Psychometric Properties of the Conners 3rd Edition

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Stephen Gallant , M.A, C. Keith Conners , Ph.D., Sara Rzepa , M.A., Jenni Pitkanen , M.Sc., Maria-Luisa Marocco , B.Sc.,
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and Gill Sitarenios , Ph.D.,
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Multi-Health Systems, Inc., Toronto, Ontario, Canada Professor Emeritus, Duke University Medical Centre, Durham, NC, USA

ABSTRACT PROCEDURE & RESULTS Internal Consistency Reliability Table 6. Univariate Statistics for Diagnostic Group Effects Across Conners 3 Scales
Conners 3 Scale Conners 3-P Group Effects Conners 3-T Group Effects Conners 3-SR Group
The Conners 3rd Edition (Conners 3), a revision of the Conners Rating Scales- Data analysis focused on the following aspects of the Conners 3 psychometrics: • The internal consistency of the empirical scales, as well as other rationally derived Effects
Revised (CRS-R), is equipped with updated norms and item content focusing on scales (See Table 5 for a complete listing of scales) was assessed using Cronbach’s Empirical Scales
• Factor structure.
Attention-Deficit Hyperactivity Disorder (ADHD) and its most co-morbid disor- alpha. Executive Functioning F (3, 1553) = 161.37, p <.001 F (3, 1608) = 115.72, p <.001 NA
ders and problems. The present report discusses the psychometric properties of • Internal Consistency Reliability
• Alpha values were found to range from acceptable to very high levels. Learning Problems F (3, 1553) = 138.19, p <.001 F (3, 1406) = 71.63, p <.001
the Conners 3. Specifically, the present report discusses the scale’s stable fac- • Group differences (Non-Clinical vs. ADHD vs. Behavior Disorder vs. Learning Disor- • Empirical scale alphas ranged from .84 to .97, rational scale alphas ranged from .78 Aggression F (3, 1553) = 63.22, p <.001 F (3, 1608) = 147.90, p<.001 F (3, 1406) = 51.34, p <.001
tor structure, its strong levels of reliability and its ability to discriminate between der).
to .95. Peer Relations F (3, 1553) = 57.66, p <.001 F (3, 1608) = 74.47, p <.001 NA
various diagnostic groups. The Conners 3 will benefit potential users by serving • Empirical scale average item-total correlations ranged from .54 to .83, rational scale
as a statistically sound assessment of ADHD. Such an assessment will facilitate average item-total correlations ranged from .44 to .78. Family Relations NA NA F (3, 1406) = 58.64, p <.001
accurate identification of youth with ADHD and can be used for intervention and Factor Analysis • These findings suggest strong inter-item correlations across all the Conners 3 scales Hyperactivity/Impulsivity F (3, 1553) = 178.24, p <.001 F (3, 1608) = 121.17, p <.001 F (3, 1406) = 53.59, p <.001
treatment planning efforts. and a strong likelihood that the items within each scale are measuring the same Rational Scale
• The Conners 3 normative data was divided into 2 portions: the derivation sample construct. Inattention F (3, 1553) = 247.34, p <.001 F (3, 1608) = 177.83, p <.001 F (3, 1406) = 85.30, p <.001
(approx. one third of the data), which was used for Exploratory Factor Analysis (EFA)
INTRODUCTION & RATIONALE and the confirmatory sample (approx. two thirds of the data), which was used for DSM-IV-TR Symptom Scales
Confirmatory Factor Analysis (CFA). Table 5. Internal Consistency Statistics F (3, 1614) = 160.83, p <.001 F (3, 1641) = 124.88, p <.001 F (3, 1421) = 61.99, p <.001
ADHD Hyperactive/
• The EFA was conducted using Maximum Likelihood estimation and varimax rotation. Conners 3 Conners Conners Conners 3 Conners 3 Conners Conners Impulsive
• The Conners Rating Scales-Revised (Conners, 1997) are among the most • Scree plots, eigenvalues, and factor interpretability were used to determine the opti- Scale 3-P Alpha 3-P -T Alpha -T 3-SR Alpha 3-SR
Avg. Avg. Avg. ADHD Inattentive F (3, 1614) = 229.37, p <.001 F (3, 1641) = 172.65, p <.001 F (3, 1421) = 72.42, p <.001
popular assessment tools for research and clinical use. However, the norma- mal number of factors for each of the three forms.
tive sample for the CRS-R is presently over 10 years old and was in need of Item-Total r Item-Total Item-Total r Oppositional Defiant F (3, 1614) = 83.33, p <.001 F (3, 1641) = 155.29, p <.001 F (3, 1421) = 56.41, p <.001
• Items were excluded from the final solution if they loaded less than .35 on any fac-
updating. r Disorder
tor, or cross-loaded on several factors (defined as a loading differential <.20).
