German validation of the Conners Adult ADHD Rating Scales–self-report (CAARS-S) I: Factor structure and normative data (original) (raw)
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Revista de Psiquiatría y Salud Mental, 2012
Introduction: Attention deficit-hyperactivity disorder (ADHD) is a common neuropsychiatric disorder in adulthood. Its diagnosis requires a retrospective evaluation of ADHD symptoms in childhood, the continuity of these symptoms in adulthood, and a differential diagnosis. For these reasons, diagnosis of ADHD in adults is a complex process which needs effective diagnostic tools. Aim: To analyse the criterion validity of the CAADID semi-structured interview, Spanish version, and the concurrent validity compared with other ADHD severity scales. Methods: An observational case-control study was conducted on 691 patients with ADHD. They were outpatients treated in a programme for adults with ADHD in a hospital. Results: A sensitivity of 98.86%, specificity 67.68%, positive predictive value 90.77% and a negative predictive value 94.87% were observed. Diagnostic precision was 91.46%. The kappa index concordance between the clinical diagnostic interview and the CAADID was 0.88. Good concurrent validity was obtained, the CAADID correlated significantly with WURS scale (r = 0.522, P< .01), ADHD Rating Scale (r = 0.670, P < .0.1) and CAARS (self-rating version; r = 0.656, P < .01 and observer-report r = 0.514, P < .01). Conclusion: CAADID is a valid and useful tool for the diagnosis of ADHD in adults for clinical, as well as for research purposes.
Journal of Attention Disorders, 2012
Objective: To validate the Catalan adaptation of the Conners’ Adult ADHD Rating Scales (CAARS), short version (self-report: CAARS-S:S; observer: CAARS-O:S). Method: A community sample of 424 adults responded to the two forms. Confirmatory factor analysis was used to test the dimensional structure. Results: The hypothesized four-factor model (Inattention/Memory Problems, Hyperactivity/Restlessness, Impulsivity/Emotional Lability, and Problems With Self-Concept) presented an adequate fit for the self-report and observer forms. Reliability was slightly higher for the CAARS-O:S (average α = .78) than for the CAARS-S:S (average α = .75). Test–retest average correlations were r = .80 (self-reports) and r = .73 (observer ratings). Informant agreement was high at test (average r = .59) and retest (average r = .61). There were significant gender and age differences. Conclusion: This adaptation of the two short forms of the CAARS-S presents adequate evidence of validity and reliability, and i...
2022
Background : ADHD is classically seen as a disease of children, although it persists in one out of two cases in adults. The diagnosis is based on a long and multidisciplinary process, involving different health professionals, leading to an under-diagnosis of adult ADHD individuals. We therefore present a psychometric screening scale for the identification of adult ADHD, in order to serve as an aid in the decision whether or not to engage in a diagnostic process.Method : We designed the scale from the DSM-5 and administered it to n=110 control individuals and n=110 ADHD individuals. The number of items was reduced using regression techniques. We then performed factor analyses and a machine-learning assessment of the predictive power of the scale.Results : Internal consistency coefficients were calculated satisfactorily for TRAQ10, with Cronbach's alpha measured at .9. The 3-factor model tested was confirmed, with standardized factor loadings greater than .53 for all items. Finall...
Psychological Medicine, 2005
Background. A self-report screening scale of adult attention-deficit/hyperactivity disorder (ADHD), the World Health Organization (WHO) Adult ADHD Self-Report Scale (ASRS) was developed in conjunction with revision of the WHO Composite International Diagnostic Interview (CIDI). The current report presents data on concordance of the ASRS and of a short-form ASRS screener with blind clinical diagnoses in a community sample.Method. The ASRS includes 18 questions about frequency of recent DSM-IV Criterion A symptoms of adult ADHD. The ASRS screener consists of six out of these 18 questions that were selected based on stepwise logistic regression to optimize concordance with the clinical classification. ASRS responses were compared to blind clinical ratings of DSM-IV adult ADHD in a sample of 154 respondents who previously participated in the US National Comorbidity Survey Replication (NCS-R), oversampling those who reported childhood ADHD and adult persistence.Results. Each ASRS symptom...
