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German validation of the Conners Adult ADHD Rating Scales (CAARS) II: Reliability, validity, diagnostic sensitivity and specificity

Published online by Cambridge University Press:  15 April 2020

H. Christiansen ,
B. Kis ,
O. Hirsch ,
S. Matthies ,
J. Hebebrand ,
J. Uekermann ,
M. Abdel-Hamid ,
M. Kraemer ,
J. Wiltfang  and
E. Graf
...Show all authors
H. Christiansen*
Affiliation:
Philipps-University Marburg, Department of Clinical Psychology, Gutenbergstr. 18, 35037Marburg, Germany
B. Kis
Affiliation:
University of Duisburg-Essen, Department of Psychiatry and Psychotherapy, Essen, Germany
O. Hirsch
Affiliation:
Philipps-University Marburg, Department of General Practice/Family Medicine, Marburg, Germany
S. Matthies
Affiliation:
University of Medical Center Freiburg, Department of Psychiatry and Psychotherapy, Freiburg, Germany
J. Hebebrand
Affiliation:
University of Duisburg-Essen, Department of Child and Adolescent Psychiatry and Psychotherapy, Essen, Germany
J. Uekermann
Affiliation:
University of Duisburg-Essen, Department of Psychiatry and Psychotherapy, Essen, Germany
M. Abdel-Hamid
Affiliation:
University of Duisburg-Essen, Department of Psychiatry and Psychotherapy, Essen, Germany
M. Kraemer
Affiliation:
Alfried-Krupp Hospital, Department of Neurology and clinical Neurophysiology, Essen, Germany
J. Wiltfang
Affiliation:
University of Duisburg-Essen, Department of Psychiatry and Psychotherapy, Essen, Germany
E. Graf
Affiliation:
University Medical Center Freiburg, Clinical Trials Unit, Freiburg, Germany
M. Colla
Affiliation:
Department of Psychiatry, Charite – University Medicine Berlin, Campus Benjamin Franklin, Berlin, Germany
E. Sobanski
Affiliation:
Central Institute of Mental Health, Mannheim, Germany
B. Alm
Affiliation:
Central Institute of Mental Health, Mannheim, Germany
M. Rösler
Affiliation:
Saarland University, Institute for Forensic Psychology and Psychiatry, Homburg, Germany
C. Jacob
Affiliation:
University of Wuerzburg, University Hospital, Department of Psychiatry and Psychotherapy, Wuerzburg, Germany
T. Jans
Affiliation:
University of Wuerzburg, University Hospital, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Wuerzburg, Germany
M. Huss
Affiliation:
University of Mainz, Department of Child and Adolescent Psychiatry and Psychotherapy, Mainz, Germany
B.G. Schimmelmann
Affiliation:
University Hospital of Child and Adolescent Psychiatry, Bern, Switzerland
A. Philipsen
Affiliation:
University of Medical Center Freiburg, Department of Psychiatry and Psychotherapy, Freiburg, Germany
*
*Corresponding author. Tel.: +49 0 6421 282 3706; fax: +49 0 6421 282 4281. E-mail address: [email protected] (H. Christiansen).
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Abstract

Background

The German version of the Conners Adult ADHD Rating Scales (CAARS) has proven to show very high model fit in confirmative factor analyses with the established factors inattention/memory problems, hyperactivity/restlessness, impulsivity/emotional lability, and problems with self-concept in both large healthy control and ADHD patient samples. This study now presents data on the psychometric properties of the German CAARS-self-report (CAARS-S) and observer-report (CAARS-O) questionnaires.

Methods

CAARS-S/O and questions on sociodemographic variables were filled out by 466 patients with ADHD, 847 healthy control subjects that already participated in two prior studies, and a total of 896 observer data sets were available. Cronbach's-alpha was calculated to obtain internal reliability coefficients. Pearson correlations were performed to assess test-retest reliability, and concurrent, criterion, and discriminant validity. Receiver Operating Characteristics (ROC-analyses) were used to establish sensitivity and specificity for all subscales.

Results

Coefficient alphas ranged from .74 to .95, and test-retest reliability from .85 to .92 for the CAARS-S, and from .65 to .85 for the CAARS-O. All CAARS subscales, except problems with self-concept correlated significantly with the Barrett Impulsiveness Scale (BIS), but not with the Wender Utah Rating Scale (WURS). Criterion validity was established with ADHD subtype and diagnosis based on DSM-IV criteria. Sensitivity and specificity were high for all four subscales.

Conclusion

The reported results confirm our previous study and show that the German CAARS-S/O do indeed represent a reliable and cross-culturally valid measure of current ADHD symptoms in adults.

