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. 2000 Sep;39(9):1144-51.
doi: 10.1097/00004583-200009000-00014.

Reformulating attention-deficit/hyperactivity disorder according to signal detection theory

V L Mota  1 , R J Schachar
Affiliations

Reformulating attention-deficit/hyperactivity disorder according to signal detection theory

V L Mota et al. J Am Acad Child Adolesc Psychiatry. 2000 Sep.

Abstract

Objective: The current diagnostic algorithm for attention-deficit/hyperactivity disorder (ADHD) is not highly predictive of impairment and yields low interrater agreement. The objective of this study was to enhance the diagnostic accuracy of ADHD by identifying the symptoms that are associated with impairment.

Method: Semistructured interviews and impairment rating scales were administered to parents and teachers of 218 children. Combinations of ADHD symptoms were examined according to a receiver operating characteristic (ROC) based procedure to create diagnostic algorithms that predict impairment.

Results: In comparison with the DSM-IV, the ROC-based algorithms were 2 to 3 times more efficient in discriminating impaired from nonimpaired children. Parent and teacher agreement was also 3 times higher.

Conclusions: Limiting the diagnosis to symptoms that predict impairment can increase the validity of the ADHD diagnosis. Results also support the use of ROC analyses in developing better diagnostic algorithms.

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Comment in

  • Validity of DSM-IV ADHD.
    Lahey BB, Applegate B. Lahey BB, et al. J Am Acad Child Adolesc Psychiatry. 2001 May;40(5):502-4. doi: 10.1097/00004583-200105000-00003. J Am Acad Child Adolesc Psychiatry. 2001. PMID: 11349689 No abstract available.

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