Cross-validating the Dot Counting Test Among an Adult ADHD Clinical Sample and Analyzing the Effect of ADHD Subtype and Comorbid Psychopathology

Assessment ◽  
2021 ◽  
pp. 107319112110508
Author(s):  
Dayna A. Abramson ◽  
Daniel J. White ◽  
Tasha Rhoads ◽  
Dustin A. Carter ◽  
Nicholas D. Hansen ◽  
...  
Keyword(s):  
Adult Adhd ◽  
Clinical Sample ◽  
Clinical Population ◽  
Performance Validity ◽  
Neurocognitive Performance ◽  
Cut Scores ◽  
Hyperactivity Disorder ◽  
Adhd Subtype ◽  
Independent Criterion ◽  
Comorbid Psychopathology

This study cross-validated the dot counting test (DCT) as a performance validity test (PVT) in an adult attention-deficit/hyperactivity disorder (ADHD) clinical population and examined the effect of ADHD subtype and psychiatric comorbidity on accuracy for detecting invalidity. DCT performance was assessed among 210 consecutive adult ADHD referrals who underwent neuropsychological evaluation and were classified into valid ( n = 175) or invalid ( n = 35) groups based on seven independent criterion PVTs. The invalid group had significantly worse DCT performance than the valid group using both the standard and unrounded scoring procedure ([Formula: see text]). Classification accuracy was excellent, with 54.3% sensitivity/92% specificity at optimal cut-scores of ≥14 (rounded) and ≥13.38 (unrounded). Nonsignificant DCT performance differences emerged based on ADHD subtype or the presence/absence of comorbid psychopathology. The DCT functions well as a nonmemory-based PVT in an ethnoracially diverse ADHD population, supporting its clinical utility for detecting invalid neurocognitive performance during ADHD evaluations.

scholarly journals Prevalence of ADHD and Its Subtypes in Male and Female Adult Prison Inmates

2021 ◽  
Author(s):  
Brian Stephen Cahill ◽  
Frederick L. Coolidge ◽  
Daniel L. Segal ◽  
Kelli J. Klebe ◽  
Peter D. Marle ◽  
...  
Keyword(s):  
Prevalence Rate ◽  
Self Report ◽  
Gender Differentials ◽  
Text Revision ◽  
Hyperactivity Disorder ◽  
Diagnostic And Statistical Manual ◽  
Female Inmate ◽  
Male Inmate ◽  
Adhd Subtype ◽  
Comorbid Psychopathology

There are few published studies of attention-deficit/hyperactivity disorder (ADHD) in adult inmates, and even fewer studies that have considered ADHD in adult inmates by gender. The present study examined the prevalence of ADHD, its subtypes, and associated psychological and neuropsychological comorbidity as a function of gender in a sample of 3,962 inmates (3,439 men and 523 women; mean age =33.6 years, range 17–73) who had completed the 250-item, self-report, Diagnostic and Statistical Manual of Mental Disorders, 4th edition (Text Revision) (DSM-IV-TR)-aligned Coolidge Correctional Inventory (CCI). The overall ADHD prevalence rate found was 10.5%, which is substantially higher than the rate among adults in the general population (2–5%). The female inmate ADHD prevalence rate (15.1%) was higher than the male inmate ADHD rate (9.8%), consistent with some previous studies. The most prevalent ADHD subtype for both genders was the hyperactive-impulsive subtype. The combined and inattentive ADHD subtypes had higher levels of comorbid psychopathology than the hyperactive-impulsive ADHD subtype. As the presence of ADHD and associated gender differentials may impact the success of rehabilitation and educative programs with inmates, the assessment of ADHD and comorbid psychopathology should be a priority in initial inmate screening and evaluation.

