Reliability and validity of self- and other-ratings of symptoms of ADHD in adults.

Duke University Medical Center, Durham, NC 27710, USA.
Journal of Attention Disorders (Impact Factor: 2.4). 04/2011; 15(3):224-34. DOI: 10.1177/1087054709356163
Source: PubMed

ABSTRACT Few studies have examined concordance between raters of ADHD symptoms in adults; there is less information on how well rating scales function in distinguishing adult ADHD from other disorders. This study examined these variables using the Conners Adult ADHD Rating Scales (CAARS).
The sample included 349 adults evaluated for attention problems. Correlations and kappa values were calculated using self- and observer-ratings of item-level symptoms; sensitivity, specificity, and discriminant validity of cluster scores in predicting clinician diagnoses were computed for 269 participants.
Item-level concordance rates ranged from slight to fair. Cluster scores demonstrated a poor balance of sensitivity and specificity in predicting ADHD diagnosis; a high percentage of participants with internalizing disorders had scores in the clinical range.
Self-and observer- ratings on the CAARS provide clinically relevant data about attention problems in adults, but the instrument does not effectively distinguish between ADHD and other adult psychiatric disorders.

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    • "In addition, Katz, Wood, Goldstein, Auchenbach, and Geckle (1998) found a low overall classification rate when trying to discriminate between adults with ADHD and adults with depression, although in their study, it was the specificity that was particularly low (.40). Low overall classification rates have also been found in studies comparing adults with ADHD and psychiatric controls using questionnaire data measuring functions such as attention and memory (Solanto, Etefia, & Marks, 2004; Voorhees, Hardy, & Kollins, 2011). "
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    ABSTRACT: Objective: The aim was to investigate how well neuropsychological measures can discriminate between adults with ADHD and those with other psychiatric disorders. Method: Adults with ADHD and a clinical control group (n = 110) were included. Neuropsychological functioning was investigated using measures of inhibition, working memory, set shifting, planning, fluency, reaction-time variability, and delay aversion. Results: Adults with ADHD performed more poorly compared with clinical controls with regard to all constructs. The effects of verbal memory, inhibition, set shifting, fluency, and delay aversion remained significant when controlling for IQ. However, when controlling for basic cognitive functions, only the effects of inhibition, fluency, and delay aversion were significant. Sensitivity ranged between 64% and 75%, and specificity between 66% and 81%. Conclusion: Neuropsychological tests have a relatively poor ability to discriminate between adults with ADHD and clinical controls, but they may be used to identify individuals at particularly high risk for poor daily functioning. (J. of Att. Dis. XXXX; XX(X) XX-XX).
    Journal of Attention Disorders 10/2013; DOI:10.1177/1087054713506264 · 2.40 Impact Factor
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    • "Internal consistency for the ADHD-RS items in this sample was very good (α's ranged from 0.90 to 0.95 for the current and retrospective scales). In general, self-reported ADHD symptoms on questionnaires are correlated with collateral reports and diagnostic interviews (Belendiuk et al. 2007; Van Voorhees et al. 2011). Finally, a modified version of the DISC-IVADHD module (NIMH 1997) was administered to the clinical group. "
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    ABSTRACT: Recent reviews argue that emotion dysregulation is an important feature of attention-deficit/hyperactivity dis-order (ADHD) and involves a failure to inhibit negative emotions that leads to negative affectively-driven impulsive behavior (i.e., emotional impulsivity). The goal of the current study was to assess (a) whether emotion dysregulation and emotional impulsivity was higher in a group of adults diagnosed with ADHD and (b) if the relationship between core ADHD symptoms (i.e., inattention and hyperactivity-impulsivity) and emotional impulsivity is mediated by emotion dysregulation symptoms. A group of adults with (n = 18) and without (n = 23) ADHD completed measures of core ADHD symptoms, emotion dysregulation, and emotional impulsivity. A series of one-way analyses of covariance indicated significant between-group differences in emotion dysregulation and emotional impulsivity when current depression and oppositional defiant disorder ratings were covaried. In addition, the relationship between ADHD symptoms and emotional impulsivity was mediated by emotion dysregulation symptoms. These findings suggest that emotion dysregulation and emotional impulsivity are higher in adults diagnosed with ADHD and that emotion dysregulation symptoms have predictive value beyond core ADHD symptoms. Keywords ADHD . Emotion dysregulation . Emotional impulsivity Attention-deficit/hyperactivity disorder (ADHD) is a developmental disorder that persists into adulthood for the majority of cases (Barkley et al. 2008; Mannuzza et al. 1993; G. Weiss and Hechtman 1993) and occurs among approximately 4 % of adults (Kessler et al. 2006). Though developmentally inappropriate symptoms of inattention and hyperactivity-impulsivity are the two core symptom sets of the disorder (American Psychiatric Association 2000), recent reviews argue that emo-tion dysregulation is an additional feature of ADHD that should be incorporated into theoretical conceptualizations and diagnostic criteria (Barkley 2010; Martel 2009; Skirrow et al. 2009). Even though there is no consistently agreed upon defini-tion of emotion dysregulation (Putnam and Silk 2005), most accounts describe it as a multidimensional construct (Gratz and Roemer 2004) that includes (a) the lack of inhibition of behavior associated with strong negative or positive emo-tion and (b) subsequent failure to engage in self-regulatory actions, including self-soothing, refocusing attention, mod-erating the initial emotion, and organizing for coordinated action in the service of goal-directed behavior (Barkley 2010; Gottman and Katz 1989; Hinshaw 2003; Martel 2009; Melnick and Hinshaw 2000). According to one ac-count of emotion dysregulation in ADHD (Barkley 2010), those with the disorder are less likely to inhibit their emo-tions, particularly those pertaining to frustration, impatience, and anger, as a result of deficient cognitive control. The outcome of this poor inhibitory process is emotional impul-sivity, which "refers to the quickness or speed with which and the greater likelihood that an individual with ADHD will react with negative emotions in response to events J. T. Mitchell (*) : S. H. Kollins
    Journal of Psychopathology and Behavioral Assessment 12/2012; DOI:10.1007/s10862-012-9297-2 · 1.55 Impact Factor
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    ABSTRACT: Attention deficit/hyperactivity disorder (ADHD) is prevalent in homeless populations, but no studies have assessed the psychometric properties of assessment instruments for this population. Self-other agreement on the ADHD Self-Rating Scale 6 was studied using a cohort of admissions to an outreach clinic for the homeless (n = 72). Alcohol use was assessed with the fast alcohol screening test. Other drug use was assessed by interview. For the six-item ASRS-6, the self-nurse correlation was .63 (p < .001). Discriminant correlations were low. Higher ASRS-6 scores as rated by both nurse and self-report were associated with illicit drug use but not alcohol problems. Concordance was lower at higher levels of alcohol problems (p < .05) CONCLUSION:: The observations of experienced nurses converge well with self-reported symptoms of ADHD. Further research is needed to assess the relative contribution of clinical observation and self-report in assessing homeless patients.
    Journal of Addictions Nursing 04/2013; 24(2):108-15. DOI:10.1097/JAN.0b013e3182929447 · 0.34 Impact Factor
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