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Development of Korean Adult ADHD Rating Scale

한국형 성인 ADHD 평가척도 개발 연구

  • Received : 2015.11.03
  • Accepted : 2015.12.09
  • Published : 2015.12.31

Abstract

Objectives : Symptoms of attention-deficit hyperactivity disorder (ADHD) during childhood may persist into adulthood. This study included the development and validation process of the Korean Adult ADHD Rating Scale (K-AARS), which was developed for screening and monitoring treatment of adults with ADHD. Methods : Preliminary questionnaires of the K-AARS were based on the reviews of previous adult ADHD scales and clinical experiences of the board certified child and adolescent psychiatrists in Korea. For this study, 136 adults (18-50 years old) with inattention, hyperactivity and/or impulsivity symptoms were enrolled as ADHD subjects, and compared with 406 control subjects (18-50 years old) without ADHD symptoms. Construct validity was examined using explorative factor analysis and Cronbach's alpha to obtain internal reliability coefficients. Concurrent validity was evaluated by comparison with the Conners' Adult ADHD Rating Scale (CAARS). Results : An explorative factor analysis showed that the K-AARS had 8 factors (inattention, hyperactivity, impulsivity, antisocial personality disorder/conduct disorder/oppositional defiant disorder, impairment, driving, emotional dysregulation, disorganization). K-AARS was highly reliable in terms of internal consistency (Cronbach's alpha 0.77-0.95) and correlation between factors (0.57-0.86). Concurrent validity with the CAARS and discriminant validity were statistically significant. Conclusion : The K-AARS is a valid and reliable measure for assessment of Korean adults with ADHD.

