Measuring adult A ttention D eficit H yperactivity D isorder using the Q uantified B ehavior T est P lus
Open accessAbstract
A ttention D eficit H yperactivity D isorder (ADHD) occurs in approximately 5% of the adult population and includes cardinal symptoms of hyperactivity, inattention, and impulsivity that may be difficult to identify with clinical routine methods. Continuous performance tests are objective measures of inattention and impulsivity that, combined with objective measures of motor activity, facilitate identification of ADHD among adults. The aim of the present study was to examine the sensitivity, specificity, and a composite measure of ADHD using objective measures of the ADHD‐cardinal symptoms in adult participants with ADHD and non‐ADHD normative participants. Cardinal symptoms were measured in 55 participants having ADHD, 202 non‐ADHD normative participants, as well as 84 ADHD normative participants using the Q uantified B ehavior T est P lus. This test measures inattention and impulsivity using a continuous performance test, and hyperactivity using a motion‐tracking system. A predictive variable for the detection of ADHD called Prediction of ADHD yielded 86% sensitivity and 83% specificity. A composite measure of ADHD cardinal symptoms was developed using a Weighed Core Symptoms scale that indicated the total amount of ADHD symptoms on a numeric scale from 0 to 100. The total amount of ADHD symptoms was measured on a scale and predicted with the categorical variable in a majority of the cases in the present study. Further studies are needed in order to confirm the results with regard to additional clinical and normative samples. Careful consideration of potential sex and diagnostic subtype differences are noteworthy aspects for future examinations of the new instruments.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The measure of impulsivity is the least sensitive symptom for discriminating between adults with and without ADHD and between patients with ADHD or other psychiatric disorders.
“The measure of impulsivity has been shown to be the least sensitive symptom with regard to discriminating between adults with and without ADHD as well as between patients with ADHD or other psychiatric disorders [35, 36, 39].”
From Assessing ADHD symptoms in children and adults: evaluating the role of objective measures (2018) · cites this paper as [36]
The Discussion (‘The composite measure’; page unavailable) calls impulsivity ‘probably the measure with the least sensitivity’ for detecting ADHD in the study’s ADHD and non-ADHD groups. The paper discusses distinguishing ADHD from other psychiatric disorders, but does not establish that impulsivity is the least sensitive measure for that comparison; the cited clinical-group findings concern the composite measure and motor activity. (LLM, conf=0.86)
Experimental — accuracy not yet measuredStudies of Qb+© demonstrated high sensitivity (86%) and specificity (83%) when differentiating between subjects with and without ADHD.
“There are studies of the Qb+©, the version used for adolescents and adults, demonstrating high sensitivity (86%) and specificity (83%) when trying to differentiate between subjects with and without ADHD [35, 36].”
From Assessing ADHD symptoms in children and adults: evaluating the role of objective measures (2018) · cites this paper as [36]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Diagnostic and Statistical Manual of Mental Disorders