A new rating scale for adult ADHD based on the Symptom Checklist 90 (SCL-90-R)
European Archives of Psychiatry and Clinical Neuroscience, 2012
Attention deficit hyperactivity disorder (ADHD) in adults is increasingly recognized as a clinically important syndrome. The aim of this study was to evaluate the psychometric performance of a new scale for adult ADHD based on the widely used Symptom Checklist 90 Revised (SCL-90-R). Scale performance was assessed in a clinical study including 100 ADHD patients and 65 opiate-dependent patient controls, and in the Zurich study, an epidemiological age cohort followed over 30 years of adult life. Assessments included a ROC analysis of sensitivity and specificity, internal consistency, test-retest reliability, external validity and measurement invariance over nine testing occasions. The new scale showed a sensitivity and specificity of 75 and 54%, respectively, internal consistency over 0.8 (McDonald's omega, Cronbach's alpha), one-year test-retest reliabilities over 0.7, statistically significant and substantial correlations with two other validated self-rating scales of adult ADHD (R = 0.5 and 0.66, respectively), and an acceptable degree of longitudinal stability (i.e., measurement invariance). The proposed scale must be further evaluated, but these preliminary results indicate it could be a useful rating instrument for adult ADHD in situations where SCL-90-R data, but no specific ADHD assessment, are available, such as in retrospective data analysis or in prospective studies with limited methodical resources.
Journal of Attention Disorders, 2017
Objective: The Strengths and Weaknesses of ADHS-Symptoms and Normal Behavior (SWAN) Scale has been developed to support the dimensional assessment of ADHD symptoms by capturing variance on both poles of the ADHD continuum. The present study provides the first validation of the German version of SWAN (SWAN-DE). Method: Based on a sample of N 1 = 343 children from the general population and N 2 = 62 children with ADHD, both aged between 8 and 18 years, normality, internal consistency, test-retest reliability, and different validity indices were examined. Results: SWAN was characterized by normally distributed scores, good to excellent reliability, and factorial validity. It showed high diagnostic utility in discriminating between patients with ADHD and healthy controls and significant correlations to related clinical scales and neuropsychological constructs, such as intra-subject variability. Conclusion: The present study reveals the excellent psychometric properties of SWAN-DE, which can now be usefully applied in the German-speaking countries as well as in cross-national studies.
ADHD} in {DSM}-5: a field trial in a large, representative sample of 18- to 19-year-old adults
BACKGROUND: The DSM criteria for adult attention-deficit/hyperactivity disorder (ADHD) have not been tested in American Psychiatric Association (APA) field trials for either DSM-IV or DSM-5. This study aimed to assess: (a) the prevalence of ADHD according to DSM-5 criteria; (b) the factor solution that provides the best fit for ADHD symptoms; (c) the symptoms with the highest predictive value for clinical impairment; and (d) the best symptomatic threshold for each ADHD dimension (inattention and hyperactivity/impulsivity). METHOD: Trained psychologists evaluated 4000 young adults from the 1993 Pelotas Birth Cohort Study with an instrument covering all DSM-5 ADHD criteria. A series of confirmatory factor analyses (CFAs) tested the best factor structure. Complex logistic regressions assessed differential contributions of each symptom to clinical impairment. Receiver-operating characteristic (ROC) analyses tested which would be the best symptomatic cut-off in the number of symptoms for predicting impairment. RESULTS: The prevalence of DSM-5 ADHD was 3.55\% [95\% confidence interval (CI) 2.98-4.12]. The estimated prevalence of DSM-IV ADHD was 2.8\%. CFA revealed that a bifactor model with a single general factor and two specific factors provided the best fit for DSM-5 symptoms. Inattentive symptoms continued to be the most important predictors of impairment in adults. The best cut-offs were five symptoms of inattention and four symptoms of hyperactivity/impulsivity. CONCLUSIONS: Our results, combined with previous findings, suggest a 27\% increase in the expected prevalence of ADHD among young adults, comparing DSM-IV to DSM-5 criteria. The DSM-5 symptomatic organization derived a similar factor structure for adults as DSM-IV symptoms. Data using DSM-5 criteria support lowering the symptomatic threshold for diagnosing ADHD in adults.
Journal of Attention Disorders, 2013
Objective: Recent publications reported that a bifactor model better represented the underlying structure of ADHD than classical models, at least in youth. The Adult ADHD Symptoms Rating Scale (ASRS) has been translated into many languages, but a single study compared its structure in adults across Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV) and International Classification of Diseases (ICD-10) classifications. Method: We investigated the factor structure, reliability, and measurement invariance of the ASRS among a community sample of 1,171 adults. Results: Results support a bifactor model, including one general ADHD factor and three specific Inattention, Hyperactivity, and Impulsivity factors corresponding to ICD-10, albeit the Impulsivity specific factor was weakly defined. Results also support the complete measurement invariance of this model across gender and age groups, and that men have higher scores than women on the ADHD G-factor but lower scores ...