Keywords

Adult;ADHD;Scale;Validity;Reliability;Factor Analysis

References

  1. Goldman LS, Genel M, Bezman RJ, Slanetz PJ. Diagnosis and treatment of attention-deficit/hyperactivity disorder in children and adolescents. Council on Scientific Affairs, American Medical Association. JAMA 1998;279:1100-1107. https://doi.org/10.1001/jama.279.14.1100
  2. American Psychiatric Association. Diagnostic and statistical manual of mental disorders: DSM-5. 5th ed. Washington, DC: American Psychiatric Association;2013.
  3. Mannuzza S, Klein RG, Bessler A, Malloy P, LaPadula M. Adult psychiatric status of hyperactive boys grown up. Am J Psychiatry 1998;155:493-498. https://doi.org/10.1176/ajp.155.4.493
  4. Meszaros A, Czobor P, Balint S, Komlosi S, Simon V, Bitter I. Pharmacotherapy of adult attention deficit hyperactivity disorder (ADHD): a meta-analysis. Int J Neuropsychopharmacol 2009;12:1137-1147. https://doi.org/10.1017/S1461145709990198
  5. Moffitt TE, Houts R, Asherson P, Belsky DW, Corcoran DL, Hammerle M, et al. Is adult A DHD a childhood-onset neurodevelopmental disorder? evidence from a four-decade longitudinal cohort study. Am J Psychiatry 2015;172:967-977. https://doi.org/10.1176/appi.ajp.2015.14101266
  6. Biederman J, Mick E, Faraone SV. Age-dependent decline of symptoms of attention deficit hyperactivity disorder: impact of remission definition and symptom type. Am J Psychiatry 2000;157:816-818. https://doi.org/10.1176/appi.ajp.157.5.816
  7. Nigg JT, Stavro G, Ettenhofer M, Hambrick DZ, Miller T, Henderson JM. Executive functions and ADHD in adults: evidence for selective effects on ADHD symptom domains. J Abnorm Psychol 2005;114:706-717. https://doi.org/10.1037/0021-843X.114.3.706
  8. Wender PH. Attention-deficit hyperactivity disorder in adults. Psychiatr Clin North Am 1998;21:761-774, v. https://doi.org/10.1016/S0193-953X(05)70039-3
  9. Barkley RA, Fischer M, Smallish L, Fletcher K. Young adult follow-up of hyperactive children: antisocial activities and drug use. J Child Psychol Psychiatry 2004;45:195-211. https://doi.org/10.1111/j.1469-7610.2004.00214.x
  10. Mannuzza S, Klein RG, Bessler A, Malloy P, LaPadula M. Adult outcome of hyperactive boys. Educational achievement, occupational rank, and psychiatric status. Arch Gen Psychiatry 1993;50:565-576. https://doi.org/10.1001/archpsyc.1993.01820190067007
  11. Klein RG, Mannuzza S, Olazagasti MA, Roizen E, Hutchison JA, Lashua EC, et al. Clinical and functional outcome of childhood attention-deficit/hyperactivity disorder 33 years later. Arch Gen Psychiatry 2012;69:1295-1303. https://doi.org/10.1001/archgenpsychiatry.2012.271
  12. Kessler RC, Adler L, Barkley R, Biederman J, Conners CK, Demler O, et al. The prevalence and correlates of adult ADHD in the United States: results from the National Comorbidity Survey Replication. Am J Psychiatry 2006;163:716-723. https://doi.org/10.1176/ajp.2006.163.4.716
  13. Greydanus DE, Pratt HD, Patel DR. Attention deficit hyperactivity disorder across the lifespan: the child, adolescent, and adult. Dis Mon 2007;53:70-131. https://doi.org/10.1016/j.disamonth.2007.01.001
  14. McCann BS, Roy-Byrne P. Screening and diagnostic utility of self-report attention deficit hyperactivity disorder scales in adults. Compr Psychiatry 2004;45:175-183. https://doi.org/10.1016/j.comppsych.2004.02.006
  15. Adler L, Cohen J. Diagnosis and evaluation of adults with attentiondeficit/hyperactivity disorder. Psychiatr Clin North Am 2004;27:187-201. https://doi.org/10.1016/j.psc.2003.12.003
  16. Murphy K, Barkley RA. Attention deficit hyperactivity disorder adults: comorbidities and adaptive impairments. Compr Psychiatry 1996;37:393-401. https://doi.org/10.1016/S0010-440X(96)90022-X
  17. Solanto MV, Marks DJ, Mitchell KJ, Wasserstein J, Kofman MD. Development of a new psychosocial treatment for adult ADHD. J Atten Disord 2008;11:728-736. https://doi.org/10.1177/1087054707305100
  18. Wilens TE, Spencer TJ, Biederman J. A review of the pharmacotherapy of adults with attention-deficit/hyperactivity disorder. J Atten Disord 2002;5:189-202.
  19. Barkley RA, Murphy KR. Attention-deficit hyperactivity disorder: a clinical workbook. 2nd ed. New York: Guilford Press;1998.
  20. Barkley RA, Brown TE. Unrecognized attention-deficit/hyperactivity disorder in adults presenting with other psychiatric disorders. CNS Spectr 2008;13:977-984. https://doi.org/10.1017/S1092852900014036
  21. Young S, Murphy CM, Coghill D. Avoiding the 'twilight zone': recommendations for the transition of services from adolescence to adulthood for young people with ADHD. BMC Psychiatry 2011;11:174. https://doi.org/10.1186/1471-244X-11-174
