How Often is “Often”? Improving Assessment of the Externalizing Spectrum Using Absolute Frequency

Nearly all questionnaires of externalizing problems use vague quantifiers of relative frequency (e.g., rarely/sometimes/often) or true/false statements. Vague quantifiers have many problems, including imprecision and low interpretability. An alternative is numeric quantifiers that quantify, in absolute frequency, how many times the person engaged in the behavior during a given timeframe. This study evaluates whether absolute frequency provides utility for assessing the externalizing spectrum. Participants included adults recruited online and college students, for a combined sample of 1,237 adults (290 males; 947 females) spanning 18–92 years of age. A subset of items was adapted from the Externalizing Spectrum Inventory to assess absolute frequency, supplemented with additional items to ensure broad coverage. Using a 30-day reference period, participants indicated how many times they engaged in each behavior per day, per week, in the past month, or in the prior year. Externalizing problems showed age-related decreases from early to later adulthood. On average, men showed greater externalizing problems than women in early and older adulthood; women showed greater externalizing problems than men in middle adulthood. Latent scores derived from absolute frequency items demonstrated convergent validity with a widely used measure of externalizing problems (Adult Self-Report), discriminant validity with respect to internalizing problems, and criterion and incremental validity in relation to functional impairment and inhibitory control. Count data led to greater precision—less uncertainty in the estimate of each person’s level of externalizing problems—than dichotomized versions of the items. Findings suggest there is key utility in assessing absolute frequency of externalizing behavior.