• The updated version of the Conners Rating Scales has been named the • EFA statistics are presented in Table 3. Empirical Scales Conduct Disorder F (3, 1614) = 55.18, p <.001 F (3, 1641) = 106.46, p <.001 F (3, 1421) = 40.96, p <.001
Conners 3rd Edition (Conners 3) and features updated norms and more • Items that did not load onto a factor and which were not selected for a rational scale,
streamlined item content specifically relating to ADHD (i.e., hyperactivity, im- were retained only if they were critical for inclusion in a DSM-IV-TR scale. Executive .92 .71 .961 .70 NA NA
pulsivity, inattention, and executive functioning) and its most commonly co- Functioning
• EFA results revealed similar factors across the three forms. Empirical factor struc- Table 7. Diagnostic Group Differences across Conners 3 Scales
morbid disorders (Oppositional Defiant Disorder and Conduct Disorder) and Learning .90 .67 .84 .58
tures are presented in tables 5, 6, and 7 Problems
associated problems (aggression, learning problems, peer/family relations, Conners 3 Scale Conners 3-P Diagnostic Group Conners 3-T Diagnostic Group Conners 3-SR Diagnostic
• These factor structures were closely replicated across age, gender and diagnostic Aggression .91 .64 .95 .72 .85 .54 Differences Differences Group Differences
anxiety, and depression). groups.
• Three versions of the Conners 3 have been created for different informants: • Support for the stability of the factor structure was provided through CFAs with item Peer .85 .66 .92 .77 NA NA Empirical Scales
Relations Executive Functioning ADHD> Behavior Disorder> ADHD=Learning Disorder> Be- NA
–Parents (Conners 3-P) for ages 6-18 years parcelling conducted on the confirmatory sample. CFA results were evaluated by ex- Family NA NA NA NA .88 .66 Learning Disorder = Non-Clinical havior Disorder > Non-Clinical
–Teachers (Conners 3-T) for ages 6-18 years amining a number of goodness-of-fit indicators. Table 4 displays the indicators that Relations
–Youth (Conners 3-SR) for ages 8-18 years best supported the fit of the parent, teacher and self-report factor structures. Hyperactivity/ .94 .70 .97 .83 .90 .58 Learning Problems Learning Disorder> ADHD > Learning Disorder > ADHD >
• CFAs are ongoing in an attempt to further improve the fit of the factor structures. Impulsivity Behavior Disorder > Non-Clinical Behavior Disorder = Non-
Rational Scale Clinical
PARTICIPANTS Table 3. Conners 3 EFA Statistics Inattention .93 .73 .95 .78 .89 .61 Aggression Behavior Disorder> ADHD>
Learning Disorder=Non-Clinical
Behavior Disorder > ADHD > Behavior Disorder > ADHD >
Learning Disorder = Non-Clinical Learning Disorder = Non-
Factor 1 Factor 2 Factor 3 Factor 4 Factor 5 DSM-IV-TR Symptom Scales Clinical
• General population, and clinical data were collected from 2005 to 2007 from Factor Peer Relations ADHD= Behavior Disorder ADHD= Behavior Disorder > NA
different sites across North America. Loading .47-.83 .45-.78 .47-.81 .35-.77 .46-.70 ADHD .92 .70 .95 .78 .86 .55 =Learning Disorder > Non- Learning Disorder > Non-Clinical
Hyperactive/ Clinical
• The gender ratio of the samples was approximately equal at each age Range
Impulsive Family Relations NA NA Behavior Disorder > ADHD >
• The sample was stratified according to recent U. S. census data on gender Parent Form Eigenvalue 17.9 4.0 2.8 2.1 1.7 ADHD .93 .73 .94 .77 .89 .61 Learning Disorder=Non-
and ethnicity. Also, the sample represents a wide range of SES levels and Inattentive Clinical
% Variance Oppositional .91 .70 .94 .78 .83 .56
geographic locations. Explained
33.8 7.5 5.4 4.0 3.2
Hyperactivity/ ADHD=Behavior Disorder > ADHD=Behavior Disorder > ADHD=Behavior Disorder >
• Clinical cases were obtained from several diagnostic groups. Defiant
Disorder Impulsivity Learning Disorder = Non-Clinical Learning Disorder = Non-Clinical Learning Disorder =Non-
Factor
• Detailed sample descriptions in regards to age, gender, ethnicity and diag- Loading .51-.85 .38-.83 .61-.84 .42-.84 NA Conduct .83 .47 .78 .44 .81 .46 Clinical
nostic category (clinical vs. non-clinical) are presented in tables 1 and 2. Range Disorder Rational Scale
