Professional perceptions of criteria for attention deficit hyperactivity disorder in adults
Abstract
This was an exploratory, descriptive study, exploring the diagnostic criteria for adults with ADHD disorder. Respondents were asked to identify behavioral characteristics of adults with ADHD. The overall purpose of this study was to examine the majority agreement among three different clinical specialty groups. The groups were social workers, psychologists, and psychiatrists. These groups were chosen because they are the clinicians primarily responsible for diagnosing and treating patients with ADHD. The 18 DSM-IV criteria for diagnosing children with ADHD were modified to use with adults and were used to calculate subscale scores for hyperactivity/impulsivity and inattention. The three clinical specialties were compared with regard to these scores. The impact of experience was examined relative to the subscale scores and the individual questions. The individual questions which the majority of clinicians endorsed were also identified. The major findings of this study were the significant differences between psychiatrists and social workers regarding the inattention subscale. The psychiatrists rated the presence of inattention more highly than did the social workers. There was no significant difference in the rating of hyperactivity between the three groups. The item analysis revealed that the three groups differed in their endorsement of "little or no close attention to detail," "pay little attention to others who are speaking," and "little follow-through with projects." In all three comparisons where a difference was found, a larger percentage of psychiatrists endorsed the items than did the social workers. Relative to experience, the group of inexperienced clinicians was too small to stratify the analysis by clinical specialty. The subscale scores did not differ based on experience. An item analysis revealed a higher percentage of experienced clinicians endorsed the items "difficulty organizing activities and tasks" and "inability to follow-through" than did the inexperienced group. Nineteen items were endorsed by the majority of clinicians. These items included 11 Inattention items, 5 Hyperactive items, and 3 non-DSM-IV items. Further research is necessary to identify appropriate diagnostic criteria for the disorder of adult ADHD. Future research needs to address similarities and differences between experienced and inexperienced clinicians. The behaviors that were endorsed by the majority of clinicians need to be studied for their actual presence in ADHD adults. Further, these behaviors in adults with ADHD need to be compared with the behaviors found in subjects with other established diagnoses.
This paper has been withdrawn.