Article

Impact of the Impairment Criterion in the Diagnosis of Adult ADHD: 33-Year Follow-Up Study of Boys With ADHD

New York University Child Study Center, 215 Lexington Avenue, Floor 13, New York, NY 10016, USA.
Journal of Attention Disorders (Impact Factor: 2.4). 04/2010; 15(2):122-9. DOI: 10.1177/1087054709359907
Source: PubMed

ABSTRACT To investigate the relationship between ADHD symptoms and impairment among adults diagnosed as having ADHD in childhood (ages 6-12).
Clinicians blindly interviewed 121 White males; the mean age was 41 years across the sample. DSM-IV adult ADHD behaviors were systematically rated, and impairment resulting from symptoms was scored on a 5-point Likert-type scale.
Correlations between degree of impairment and number of behaviors were high (r's = .83 to .85, p < .001). The impairment criterion had no effect on classifying any participants as having, or not having, adult ADHD. All participants who reported experiencing 5 or more inattention or hyperactive-impulsive behaviors as "often" or "very often" in adulthood were significantly impaired by their symptoms.
Contrary to results reported in children, there was a strong relationship between number of ADHD symptoms and degree of impairment. However, for several reasons (discussed in the article), it should not be concluded that the impairment criterion is superfluous.

Download full-text

Full-text

Available from: Rachel G Klein, Jul 02, 2015
0 Followers
 · 
145 Views
  • Source
  • [Show abstract] [Hide abstract]
    ABSTRACT: The conceptual issues are briefly noted with respect to the distinctions between classification and diagnosis; the question of whether mental disorders can be considered to be 'diseases'; and whether descriptive psychiatry is outmoded. The criteria for diagnosis are reviewed, with the conclusion that, at present, there are far too many diagnoses, and a ridiculously high rate of supposed comorbidity. It is concluded that a separate grouping of disorders with an onset specific to childhood should be deleted, the various specific disorders being placed in appropriate places, and the addition for all diagnoses of the ways in which manifestations vary by age. A new group should be formed of disorders that are known to occur but for which further testing for validity is needed. The overall number of diagnoses should be drastically reduced. Categorical and dimensional approaches to diagnosis should be combined. The requirement of impairment should be removed from all diagnoses. Research and clinical classifications should be kept separate. Finally, there is a need to develop a primary care classification for causes of referral to both medical and non-medical primary care.
    Journal of Child Psychology and Psychiatry 03/2011; 52(6):647-60. DOI:10.1111/j.1469-7610.2011.02367.x · 5.67 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: This review evaluates the diagnostic criteria for three of the most common disorders for which children and adolescents are referred for mental health treatment: attention deficit hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), and conduct disorder (CD). Although research supports the validity and clinical utility of these disorders, several issues are highlighted that could enhance the current diagnostic criteria. For ADHD, defining the core features of the disorder and its fit with other disorders, enhancing the validity of the criteria through the lifespan, considering alternative ways to form subtypes of the disorder, and modifying the age-of-onset criterion are discussed relative to the current diagnostic criteria. For ODD, eliminating the exclusionary criteria of CD, recognizing important symptom domains within the disorder, and using the cross-situational pervasiveness of the disorder as an index of severity are highlighted as important issues for improving classification. Finally, for CD, enhancing the current subtypes related to age of onset and integrating callous-unemotional traits into the diagnostic criteria are identified as key issues for improving classification.
    Annual Review of Clinical Psychology 04/2011; 8:77-107. DOI:10.1146/annurev-clinpsy-032511-143150 · 12.92 Impact Factor