Williams, J. B. W., & First, M. B. (2013) · Oxford University Press eBooks · doi:10.1093/acrefore/9780199975839.013.104 · Cited by 109,841 · see citing works
Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR)
American Psychiatric Association (2000) · doi:10.1176/appi.books.9780890423349 · Cited by 11,069 · see citing works
Kessler, R. C., & Üstün, T. B. (2004) · International Journal of Methods in Psychiatric Research · doi:10.1002/mpr.168 · Cited by 4,771 · see citing works
Attention Deficit Hyperactivity Disorder: A Handbook for Diagnosis and Treatment
Barkley, R. A., & Poillion, M. J. (1994) · Behavioral Disorders · doi:10.1177/019874299401900205 · Cited by 4,632 · see citing works
KESSLER, R. C., ADLER, L., AMES, M., DEMLER, O., FARAONE, S., HIRIPI, E., HOWES, M. J., JIN, R., SECNIK, K., SPENCER, T., et al. (2005) · Psychological Medicine · doi:10.1017/s0033291704002892 · Cited by 3,452 · see citing works
A continuous performance test of brain damage
Rosvold, H. E., Mirsky, A. F., Sarason, I., Bransome, E. D., & Beck, L. H. (1956) · Journal of Consulting Psychology · doi:10.1037/h0043220 · Cited by 2,261 · see citing works
Gender Differences in ADHD: A Meta-Analysis and Critical Review
GAUB, M., & CARLSON, C. L. (1997) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-199708000-00011 · Cited by 1,117 · see citing works
A Meta-Analytic Review of Gender Differences in ADHD
Gershon, J., & Gershon, J. (2002) · Journal of Attention Disorders · doi:10.1177/108705470200500302 · Cited by 875 · see citing works
Gender Differences in ADHD: A Meta-Analysis and Critical Review
Gaub, M., & Carlson, C. L. (1997) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-199708000-00023 · Cited by 871 · see citing works
Frazier, T. W., Demaree, H. A., & Youngstrom, E. A. (2004) · Neuropsychology · doi:10.1037/0894-4105.18.3.543 · Cited by 792 · cited 1× · see citing works
“…from literature reviews of adult ADHD (Epstein, Johnson, Varia, & Conners, 2001) using recent neuropsychological and neuroimaging perspectives, a heavier weight on performance-based assessments has been suggested for clinical and research methodologies (Doyle et al., 2005; Frazier et al., 2004).”
BackgroundNeuropsychology of Adults With Attention-Deficit/Hyperactivity Disorder: A Meta-Analytic Review.
Hervey, A. S., Epstein, J. N., & Curry, J. F. (2004) · Neuropsychology · doi:10.1037/0894-4105.18.3.485 · Cited by 781 · see citing works
Attention-Deficit Hyperactivity Disorder: A Handbook for Diagnosis and Treatment, 3rd ed
Lyon, G. J., & Coffey, B. J. (2008) · The Journal of Clinical Psychiatry · Cited by 755 · see citing works
Douglas, V. I. (1972) · Canadian Journal of Behavioural Science/Revue canadienne des sciences du comportement · doi:10.1037/h0082313 · Cited by 654 · see citing works
Executive functioning in adult ADHD: a meta-analytic review
MARIJE BOONSTRA, A., OOSTERLAAN, J., SERGEANT, J. A., & BUITELAAR, J. K. (2005) · Psychological Medicine · doi:10.1017/s003329170500499x · Cited by 560 · see citing works
Clinicians' Judgments of Mental Health
Luborsky, L. B. (1962) · Archives of General Psychiatry · doi:10.1001/archpsyc.1962.01720060019002 · Cited by 463 · see citing works
Symptom profiles in children with ADHD: effects of comorbidity and gender.
Newcorn, J. H., Halperin, J., Jensen, P. S., Abikoff, H., Arnold, L. E., Cantwell, D., Conners, C., Elliott, G., Epstein, J. N., Greenhill, L. L., et al. (2001) · Journal of the American Academy of Child and Adolescent Psychiatry · doi:10.1097/00004583-200102000-00008 · Cited by 442 · see citing works
