Skip to main content
Log in

Discriminant validity of the Conners’ scales for ADHD subtypes

  • Published:
Current Psychology Aims and scope Submit manuscript

Abstract

Differential diagnosis and treatment of children with Attention-Deficit/Hyperactivity Disorder (ADHD) remains difficult and controversial, particularly when children present with concomitant academic and behavior problems. Describing a sample of 184 chil-dren referred for evaluation in a university-affiliated outpatient pediatric clinic, this study subsequently examined the discriminant validity of the Conners’ parent and teacher rating scales for ADHD subtypes with and without comorbid conditions. Although discriminant analyses suggest several Conners’ subscales help differentiate subtypes, multimethod evaluations using a variety of data sources are necessary for accurate identification and classification of the disorder with and without comorbid conditions.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  • Abikoff, H., & Klein, R. G. (1992) Attentiondeficit hyperactivity and conduct disorder: Comorbidity and implications for treatment. Journal of Consulting and Clinical Psychology, 60, 881892.

    Article  Google Scholar 

  • Accardo, P. J., Blondis, T. A., & Whitman, B. Y. (1990). Disorders of attention and activity level in a referral population. Pediatrics, 85, 426431.

    Google Scholar 

  • Achenbach, T. M., McConaughy, S. H., & Howell, C. T. (1987). Child/adolescent behavioral and emo-tional problems: Implications of crossinformant correlations for situational specificity. Psychological Bulletin, 101, 213232.

    Article  Google Scholar 

  • American Psychiatric Association (1980). Diagnostic and statistical manual of mental disorders (3rd ed.). Washington, DC: Author.

    Google Scholar 

  • American Psychiatric Association (1987). Diagnostic and statistical manual of mental disorders (3rd ed.-revised). Washington, DC: Author.

    Google Scholar 

  • American Psychiatric Association (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.

    Google Scholar 

  • Barbaresi, W. J. (1996). Primarycare approach to the diagnosis and management of attentiondeficit hyper-activity disorder. Mayo Clinic Proceedings, 71, 463471.

    Google Scholar 

  • Barkley, R. A. (1987). The assessment of attention deficithyperactivity disorder. Behavioral Assessment, 9, 207233.

    Google Scholar 

  • Barkley, R. A. (1996). Critical issues in research on attention. In G. R. Lyon & N. A. Krasnegor (Eds.), Attention, memory, and executive function (pp. 69–102). Baltimore, MD: Brookes.

    Google Scholar 

  • Barkley, R. A. (1997). ADHD and the nature of selfcontrol. New York, NY: The Guilford Press.

    Google Scholar 

  • Barkley, R. A., DuPaul, G. J., & McMurray, M. B. (1990). Comprehensive evaluation of attention deficit disorder with and without hyperactivity as defined by research criteria. Journal of Consulting and Clinical Psychology, 58, 775789.

    Article  Google Scholar 

  • Barkley, R. A., DuPaul, G. J., & McMurray, M. B. (1991). Attention deficit disorder with and without hyperactivity: Clinical response to three dose levels of methylphenidate. Pediatrics, 87, 519531.

    Google Scholar 

  • Barkley, R. A., McMurray, M. B., Edelbrock, C. S., & Robbins, K. (1989). The response of aggressive and nonaggressive ADHD children to two doses of methylphenidate. Journal of the American Academy of Child and Adolescent Psychiatry 28, 873881.

    Article  Google Scholar 

  • Biederman, J., Newcorn, J., & Sprich, S. (1991). Comorbidity of attention deficit hyperactivity disorder with conduct, depressive, anxiety, and other disorders. American Journal of Psychiatry, 148, 1991.

    Google Scholar 

  • Biederman, J., Wozniak, J., Kiely, K., Ablon, S., Faraone, S., Mick, E., Mundy, E., & Kraus, I. (1995). CBCL clinical scales discriminate prepubertal children with structured interview-derived diagnosis of mania from those with ADHD. Journal of the American Academy of Child and Adolescent Psychiatry, 34, 464–471.

    Article  PubMed  Google Scholar 

  • Breen, M. J., Eckert, T. L., & DuPaul, G. J. (1996). Interpreting childbehavior questionnaires. In M. J. Breen & C. R. Fielder (Eds.), Behavioral approach to assessment of youth with emotional/behavioral disorders: A handbook for schoolbased practitioners (pp. 225–241). Austin, TX: ProEd.

    Google Scholar 

  • Brown, R. T. (1985). The validity of teacher ratings in differentiating between two subgroups of attention deficit disordered children with or without hyperactivity. Educational and Psychological Measurement, 45, 661669.

