Hostname: page-component-cd9895bd7-dzt6s Total loading time: 0 Render date: 2024-12-26T13:12:08.654Z Has data issue: false hasContentIssue false
  • English
  • Français

Low self-awareness of ADHD in adults using a self-report screening questionnaire

Published online by Cambridge University Press:  15 April 2020

I. Manor ,
N. Vurembrandt ,
S. Rozen ,
D. Gevah ,
A. Weizman  and
G. Zalsman
I. Manor*
Affiliation:
Division of Child and Adolescent Psychiatry, ADHD Unit, Geha Mental Health Center, 100, Jabotinski Street, 3rd fl., Petah Tikva, Israel Sackler Mental Health Center, Tel Aviv University, Tel Aviv, Israel
N. Vurembrandt
Affiliation:
Kibbutzim College of Education Technology and Arts, Tel Aviv, Israel
S. Rozen
Affiliation:
Division of Child and Adolescent Psychiatry, ADHD Unit, Geha Mental Health Center, 100, Jabotinski Street, 3rd fl., Petah Tikva, Israel
D. Gevah
Affiliation:
Service for Clinical Statistics, Tel Aviv University, Tel Aviv, Israel
A. Weizman
Affiliation:
Sackler Mental Health Center, Tel Aviv University, Tel Aviv, Israel Felsenstein Medical Research Center, Petah Tikva, Israel Research Unit, Geha Mental Health Center, Petah Tikva, Israel
G. Zalsman
Affiliation:
Division of Child and Adolescent Psychiatry, ADHD Unit, Geha Mental Health Center, 100, Jabotinski Street, 3rd fl., Petah Tikva, Israel Sackler Mental Health Center, Tel Aviv University, Tel Aviv, Israel Division of Molecular Imaging and Neuropathology, Psychiatry Department, Columbia University, NY, USA
*
*Corresponding author. E-mail address: [email protected] (I. Manor).
Get access

Abstract

Introduction

Awareness of attention deficit hyperactivity disorder (ADHD) in adults has been growing over the last decade. One of the most interesting issues related to this topic is these adults’ self-awareness of their ADHD symptoms and their estimation of their own impairments. Our hypothesis while studying young adult ADHD populations was that there would be a significant difference between their self-report and their clinical assessment.

Method

One hundred and three students volunteered for this study. In order to validate our ADHD screening questionnaire (ADHD-SQ), and to assess the level of awareness they have of their own symptoms, participants underwent a complete clinical assessment for ADHD. They were divided into a control group (n = 24), and an ADHD study group (n = 79), which in turn was composed of two sub-groups, one comprising 24 ADHD predominantly inattentive (ADHD-I) and the other 55 ADHD combined type (ADHD-C).

Results

Factor analysis yielded two factors explaining 41% of the variance. The Inattention (IA) subscale score tended to be higher in both ADHD sub-groups as compared to the control group (6.5±2.1 vs. 2.34±2.3 with P<0.001), with no significant difference between the two ADHD sub-groups. Hyperactivity Impulsivity (HI) subscale was significantly higher for the ADHD-C sub-group than in the ADHD-I sub-group, whose score was similar to that of the control group (control: 1.6±2.1; ADHD-I: 1.55±1.0; ADHD-C: 4.5±2.6, P<0.0001). Receiver Operating Characteristics (ROC) analysis showed similar results. The area under the curve (AUC) of IA subscale score was 0.90 (95% confidence: 0.83–0.96) and for HI subscale score was 0.75, (95% confidence: 0.63–0.86). Classification into groups used a cut-off point of 3+ items out of nine, in the SQ and 6+ items out of nine in the clinical assessment. These two classifications showed 68% agreement (46% sensitivity and 95% specificity). In both ADHD sub-groups, the self-reported average number of positive symptoms per student was relatively low for both clusters; this phenomenon was pronounced in the specific subtypes. The self-rated HI cluster score was considerably low in the ADHD-C sub-group (4.5±2.6), and the IA one was particularly low in the ADHD-IADHD-I sub-group (5.9±1.9).

