Department of Psychology, Butler University, Indianapolis, Indiana, USA.
College of Education, Butler University, Indianapolis, Indiana, USA.
Br J Clin Psychol. 2021 Jun;60(2):252-269. doi: 10.1111/bjc.12276. Epub 2021 Jan 4.
This study examined the effect of whether participants were on or off their medications and the effect of questionnaire wording on self-reported symptoms in young adults with ADHD. Additionally, this research evaluated the relationships between these self-reported symptoms and objective performance on measures of working memory.
This experimental study utilized a mixed factorial design with one between-subjects factor (whether participants were unmedicated or medicated at the time they completed their assessment) and one within-subjects factor (whether participants reported their on-medication or off-medication symptoms when describing their ADHD subjective symptomatology).
Forty-five young adults with ADHD (ages 18-23) completed a brief neuropsychological evaluation and several self-report questionnaires.
Although being medicated or unmedicated while completing the questionnaires did not directly affect self-reported symptoms or their accuracy, questionnaire wording exerted a statistically significant effect on subjective symptomatology; participants described themselves as substantially more symptomatic at times when they are off than at times when they are on their medications. More importantly, their general self-perceptions (symptoms when medication state was not specified) of their Inattention/Memory Problems and their Hyperactivity/Restlessness aligned with their descriptions of their off-medication symptoms, whereas their general self-perceptions of their Impulsivity/Emotional Lability and Problems with Self-Concept related to both their self-reported off-medication and on-medication symptoms.
These results highlight the necessity of specifying medication state when asking patients to report their current symptomatology. Failing to do so risks an over-reporting of symptoms from patients who are typically on medications as they may describe the extent of their unmedicated, rather than medicated, symptomatology.
Being medicated or unmedicated while completing questionnaires about subjective symptomatology did not directly affect self-reported symptoms of young adults with ADHD or the accuracy of these self-reports. When medication state was not specified on a questionnaire, young adults with ADHD reported symptoms similar to those they experience when they are not medicated. These results highlight the importance of specifying medication state when asking young adults with ADHD to report their current symptomatology. Failing to do so risks an over-reporting of symptoms from patients who are typically on medications. These findings open the door for further research with larger and more diverse and representative samples of adults with ADHD to evaluate the accuracy of their subjective symptomatology relative to their objective abilities. Future studies should also examine whether gender affects subjective symptoms, their accuracy, or the influence of question wording and medications on self-reported symptomatology of adults with ADHD, as the current study was unable to address this important issue.
本研究考察了参与者是否服药以及问卷措辞对 ADHD 年轻患者自我报告症状的影响。此外，本研究还评估了这些自我报告症状与工作记忆客观测量结果之间的关系。
本实验研究采用混合因子设计，有一个被试间因素（参与者在完成评估时是否服药）和一个被试内因素（参与者在描述 ADHD 主观症状时报告其服药或停药症状）。
45 名 ADHD 年轻患者（年龄 18-23 岁）完成了简短的神经心理学评估和几项自我报告问卷。
尽管在填写问卷时服药或不服药并不直接影响自我报告的症状或其准确性，但问卷措辞对主观症状学有统计学上的显著影响；与服药时相比，参与者在停药时描述自己的症状明显更严重。更重要的是，他们对自己的注意力/记忆问题和多动/不安的一般自我认知（未指定药物状态时）与他们对停药症状的描述相符，而他们对冲动/情绪不稳定和自我概念问题的一般自我认知与他们自我报告的停药和服药症状有关。
这些结果强调了在要求患者报告当前症状时指定药物状态的必要性。如果不这样做，可能会导致正在服用药物的患者过度报告症状，因为他们可能会描述自己未服药时的症状，而不是服药时的症状。
在填写有关主观症状学的问卷时，是否服药并不会直接影响 ADHD 年轻患者的自我报告症状或这些自我报告的准确性。当问卷中未指定药物状态时，ADHD 年轻患者报告的症状与他们未服药时的症状相似。这些结果强调了在要求 ADHD 年轻患者报告当前症状时指定药物状态的重要性。如果不这样做，可能会导致正在服用药物的患者过度报告症状。这些发现为进一步研究提供了机会，研究更大、更多样化和更具代表性的 ADHD 成年患者的主观症状学，评估他们的主观症状学与客观能力的准确性。未来的研究还应检查性别是否会影响成年 ADHD 患者的主观症状、其准确性或问题措辞和药物对自我报告症状学的影响，因为目前的研究无法解决这个重要问题。