    Google Scholar 

  • Carlson, C. L., Lahey, B. B., Frame, C. L., Walker, J., & Hynd, G. W. (1987). Sociometric status of clinicreferred children with attention deficit disorders with and without hyperactivity. Journal of Abnor-mal Child Psychology, 15, 537547.

    Google Scholar 

  • Carlson, C. L., Shin, M., & Booth, J. (1999). The case for DSM-IV subtypes in ADHD. Mental Retarda-tion and Developmental Disabilities Research, 5, 199–206.

    Article  Google Scholar 

  • Cohen, M., Becker, M. G., & Campbell, R. (1990). Relationships among four methods of assessment of children with Attention DeficitHyperactivity Disorder. Journal of School Psychology, 28, 189202.

    Article  Google Scholar 

  • Conners, C. K. (1989). Conners’ rating scales manual. North Tonawanda, NY: Multi-Health Systems.

    Google Scholar 

  • Conners, C. K. (1997). Conners rating scales-revised. North Tonawanda, NY: Multi-Health Systems.

    Google Scholar 

  • Conners, C. K. (2000). Attention-deficit/hyperactivity disorder-historical development and overview. Journal of Attention Disorders, 3, 173–191.

    Article  Google Scholar 

  • Conners, C. K., Sitarenios, G., Parker, J. D. A., & Epstein, J. N. (1998). The revised Conners’ Parent Rating Scale (CPRS-R): Factor structure, reliability, and criterion validity. Journal of Abnormal Child Psychology, 26, 257–268.

    Article  PubMed  Google Scholar 

  • DuPaul, G. J., & Barkley, R. A. (1993). Behavioral contributions to pharmacotherapy: The utility of behavioral methodology in medication treatment of children with attention deficit hyperactivity disorder. Behavior Therapy, 24, 47–65.

    Article  Google Scholar 

  • DuPaul, G. J., Barkley, R. A., & McMurray, M. B. (1991). Therapeutic effects of medication on ADHD: Implications for school psychologists. School Psychology Review, 20, 203219.

    Google Scholar 

  • Dykman, R. A., & Ackerman, P. T. (1993). Behavioral subtypes of attention deficit disorder. Exceptional Children, 60, 132141.

    Google Scholar 

  • Eckert, T. L., & DuPaul, G. J. (1996). Youthcompleted and narrowband childbehavior questionnaires. In M. J. Breen & C. R. Fielder (Eds.), Behavioral approach to assessment of youth with emotional/ behavioral disorders: A handbook for schoolbased practitioners (pp. 289358). Austin, TX: ProEd.

    Google Scholar 

  • Edelbrock, C., Greenbaum, R., & Conover, N. C. (1985). Reliability and concurrent relations between the teacher version of the Child Behavior Profile and the Conners Revised Teacher Rating Scale. Journal of Abnormal Child Psychology, 13, 295303.

    Article  Google Scholar 

  • Eiraldi, R. B., Power, T. J., & Nezu, C. M. (1997). Patterns of comorbidity associated with subtypes of attention-deficit/hyperactivity disorder among 6-12 year old children. Journal of the American Academy of Child and Adolescent Psychiatry 36, 503–514.

    Article  PubMed  Google Scholar 

  • Erford, B. T. (1996). Analysis of the Conners’ Teacher Rating Scale-28. Assessment, 3, 27–36.

    Google Scholar 

  • Fletcher, J. M., Francis, D. J., Stuebing, K. K., Shaywitz, B. A., Shaywitz, S. E., Shakweiler, D. P., Katz, L., & Morris, R. D. (1996). Conceptual and methodological issues in construct definition. In G. R. Lyon & N. A. Krasnegor (Eds.), Attention, memory, and executive function (pp. 17–42). Baltimore, MD: Brookes.

    Google Scholar 

  • Fletcher, J. M., Morris, R. D., & Francis, D. J. (1991). Methodological issues in the classification of attentionrelated disorders. Journal of Learning Disabilities, 24, 7277.

    Google Scholar 

  • Golden, G. S. (1991). Role of attention deficit hyperactivity disorder in learning disabilities. Seminars in Neurology, 11, 35–41.

    PubMed  Google Scholar 

  • Goodyear, P., & Hynd, G. W. (1992). Attentiondeficit disorder with (ADD/H) and without (ADD/WO) hyperactivity: Behavioral and neuropsychological differentiation. Journal of Clinical Child Psychology, 21, 273–305.

