Reliability and validity of self- and other-ratings of symptoms of ADHD in adults.
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.
SourceAvailable from: Margaret Danielle Weiss[Show abstract] [Hide abstract]
ABSTRACT: Objective: To review measures used to assess treatment response in patients with attention-deficit/hyperactivity disorder (ADHD) across the life span. Data Sources: Keyword searches of English-language articles in the PubMed database up to and including the May 4, 2011, index date were performed with the search strings (1) (attention deficit disorder with hyperactivity [MeSH] OR ADHD) AND (outcome assessment [MeSH] OR adaptation of life skills OR executive function [MeSH]) and (2) (attention deficit disorder with hyperactivity [MeSH] OR ADHD) AND (function OR functioning OR quality of life [MeSH]). Study Selection: Articles found through this search were then selected based on relevance to the topic area; no specific quality criteria were applied. Data Extraction: Narrative review. Results: The vast majority of studies assessing ADHD treatments have measured treatment response using ADHD symptom measures. Additional domains relevant for assessing treatment response among children and adults with ADHD include functional impairment, quality of life, adaptive life skills, and executive function. Validated rating scales exist for assessing these additional domains, but there has been minimal research evaluating the sensitivity of these instruments for detecting treatment response in pediatric and adult samples. Conclusions: Assessment of treatment outcomes in ADHD should move beyond symptom assessment to incorporate measures of functioning, quality of life, adaptive skills, and executive function, especially when assessing long-term treatment response. The authors recommend a potential battery and schedule of measures that could be used to more comprehensively assess treatment response in patients with ADHD.11/2012; 14(6). DOI:10.4088/PCC.11r01336
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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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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