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Diagnostic accuracy of a brief screening tool for attention deficit hyperactivity disorder in UK prison inmates

Published online by Cambridge University Press:  12 February 2016

S. Young ,
R. A. González ,
L. Mutch ,
I. Mallet-Lambert ,
L. O'Rourke ,
N. Hickey ,
P. Asherson  and
G. H. Gudjonsson
S. Young*
Affiliation:
Division of Brain Sciences, Department of Medicine, Centre for Mental Health, Imperial College, London, UK Broadmoor Hospital, West London Mental Health Trust, London, UK Reykjavik University, Reykjavík, Iceland
R. A. González
Affiliation:
Division of Brain Sciences, Department of Medicine, Centre for Mental Health, Imperial College, London, UK Center for Evaluation and Sociomedical Research, Graduate School of Public Health, University of Puerto Rico, Puerto Rico
L. Mutch
Affiliation:
Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
I. Mallet-Lambert
Affiliation:
Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
L. O'Rourke
Affiliation:
Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
N. Hickey
Affiliation:
Division of Brain Sciences, Department of Medicine, Centre for Mental Health, Imperial College, London, UK
P. Asherson
Affiliation:
Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
G. H. Gudjonsson
Affiliation:
Reykjavik University, Reykjavík, Iceland Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
*
*Address for correspondence: Dr S. Young, Centre for Mental Health, Imperial College London, 7th floor Commonwealth Building, Du Cane Road, London W12 0NN, UK. (Email: [email protected])
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Abstract

Background

Attention deficit hyperactivity disorder (ADHD) is overrepresented in prison, making it imperative to identify a screening tool that can be quickly applied to efficiently detect the disorder. We explored the discrimination ability of a widely used ADHD screen, the Barkley Adult ADHD Rating Scale (BAARS-IV), against a clinical diagnostic interview. A brief version of the screen was then developed in order to simplify its use in the prison context, and maximize its diagnostic properties.

Method

A cross-sectional study of 390 male prison inmates was performed in the UK, all participants were screened and interviewed via the Diagnostic Interview for ADHD in Adults 2.0 (DIVA-2).

Results

A total of 47 (12.1%) inmates screened positive for ADHD using the full BAARS-IV, and 96 (24.6%) were clinically diagnosed, for a sensitivity of 37.9 and a specificity of 96.3. Our models identified the six items that most predicted ADHD diagnosis, with adjusted odds ratios ranging from 2.66 to 4.58. Sensitivity, specificity and accuracy were 0.82, 0.84 and 0.84, respectively, for the developed brief scale, and 0.71, 0.85 and 0.81 for its validation. Weighted probability scores produced an area under the curve of 0.89 for development, and 0.82 for validation of the brief scale.

Conclusions

The original BAARS-IV performed poorly at identifying prison inmates with ADHD. Our developed brief scale substantially improved diagnostic accuracy. The brief screening instrument has great potential to be used as an accurate and resource-effective tool to screen young people and adults for likely ADHD in the criminal justice system.

Keywords

ADHDcriminal justice systemdiagnosisprisonscreening
Type
Original Articles
Information
Psychological Medicine , Volume 46 , Issue 7 , May 2016 , pp. 1449 - 1458
Copyright
Copyright © Cambridge University Press 2016 