Keywords

Attention-deficit/hyperactivity disorderAdult ADHDAdult ADHD assessmentDiagnostic issuesConners Adult ADHD Rating Scales (CAARS)ADHD, Attention-deficit/hyperactivity disorderADHD-DC, German ADHD Observer-Rating ScaleADHD-SR, German ADHD Self-Rating ScaleASRS, Adult Self-Report ScaleCAARS, Conners Adult ADHD Rating ScalesCP/TRS, Conners Parent/Teacher Rating ScaleDSM-IV, Diagnostic and Statistical Manual of the American Psychiatric Association, 4th versionICD-10, International Classification of Diseases, 10th versionWHO, World Health OrganizationWURS/WURS-K, Wender Utah Rating Scale/German short version
Type
Original articles
Information
European Psychiatry , Volume 27 , Issue 5 , July 2012 , pp. 321 - 328
Copyright
Copyright © Elsevier Masson SAS 2012

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Footnotes

1

Contributed equally to this paper.

References

Adler, L., Kessler, R., Spencer, T.Adult Self-Report Scale. ASRS-V1. 1 Screener. New York: World Health Organization; 2003.Google Scholar
Adler, L., Spencer, T., Biederman, J.Adult ADHD Investigator Symptom Rating Scale. New York: New York University School of Medicine; 2003.Google Scholar
Barkley, R.A., Fischer, M.The unique contribution of emotional impulsiveness to impairment in major life activities in hyperactive children as adults. J Am Acad Child Adolesc Psychiatry. 2010; 49: 503–513.Google ScholarPubMed
Beck, A.T., Steer, R.A.Beck Depression Inventory - Manual. San Antonio: The Psychological Association; 1987.Google Scholar
Bell A. A critical review of ADHD diagnostic criteria: what to address in the DSM-V. J Atten Disord 2011;15:3–10.10.1177/1087054710365982CrossRefGoogle Scholar
Brickenkamp, R.Handbuch psychologischer und pädagogischer Tests. Göttingen: Hogrefe; 1997.Google Scholar
Brown, T.E.Brown Attention-Deficit Disorder Scales. San Antonio, TX: Psychological Corporation; 1996.Google Scholar
Christiansen H, Kis B, Hirsch O, Philipsen A, Henneck M, Panczuk A, et al. German validation of the Conners Adult ADHD Rating Scales-self-report (CAARS-S) I: factor structure and normative data. Eur Psychiatry 2010 [10.1016/j.europsy.2009.12.024].10.1016/j.eurpsy.2009.12.024CrossRefGoogle Scholar
Christiansen H, Hirsch, O, Philipsen A, Matthies S, Hebebrand J, Ueckermann J, et al. German validation of the Conners Adult ADHD Rating Scales–self-report (CAARS-S): replication of factor structure in a large patient sample (under review).Google Scholar
Conners, C.K., Erhardt, D., Epstein, J.N., Parker, J.D.A., Sitarenios, G., Sparrow, E.Self-ratings of ADHD symptoms in adults I: factor structure and normative data. J Atten Disord. 1999; 3: 141–151.10.1177/108705479900300303CrossRefGoogle Scholar
Conners, C.K., Erhardt, D., Sparrow, E.P.Conners’ Adult ADHD Rating Scales (CAARS). North Tonawanda: Multi-Health Systems; 1999.Google Scholar
DuPaul, G., Power, T.J., Anastopoulos, A.D., Reid, R.ADHD Rating Scale-IV: checklists, norms, and clinical interpretation. New York: Guilford; 1998.Google Scholar
Erhardt, D., Epstein, J.N., Conners, C.K., Parker, J.D.A., Sitarenios, G.Self-ratings of ADHD symptoms in adults II: reliability, validity, and diagnostic sensitivity. J Atten Disord. 1999; 3: 153–158.10.1177/108705479900300304CrossRefGoogle Scholar
Faraone, S.V., Biederman, J., Spencer, T., Mick, E., Murray, K., Petty, C.et al.Diagnosing adult attention-deficit hyperactivity disorder: are late onset and subthreshold diagnoses valid?. Am J Psychiatry. 2006; 163: 1720–1729.10.1176/ajp.2006.163.10.1720CrossRefGoogle ScholarPubMed
Friedrichs B, Igl W, Larsson H, Larsson JO. Coexisting psychiatric problems and stressful life events in adults with symptoms of ADHD–A large Swedish population-based study of twins. J Atten Disord 2010, Aug. 4. [Epub ahead of print].10.1177/1087054710376909CrossRefGoogle Scholar
Hautzinger, M., Bailer, M., Worall, H., Keller, F.Beck-Depressions-Inventar (BDI). Bearbeitung der deutschen Ausgabe. Testhandbuch. Bern, Göttingen, Toronto. Seattle: Huber; 1994.Google Scholar