Losier, B. J., McGrath, P. J., & Klein, R. M. (1996) · Journal of Child Psychology and Psychiatry · doi:10.1111/j.1469-7610.1996.tb01494.x · Cited by 424 · see citing works
Corkum, P. V., & Siegel, L. S. (1993) · Journal of Child Psychology and Psychiatry · doi:10.1111/j.1469-7610.1993.tb01784.x · Cited by 378 · see citing works
Prevalence of DSM-IV symptoms of ADHD in adult licensed drivers: Implications for clinical diagnosis
Murphy, K., & Barkley, R. A. (1996) · Journal of Attention Disorders · doi:10.1177/108705479600100303 · Cited by 370 · see citing works
Seidman, L. J., Biederman, J., Faraone, S. V., Weber, W. J., & Ouellette, C. (1997) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.65.1.150 · Cited by 359 · see citing works
SCHOECHLIN, C., & ENGEL, R. (2005) · Archives of Clinical Neuropsychology · doi:10.1016/j.acn.2005.04.005 · Cited by 312 · see citing works
Self-Report of ADHD Symptoms in University Students
DuPaul, G. J., Schaughency, E. A., Weyandt, L. L., Tripp, G., Kiesner, J., Ota, K., & Stanish, H. (2001) · Journal of Learning Disabilities · doi:10.1177/002221940103400412 · Cited by 272 · see citing works
Psychological adjustment and adaptive impairments in young adults with ADHD
Barkley, R. A., Murphy, K. R., & Kwasnik, D. (1996) · Journal of Attention Disorders · doi:10.1177/108705479600100104 · Cited by 269 · see citing works
Objective measurement of hyperactivity and attentional problems in ADHD
TEICHER, M. H., ITO, Y., GLOD, C. A., & BARBER, N. I. (1996) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-199603000-00015 · Cited by 243 · see citing works
SUSTAINED ATTENTION IN HYPERACTIVE CHILDREN*
Sykes, D. H., Douglas, V. I., & Morgenstern, G. (1973) · Journal of Child Psychology and Psychiatry · doi:10.1111/j.1469-7610.1973.tb01189.x · Cited by 236 · see citing works
Doyle, A. E., Faraone, S. V., Seidman, L. J., Willcutt, E. G., Nigg, J. T., Waldman, I. D., Pennington, B. F., Peart, J., & Biederman, J. (2005) · Journal of Child Psychology and Psychiatry · doi:10.1111/j.1469-7610.2005.01476.x · Cited by 214 · see citing works
Presenting ADHD symptoms and subtypes in clinically referred adults with ADHD
Millstein, R., Wilens, T., Biederman, J., & Spencer, T. J. (1997) · Journal of Attention Disorders · doi:10.1177/108705479700200302 · Cited by 208 · see citing works
Does the Conners' Continuous Performance Test Aid in ADHD Diagnosis?
McGee, R. A., Clark, S. E., & Symons, D. K. (2000) · Research on Child and Adolescent Psychopathology · doi:10.1023/a:1005127504982 · Cited by 200 · see citing works
Neuropsychological Assessment of Response Inhibition in Adults With ADHD
Epstein, J. N., Johnson, D. E., Varia, I., & Conners, C. K. (2001) · Journal of Clinical and Experimental Neuropsychology · doi:10.1076/jcen.23.3.362.1186 · Cited by 189 · see citing works
Comorbidity of Attention-deficit Hyperactivity Disorder and Overanxious Disorder
Pliszka, S. R. (1992) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-199203000-00003 · Cited by 183 · see citing works
Boonstra, A. M., Kooij, J. J. S., Oosterlaan, J., Sergeant, J. A., Buitelaar, J. K., & Van Someren, E. J. W. (2007) · Sleep · doi:10.1093/sleep/30.4.433 · Cited by 155 · see citing works
Neuropsychological performance deficits in adults with attention deficit/hyperactivity disorder
Johnson, D. E., Epstein, J. N., Waid, L. R., Latham, P. K., Voronin, K. E., & Anton, R. F. (2001) · Archives of Clinical Neuropsychology · doi:10.1016/s0887-6177(00)00070-6 · Cited by 140 · see citing works
Predictive Power of Frontal Lobe Tests in the Diagnosis of Attention Deficit Hyperactivity Disorder
