title: When diagnosing ADHD in young adults emphasize informant reports, DSM items, and impairment.
abstract: OBJECTIVE
  This study examined several questions about the diagnosis of attention-deficit/hyperactivity disorder (ADHD) in young adults using data from a childhood-diagnosed sample of 200 individuals with ADHD (age M = 20.20 years) and 121 demographically similar non-ADHD controls (total N = 321).
  
  
  METHODS
  We examined the use of self- versus informant ratings of current and childhood functioning and evaluated the diagnostic utility of adult-specific items versus items from the Diagnostic and Statistical Manual of Mental Disorders (DSM).
  
  
  RESULTS
  Results indicated that although a majority of young adults with a childhood diagnosis of ADHD continued to experience elevated ADHD symptoms (75%) and clinically significant impairment (60%), only 9.6%-19.7% of the childhood ADHD group continued to meet DSM-IV-TR (DSM, 4th ed., text rev.) criteria for ADHD in young adulthood. Parent report was more diagnostically sensitive than self-report. Young adults with ADHD tended to underreport current symptoms, while young adults without ADHD tended to overreport symptoms. There was no significant incremental benefit beyond parent report alone to combining self-report with parent report. Non-DSM-based, adult-specific symptoms of ADHD were significantly correlated with functional impairment and endorsed at slightly higher rates than the DSM-IV-TR symptoms. However, DSM-IV-TR items tended to be more predictive of diagnostic group membership than the non-DSM adult-specific items due to elevated control group item endorsement.
  
  
  CONCLUSIONS
  Implications for the assessment and treatment of ADHD in young adults are discussed (i.e., collecting informant reports, lowering the diagnostic threshold, emphasizing impairment, and cautiously interpreting retrospective reports).
authors: Center for Children and Families.
authors: Margaret H
authors: MH
authors: Sibley
authors: Center for Children and Families.
authors: William E
authors: WE
authors: Pelham
authors: Department of Psychiatry, University of Pittsburgh Medical Center.
authors: Brooke S G
authors: BSG
authors: Molina
authors: Center for Children and Families.
authors: Elizabeth M
authors: EM
authors: Gnagy
authors: Center for Children and Families.
authors: James G
authors: JG
authors: Waxmonsky
authors: Center for Children and Families.
authors: Daniel A
authors: 0000-0002-8115-1286
authors: DA
authors: Waschbusch
authors: Center for Children and Families.
authors: Karen J
authors: KJ
authors: Derefinko
authors: Seattle Children's Research Institute.
authors: Brian T
authors: BT
authors: Wymbs
authors: Department of Psychology, Kennesaw State University.
authors: Allison C
authors: AC
authors: Garefino
authors: Center for Children and Families.
authors: Dara E
authors: DE
authors: Babinski
authors: Center for Children and Families.
authors: Aparajita B
authors: AB
authors: Kuriyan
mesh_terms: D000293:Adolescent; D000328:Adult; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D010290:Parents; D012189:Retrospective Studies; D057566:Self Report; D012720:Severity of Illness Index; D063189:Symptom Assessment