Jans T, Philipsen A, Graf E, Ihorst G, Gerlach M, Warnke A. Does the treatment of maternal attention deficit and hyperactivity disorder (ADHD) enhance the efficacy of a behavioural parent training for the treatment of their children's ADHD? Study protocol of a randomized controlled multicentre trail. ADHD Attention Deficit and Hyperactivity Disorders 2009;1:33–45 [http://dx.doi.org/10.1007/s12402-009-0004-4].CrossRefGoogle Scholar
Kessler, R.C., Adler, L., Ames, M., Delmer, O., Faraone, S., Hiripi, E.et al.The World Health Organization Adult ADHD Self-Report Scale (ASRS): a short screening scale for use in the general population. Psychol Med. 2005; 35: 245–256.10.1017/S0033291704002892CrossRefGoogle Scholar
Laux, L., Glanzmann, P., Schaffner, P., Spielberger, C.D.Das State-Trait-Angstinventar. Theoretische Grundlagen und Handanweisung. Weinheim: Beltz Test GmbH; 1981.Google Scholar
Newcomer, P., Hammill, D.Test of language development. Austin, Tx: Pro-Ed; 1982.Google Scholar
Patton, J.H., Stanford, M.S., Barratt, E.S.Factor structure of the Barrattimpulsiveness scale. J Clin Psychol. 1995; 51: 768–774.10.1002/1097-4679(199511)51:6<768::AID-JCLP2270510607>3.0.CO;2-13.0.CO;2-1>CrossRefGoogle ScholarPubMed
Philipsen A, Graf E, van Elst LT, Jans T, Warnke A, Hesslinger B, et al. Evaluation of the efficacy and effectiveness of a structured disorder tailored psychotherapy in ADHD in adults: study protocol of a randomized controlled multicentre trial. Attention Deficit and Hyperactivity Disorders 2010;2:203–12 [http://dx.doi.org/10.1007/s12402-010-0046-7].CrossRefGoogle Scholar
Retz-Junginger, P., Retz, W., Blocher, D., Weijers, H.G., Trott, G.E., Wender, P.H.et al.Wender Utah Rating Scale (WURS-k) Die deutsche Kurzform zur retrospektiven Erfassung des hyperkinetischen Syndroms bei Erwachsenen. Nervenarzt. 2002; 73: 830–838.10.1007/s00115-001-1215-xCrossRefGoogle Scholar
Reuter, M., Kirsch, P., Hennig, J.Inferring candidate genes for Attention Deficit Hyperactivity Disorder (ADHD) assessed by the World Health Organization Adult ADHD Self-Report Scale (ASRS). J Neural Transm. 2006; 113: 929–938.10.1007/s00702-005-0366-5CrossRefGoogle ScholarPubMed
Roesler, M., Retz, W., Retz-Junginger, P., Thome, J., Supprian, T., Nissen, T.et al.Instrumente zur Diagnostik der Aufmerksamkeitsdefizit-/Hyperaktivitätsstörung (ADHS) im Erwachsenenalter Selbstbeurteilungsskala (ADHS-SB) und Diagnosecheckliste (ADHS-DC). Nervenarzt. 2004; 75: 888–895.Google Scholar
Safren, S.A., Sprich, S.E., Cooper-Vince, C., Knouse, L.E., Lerner, J.A.Life impairments in adults with medication-treated ADHD. J Atten Disord. 2010; 5: 524–531.CrossRefGoogle Scholar
Sobanski, E., Alm, B.Aufmerksamkeitsdefizit-/Hyperaktivitätsstörung (ADHS) bei Erwachsenen. Ein Überblick. Nervenarzt. 2004; 75: 697–716.10.1007/s00115-004-1757-9CrossRefGoogle Scholar
Ward, M.F., Wender, P.H., Reimherr, F.W.The Wender Utah Rating Scale: an aid in the retrospective diagnosis of childhood attention deficit hyperactivity disorder. Am J Psychiatry. 1993; 6: 885–890.Google Scholar
Weiner, E., Stewart, B.Assessing individuals. Boston: Little, Brown; 1984.Google Scholar
Weiss, M., Murray, C.Assessment and management of attention-deficit hyperactivity disorder in adults. CMAJ. 2003; 168: 715–722.Google ScholarPubMed
Weiss, M.D., Gibbins, C., Goodman, D.W., Hodgkins, P.S., Landgraf, J.M., Faraone, S.V.Moderators and mediators of symptoms and quality of life outcomes in an open-label study of adults treated for attention-deficit/hyperactivity disorder. J Clin Psychiatry. 2010; 71: 381–390.CrossRefGoogle Scholar
Wender, P.Attention deficit hyperactivity disorder in adults. New York: Oxford University Press; 1995.Google Scholar
Wender, P.H., Reimherr, F.W., Wood, D.R.Attention deficit disorder (‘minimal brain dysfunction’) in adults. A replication study of diagnosis and drug treatment. Arch Gen Psychiatry. 1981; 38: 449–456.10.1001/archpsyc.1981.01780290083009CrossRefGoogle ScholarPubMed
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