Correspondence and Disparity in the Self- and Other Ratings of Current and Childhood ADHD Symptoms and Impairment in Adults With ADHD
Department of Psychiatry, Medical University of South Carolina, USA.Psychological Assessment (Impact Factor: 2.99). 03/2011; 23(2):437-46. DOI: 10.1037/a0022172
Experts recommend that clinicians evaluating adults for attention-deficit/hyperactivity disorder (ADHD) obtain information from others who know the patient well. The authors examined correspondence between the self- and other-ratings of ADHD symptoms and impairment using 3 groups of adults recruited on the basis of their severity of ADHD: ADHD diagnosis (n = 146), clinical controls self-referring for ADHD but not diagnosed (n = 97), and community controls (n = 109). The influences of diagnostic group, informant relationship, sex of participant, IQ, and comorbid anxiety and depression on self-informant disparities were also examined. Results indicated moderate to high agreement (.59-.80) between self and others on current functioning and slightly lower levels (.53-.75) between self- and parent ratings of childhood functioning. Examination of difference scores between self- and other ratings revealed small mean disparities (-0.1 to +5.0 points) but substantial variation (SDs = -2.4 to 8.9 points) for both current and childhood ratings. Clinic referrals not diagnosed with ADHD, particularly women, had higher disparities than was evident in the ADHD and community groups. Age, IQ, and education were not associated with disparities in most ratings. Higher anxiety, in contrast, was associated with greater disparities on all current and childhood measures of both ADHD and impairment.
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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 · 0.45 Impact Factor
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ABSTRACT: The heterogeneous, chronic, and proliferating aspect of attention deficit hyperactivity disorder (ADHD) and comorbidities covers heritability, cognitive, emotional, motor, and everyday behavioral domains that place individuals presenting the condition at some considerable disadvantage. Disruption of "typical developmental trajectories" in the manifestation of gene-environment interactive predispositions implies that ADHD children and adolescents may continue to perform at defective levels as adults with regard to academic achievement, occupational enterprises, and interpersonal relationships, despite the promise of pharmacotherapeutic treatments. Physical exercise provides a plethora of beneficial effects against stress, anxiety, depression, negative affect and behavior, poor impulse control, and compulsive behavior concomitant with improved executive functioning, working memory and positive affect, as well as improved conditions for relatives and care-givers. Brain-derived neurotrophic factor, an essential element in normal brain development that promotes health-associated behaviors and quality-of-life, though reduced in ADHD, is increased markedly by the intervention of regular physical exercise. Functional, regional, and biomarker deficits, as well as hypothalamic-pituitary-adrenal disruptions, have been improved through regular and carefully applied exercise programs. In view of the complications involving ADHD with co-morbidities, such as obesity, the influence of regular physical exercise has not been found negligible. Physical exercise bestows a propensity for eventual manifestation of "redifferentiated" developmental trajectories that may equip ADHD adults with a prognosis that is more adaptive functionally, independent of the applications of other therapeutic agents and treatments.Neurotoxicity Research 08/2011; 21(2):195-209. DOI:10.1007/s12640-011-9260-0 · 3.54 Impact Factor
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ABSTRACT: Although the validity of adult ADHD is well established and research has identified a variety of impairments associated with the condition in adults, study of how ADHD impacts an adult's ability to parent has been relatively neglected. Parenting is a particularly important domain of functioning given the familial nature of the disorder and emerging evidence that parenting behaviors play a role in the development or maintenance of child ADHD symptoms, comorbid psychopathologies, and other associated difficulties. In this paper, we focus on three broad categories of cognitive dysfunction proposed across models of ADHD - cognitive processes (e.g., working memory, planning, and inhibitory control), self-regulation deficits (e.g., self-monitoring of performance to detect errors or the need for regulation of behavior and/or emotions), and motivational or arousal difficulties (e.g., response to incentives, delay aversion). We consider how these deficits may lead to impairments in the parenting behaviors of effective behavioral control and emotional responsiveness, and review the available evidence regarding parenting in adults with ADHD symptoms. We conclude by noting the limitations in existing studies, and argue for further research that is theoretically grounded in how core deficits of ADHD may be related to dimensions of parenting. The implications of an improved understanding of how ADHD impacts parenting for the development of early intervention or prevention programs are outlined.Clinical psychology review 02/2012; 32(4):215-28. DOI:10.1016/j.cpr.2012.01.007 · 7.18 Impact Factor
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