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. 2012 Feb;80(1):139-150.
doi: 10.1037/a0026577. Epub 2011 Dec 12.

Diagnosing ADHD in adolescence

Margaret H Sibley  1 , William E Pelham  1 , Brooke S G Molina  2 , Elizabeth M Gnagy  3 , Daniel A Waschbusch  3 , Allison C Garefino  4 , Aparajita B Kuriyan  3 , Dara E Babinski  3 , Kathryn M Karch  5
Affiliations

Diagnosing ADHD in adolescence

Margaret H Sibley et al. J Consult Clin Psychol. 2012 Feb.

Abstract

Objective: This study examines adolescent-specific practical problems associated with current practice parameters for diagnosing attention-deficit/hyperactivity disorder (ADHD) to inform recommendations for the diagnosis of ADHD in adolescents. Specifically, issues surrounding the use of self- versus informant ratings, diagnostic threshold, and retrospective reporting of childhood symptoms were addressed.

Method: Using data from the Pittsburgh ADHD Longitudinal Study (PALS), parent, teacher, and self-reports of symptoms and impairment were examined for 164 adolescents with a childhood diagnosis of ADHD (age M = 14.74 years) and 119 demographically similar non-ADHD controls (total N = 283).

Results: Results indicated that 70% of the well-diagnosed childhood ADHD group continued to meet Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; American Psychiatric Association, 2000) diagnostic criteria for ADHD in adolescence; however, an additional 17% possessed clinically significant impairment in adolescence but did not qualify for a current ADHD diagnosis. The optimal source of information was combined reports from the parent and a core academic teacher. Adolescents with ADHD met criteria for very few symptoms of hyperactivity/impulsivity, suggesting a need to revisit the diagnostic threshold for these items. Additionally, emphasis on impairment, rather than symptom threshold, improved identification of adolescents with a gold-standard childhood diagnosis of ADHD and persistent ADHD symptoms. Parent retrospective reports of baseline functioning, but not adolescent self-reports, were significantly correlated with reports collected at baseline in childhood.

Conclusions: Recommendations are offered for diagnosing ADHD in adolescence based on these findings.

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Figures

Figure 1
Figure 1. ADHD Symptomatology and Impairment by Rater and Group
Note. Graphs reflect estimated marginal means at the mean of the covariates.
Figure 2
Figure 2. Mean Symptom Endorsement at each IRS Impairment Level within ADHD Group
Note. Clinically significant impairment is indicated by a score of “3” or higher on the Impairment Rating Scale (Evans et al., under review; Fabiano et al., 2006).
Figure 3
Figure 3. Group-level Retrospective Reporting within the ADHD Sample
Note. Values represent estimated marginal means at the mean of the covariate (years since baseline).
See this image and copyright information in PMC

References

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