Standardization and cross-cultural comparisons of the Swedish Conners 3^® rating scales

Abstract

Purpose: The Conners Rating Scales are widely used in research and clinical practice for measuring attention deficit/hyperactivity disorder (ADHD) and associated problem behaviors, but country-specific norms are seldom collected. The current study presents the standardization of the Swedish Conners 3 V R Rating Scales. In addition, we compared the Swedish norms to those collected in the U.S. and Germany. Material and methods: The study included altogether 3496 ratings of children and adolescents aged 6-18 years from population-based samples. Results: The scores obtained for the Swedish Conners 3 V R showed satisfactory to excellent internal consistency for most subscales and excellent test-retest reliability. Across-informant correlations were modest. Crosscountry comparisons revealed that aggression symptoms rated by teachers and ADHD symptoms rated by parents differed between Sweden, Germany and the U.S. Executive functioning deficits also varied as a function of rater and country, with German and Swedish teachers reporting increasing behavior problems with age, whereas a decrease was observed in the U.S. For some subscales, the observed cross-cultural differences were large enough for a child to be classified as being within the normal range (t-score <60) in one country and within the clinical range (t-score > 70) in another country. Conclusion: The present study shows that the Swedish adaptation of the Conners 3 V R provides consistent and reproducible scores. However, across-informant ratings were only modest and significant cross-cultural differences in scoring were observed. This emphasizes the need for multi-informant assessment as well as for national norms for rating instruments commonly used within child and adolescent psychiatry research and clinical settings.

Prevalence of autism traits and attention-deficit hyperactivity disorder symptoms in a clinical sample of children and adolescents with chronic pain

“…62 For the current study, the Swedish version of the C3 parent report form was used and results were compared with Swedish norms. 62 , 63 The form comprises 110 items (of which 108 are numeric) that utilize a 4-point Likert-type scale (from 0= not true at all to 3= very much true) for each item. The C3 parent questionnaire also generates an ADHD Index that has been shown to accurately differentiate children with ADHD from those without a clinical diagnosis (pooled sensitivities of 0.75 and pooled specificities of 0.75).…”

Autistic Traits and Attention-Deficit Hyperactivity Disorder Symptoms Associated With Greater Pain Interference and Depression, and Reduced Health-Related Quality of Life in Children With Chronic Pain

“…Less than 0.5% of values were missing on either SRS and C3, and imputation of missing data was performed according to scoring instructions in the respective manual for each instrument ( Constantino and Gruber, 2005 ; Thorell et al, 2015 ). Across all child forms, 0.7% of data was missing in PedsQL, 2.4% in PII, 0.5% in CES-DC, 1% in ISI, and 0.6% in PIPS.…”

“…The parent report form of the Conners 3 (C3), a widely used instrument for assessing symptoms and difficulties associated with ADHD for diagnostic and research purposes (Sparrow, 2010;Schmidt et al, 2017), was used in a Swedish version with comparisons to Swedish norms (Thorell et al, 2015(Thorell et al, , 2017. The C3 constitutes the updated third edition of the scale and includes a refined assessment of ADHD and updated norms (Conners, 2008).…”

“…Analysis of missing data and variable distributions were performed. The expectation maximization algorithm (EM) ( Dempster et al, 1977 ) was employed for imputing missing data for all variables except autistic traits (SRS) and ADHD symptoms (C3), where missing data was imputed according to instructions in the respective manual ( Constantino and Gruber, 2005 ; Thorell et al, 2015 ).…”

Volitional eye movement control and ADHD traits: a twin study

“…We measured ADHD traits using the Swedish version of the parent-response long version of the Conners 3 (Conners, 2008;Thorell et al, 2018). It has sound psychometric properties with a high test-retest reliability (r = .71-.98), satisfactory to excellent internal consistency (a = .52-.94), and good diagnostic validity regarding discrimination of ADHD from other disorders.…”