Conclusion

This study's results indicate that ADHD symptoms are under-reported for both inattentive and hyperactive-impulsive clusters, indicating that adults with ADHD tend to under-estimate their own ADHD-related impairments. We suggest that this questionnaire may be used both in research and academic settings to help counsellors and students to obtain early indication of ADHD and to refer students suspected of having ADHD to full clinical assessment.

Keywords

ADHDAdultsObjectiveScreening questionnaireSelf-awarenessSubjective
Type
Original articles
Information
European Psychiatry , Volume 27 , Issue 5 , July 2012 , pp. 314 - 320
Copyright
Copyright © Elsevier Masson SAS 2012

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Adler, L.A., Spencer, T., Faraone, S.V., Kessler, R.C., Howes, M.J., Biederman, J.et al.Validity of pilot Adult ADHD Self-Report Scale (ASRS) to Rate Adult ADHD symptoms. Ann Clin Psychiatry. 2006; 18: 145–148.CrossRefGoogle ScholarPubMed
American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders. 4th edWashington, DC: American Psychiatric Press; 1994.Google Scholar
Barrilleaux, K., Advokat, C.Attribution and self-evaluation of continuous performance test task performance in medicated and unmedicated adults with ADHD. J Atten Disord. 2009 291–298.CrossRefGoogle Scholar
Dias, G., Mattos, P., Coutinho, G., Segenreich, D., Saboya, E., Ayrao, V.Agreement rates between parent and self-report on past ADHD symptoms in an adult clinical sample. J Atten Disord. 2008; 12: 70–75.CrossRefGoogle Scholar
DuPaul, G.J., Weyandt, L.L., O’Dell, S.M., Varejao, M.College students with ADHD: current status and future directions. J Atten Disord. 13 3: 2009 234–250 [Epub 2009Jul20].CrossRefGoogle ScholarPubMed
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 sub-threshold diagnoses valid?. Am J Psychiatry. 2006; 163: 1720–1729.CrossRefGoogle Scholar
First, M.B., Gibbon, R.L., Williams, J.B.W.Structured Clinical Interview for Axis I DSM-IV Disorders – Patient Edition ([SCID-I/P], Version 2.0 – Hebrew Version) New York: Biometrics Research Department; 1996.Google Scholar
Greenberg, L.M., Waldman, I.D.Developmental normative data on the test of variables of attention (TOVA). J Child Psychol Psychiatry. 1993; 34: 1019–1030.CrossRefGoogle Scholar
Hallowell, E.M., Ratey, J.Driven to distraction: recognizing and coping with attention deficit disorder from childhood through adulthood. 1994 Pantheon Books New York, NY p. 73–6.Google Scholar
Leong, F.T.L., Zachar, P.Gender and opinions about mental illness as predictors of attitudes toward seeking professional psychological help. Br J Guid Counc. 1999 123–132.CrossRefGoogle Scholar
Mitchell, J.T., Knouse, L.E., Nelson-Gray, R.O., Kwapil, T.R.Self-reported ADHD symptoms among college students: item positioning affects symptom endorsement rates. J Atten Disord. 2009; 13: 154–160.CrossRefGoogle ScholarPubMed
Sax, L., Kathleen, F K.Who first suggests the diagnosis of attention-deficit/hyperactivity disorder?. Ann Fam Med. 1 3: 2003 171–174.CrossRefGoogle Scholar
Simon, V., Czobor, P., Bálint, S., Mészáros, A., Bitter, I.Prevalence and correlates of adult attention-deficit hyperactivity disorder: meta-analysis. Br J Psychiatry. 194 3: 2009 204–211.CrossRefGoogle ScholarPubMed
Suhr, J., Zimak, E., Buelow, M., Fox, L.Self-reported childhood attention-deficit/hyperactivity disorder symptoms are not specific to the disorder. Compr Psychiatry. 2009; 50: 269–275.CrossRefGoogle 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; 150: 885–890.Google ScholarPubMed
World Health Organization. International Statistical Classification of Diseases and Related Health Problems – 10th Revision (ICD-10). 1992.Google Scholar
Submit a response

Comments

No Comments have been published for this article.