Department of Psychiatry, Medical University of South Carolina, USA.
Psychol Assess. 2011 Jun;23(2):437-46. doi: 10.1037/a0022172.
Experts recommend that clinicians evaluating adults for attention-deficit/hyperactivity disorder (ADHD) obtain information from others who know the patient well. The authors examined correspondence between the self- and other-ratings of ADHD symptoms and impairment using 3 groups of adults recruited on the basis of their severity of ADHD: ADHD diagnosis (n = 146), clinical controls self-referring for ADHD but not diagnosed (n = 97), and community controls (n = 109). The influences of diagnostic group, informant relationship, sex of participant, IQ, and comorbid anxiety and depression on self-informant disparities were also examined. Results indicated moderate to high agreement (.59-.80) between self and others on current functioning and slightly lower levels (.53-.75) between self- and parent ratings of childhood functioning. Examination of difference scores between self- and other ratings revealed small mean disparities (-0.1 to +5.0 points) but substantial variation (SDs = -2.4 to 8.9 points) for both current and childhood ratings. Clinic referrals not diagnosed with ADHD, particularly women, had higher disparities than was evident in the ADHD and community groups. Age, IQ, and education were not associated with disparities in most ratings. Higher anxiety, in contrast, was associated with greater disparities on all current and childhood measures of both ADHD and impairment.
专家建议,评估成年人注意力缺陷多动障碍(ADHD)的临床医生应从了解患者的其他人那里获取信息。作者使用基于 ADHD 严重程度招募的三组成年人(ADHD 诊断组(n=146)、因 ADHD 自我转诊但未被诊断的临床对照组(n=97)和社区对照组(n=109)),考察了 ADHD 症状和损害的自我和他人评定之间的一致性。还研究了诊断组、信息来源关系、参与者的性别、智商以及合并的焦虑和抑郁对自我与信息提供者差异的影响。结果表明,当前功能的自我和他人之间存在中度到高度一致性(.59-.80),而儿童功能的自我和父母评定之间的一致性略低(.53-.75)。对自我和他人评定之间的差异分数进行检查发现,当前和儿童评定的平均差异较小(-0.1 至+5.0 分),但差异很大(SD=-2.4 至 8.9 分)。未被诊断为 ADHD 的临床转诊者,尤其是女性,其差异比 ADHD 和社区组更为明显。年龄、智商和教育程度与大多数评定的差异无关。相比之下,更高的焦虑与 ADHD 和损害的所有当前和儿童测量的更大差异相关。