  22. Conners CK, Erhardt D, Sparrow E. Conners' Adult ADHD Rating Scales: CAARS. Toronto: MHS;1999.
  23. Brown TE. Brown Attention-Deficit Disorder Scales. San Antonio, TX: The Psychological Corporation, Harcourt Brace;1996.
  24. Ward MF, Wender PH, Reimherr FW. The Wender Utah Rating Scale: an aid in the retrospective diagnosis of childhood attention deficit hyperactivity disorder. Am J Psychiatry 1993;150:885-890. https://doi.org/10.1176/ajp.150.6.885
  25. McCann BS, Scheele L, Ward N, Roy-Byrne P. Discriminant validity of the Wender Utah Rating Scale for attention-deficit/hyperactivity disorder in adults. J Neuropsychiatry Clin Neurosci 2000;12:240-245. https://doi.org/10.1176/jnp.12.2.240
  26. Kessler RC, Adler L, Ames M, Demler 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. https://doi.org/10.1017/S0033291704002892
  27. Kim JH, Lee EH, Joung YS. The WHO Adult ADHD Self-Report Scale: reliability and validity of the Korean version. Psychiatry Investig 2013;10:41-46. https://doi.org/10.4306/pi.2013.10.1.41
  28. Kim EJ. The Validation of Korean Adult ADHD Scale (K-AADHDS). Korean J Clin Psychol 2003;22:897-911.
  29. Park JS, Lee WH, Lee SR, Kim SM, Bahn GH. Reliability and validity of Korean version of the conners adult attention deficit hyperactivity disorder scale in general population. J Korean Neuropsychiatr Assoc 2013;52:342-352. https://doi.org/10.4306/jknpa.2013.52.5.342
  30. Asherson P, Akehurst R, Kooij JJ, Huss M, Beusterien K, Sasane R, et al. Under diagnosis of adult ADHD: cultural influences and societal burden. J Atten Disord 2012;16(5 Suppl):20S-38S. https://doi.org/10.1177/1087054711435360
  31. Derogatis LR. SCL-90: administration, scoring & procedures manual for the R (revised) version and other instruments of the psychopathology rating scale series. Chicago: Johns Hopkins University School of Medicine;1977.
  32. Kim HY, Lee JY, Cho SS, Lee IS, Kim JH. A preliminary study on reliability and validity of the conners Adult ADHD Rating Scales-Korean version in college students. Korean J Clin Psychol 2005;24:171-185.
  33. Kim KI, Kim JH, Won HT. Korean Manual of Symptom Checklist-90-Revision. Seoul: Jungangjeokseong Publishing;1984.
  34. Kessler RC, Green JG, Adler LA, Barkley RA, Chatterji S, Faraone SV, et al. Structure and diagnosis of adult attention-deficit/hyperactivity disorder: analysis of expanded symptom criteria from the Adult ADHD Clinical Diagnostic Scale. Arch Gen Psychiatry 2010; 67:1168-1178. https://doi.org/10.1001/archgenpsychiatry.2010.146
  35. Biederman J, Wilens T, Mick E, Milberger S, Spencer TJ, Faraone SV. Psychoactive substance use disorders in adults with attention deficit hyperactivity disorder (ADHD): effects of ADHD and psychiatric comorbidity. Am J Psychiatry 1995;152:1652-1658. https://doi.org/10.1176/ajp.152.11.1652
  36. Wehmeier PM, Schacht A, Barkley RA. Social and emotional impairment in children and adolescents with ADHD and the impact on quality of life. J Adolesc Health 2010;46:209-217. https://doi.org/10.1016/j.jadohealth.2009.09.009
  37. Biederman J, Ball SW, Monuteaux MC, Mick E, Spencer TJ, McCreary M, et al. New insights into the comorbidity between ADHD and major depression in adolescent and young adult females. J Am Acad Child Adolesc Psychiatry 2008;47:426-434. https://doi.org/10.1097/CHI.0b013e31816429d3
  38. Reimherr FW, Marchant BK, Strong RE, Hedges DW, Adler L, Spencer TJ, et al. Emotional dysregulation in adult ADHD and response to atomoxetine. Biol Psychiatry 2005;58:125-131. https://doi.org/10.1016/j.biopsych.2005.04.040
  39. Friedman SR, Rapport LJ, Lumley M, Tzelepis A, VanVoorhis A, Stettner L, et al. Aspects of social and emotional competence in adult attention-deficit/hyperactivity disorder. Neuropsychology 2003;17:50-58. https://doi.org/10.1037/0894-4105.17.1.50
  40. Biederman J, Faraone SV, Milberger S, Jetton JG, Chen L, Mick E, et al. Is childhood oppositional defiant disorder a precursor to adolescent conduct disorder? Findings from a four-year follow-up study of children with ADHD. J Am Acad Child Adolesc Psychiatry 1996;35:1193-1204. https://doi.org/10.1097/00004583-199609000-00017
  41. Murphy KR, Adler LA. Assessing attention-deficit/hyperactivity disorder in adults: focus on rating scales. J Clin Psychiatry 2004;65 Suppl 3:12-17.
  42. Rosler M, Retz W, Thome J, Schneider M, Stieglitz RD, Falkai P. Psychopathological rating scales for diagnostic use in adults with attention-deficit/hyperactivity disorder (ADHD). Eur Arch Psychiatry Clin Neurosci 2006;256 Suppl 1:i3-i11. https://doi.org/10.1007/s00406-006-1001-7

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