Indices Inattention ADHD > Behavior Disorder > ADHD > Behavior Disorder = ADHD > Behavior Disorder =
Teacher Form Eigenvalue 25.0 5.8 4.4 2.3 NA Learning Disorder> Non-Clinical Language Disorder > Non- Learning Disorder > Non-
Table 1. Conners 3 Sample Descriptions Conners 3 .93 .72 .95 .78 .84 .54 Clinical Clinical
% Variance ADHD Index
Conners 3 Scale Non-Clinical N Clinical N Male N Female N Mean Age 43.0 9.7 7.2 3.8 NA DSM-IV-TR Symptom Scales
Explained .89 .63 .91 .67 NA NA
(SD) Conners 3
Factor Global Index ADHD Hyperactive/ ADHD=Behavior Disorder ADHD=Behavior Disorder> ADHD=Behavior Disorder >
Loading .53-.82 .43-.75 .40-.63 .45-.73 NA Impulsive >Learning Disorder = Non- Learning Disorder = Non-Clinical Learning Disorder = Non-
Conners 3-P 1,373 578 998 953 11.9 (3.3) Range Clinical Clinical
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Self-Report Form Eigenvalue 11.8 3.3 2.1 1.9 NA Items measuring executive functioning and learning problems loaded together on the ADHD Inattentive ADHD > Behavior Disorder > ADHD > Behavior Disorder = ADHD > Behavior Disor-
Conners 3-T 1,415 525 901 1,039 12.1 (3.2) Conners 3-T. However, these items form separate factors on the Conners 3-P. Learning Disorder > Non-Clinical Learning Disorder > Non-Clinical der=Learning Disorder > Non-
% Variance Clinical
Conners 3-SR 1,272 571 927 916 12.6 (2.9) 27.3 7.2 4.5 4.2 NA
Explained Oppositional Defiant Behavior Disorder > ADHD > Behavior Disorder >ADHD > Behavior Disorder > ADHD>
Disorder Learning Disorder = Non-Clinical Learning Disorder > Non-Clinical Learning Disorder=Non-
Group Differences Clinical
Table 4. Conners 3 CFA Statistics Conduct Disorder Behavior Disorder > ADHD > Behavior Disorder > ADHD > Behavior Disorder >ADHD
• A Diagnostic Group x Age x Gender multivariate general linear model analysis was Learning Disorder = Non-Clinical Learning Disorder = Non-Clinical >Learning Disorder =Non-
Table 2. Conners 3 Ethnicity Breakdown Goodness-of-fit Conners 3-P Conners 3-T Conners 3-SR conducted in order to investigate the Conners 3’s ability to differentiate between
indicator Clinical
Ethnicity Group Conners 3-P Conners 3-T Conners 3-SR respondents from the general population and respondents diagnosed with ADHD,
Behavior Disorder (Conduct Disorder and Oppositional Defiant Disorder) and
Bentler-Bonett .94 .87 .91 Learning Disorder while controlling for the effects of age and gender.
Asian/Pacific Island 67 102 62 Normed Fit Index • Separate analyses were conducted on the empirical scales and rational scales in CONCLUSIONS
order to avoid multicolliniarity due to item overlap.
Bentler-Bonett .94 .86 .91 • Significant diagnostic group effects emerged across the parent, teacher and self- • The Conners 3 is a psychometrically sound tool for the evaluation of ADHD and its most co-morbid disorders
Non-Normed Fit and associated problems.
Black/African 299 305 293 report forms at the multivariate level (all Fs> 57.56, ps <.001).
Index
American/African • Several significant age and gender effects emerged thus supporting the decision to • The results presented here support this purpose by indicating a sound and replicable factor structure, reliable
Bentler Comparative .95 .88 .92
Canadian Fit Index control for these demographic variables. empirical and rational scales, and sensitivity to diagnostic group differences.
• At the univariate level, significant diagnostic group effects emerged across all the • The implications of these findings are significant as potential users will be provided with a statistically sound
Hispanic 240 270 217 RMSEA .07 .13 .07 assessment of ADHD in youth.
Conners 3 scales (see Table 6).
• Subsequent t-test analyses were conducted in order to identify significant diagnos- • Such an assessment will facilitate accurate identification of youth with ADHD and can be used for intervention
White/Caucasian 1,239 1,030 1,144
tic group differences (p<.05) at the univariate level across the Conners 3 scales and treatment planning efforts.
(see Table 7).
Multiracial 81 90 84
REFERENCES
Other 25 143 43 Conners, C.K. (1997). Conner’s Rating Scales-Revised Technical Manual. Toronto, Ontario, Canada: Multi-Health Systems Inc.