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Clinical Trial
. 1997 Sep;36(9):1211-21.

Validity of the age-of-onset criterion for ADHD: a report from the DSM-IV field trials

B Applegate  1 , B B Lahey, E L Hart, J Biederman, G W Hynd, R A Barkley, T Ollendick, P J Frick, L Greenhill, K McBurnett, J H Newcorn, L Kerdyk, B Garfinkel, I Waldman, D Shaffer
Affiliations
  • PMID: 9291722
Clinical Trial

Validity of the age-of-onset criterion for ADHD: a report from the DSM-IV field trials

B Applegate et al. J Am Acad Child Adolesc Psychiatry. 1997 Sep.

Abstract

Objective: To examine the validity of the DSM-IV requirement of an age of onset of impairment due to symptoms before 7 years of age for the diagnosis of attention-deficit/hyperactivity disorder (ADHD).

Method: The validity of this criterion was examined in a clinic sample of 380 youths aged 4 through 17 years by comparing youths who met symptom criteria for ADHD and either did or did not display impairment before age 7 years.

Results: Nearly all youths who met symptom criteria for the predominantly hyperactive-impulsive subtype also met the age of onset of impairment criterion, but 18% of youths who met symptom criteria for the combined type, and 43% of youths who met symptom criteria for the predominantly inattentive type, did not manifest impairment before 7 years. For the latter two subtypes, requiring impairment before age 7 years reduced the accuracy of identification of currently impaired cases of ADHD and reduced agreement with clinicians' judgments.

Conclusions: These findings raise questions about the validity of the DSM-IV definition of age of onset of ADHD. Marked differences in the ages of onset of both symptoms and impairment for the three subtypes of ADHD support the validity of distinguishing among these subtypes in DSM-IV.

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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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