    Article  Google Scholar 

  • Greenhill, L. L., Abikoff, H. B., Arnold, L. E., Cantwell, D. P., Conners, C. K., Elliott, G., Hechtman, L., Hinshaw, S. P., Jensen, P. S., March, J. S., Newcorn, J., Pelham, W. E., Severe, J. B., Swanson, J. M., Vitiello, B., & Wells, K. (1996). Medication treatment strategies in the MTA Study: Relevance to clinicians and researchers. Journal of the American Academy of Child and Adolescent Psychiatry, 35, 13041313.

    Article  Google Scholar 

  • Hale, J. B., Hoeppner, J. B., DeWitt, M. B., Coury, D. L., Ritacco, D., & Trommer, B. (1998). Evaluating medication response in ADHD: Cognitive, behavioral, and single subject methodology. Journal of Learning Disabilities, 31, 595–607.

    Article  PubMed  Google Scholar 

  • Halperin, J. M., Newcorn, J. H., Matier, K., Sharma, V., McKay, K. E., & Schwartz, S. (1993). Discrimi-nant validity of attentiondeficit hyperactivity disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 32, 10381043.

    Article  Google Scholar 

  • Halperin, J. M., Newcorn, J. H., Sharma, V., Healey, J. M., Wolf, L. E., Pascualvaca, D. M., & Schwartz, M. (1990). Inattentive and noninattentive ADHD children: Do they constitute a unitary group? Journal of Abnormal Child Psychology, 18, 437–449.

    Article  PubMed  Google Scholar 

  • Halperin, J. M., O'Brien, J. D., Newcorn, J. H., Healey, J. M., Pascualvaca, D. M., Wolf, L. E., & Young, J. G. (1990). Validation of hyperactive, aggressive, and mixed hyperactive/aggressive childhood disor-ders: A research note. Journal of Child Psychology and Psychiatry and Allied Disciplines, 31, 455459.

    Google Scholar 

  • Henker, B., & Whalen, C. K. (1989). Hyperactivity and attention deficits. American Psychologist, 44, 216223.

    Article  Google Scholar 

  • Hinshaw, S. P. (1992). Academic underachievement, attention deficits, and aggression: Comorbidity and implications for intervention. Journal of Consulting and Clinical Psychology, 60, 893903.

    Google Scholar 

  • Houghton, S., Douglas, G., West, J., Whiting, K., Wall, M., Langsford, S., Powell, L., & Carroll, A. (1999). Differential patterns of executive function in children with attention-deficit/hyperactivity disor-der according to gender and subtype. Journal of Child Neurology, 14, 801–805.

    PubMed  Google Scholar 

  • Hutton, J. B., Dubes, R., & Muir, S. (1992). Assessment practices of school psychologists: Ten years later. School Psychology Review, 21, 271284.

    Google Scholar 

  • Jensen, P. S., Martin, D., & Cantwell, D. P. (1997). Comorbidity in ADHD: Implications for research, practice, and DSMV. Journal of the American Academy of Child and Adolescent Psychiatry, 36, 10651079.

    Google Scholar 

  • Kuehne, C., Kehle, T. J., & McMahon, W. (1987). Differences between children with Attention Deficit Disorder, children with Specific Learning Disabilities, and normal children. Journal of School Psychol-ogy, 25, 161166.

    Google Scholar 

  • Kramer, C. Y. (1956). Extension of multiple range test to group means with unequal numbers of replica-tions. Biometrics, 12, 307–310.

    Article  Google Scholar 

  • Lahey, B. B., & Carlson, C. L. (1991). Validity of the diagnostic criteria of attention deficit disorder without hyperactivity: A review of the literature. Journal of Learning Disabilities, 24, 110–120.

    PubMed  Google Scholar 

  • Lahey, B. B., Pelham, W. E., Stein, M. A., Loney, J., Trapani, C., Nugent, K., Kipp, H., Schmidt, W., Lee, S., Cale, M., Gold, E., Hartung, C. M., Willcutt, E., & Baumann, B. (1998). Validity of the DSM-IV attention-deficit/hyperactivity disorder for younger children. Journal of the American Academy of Child and Adolescent Psychiatry, 37, 695–702.

    Article  PubMed  Google Scholar 

  • Lahey, B. B., Schaughency, E. A., Hynd G. W., Carlson, C. L., & Nieves, N. (1987). Attention deficit disorder with and without hyperactivity: Comparison of behavioral characteristics of clinicreferred chil-dren. Journal of the American Academy of Child and Adolescent Psychiatry, 26, 718723.

    Article  Google Scholar 

  • Lahey, B. B., Schaughency, E. A., Strauss, C. C., & Frame, C. L. (1984). Are attention deficit disorders with and without hyperactivity similar or dissimilar disorders? Journal of the American Academy of Child and Adolescent Psychiatry, 23, 302–309.

