ADHD. John's score on this index is notably elevated, indicating possible ADHD. This finding
should be combined with other information to corroborate whether a diagnosis of ADHD is appropriate.

Inattention/Memory Problems: T-Score = 72

Marked elevated. John could experience serious difficulties with organizing or planning his work,
completing tasks or projects, and concentrating on tasks that require sustained mental effort. A number
of items on this subscale indicate some difficulties related to memory and inattentiveness.
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Hyperactivity/Restlessness: T-Score = 56
Slightly elevated. The score obtained on this subscale indicates that John might have some difficulty
sitting still or remaining stationary for very long. John is probably also a little more restless than most
individuals.

Impulsivity/Emotional Lability: T-Score = 73

Markedly elevated: John's score on the Impulsivity/Emotional Lability subscale is quite high, indicating
an individual who is very prone to emotional responses/behaviors like getting upset or having temper
outbursts. John is likely to be more impulsive, both verbally and behaviorally, than is typical of others.
He is also likely to have a low frustration tolerance and hence prone to moodiness and to be easily
angered or irritated.

Problems with Self Concept: T-Score = 66

Moderately elevated. The score on this subscale indicates that John perceives himself as having low
self-confidence and low self-esteem. Assessment efforts might focus on identifying the factor or factors
that contribute to this individual's poor self-concept. He may lack confidence in his own abilities and
avoid taking on new challenges as a result.

Analysis DSM-IV Subscales

Inattentive Symptoms: T-Score = 65
John's responses to the DSM-IV items indicate that the criterion for the Inattentive Subtype of ADHD
has not been met. Six or more symptoms of ADHD are required, but only 1 of 9 items is rated "Very
much, Very frequently" and only 2 of 9 items is rated "Pretty much, Often".

Hyperactive-Impulsive Symptoms: T-Score = 65

Six or more symptoms of ADHD are required for Hyperactive-Impulsive Subtype of ADHD to be present.
John's responses suggest that this criterion has not been met. However, given that close to six
symptoms could be present (i.e., 1 of 9 items is rated "Very much, Very frequently", 4 of 9 items is rated
"Pretty much, Often"), further investigation of the possible presence of Hyperactive-Impulsive Subtype of
ADHD is warranted.

Combined Type ADHD: T-Score = 68

Based on John's self-report, there is strong evidence for a diagnosis of the Inattentive Subtype ADHD.
The evidence for Hyperactive-Impulsive Subtype is more moderate. Nonetheless, the possibility of
Combined Type ADHD should be considered.

General Examination of the Profile

There are several substantial subscale elevations. These elevations relate to different areas of behavior
suggesting the possibility of comorbidity. More specific information about the areas that are elevated can
be obtained from examining the subscale descriptions.

Integrating Results with Other Information, and (if required)

Determine Intervention Strategy
· Inattention/Memory Problems
The following subscale scores are elevated (T-Score > 60) and could be cause for concern.

· Impulsivity/Emotional Lability
· Problems with Self-Concept
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·
·
DSM-IV: Inattentive Symptoms

·
DSM-IV: Hyperactive-Impulsive Symptoms

·
DSM-IV: ADHD Symptoms Total
ADHD Index

These results must be incorporated with other information before drawing any conclusions. At a
minimum, it is recommended that a comprehensive evaluation include

·
·
A history of the pregnancy, delivery, and developmental milestones from infancy;

·
A family history of psychiatric disorders;
Assessment of specific symptoms, including onset, severity, frequency, chronicity, situational

·
specificity, and duration;

·
A functional assessment that covers school history, employment history, and work records;
An overview of the individual's intrapsychic processes, including self-image and sense of efficacy

·
with family, peers, and work;

·
Current family interaction patterns and family structure;
Screen for medical and psychiatric disorders and life circumstances that can lead to symptoms that

·
mimic ADHD;
An assessment of neurological status, when indicated by other evidence.

CAARS–S:L results interpreted without considering these other factors may have limited validity.

There are a large number of possible treatment approaches and the choice of which treatment is most
appropriate can vary from case to case. The following resources are recommended for use in making
treatment decisions:

Barkley, R. A. (1997). ADHD and the nature of self-control. New York: Guilford Press.

Barkley, R. A. (1998). Attention-deficit hyperactivity disorder: A handbook for diagnosis and treatment
(2nd ed.). New York: Guilford Press.

Biederman, J. (Presenter), Spencer, T. (Presenter), & Wilens, T. (Presenter). (1997). Medical

management of attention deficit hyperactivity disorder [Videotape Series]. Plantation, FL: Specialty
Press.

Conners, C. K. (Ed.). (1996 --). Journal of Attention Disorders. Toronto, ON: Multi-Health Systems Inc.

Conners, C. K. & Jett, J. L. (1999). Attention deficit hyperactivity disorder in adults and children: The
latest assessment and treatment strategies. Kansas City, MO: Compact Clinicals.

Dawson, P. & Guare, R. (1998). Coaching the ADHD Student. Toronto, ON: Multi-Health Systems Inc.

Hallowell, E. M. & Ratey, J. J. (1995). Driven to distraction: Recognizing and coping with attention
deficit disorder from childhood through to adulthood. New York: Simon & Schuster.

Ingersoll, B. D. & Goldstein, S. (1993). Attention deficit disorder and learning disabilities: Realities,
myths and controversial treatments. New York: Doubleday.

Additional information can be obtained by contacting this organization:

Children and Adults with Attention Deficit Disorders (C.H.A.D.D.)

National Office
499 NW 70th Avenue, Suite 109
Plantation, FL
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USA 33317

Phone: (305) 587-3700 Fax: (305) 587-4599

Date Printed: January 12, 2005

End of Report