When diagnosing ADHD in young adults emphasize informant reports, DSM items, and impairment.
Open accessAbstract
OBJECTIVE: This study examined several questions about the diagnosis of attention-deficit/hyperactivity disorder (ADHD) in young adults using data from a childhood-diagnosed sample of 200 individuals with ADHD (age M = 20.20 years) and 121 demographically similar non-ADHD controls (total N = 321). METHOD: We examined the use of self- versus informant ratings of current and childhood functioning and evaluated the diagnostic utility of adult-specific items versus items from the Diagnostic and Statistical Manual of Mental Disorders (DSM). RESULTS: Results indicated that although a majority of young adults with a childhood diagnosis of ADHD continued to experience elevated ADHD symptoms (75%) and clinically significant impairment (60%), only 9.6%-19.7% of the childhood ADHD group continued to meet DSM-IV-TR (DSM, 4th ed., text rev.) criteria for ADHD in young adulthood. Parent report was more diagnostically sensitive than self-report. Young adults with ADHD tended to underreport current symptoms, while young adults without ADHD tended to overreport symptoms. There was no significant incremental benefit beyond parent report alone to combining self-report with parent report. Non-DSM-based, adult-specific symptoms of ADHD were significantly correlated with functional impairment and endorsed at slightly higher rates than the DSM-IV-TR symptoms. However, DSM-IV-TR items tended to be more predictive of diagnostic group membership than the non-DSM adult-specific items due to elevated control group item endorsement. CONCLUSIONS: Implications for the assessment and treatment of ADHD in young adults are discussed (i.e., collecting informant reports, lowering the diagnostic threshold, emphasizing impairment, and cautiously interpreting retrospective reports).
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Discrepancies between participant self-report and parent-report data have been reported, with parent-reported data considered to be more diagnostically sensitive than self-reports.
“With regard to reporting of symptoms, discrepancies between participant self-report and parent-report data have been reported, with parent-reported data being considered to be more diagnostically sensitive than self-reports (Sibley et al. 2012).”
From Participant-Perceived Quality of Life in a Long-Term, Open-Label Trial of Lisdexamfetamine Dimesylate in Adolescents with Attention-Deficit/Hyperactivity Disorder (2014) · cites this paper as Sibley et al. 2012
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- Authors
- Sibley, M. H., Pelham, W. E., Molina, B. S. G., Gnagy, E. M., Waxmonsky, J. G., Waschbusch, D. A., Derefinko, K. J., Wymbs, B. T., Garefino, A. C., Babinski, D. E., & Kuriyan, A. B.
- Affiliations
- Florida International University (US)
- University of Pittsburgh Medical Center (US)
- Seattle Children's Hospital (US)
- Kennesaw State University (US)
- ORCID
- Venue
- Journal of Consulting and Clinical Psychology
- Published
- 2012-12
- Volume
- 80
- Issue
- 6
- Pages
- 1052-1061
- ISSN
- 0022-006X (ISSN-L)
- 1939-2117
- PMC
- PMC3919146
- OpenAlex
- W1992861435
- Cited by
- 259
- References
- 44
- Citations by year
- 2026: 8 · 2025: 15 · 2024: 9 · 2023: 19 · 2022: 17 · 2021: 26 · 2020: 17 · 2019: 24 · 2018: 25 · 2017: 22 · 2016: 36 · 2015: 10 · 2014: 18 · 2013: 7 · 2012: 6
- FWCI
- 9.37
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Consulting and Clinical Psychology (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- DigitalCommons - Kennesaw State University (Kennesaw State University) (submittedVersion)
- Funders
- National Institute on Drug Abuse (DA12414, DA05605, F31 DA017546)
- National Institute of Alcohol Abuse and Alcoholism (AA11873, AA00202, AA12342, AA08746, AA06267)
- National Institute of Mental Health (MH12010, MH48157, MH45576, MH50467, MH069614, MH53554, MH47390)
- National Institute of Environmental Health Sciences (ES0515-08)
- Institute of Education Sciences (IESLO3000665A, IESR324B060045)
- American Psychological Foundation
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Social Sciences › Psychology › Neuropsychology and Physiological Psychology › Developmental and Educational Neuropsychology
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Keywords
- attention deficit hyperactivity disorder, young adults, ADHD diagnosis, informant reports, parent report, self-report, DSM-IV-TR diagnostic criteria, functional disability, symptom underreporting, diagnostic thresholds
- MeSH terms
- Adolescent, Adult, Attention Deficit Disorder with Hyperactivity, Female, Humans, Interview, Psychological, Male, Parents, Retrospective Studies, Severity of Illness Index, Diagnostic and Statistical Manual of Mental Disorders, Self Report, Symptom Assessment
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