A Cognitive Therapy Approach for Adult Attention Deficit/Hyperactivity Disorder

2003 ◽  
Vol 17 (4) ◽  
pp. 319-334 ◽  
Author(s):  
Russell J. Ramsay ◽  
Anthony L. Rostain
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Cognitive Therapy ◽  
Attention Deficit ◽  
Adult Adhd ◽  
Behavioral Disorder ◽  
Clinical Population ◽  
Psychological Issues ◽  
Therapy Approach ◽  
Case Examples ◽  
Hyperactivity Disorder

While attention deficit/hyperactivity disorder (ADHD) is the most prevalent behavioral disorder of childhood, the past decade has seen a rise in the number of adults presenting for treatment with difficulties related to ADHD. Few treatments (particularly psychosocial treatments) offered to adult patients with ADHD, however, have been empirically tested, much less been grounded in an overarching treatment model that captures the complexity of the various neurobiological, developmental, and psychological issues germane to this clinical population. The purpose of this article is to introduce a cognitive therapy approach for treating adults with ADHD. To do so we will describe the nature of ADHD, discuss some of the clinical issues unique to this diagnosis, and outline a cognitive therapy approach for conceptualizing and treating adult ADHD, integrating a number of case examples.

Neuropsychological Functioning and Psychosocial Outcome in Adults with Attention-Deficit/ Hyperactivity Disorder

2015 ◽  
Vol 26 (1) ◽  
pp. 17-26 ◽  
Author(s):  
Esther Sobanski ◽  
Alexandra Sirtl ◽  
Barbara Alm ◽  
Oliver Hennig ◽  
Tobias Banaschewski
Keyword(s):  
Psychosocial Functioning ◽  
Neuropsychological Tests ◽  
Adult Adhd ◽  
Clinical Sample ◽  
Neuropsychological Functioning ◽  
Neuropsychological Impairment ◽  
Adhd Symptoms ◽  
Global Assessment Of Functioning ◽  
Psychosocial Impairment ◽  
Hyperactivity Disorder

This study explores the association of neuropsychological functioning with ADHD-symptoms and psychosocial functioning in a clinical sample of 131 adults with ADHD. Neuropsychological functioning was assessed with the computerized Test Battery of Attentional Performance (TAP). Overall psychosocial impairment was assessed with the Global Assessment of Functioning Scale (GAF). Neuropsychological performance was impaired in 39.6 % of the ADHD-patients meeting a predefined impairment criterion of a perfomance reduction of 1.5 standard deviations below normative controls in ≥ 2 TAP-subtests; 28.4 % of the patients showed regular performance in all neuropsychological tests. Severity of neuropsychological impairment was inversely correlated to severity of psychosocial impairment (GAF score; = -.24, p < .001) but not to childhood or adult ADHD symptoms. Overall severity of neuropsychological impairment explained 10 % (p < .05) of variance of psychosocial impairment.

scholarly journals A risk calculator to predict adult attention-deficit/hyperactivity disorder: generation and external validation in three birth cohorts and one clinical sample

2019 ◽  
Vol 29 ◽  
Author(s):  
A. Caye ◽  
J. Agnew-Blais ◽  
L. Arseneault ◽  
H. Gonçalves ◽  
C. Kieling ◽  
...  
Keyword(s):  
Birth Cohort ◽  
Regression Models ◽  
Adult Adhd ◽  
Clinical Sample ◽  
Test Sample ◽  
Population Based ◽  
Learning Approaches ◽  
Risk Calculator ◽  
Logistic Regression Models ◽  
Hyperactivity Disorder

