Quantitative and subjective behavioural aspects in the assessment of attention-deficit hyperactivity disorder (ADHD) in adults
Abstract
BACKGROUND: Self-rating scales and cognitive tests are instruments used in the assessment of attention-deficit hyperactivity disorder (ADHD). However, few studies have examined the differential validity of these kinds of instruments in psychiatric samples. AIMS: To examine the discriminative validity of two self-report scales (ADHD Self-Report Scale [ASRS v.1.1], Current Symptom Scale [CSS]) and a continuous performance test with measures of motor activity (QBTest Plus). METHODS: The interrelation between the instruments, and their abilities to differentiate between patients with an ADHD diagnosis and non-ADHD patients referred for psychiatric assessment were examined in a naturalistic sample of 61 adult patients. RESULTS: The area under the receiver operating characteristic curve (AUC) for the dichotomized versions of the test variables in all tests ranged from 0.61 to 0.71. The ASRS and CSS exhibited sensitivity of 90.2% and 85.4%, and specificity of 35.0% and 40.0%, respectively. Variables from the QBTest Plus showed the opposite result for the variables QBImpulsivity and QBInattention, with sensitivity of 58.5% and 36.3% and specificity of 80.0% and 100.0%. Sensitivity and specificity of QBActivity were 68.3% and 65.0%, respectively. A stepwise discriminant function analysis showed that two variables from the QBTest Plus--QBInattention and QBActivity--accounted for 22.8% of the between-group variability, with the strongest predictor being QBInattention. The function yielded an overall correct classification of 72.1%. The classification correctly identified 87.8% of patients diagnosed with ADHD and 40.0% of non-ADHD patients. CONCLUSION: The discriminant validity of self-rating scales and the more objective measure of ADHD symptoms are poor and should be integrated generally with other sources of data.
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Another study reported satisfactory overall classification rates (87.8% correctly identified ADHD patients), but lower correct prediction rates regarding AUC for sensitivity (36.5-58.5%) and specificity (80-100%).
“Another study reported satisfactory overall classification rates (87.8% correctly identified ADHD patients), but lower correct prediction rates regarding the area under the curve (AUC) range for sensitivity (36.5–58.5%) and specificity (80–100%; [38]).”
From Assessing ADHD symptoms in children and adults: evaluating the role of objective measures (2018) · cites this paper as [38]
Omission errors and reaction time variance are generally considered to be indicative of inattention, supported by previous factor analyses.
“These two variables are generally considered to be indicative of inattention, which has been supported in previous factor analyses [38].”
From Assessing ADHD symptoms in children and adults: evaluating the role of objective measures (2018) · cites this paper as [38]
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- Authors
- Söderström, S., Pettersson, R., & Nilsson, K. W.
- Affiliations
- Västerås Municipality (SE)
- Uppsala University (SE)
- Corresponding author
- Söderström, Staffan
- ORCID
- Nilsson, Kent W.
- Venue
- Nordic Journal of Psychiatry
- Publisher
- Informa UK Limited
- Published
- 2013-03-26
- Volume
- 68
- Issue
- 1
- Pages
- 30-37
- ISSN
- 0029-1455 (ISSN-L)
- 0803-9488
- 1502-4725
- OpenAlex
- W1982617517
- Cited by
- 52
- References
- 22
- Citations by year
- 2026: 2 · 2025: 6 · 2024: 3 · 2023: 10 · 2022: 4 · 2021: 3 · 2020: 3 · 2019: 2 · 2018: 5 · 2017: 1 · 2016: 4 · 2015: 6 · 2014: 3
- FWCI
- 3.07
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Nordic Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- 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 › Historical and Modern Theater Studies
- Keywords
- adult ADHD, continuous performance test, discriminant validity, self-report scale, inattention, impulsivity, motor activity, psychiatric assessment, sensitivity and specificity
- MeSH terms
- Adult, Attention Deficit Disorder with Hyperactivity, Diagnosis, Differential, Female, Humans, Male, Middle Aged, Psychiatric Status Rating Scales, Psychometrics, Psychomotor Performance, Surveys and Questionnaires, ROC Curve, Sensitivity and Specificity, Sweden, Discriminant Analysis, Qualitative Research, Executive Function, Checklist
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