The reliability and validity of self- and investigator ratings of ADHD in adults.
OBJECTIVE
Little information is available comparing self- versus investigator ratings of symptoms in adult ADHD. The authors compared the reliability, validity, and utility in a sample of adults with ADHD and also as an index of clinical improvement during treatment of self- and investigator ratings of ADHD symptoms via the Conners Adult ADHD Rating Scale (CAARS).


METHODS
We analyzed data from two double-blind, parallel-design studies of 536 adult ADHD patients, randomized to 10-week treatment with atomoxetine or placebo. Outcome variables included ADHD symptom severity (CAARS self- and investigator ratings), psychiatric symptom comorbidity, and functioning.


RESULTS
All five CAARS subscales showed good internal consistency at each time point. Similarly, interrater reliability was acceptable for each subscale. Following treatment, CAARS total scores and subscale scores improved significantly from baseline. CAARS subscales also predicted changes in other psychiatric symptoms and functioning. Overall, baseline investigator ratings were stronger predictors of treatment outcome than baseline self-report scores.


CONCLUSIONS
The CAARS demonstrated good internal consistency and inter-rater reliability, as well as sensitivity to treatment outcome. The finding of greater predictive power of investigator-rated baseline scores merits further investigation.
Adler
Lenard A
LA
New York University School of Medicine, New York, NY 10016, USA. Lenard.adler@med.nyu.edu
Faraone
Stephen V
SV
Spencer
Thomas J
TJ
Michelson
David
D
Reimherr
Frederick W
FW
Glatt
Stephen J
SJ
Marchant
Barrie K
BK
Biederman
Joseph
J
D018759:Adrenergic Uptake Inhibitors / Q000627:therapeutic use; D000328:Adult; D000069445:Atomoxetine Hydrochloride; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis* / Q000188:drug therapy; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D011437:Propylamines / Q000627:therapeutic use; D015203:Reproducibility of Results; D012647:Self-Assessment; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires
D018759:Adrenergic Uptake Inhibitors; D011437:Propylamines; D000069445:Atomoxetine Hydrochloride