Abstract Aim Few personalised medicine investigations have been conducted for mental health. We aimed to generate and validate a risk tool that predicts adult attention-deficit/hyperactivity disorder (ADHD). Methods Using logistic regression models, we generated a risk tool in a representative population cohort (ALSPAC – UK, 5113 participants, followed from birth to age 17) using childhood clinical and sociodemographic data with internal validation. Predictors included sex, socioeconomic status, single-parent family, ADHD symptoms, comorbid disruptive disorders, childhood maltreatment, ADHD symptoms, depressive symptoms, mother's depression and intelligence quotient. The outcome was defined as a categorical diagnosis of ADHD in young adulthood without requiring age at onset criteria. We also tested Machine Learning approaches for developing the risk models: Random Forest, Stochastic Gradient Boosting and Artificial Neural Network. The risk tool was externally validated in the E-Risk cohort (UK, 2040 participants, birth to age 18), the 1993 Pelotas Birth Cohort (Brazil, 3911 participants, birth to age 18) and the MTA clinical sample (USA, 476 children with ADHD and 241 controls followed for 16 years from a minimum of 8 and a maximum of 26 years old). Results The overall prevalence of adult ADHD ranged from 8.1 to 12% in the population-based samples, and was 28.6% in the clinical sample. The internal performance of the model in the generating sample was good, with an area under the curve (AUC) for predicting adult ADHD of 0.82 (95% confidence interval (CI) 0.79–0.83). Calibration plots showed good agreement between predicted and observed event frequencies from 0 to 60% probability. In the UK birth cohort test sample, the AUC was 0.75 (95% CI 0.71–0.78). In the Brazilian birth cohort test sample, the AUC was significantly lower –0.57 (95% CI 0.54–0.60). In the clinical trial test sample, the AUC was 0.76 (95% CI 0.73–0.80). The risk model did not predict adult anxiety or major depressive disorder. Machine Learning approaches did not outperform logistic regression models. An open-source and free risk calculator was generated for clinical use and is available online at https://ufrgs.br/prodah/adhd-calculator/. Conclusions The risk tool based on childhood characteristics specifically predicts adult ADHD in European and North-American population-based and clinical samples with comparable discrimination to commonly used clinical tools in internal medicine and higher than most previous attempts for mental and neurological disorders. However, its use in middle-income settings requires caution.

scholarly journals Adult attention-deficit/hyperactivity disorder: Associations between subtype and lifetime substance use – a clinical study

F1000Research ◽  
2016 ◽  
Vol 4 ◽  
pp. 407 ◽  
Author(s):  
Michael Liebrenz ◽  
Alex Gamma ◽  
Iliyan Ivanov ◽  
Anna Buadze ◽  
Dominique Eich
Keyword(s):  
Substance Use ◽  
Adult Adhd ◽  
Clinical Sample ◽  
High Rate ◽  
Clinical Risk Factor ◽  
Adhd Subtypes ◽  
Childhood Disorders ◽  
Psychotropic Substances ◽  
Hyperactivity Disorder ◽  
The One

ADHD is the one of the most prevalent childhood disorders and has been associated with impairments persisting into adulthood. Specifically, childhood ADHD is an independent clinical risk factor for the development of later substance use disorders (SUD). Moreover, adults who meet diagnostic criteria for ADHD have shown high rates of comorbid SUDs. Few studies, however, have reported on the relationship between ADHD subtypes and SUD in adult samples. The purpose of this study was to characterize a clinical sample of adults with ADHD and to identify possible associations between ADHD subtypes, lifetime substance use, and if ADHD subtypes may be preferentially associated with specific substances of abuse. We recruited 413 adult ADHD patients, performed an evaluation of their ADHD and conducted an interview on their use of psychotropic substances. Complete data was obtained for 349 patients. Lifetime substance abuse or dependence was 26% and occasional use was 57% in this sample. The inattentive subtype was significantly less likely to abuse or be dependent on cocaine than the combined subtype. Our findings underscore the high rate of comorbidity between substance use and ADHD in adults. The more frequent abuse/dependence of cocaine by adult patients with hyperactive-impulsive symptoms should be kept in mind when treating this patient group.

The impact of attention deficit hyperactivity disorder (ADHD) in adulthood: a qualitative study

2017 ◽  
Vol 35 (3) ◽  
pp. 173-179
Author(s):  
C. Watters ◽  
D. Adamis ◽  
F. McNicholas ◽  
B. Gavin
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Attention Deficit ◽  
Adult Adhd ◽  
Clinical Sample ◽  
Phenomenological Approach ◽  
Individual Treatment ◽  
Negative Effects ◽  
Hyperactivity Disorder ◽  
Qualitative Approaches ◽  
The Impact