    Article  Google Scholar 

  • Landau, S., & Burcham, B. G. (1995). Best practices in the assessment of children with attention disorders. In A. Thomas & J. Grimes (Eds.), Best practices in school psychology-III (pp. 817–829). Washington, DC: National Association of School Psychologists.

    Google Scholar 

  • Landau, S., & Moore, L. A. (1991). Social skill deficits in children with attentiondeficit hyperactivity disorder. School Psychology Review, 20, 235251.

    Google Scholar 

  • Lee, S. W., Elliott, J., & Barbour, J. D. (1994). A comparison of crossinformant behavior ratings in schoolbased diagnosis. Behavior Disorders, 19, 8797.

    Google Scholar 

  • Leung, A. K., Robson, W. L., Fagan, J. E., & Lim, S. H. (1994). Attentiondeficit hyperactivity disorder. Getting control of impulsive behavior. Postgraduate Medicine, 95, 153–160.

    PubMed  Google Scholar 

  • Matier, K., Halperin, J. M., Sharma, V., Newcorn, J. H., & Sathaye, N. (1992). Methylphenidate response in aggressive and nonaggressive ADHD children: Distinctions on laboratory measures of symptoms. Journal of the American Academy of Child and Adolescent Psychiatry, 31, 219225.

    Article  Google Scholar 

  • Marshall, R. M., Hynd, G. W., Handwerk, M. J., & Hall, J. (1997). Academic underachievement in ADHD subtypes. Journal of Learning Disabilities, 30, 635–642.

    PubMed  Google Scholar 

  • McBride, M. C. (1988). An individual doubleblind crossover trial for assessing methylphenidate response in children with attention deficit disorder. Journal of Pediatrics 113, 137145.

    Google Scholar 

  • Merrell, K. W., & Stein, S. (1992). Behavior problems of learning disabled, low achieving, and average boys: A comparative study with the Conners’ Teacher Rating Scale-28. Journal of Psychoeducational Assessment, 10, 76–82.

    Article  Google Scholar 

  • Miller, L. S., Koplewicz, H. S., & Klein, R. G. (1997). Teacher ratings of hyperactivity, inattention, and conduct problems in preschoolers. Journal of Abnormal Child Psychology, 25, 113–119.

    Article  PubMed  Google Scholar 

  • Nolan, E. E., Volpe, R. J., Gadow, K. D., & Sprafkin, J. (1999). Developmental, gender, and comorbidity differences in clinically-referred children with ADHD. Journal of Emotional and Behavioral Disorders, 7, 11–20.

    Google Scholar 

  • Parker, J. D. A., Sitarenios, G., & Conners, C. K. (1996). Abbreviated Conners’ rating scales revisited: A confirmatory factor analytic study. Journal of Attention Disorders, 1, 55–62.

    Article  Google Scholar 

  • Pliszka, S. R. (1992). Comorbidity of attentiondeficit hyperactivity disorder and overanxious disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 31, 197203.

    Article  Google Scholar 

  • Power, T. J., Andrews, T. J., Eiraldi, R. B., Doherty, B. J., Ikeda, M. J., DuPaul, G. J., & Landau, S. (1998). Evaluating attention deficit hyperactivity disorder using multiple informants: The incremental utility of combining teacher with parent reports. Psychological Assessment, 10, 250–260.

    Article  Google Scholar 

  • Rapport, M. D., & Kelly, K. L. (1991). Psychostimulant effects on learning and cognitive function: Findings and implications for children with attention deficit hyperactivity disorder. Clinical Psychology Review, 11, 6192.

    Article  Google Scholar 

  • Reich, W., Welner, Z., Herjanic, B., & MHS Staff (1998). Diagnostic Interview for Children and Adoles-cents-IV. North Tonawanda, NY: Multi-Health Systems.

    Google Scholar 

  • Reid, R., & Maag, J. W. (1994). How many fidgets in a pretty much: A critique of behavior rating scales for identifying students with ADHD. Journal of School Psychology, 32, 339354.

    Article  Google Scholar 

  • Reid, R., Maag, J. W., Vasa, S. F., & Wright, G. (1994). Who are the children with attention deficithyperactivity disorder? A schoolbased survey. Journal of Special Education, 28, 117137.

    Google Scholar 

  • Riccio, C. A., Gonzalez, J. J., & Hynd, G. W. (1994). Attentiondeficit hyperactivity disorder (ADHD) and learning disabilities. Learning Disability Quarterly, 17, 311322.