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References

APA (2013). Diagnostic and Statistical Manual of Mental Disorders. American Psychiatric Association: Washington, DC.Google Scholar
Barkley, RA (2011). Barkley Adult ADHD Rating Scale-IV (BAARS-IV) . Guilford: New York, NY.Google Scholar
Barkley, RA, Guevremont, DC, Anastopoulos, AD, DuPaul, GJ, Shelton, TL (1993). Driving-related risks and outcomes of attention deficit hyperactivity disorder in adolescents and young adults: a 3- to 5-year follow-up survey. Pediatrics 92, 212–218.Google Scholar
Barkley, RA, Murphy, KR, Fischer, M (2008). ADHD in Adults: What the Science Says. Guilford Press: New York.Google Scholar
Bautista, D, Arana, E, Marti-Bonmati, L, Paredes, R (1999). Validation of logistic regression models in small samples: application to calvarial lesions diagnosis. Journal of Clinical Epidemiology 52, 237–241.Google Scholar
Chang, Z, Lichtenstein, P, D'onofrio, BAS, Larsson, H (2014). Serious transport accidents in adults with attention-deficit/hyperactivity disorder and the effect of medication: a population-based study. JAMA Psychiatry 71, 319–325.Google Scholar
Daigre, C, Roncero, C, Rodriguez-Cintas, L, Ortega, L, Lligona, A, Fuentes, S, Perez-Pazos, J, Martinez-Luna, N, Casas, M (2015). Adult ADHD screening in alcohol-dependent patients using the Wender-Utah rating scale and the adult ADHD self-report scale. Journal of Attention Disorders 19, 328–334.Google Scholar
Dalsgaard, S, Ostergaard, SD, Leckman, JF, Mortensen, PB, Pedersen, MG (2015). Mortality in children, adolescents, and adults with attention deficit hyperactivity disorder: a nationwide cohort study. Lancet 385, 2190–2196.Google Scholar
Deberdt, W, Thome, J, Lebrec, J, Kraemer, S, Fregenal, I, Ramos-Quiroga, JA, Arif, M (2015). Prevalence of ADHD in nonpsychotic adult psychiatric care (ADPSYC): a multinational cross-sectional study in Europe. BMC Psychiatry 15, 242.Google Scholar
Faraone, SV, Biederman, J, Mick, E (2006). The age-dependent decline of attention deficit hyperactivity disorder: a meta-analysis of follow-up studies. Psychological Medicine 36, 159–165.Google Scholar
Farrington, DP, Ttofi, MM, Losel, F (2011). School bullying and later criminal offending. Criminal Behaviour and Mental Health 21, 77–79.Google Scholar
Ginsberg, Y, Hirvikoski, T, Grann, M, Lindefors, N (2012). Long-term functional outcome in adult prison inmates with ADHD receiving OROS-methylphenidate. European Archives of Psychiatry and Clinical Neuroscience 262, 705–724.Google Scholar
Gonzalez, RA, Gudjonsson, GH, Wells, J, Young, S (in press). The role of emotional distress and ADHD on institutional behavioral disturbance and recidivism among offenders. Journal of Attention Disorders.Google Scholar
Gonzalez, RA, Velez-Pastrana, MC, Ruiz Varcarcel, JJ, Levin, FR, Albizu-Garcia, CE (2015). Childhood ADHD symptoms are associated with lifetime and current illicit substance-use disorders and in-site health risk behaviors in a representative sample of latino prison inmates. Journal of Attention Disorders 19, 301–312.Google Scholar
Gudjonsson, G, Sigurdsson, JF, Young, S, Newton, AK, Peersen, M (2009). Attention Deficit Hyperactivity Disorder (ADHD). How do ADHD symptoms relate to personality among prisoners? Personality and Individual Differences 47, 64–68.Google Scholar
Kessler, RC, Adler, L, Ames, M, Demler, O, Faraone, S, Hiripi, E, Howes, MJ, Jin, R, Secnik, K, Spencer, T, Ustun, TB, Walters, EE (2005). The World Health Organization Adult ADHD Self-Report Scale (ASRS): a short screening scale for use in the general population. Psychological Medicine 35, 245–256.Google Scholar
Kessler, RC, Adler, L, Barkley, R, Biederman, J, Conners, CK, Demler, O, Faraone, SV, Greenhill, LL, Howes, MJ, Secnik, K, Spencer, T, Ustun, TB, Walters, EE, Zaslavsky, AM (2006). The prevalence and correlates of adult ADHD in the United States: results from the National Comorbidity Survey Replication. American Journal of Psychiatry 163, 716–723.Google Scholar
Kessler, RC, Adler, LA, Gruber, MJ, Sarawate, CA, Spencer, T, Van Brunt, DL (2007). Validity of the World Health Organization Adult ADHD Self-Report Scale (ASRS) Screener in a representative sample of health plan members. International Journal of Methods in Psychiatric Research 16, 52–65.Google Scholar
Koegl, CJ, Farrington, DP, Augimeri, LK (2009). Clinician perceptions of childhood risk factors for future antisocial behavior. Journal of Clinical Child and Adolescent Psychology 38, 564–575.Google Scholar
Konstenius, M, Larsson, H, Lundholm, L, Philips, B, van de Glind, G, Jayaram-Lindstrom, N, Franck, J (2015). An epidemiological study of ADHD, substance use, and comorbid problems in incarcerated women in Sweden. Journal of Attention Disorders 19, 44–52.Google Scholar
Kooij, JJS (2012). Adult ADHD. Diagnostic Assessment and Treatment, 3rd edn. Springer, 2012.Google Scholar
Levin, FR, Evans, SM, Vosburg, SK, Horton, T, Brooks, D, Ng, J (2004). Impact of attention-deficit hyperactivity disorder and other psychopathology on treatment retention among cocaine abusers in a therapeutic community. Addictive Behaviors 29, 1875–1882.Google Scholar
Lichtenstein, P, Halldner, L, Zetterqvist, J, Sjolander, A, Serlachius, E, Fazel, S, Langstrom, N, Larsson, H (2012). Medication for attention deficit-hyperactivity disorder and criminality. New England Journal of Medicine 367, 2006–2014.Google Scholar