ObjectivesThere is limited evidence of the unmet needs and experiences of adults with attention deficit hyperactivity disorder (ADHD). Previous research in this area is predominantly quantitative by nature, few studies employing qualitative approaches. This study seeks to provide a deeper insight into the lived experiences of adults with ADHD within Western Ireland.MethodsA qualitative design, consisting of semi-structured face-to-face interviews with a clinical sample in the Sligo/Leitrim area. Participants were eligible for this study if they screened positive for symptoms of ADHD, and diagnosed with ADHD with the Conners’ Adult ADHD Diagnostic Interview for DSM-IV. In total, 11 participants completed this research. The interviews were open ended and exploratory, adopting a phenomenological approach.ResultsThematic analysis was used to explore three main themes; The Burden of symptoms of ADHD, Perceived Positive and Negative Effects of ADHD and Challenge of Accessing Services, each with several subthemes.ConclusionThis research highlights the experiences of adults with ADHD. It is important for practitioners to be aware of the perceived positive and negative effects of the disorder, and how it can impact on their patient’s lives. In addition, becoming aware of the stigma associated with ADHD can help clinicians improve upon individual treatment plans to meet their patient’s needs. It is important to note that this sample experienced co-morbid diagnoses and so this may limit the interpretation of the findings. Further research in this area could explore patient’s attitudes towards receiving a formal diagnosis of ADHD.

scholarly journals A-213 Comparing WAIS-IV Reliable Digit Span and Age Corrected Scaled Score’s Performance Validity Cutoffs when Patients’ Effort is Determined by One or More Performance Validity Tests (PVTs)

2020 ◽  
Vol 35 (6) ◽  
pp. 1008-1008
Author(s):  
Livingstone J ◽  
Reese C
Keyword(s):  
Sensitivity And Specificity ◽  
Clinical Sample ◽  
Digit Span ◽  
Verbal Learning ◽  
Wisconsin Card Sorting Test ◽  
Performance Validity ◽  
Card Sorting ◽  
Cut Scores ◽  
Adult Intelligence Scale ◽  
Cut Score

Abstract Objective The purpose of the present study was to compare Wechsler Adult Intelligence Scale-IV (WAIS-IV) Reliable Digit Span (RDS) and Digit Span Age-Corrected Scaled Score (DS-ACSS) sensitivity and specificity, when the effort criterion was determined by between one and five performance validity test (PVT) cut scores. Method Data were collected from 82 adults (18–49) referred for clinical questions of multiple sclerosis, mild traumatic brain injury, and attention deficit hyperactivity disorder. Patients were administered full neuropsychological batteries,with different combinations of PVTs (including Advanced Clinical Solutions Word Choice, Animals raw score, Trails A T-score, Wisconsin Card Sorting Test [WCST; Suhr & Boyer] equation, and California Verbal Learning Test-II Forced Choice). Chi-square and receiver operating characteristic (ROC) analyses were utilized. Results Using established RDS (≤7) and DS-ACSS (≤6) cut scores, specificity was highest (90&37; and 86%, respectively), with equivalent sensitivity (90%), when effort was determined by WCST (Suhr & Boyer) equation failure alone. Related area under the curve for RDS was .90 (CI = .76–1.0) and for DS-ACSS was .88 (CI = .74–1.0). Conclusions In this clinical sample, the highest sensitivity and specificity were observed when the RDS cut score was utilized, and effort was based on the WCST criterion. However, the DS-ACSS cut score resulted in strong sensitivity/specificity combinations across more effort classification groups.

Validation of the Advanced Clinical Solutions Word Choice Test (WCT) in a Mixed Clinical Sample: Establishing Classification Accuracy, Sensitivity/Specificity, and Cutoff Scores

Assessment ◽  
2017 ◽  
Vol 26 (7) ◽  
pp. 1320-1328 ◽  
Author(s):  
Kathleen M. Bain ◽  
Jason R. Soble
Keyword(s):  
Classification Accuracy ◽  
Clinical Sample ◽  
Choice Test ◽  
Word Choice ◽  
Performance Validity ◽  
Cut Scores ◽  
Word Memory Test ◽  
Word Memory ◽  
Good Classification ◽  
Sensitivity Specificity