Grodzinsky, G. M., & Barkley, R. A. (1999) · The Clinical Neuropsychologist · doi:10.1076/clin.13.1.12.1983 · Cited by 140 · see citing works
Neuropsychological Functioning of Adults with Attention Deficit Hyperactivity Disorder
Walker, A., Shores, E. A., Trollor, J. N., Lee, T., & Sachdev, P. S. (2000) · Journal of Clinical and Experimental Neuropsychology · doi:10.1076/1380-3395(200002)22:1;1-8;ft115 · Cited by 133 · see citing works
Taylor, A. C., Deb, S. S., & Unwin, G. (2011) · Research in Developmental Disabilities · doi:10.1016/j.ridd.2010.12.036 · Cited by 131 · see citing works
Continuous Performance Tests Are Sensitive to ADHD in Adults but Lack Specificity
Riccio, C. A., & Reynolds, C. R. (2001) · Annals of the New York Academy of Sciences · doi:10.1111/j.1749-6632.2001.tb05776.x · Cited by 125 · see citing works
Lis, S., Baer, N., Stein‐en‐Nosse, C., Gallhofer, B., Sammer, G., & Kirsch, P. (2010) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.2010.01549.x · Cited by 84 · see citing works
Neuropsychological Performance of Adults Evidencing Attention-Deficit Hyperactivity Disorder
Corbett, B., & Stanczak, D. E. (1999) · Archives of Clinical Neuropsychology · doi:10.1016/s0887-6177(98)00037-7 · Cited by 72 · see citing works
Gaub, M., & Carlson, C. L. (1997) · Journal of the American Academy of Child & Adolescent Psychiatry · Cited by 72 · see citing works
Brocki, K. C., Tillman, C. M., & Bohlin, G. (2010) · European Journal of Developmental Psychology · doi:10.1080/17405620801937764 · Cited by 53 · cited 1× · see citing works
“The need for the activity domain to be objectively accessible and measurable in adult ADHD patients has been critically discussed, with reference to reduced levels of motor activity with increased age (Brocki et al., 2010) and the influence of diagnostic subtypes.”
BackgroundTeicher, M. H., Polcari, A. M., Fourligas, N., Vitaliano, G. D., & Navalta, C. P. (2012) · BMC Psychiatry · doi:10.1186/1471-244x-12-190 · Cited by 41 · see citing works
Edebol, H., Helldin, L., & Norlander, T. (2012) · Clinical Practice & Epidemiology in Mental Health · doi:10.2174/1745017901208010134 · Cited by 40 · see citing works
Self-citationEffects of Methylphenidate on Hyperactive Children's Ability to Sustain Attention
Charles, L., Schain, R. J., Zelniker, T., & Guthrie, D. (1979) · PEDIATRICS · doi:10.1542/peds.64.4.412 · Cited by 36 · see citing works
A Review of Adult ADHD: A Neuropsychological and Neuroimaging Perspective
Kaplan, R. F., & Stevens, M. C. G. (2002) · CNS Spectrums · doi:10.1017/s1092852900017818 · Cited by 33 · see citing works
Woods, S. P., Lovejoy, D. W., Stutts, M. L., Ball, J. D., & Fals-Stewart, W. S. (2002) · Archives of Clinical Neuropsychology · doi:10.1093/arclin/17.4.351 · Cited by 30 · see citing works
Tuisku, K., Virkkunen, M. E., Holi, M. M., Lauerma, H., Naukkarinen, H., Rimón, R., & Wahlbeck, K. (2003) · Journal of Neuropsychiatry · doi:10.1176/jnp.15.2.194 · Cited by 13 · see citing works
Edebol, H., Helldin, L., Holmberg, E., Gustafsson, S.-A., & Norlander, T. (2011) · Europe’s Journal of Psychology · doi:10.5964/ejop.v7i3.143 · Cited by 10 · see citing works
Self-citationTABLE OF STATISTICS OF FRENCH LUNATIC ASYLUMS, FOR THE YEAR ENDING JUNE 30th, 1856
Vattemare, M. A. (1858) · American Journal of Psychiatry · doi:10.1176/appi.neuropsych.15.2.194 · Cited by 4 · see citing works
Polcari, A. M. (2010) · 57th Annual Meeting (October 26-31, 2010) · Cited by 3 · see citing works
