Ward M F, Wender P H, Reimherr F W
Department of Psychiatry, University of Utah School of Medicine, Salt Lake City 84132.
Am J Psychiatry. 1993 Jun;150(6):885-90. doi: 10.1176/ajp.150.6.885.
In an attempt to surmount the problem of retrospectively establishing the childhood diagnosis of attention deficit hyperactivity disorder, the authors constructed the 61-item Wender Utah Rating Scale (WURS) for adults to use to describe their own childhood behavior. In this paper they present their initial data collection and evaluation of the instrument's validity.
The scale was administered to 81 adult outpatients with attention deficit hyperactivity disorder, 100 "normal" adults, and 70 psychiatric adult outpatients with unipolar depression. The authors analyzed data from the 25 items of the scale that showed the greatest difference between the patients with attention deficit hyperactivity disorder and the normal comparison subjects and the relationship between the WURS and the patients' parents' judgment of childhood activity as measured by the Parents' Rating Scale.
The patients with attention deficit hyperactivity disorder had significantly higher mean scores on all 25 items than did the two comparison groups. The difference between the mean total scores of the patients with attention deficit hyperactivity disorder and the normal subjects was also highly significant. A cutoff score of 46 or higher correctly identified 86% of the patients with attention deficit hyperactivity disorder, 99% of the normal subjects, and 81% of the depressed subjects. Correlations obtained between WURS scores and Parents' Rating Scale scores were moderate but impressive. The ability of WURS scores to predict response to methylphenidate replicated the authors' finding regarding the ability of Parents' Rating Scale scores to predict response to pemoline.
The WURS is sensitive in identifying childhood attention deficit hyperactivity disorder and may be useful in recognizing attention deficit hyperactivity disorder in patients with ambiguous adult psychopathology.
为克服回顾性确立儿童注意力缺陷多动障碍诊断的问题,作者构建了包含61个条目的温德犹他评定量表(WURS)供成年人用于描述自己童年时期的行为。在本文中,他们展示了该量表初步的数据收集情况及对其效度的评估。
该量表施用于81名患有注意力缺陷多动障碍的成年门诊患者、100名“正常”成年人以及70名患有单相抑郁症的成年精神科门诊患者。作者分析了量表中25个条目数据,这些条目在患有注意力缺陷多动障碍的患者与正常对照受试者之间显示出最大差异,以及WURS与患者父母通过父母评定量表所测量的童年活动判断之间的关系。
患有注意力缺陷多动障碍的患者在所有25个条目上的平均得分均显著高于两个对照组。患有注意力缺陷多动障碍的患者与正常受试者的平均总分差异也非常显著。46分及以上的临界值能正确识别86%的注意力缺陷多动障碍患者、99%的正常受试者以及81%的抑郁受试者。WURS得分与父母评定量表得分之间的相关性中等但令人印象深刻。WURS得分预测对哌甲酯反应的能力重现了作者关于父母评定量表得分预测对匹莫林反应能力的研究发现。
WURS在识别儿童注意力缺陷多动障碍方面较为敏感,可能有助于在成年期精神病理学表现不明确的患者中识别注意力缺陷多动障碍。