This study examined the Word Choice Test’s (WCT) utility as a performance validity test in a mixed clinical sample of veterans referred for neuropsychological evaluation. Participants completed Green’s Word Memory Test (WMT), WCT, and Test of Memory Malingering (TOMM) Trial 1. Using the WMT as the criterion for valid performance, logistic regressions examined the WCT and TOMM’s classification accuracy for those with and without cognitive impairment (CI). Receiver operating characteristic curves were used to establish cut scores which maximized the sensitivity/specificity of each measure. In those without CI, both tests showed good classification accuracy (86.7% and 85.0%, respectively). Among those with CI, the TOMM retained good classification accuracy (82.3%), while the WCT’s decreased considerably (69.4%). Optimal WCT cut scores differed based on impairment status, with a higher sensitivity/specificity trade-off among those with CI. Successful performance on the WCT appeared to rely more heavily on cognitive processes unrelated to performance validity.

scholarly journals Adult attention-deficit/hyperactivity disorder: Associations between subtype and lifetime substance use – a clinical study.

F1000Research ◽  
2015 ◽  
Vol 4 ◽  
pp. 407 ◽  
Author(s):  
Michael Liebrenz ◽  
Alex Gamma ◽  
Iliyan Ivanov ◽  
Anna Buadze ◽  
Dominique Eich
Keyword(s):  
Substance Use ◽  
Adult Adhd ◽  
Clinical Sample ◽  
High Rate ◽  
Clinical Risk Factor ◽  
Adhd Subtypes ◽  
Childhood Disorders ◽  
Psychotropic Substances ◽  
Hyperactivity Disorder ◽  
The One

ADHD is the one of the most prevalent childhood disorders and has been associated with impairments persisting into adulthood. Specifically, childhood ADHD is an independent clinical risk factor for the development of later substance use disorders (SUD). Moreover, adults who meet diagnostic criteria for ADHD have shown high rates of comorbid SUDs. Few studies, however, have reported on the relationship between ADHD subtypes and SUD in adult samples. The purpose of this study was to characterize a clinical sample of adults with ADHD and to identify possible associations between ADHD subtypes, lifetime substance use, and if ADHD subtypes may be preferentially associated with specific substances of abuse. We recruited 413 adult ADHD patients, performed an evaluation of their ADHD and conducted an interview on their use of psychotropic substances. Complete data was obtained for 349 patients. Lifetime substance abuse or dependence was 26% and occasional use was 57% in this sample. The inattentive subtype was significantly less likely to abuse or be dependent on cocaine than the combined subtype. Our findings underscore the high rate of comorbidity between substance use and ADHD in adults. The more frequent abuse/dependence of cocaine by adult patients with hyperactive-impulsive symptoms should be kept in mind when treating this patient group.

Adolescents’ self-mutilation - Relationship with dependent behaviour

2003 ◽  
Vol 62 (4) ◽  
pp. 241-249 ◽  
Author(s):  
M. Bolognini ◽  
B. Plancherel ◽  
J. Laget ◽  
P. Stéphan ◽  
O. Halfon
Keyword(s):  
Suicide Attempts ◽  
Clinical Sample ◽  
Control Sample ◽  
Clinical Population ◽  
Control Group ◽  
Clinical Group ◽  
Self Mutilation ◽  
Self Harm ◽  
Partial Overlap ◽  
The Relationship

The aim of this study, which was carried out in the French-speacking part of Switzerland, was to examine the relationship between suicide attempts and self-mutilation by adolescents and young adults. The population, aged 14-25 years (N = 308), included a clinical sample of dependent subjects (drug abuse and eating disorders) compared to a control sample. On the basis of the Mini Neuropsychiatric Interview ( Sheehan et al., 1998 ), DSM-IV criteria were used for the inclusion of the clinical population. The results concerning the occurrence of suicide attempts as well as on self-mutilation confirm most of the hypotheses postulated: suicidal attempts and self-mutilation were more common in the clinical group compared to the control group, and there was a correlation between suicide attempts and self-mutilation. However, there was only a partial overlap, attesting that suicide and self-harm might correspond to two different types of behaviour.

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