Loeber, R, Farrington, DP (2000). Young children who commit crime: epidemiology, developmental origins, risk factors, early interventions, and policy implications. Developmental Psychopathology 12, 737–762.Google Scholar
Moya, J, Stringaris, AK, Asherson, P, Sandberg, S, Taylor, E (2014). The impact of persisting hyperactivity on social relationships: a community-based, controlled 20-year follow-up study. Journal of Attention Disorders 18, 52–60.CrossRefGoogle ScholarPubMed
Murray, J, Farrington, DP (2010). Risk factors for conduct disorder and delinquency: key findings from longitudinal studies. Canadian Journal of Psychiatry 55, 633–642.Google Scholar
Pew Charitable Trusts (2008). The Pew Center on the States. One in 100: Behind Bars in America 2008. 28 February 2008.Google Scholar
Polanczyk, G, de Lima, MS, Horta, BL, Biederman, J, Rohde, LA (2007). The worldwide prevalence of ADHD: a systematic review and metaregression analysis. American Journal of Psychiatry 164, 942–948.Google Scholar
Schisterman, EF, Perkins, NJ, Liu, A, Bondell, H (2005). Optimal cut-point and its corresponding Youden Index to discriminate individuals using pooled blood samples. Epidemiology 16, 73–81.Google Scholar
Semeijn, EJ, Korten, NC, Comijs, HC, Michielsen, M, Deeg, DJ, Beekman, AT, Kooij, JJ (2015). No lower cognitive functioning in older adults with attention-deficit/hyperactivity disorder. International Psychogeriatrics 27, 1467–1476.Google Scholar
Semeijn, EJ, Michielsen, M, Comijs, HC, Deeg, DJ, Beekman, AT, Kooij, JJ (2013). Criterion validity of an Attention Deficit Hyperactivity Disorder (ADHD) screening list for screening ADHD in older adults aged 60–94 years. American Journal of Geriatric Psychiatry 21, 631–635.Google Scholar
Shaw, M, Hodgkins, P, Caci, H, Young, S, Kahle, J, Woods, AG, Arnold, LE (2012). A systematic review and analysis of long-term outcomes in attention deficit hyperactivity disorder: effects of treatment and non-treatment. BMC Medicine 10, 99.Google Scholar
Simon, V, Czobor, P, Balint, S, Meszaros, A, Bitter, I (2009). Prevalence and correlates of adult attention-deficit hyperactivity disorder: meta-analysis. British Journal of Psychiatry 194, 204–211.Google Scholar
Singh, JP (2013). Predictive validity performance indicators in violence risk assessment: a methodological primer. Behavioral Sciences and the Law 31, 8–22.Google Scholar
StataCorp (2013). Stata Statistical Software: Release 13. College Station, TX: StataCorp LP.Google Scholar
Ttofi, MM, Farrington, DP (2012). Risk and protective factors, longitudinal research, and bullying prevention. New Directions for Youth Development 2012, 85–98.Google Scholar
van Emmerik-van Oortmerssen, K, van de Glind, G, van den Brink, W, Smit, F, Crunelle, CL, Swets, M, Schoevers, RA (2012). Prevalence of attention-deficit hyperactivity disorder in substance use disorder patients: a meta-analysis and meta-regression analysis. Drug and Alcohol Dependence 122, 11–19.Google Scholar
Velez-Pastrana, MC, Gonzalez, RA, Rodriguez Cardona, J, Purcell Baerga, P, Alicea Rodriguez, A, Levin, FR (2015). Psychometric properties of the Barkley deficits in executive functioning scale: a Spanish-language version in a community sample of Puerto Rican adults. Psychological Assessment. Published online: 24 August 2015. doi:10.1037/pas0000171.Google Scholar
Walmsley, R (2013). World Prison Population List, 10th edn, International Centre for Prison Studies, 21 November 2013 (www.prisonstudies.org/sites/prisonstudies.org/files/resources/downloads/wppl_10.pdf).Google Scholar
Ward, MF, Wender, PH, Reimherr, FW (1993). The Wender Utah Rating Scale: an aid in the retrospective diagnosis of childhood attention deficit hyperactivity disorder. American Journal of Psychiatry 150, 885–890.Google Scholar
Young, S, Adamou, M, Bolea, B, Gudjonsson, G, Muller, U, Pitts, M, Thome, J, Asherson, P (2011 a). The identification and management of ADHD offenders within the criminal justice system: a consensus statement from the UK Adult ADHD Network and criminal justice agencies. BMC Psychiatry 11, 32.CrossRefGoogle ScholarPubMed
Young, S, Goodwin, EJ, Sedgwick, O, Gudjonsson, GH (2013). The effectiveness of police custody assessments in identifying suspects with intellectual disabilities and attention deficit hyperactivity disorder. BMC Medicine 11, 248.Google Scholar
Young, S, Gudjonsson, GH, Wells, J, Asherson, P, Theobald, D, Oliver, B, Scott, C, Mooney, A (2009). Attention deficit hyperactivity disorder and critical incidents in a Scottish prison population. Personality and Individual Differences 46, 265–269.Google Scholar
Young, S, Moss, D, Sedgwick, O, Fridman, M, Hodgkins, P (2015 a). A meta-analysis of the prevalence of attention deficit hyperactivity disorder in incarcerated populations. Psychological Medicine 45, 247–258.CrossRefGoogle ScholarPubMed
Young, S, Sedgwick, O, Fridman, M, Gudjonsson, G, Hodgkins, P, Lantigua, M, Gonzalez, RA (2015 b). Co-morbid psychiatric disorders among incarcerated ADHD populations: a meta-analysis. Psychological Medicine 45, 2499–2510.Google Scholar
Young, S, Wells, J, Gudjonsson, GH (2011 b). Predictors of offending among prisoners: the role of attention-deficit hyperactivity disorder and substance use. Journal of Psychopharmacology 25, 1524–1532.Google Scholar