    Article  Google Scholar 

  • Robins, P. M. (1992). A comparison of behavioral and attentional functioning in children diagnosed as hyperactive or learningdisabled. Journal of Abnormal Child Psychology, 20, 6582.

    Article  Google Scholar 

  • Roussos, A., Richardson, C., Politikou, K., Marketos, S., Kyprianos, S., Karajianni, S., Koumoula, A., Lazaratou, H., Marketos, N., Zoubou, V., Nicholara, R., Mahera, O. (1999). The Conners-28 teacher questionnaire in clinical and nonclinical samples of Greek children 6-12 years old. European Child and Adolescent Psychiatry, 8, 260–267.

    Article  PubMed  Google Scholar 

  • Ruffalo, S. L., & Elliott, S. N. (1997). Teachers' and parents' ratings of children’s social skills: A closer look at cross-informant agreements through an item analysis protocol. School Psychology Review, 26, 489–501.

    Google Scholar 

  • Shaywitz, B. A., & Shaywitz, S. E. (1991). Comorbidity: A critical issue in attention deficit disorder. Journal of Child Neurology, 6, s13s22.

    Google Scholar 

  • Shaywitz, S. E., & Shaywitz, B. A. (1988). Increased medication use in attentiondeficit hyperactivity disorder: Regressive or appropriate? Journal of the American Medical Association, 260, 22702272.

    Article  Google Scholar 

  • Shelton, T. L., & Barkley, R. A. (1995). The assessment and treatment of attentiondeficit/hyperactivity disorder in children. In M. C. Roberts (Ed.), Handbook of pediatric psychology (2nd ed.) (pp. 633–654). New York, NY: Guilford Press.

    Google Scholar 

  • Silver, L. B. (1990). Attention Deficit-Hyperactivity Disorder: Is it a learning disability or related disorder? Journal of Learning Disabilities, 23, 394–397.

    PubMed  Google Scholar 

  • Stanford, L. D., & Hynd, G. W. (1994). Congruence of behavioral symptomology in children with ADD/H, ADD/WO, and learning disabilities. Journal of Learning Disabilities, 27, 243253.

    Google Scholar 

  • Tannock, R., Ickowicz, A., & Schachar, R. (1995). Differential effects of methylphenidate on working memory in ADHD children with and without comorbid anxiety. Journal of the American Academy of Child and Adolescent Psychiatry, 34, 886–896.

    Article  PubMed  Google Scholar 

  • Vaughn, M. L., Riccio, C. A., Hynd, G. W., & Hall, J. (1997). Diagnosing ADHD (predominantly inatten-tive and combined type subtypes): Discriminant validity of the Behavioral Assessment System for Children and the Achenbach Parent and Teacher Rating Scales. Journal of Clinical Child Psychology, 26, 349–357.

    Article  PubMed  Google Scholar 

  • Wainright, A., et al (1996). Conners’ rating scales: Over 25 years of research. An annotated bibliography. Toronto, ON: Multi-Health Systems.

    Google Scholar 

  • Walker, J. L., Lahey, B. B., Hynd, G. W., & Frame, C. L. (1987). Comparison of specific patterns of antisocial behavior in children with conduct disorder with or without coexisting hyperactivity. Journal of Consulting and Clinical Psychology, 55, 910913.

    Article  Google Scholar 

  • Whalen, C. K., Henker, B., & Granger, D. A. (1990). Social judgment processes in hyperactive boys: Effects of methylphenidate and comparisons with normal peers. Journal of Abnormal Child Psychology, 18, 297316.

    Article  Google Scholar 

  • Zametkin, A. J., & Ernst, M. (1999). Problems in the management of attention-deficit/hyperactivity disor-der. New England Journal of Medicine, 340, 40–46.

    Article  PubMed  Google Scholar 

  • Zelko, F. A. (1991). Comparison of parentcompleted behavior rating scales: Differentiating boys with ADD from psychiatric and normal controls. Journal of Developmental and Behavioral Pediatrics, 12, 3137.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to James B. Hale Ph.D..

Additional information

These data were previously reported at the 107th Annual Convention of the American Psychological Association, Boston, Massachusetts. The authors express gratitude to Ross D. Crosby, Ph.D., Director of Biomedical Statistics and Methodology at the Neuropsychiatrie Research Institute, for his pre-submission review of the article.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Hale, J.B., How, S.K., Dewitt, M.B. et al. Discriminant validity of the Conners’ scales for ADHD subtypes. Curr Psychol 20, 231–249 (2001). https://doi.org/10.1007/s12144-001-1009-0

Download citation

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12144-001-1009-0

Keywords

Navigation