TY - JOUR
T1 - Psychometrically Informed Approach to Integration of Multiple Informant Ratings in Adult ADHD in a Community-Recruited Sample
AU - Martel, Michelle M.
AU - Nigg, Joel T.
AU - Schimmack, Ulrich
N1 - Publisher Copyright:
© 2016, © The Author(s) 2016.
PY - 2017/4/1
Y1 - 2017/4/1
N2 - Although Diagnostic and Statistical Manual of Mental Disorders–Fifth edition requires that attention-deficit/hyperactivity disorder (ADHD) symptoms are apparent across settings, assessed by multiple informants, there remains no standardized approach to integration of multiple sources in adult ADHD diagnosis. The goal of the study was to evaluate informant effects on adult ADHD symptom ratings. Participants were 406 adults, ages 18 to 37, and identified second reporters, recruited from the community, and completing a comprehensive diagnostic and cognitive assessment, including a clinician-administered diagnostic interview and self- and other-report questionnaires of ADHD symptoms. Structural equation modeling indicated good fit for a trifactor model of ADHD, including general ADHD, specific inattention and hyperactivity–impulsivity, and self- and other-perspective factors. Yet there were a number of symptoms on the specific hyperactive–impulsive and self-factors that exhibited nonsignificant loadings. Significant differential item functioning across self-ratings and informant ratings was also noted. The external validation indices of laboratory executive function and diagnostic team-rated impairment was significantly correlated with the specific inattentive factor. While executive function was marginally significantly correlated with the other perspective factor, impairment was associated with the self-perspective factor. Overall, inattentive symptoms may be more sensitive measures of adult ADHD, and other and self-ratings may provide different information in relation to external criteria.
AB - Although Diagnostic and Statistical Manual of Mental Disorders–Fifth edition requires that attention-deficit/hyperactivity disorder (ADHD) symptoms are apparent across settings, assessed by multiple informants, there remains no standardized approach to integration of multiple sources in adult ADHD diagnosis. The goal of the study was to evaluate informant effects on adult ADHD symptom ratings. Participants were 406 adults, ages 18 to 37, and identified second reporters, recruited from the community, and completing a comprehensive diagnostic and cognitive assessment, including a clinician-administered diagnostic interview and self- and other-report questionnaires of ADHD symptoms. Structural equation modeling indicated good fit for a trifactor model of ADHD, including general ADHD, specific inattention and hyperactivity–impulsivity, and self- and other-perspective factors. Yet there were a number of symptoms on the specific hyperactive–impulsive and self-factors that exhibited nonsignificant loadings. Significant differential item functioning across self-ratings and informant ratings was also noted. The external validation indices of laboratory executive function and diagnostic team-rated impairment was significantly correlated with the specific inattentive factor. While executive function was marginally significantly correlated with the other perspective factor, impairment was associated with the self-perspective factor. Overall, inattentive symptoms may be more sensitive measures of adult ADHD, and other and self-ratings may provide different information in relation to external criteria.
KW - ADHD
KW - adults
KW - assessment
KW - diagnosis
KW - structural equation modeling
UR - http://www.scopus.com/inward/record.url?scp=85014619885&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85014619885&partnerID=8YFLogxK
U2 - 10.1177/1073191116646443
DO - 10.1177/1073191116646443
M3 - Article
C2 - 27126924
AN - SCOPUS:85014619885
SN - 1073-1911
VL - 24
SP - 279
EP - 289
JO - Assessment
JF - Assessment
IS - 3
ER -