title: Diagnosing ADHD in adolescence.
abstract: OBJECTIVE
  This study examines adolescent-specific practical problems associated with current practice parameters for diagnosing attention-deficit/hyperactivity disorder (ADHD) to inform recommendations for the diagnosis of ADHD in adolescents. Specifically, issues surrounding the use of self- versus informant ratings, diagnostic threshold, and retrospective reporting of childhood symptoms were addressed.
  
  
  METHODS
  Using data from the Pittsburgh ADHD Longitudinal Study (PALS), parent, teacher, and self-reports of symptoms and impairment were examined for 164 adolescents with a childhood diagnosis of ADHD (age M = 14.74 years) and 119 demographically similar non-ADHD controls (total N = 283).
  
  
  RESULTS
  Results indicated that 70% of the well-diagnosed childhood ADHD group continued to meet Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; American Psychiatric Association, 2000) diagnostic criteria for ADHD in adolescence; however, an additional 17% possessed clinically significant impairment in adolescence but did not qualify for a current ADHD diagnosis. The optimal source of information was combined reports from the parent and a core academic teacher. Adolescents with ADHD met criteria for very few symptoms of hyperactivity/impulsivity, suggesting a need to revisit the diagnostic threshold for these items. Additionally, emphasis on impairment, rather than symptom threshold, improved identification of adolescents with a gold-standard childhood diagnosis of ADHD and persistent ADHD symptoms. Parent retrospective reports of baseline functioning, but not adolescent self-reports, were significantly correlated with reports collected at baseline in childhood.
  
  
  CONCLUSIONS
  Recommendations are offered for diagnosing ADHD in adolescence based on these findings.
authors.affiliation: Department of Psychology, Center for Children and Families, Florida International University.
authors.forename: Margaret H
authors.initials: MH
authors.lastname: Sibley
authors.affiliation: Department of Psychology, Center for Children and Families, Florida International University.
authors.forename: William E
authors.initials: WE
authors.lastname: Pelham
authors.affiliation: Department of Psychiatry, University of Pittsburgh.
authors.forename: Brooke S G
authors.initials: BSG
authors.lastname: Molina
authors.affiliation: Center for Children and Families, Florida International University.
authors.forename: Elizabeth M
authors.initials: EM
authors.lastname: Gnagy
authors.affiliation: Center for Children and Families, Florida International University.
authors.forename: Daniel A
authors.identifier: 0000-0002-8115-1286
authors.initials: DA
authors.lastname: Waschbusch
authors.affiliation: Department of Psychology, Kennesaw State University.
authors.forename: Allison C
authors.initials: AC
authors.lastname: Garefino
authors.affiliation: Center for Children and Families, Florida International University.
authors.forename: Aparajita B
authors.initials: AB
authors.lastname: Kuriyan
authors.affiliation: Center for Children and Families, Florida International University.
authors.forename: Dara E
authors.initials: DE
authors.lastname: Babinski
authors.affiliation: Department of Psychology, State University of New York.
authors.forename: Kathryn M
authors.initials: KM
authors.lastname: Karch
mesh_terms: D000293:Adolescent; D000328:Adult; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis* / Q000523:psychology; D002648:Child; D005178:Faculty; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007406:Interview, Psychological; D008137:Longitudinal Studies; D008297:Male; D010290:Parents / Q000523:psychology; D010414:Pennsylvania; D011594:Psychometrics; D057566:Self Report; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D055815:Young Adult