Woods, S. (2002) · Archives of Clinical Neuropsychology · doi:10.1016/s0887-6177(01)00120-2 · Cited by 2
Flagged first, then by citations
Cited by
Sorted by citations
Adult attention-deficit hyperactivity disorder: key conceptual issues
Asherson, P., Buitelaar, J., Faraone, S. V., & Rohde, L. A. (2016) · The Lancet Psychiatry · doi:10.1016/s2215-0366(16)30032-3 · Cited by 347 · see citing works
Pettersson, R., Söderström, S., & Nilsson, K. W. (2018) · Journal of Attention Disorders · doi:10.1177/1087054715618788 · Cited by 128 · see citing works
Kofler, M. J., Raiker, J. S., Sarver, D. E., Wells, E. L., & Soto, E. F. (2016) · Clinical Psychology Review · doi:10.1016/j.cpr.2016.04.004 · Cited by 88 · see citing works
Assessing ADHD symptoms in children and adults: evaluating the role of objective measures
Emser, T. S., Johnston, B. A., Steele, J. D., Kooij, S., Thorell, L., & Christiansen, H. (2018) · Behavioral and Brain Functions · doi:10.1186/s12993-018-0143-x · Cited by 89 · see citing works
Marshall, P., Hoelzle, J., & Nikolas, M. (2021) · The Clinical Neuropsychologist · doi:10.1080/13854046.2019.1696409 · Cited by 85 · see citing works
“Edebol et al., 2012 (III) 53 clinically diagnosed adults with ADHD (mean age 36), 45 clinically diagnosed adults with bipolar or borderline personality disorder (mean age 42), 29 adults clinically evaluated but not diagnosed with ADHD (mean age 35) Qb Test- Plus, GAF, ASRS self-report form The…”
BackgroundHirjak, D., Meyer-Lindenberg, A., Fritze, S., Sambataro, F., Kubera, K. M., & Wolf, R. C. (2018) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2018.09.009 · Cited by 60 · see citing works
Edebol, H., Helldin, L., & Norlander, T. (2012) · Clinical Practice & Epidemiology in Mental Health · doi:10.2174/1745017901208010134 · Cited by 40 · see citing works
“The overarching aim of these computerized tests is to quantify the amount of impulsive and inattentive behaviors by means of appropriate and reliable measures such as commission and omission errors.”
BackgroundSelf-citationBijlenga, D., Jasperse, M., Gehlhaar, S. K., & Sandra Kooij, J. J. (2015) · European Psychiatry · doi:10.1016/j.eurpsy.2014.06.003 · Cited by 34 · see citing works
Factorial Structure and Validity of the Quantified Behavior Test Plus (Qb+©)
Hirsch, O., & Christiansen, H. (2017) · Assessment · doi:10.1177/1073191116638426 · Cited by 26 · see citing works
- Authors
- Edebol, H., Helldin, L., & Norlander, T.
- Affiliations
- Karlstad University (SE)
- NU Hospital Group (SE)
- Karolinska Institutet (SE)
- Corresponding author
- Edebol, Hanna
- Venue
- PsyCh Journal
- Publisher
- Wiley
- Published
- 2012-12-27
- Volume
- 2
- Issue
- 1
- Pages
- 48-62
- ISSN
- 2046-0252 (ISSN-L)
- 2046-0260
- PMC
- PMC3832237
- OpenAlex
- W1594944612
- Cited by
- 45
- References
- 50
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 2 · 2023: 5 · 2022: 3 · 2021: 1 · 2020: 6 · 2019: 4 · 2018: 5 · 2017: 3 · 2016: 7 · 2015: 2 · 2014: 1 · 2013: 1 · 2012: 1
- FWCI
- 1.14
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- PsyCh Journal (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Funders
- County Council (Landstinget) of Värmland, LiV, Sweden
- Janssen-Cilag AB, Sollentuna, Sweden
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Social Sciences › Psychology › Clinical Psychology › Historical and Modern Theater Studies
- Keywords
- adult ADHD, continuous performance test, inattention, impulsivity, hyperactivity, motion tracking, sensitivity and specificity, ADHD detection
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
