Defining ADHD symptom persistence in adulthood: optimizing sensitivity and specificity. (19th September 2016)

• Record Type: Journal Article
• Authors: Sibley, Margaret H.; Swanson, James M.; Arnold, L. Eugene; Hechtman, Lily T.; Owens, Elizabeth B.; Stehli, Annamarie; Abikoff, Howard; Hinshaw, Stephen P.; Molina, Brooke S.G.; Mitchell, John T.; Jensen, Peter S.; Howard, Andrea L.; Lakes, Kimberley D.; Pelham, William E.
• Other Names: Vitiello Benedetto investigator.; Severe Joanne B. investigator.; Eugene Arnold L. investigator.; Hoagwood Kimberly investigator.; Richters John investigator.; Vereen Donald investigator.; Elliott Glen R. investigator.; Wells Karen C. investigator.; Epstein Jeffery N. investigator.; Murray Desiree W. investigator.; Keith Conners C. investigator.; March John investigator.; Wigal Timothy investigator.; Cantwell Dennis P. investigator.; Greenhill Laurence L. investigator.; Newcorn Jeffrey H. investigator.; Hoza Betsy investigator.; Gibbons Robert D. investigator.; Marcus Sue investigator.; Hur Kwan investigator.; Kraemer Helena C. investigator.; Hanley Thomas investigator.; Stern Karen investigator.
• Is Part Of: Journal of child psychology and psychiatry and allied disciplines. Volume 58:Number 6(2017)
• Page Start: 655
• Page End: 662
• Publication Date: 2016-09-19
• Subjects: Adult ADHD -- DSM‐5 -- diagnosis; Child psychology -- Periodicals; Child psychiatry -- Periodicals; 155.4
• DOI: 10.1111/jcpp.12620
• Languages: English
• ISSNs: 0021-9630

Abstract

Abstract : Objective: Longitudinal studies of children diagnosed with ADHD report widely ranging ADHD persistence rates in adulthood (5–75%). This study documents how information source (parent vs. self‐report), method (rating scale vs. interview), and symptom threshold (DSM vs. norm‐based) influence reported ADHD persistence rates in adulthood. Method: Five hundred seventy‐nine children were diagnosed with DSM‐IV ADHD‐Combined Type at baseline (ages 7.0–9.9 years) 289 classmates served as a local normative comparison group (LNCG), 476 and 241 of whom respectively were evaluated in adulthood (Mean Age = 24.7). Parent and self‐reports of symptoms and impairment on rating scales and structured interviews were used to investigate ADHD persistence in adulthood. Results: Persistence rates were higher when using parent rather than self‐reports, structured interviews rather than rating scales (for self‐report but not parent report), and a norm‐based (NB) threshold of 4 symptoms rather than DSM criteria. Receiver‐Operating Characteristics (ROC) analyses revealed that sensitivity and specificity were optimized by combining parent and self‐reports on a rating scale and applying a NB threshold. Conclusion: The interview format optimizes young adult self‐reporting when parent reports are not available. However, the combination of parent and self‐reports from rating scales, using an 'or' rule and a NB threshold optimized the balance between sensitivity and specificity. With this definition, 60% of the ADHD group demonstrated symptom persistence and 41% met both symptom and impairment criteria in adulthood. Abstract : Read the Commentary on this article at doi:10.1111/jcpp.12758 Podcast link