title: The incremental validity of a computerised assessment added to clinical rating scales to differentiate adult ADHD from autism spectrum disorder.
abstract: There is a clinical need for objective evidence-based measures that are sensitive and specific to ADHD when compared with other neurodevelopmental disorders. This study evaluated the incremental validity of adding an objective measure of activity and computerised cognitive assessment to clinical rating scales to differentiate adult ADHD from Autism spectrum disorders (ASD). Adults with ADHD (n=33) or ASD (n=25) performed the QbTest, comprising a Continuous Performance Test with motion-tracker to record physical activity. QbTest parameters measuring inattention, impulsivity and hyperactivity were combined to provide a summary score ('QbTotal'). Binary stepwise logistic regression measured the probability of assignment to the ADHD or ASD group based on scores on the Conners Adult ADHD Rating Scale-subscale E (CAARS-E) and Autism Quotient (AQ10) in the first step and then QbTotal added in the second step. The model fit was significant at step 1 (CAARS-E, AQ10) with good group classification accuracy. These predictors were retained and QbTotal was added, resulting in a significant improvement in model fit and group classification accuracy. All predictors were significant. ROC curves indicated superior specificity of QbTotal. The findings present preliminary evidence that adding QbTest to clinical rating scales may improve the differentiation of ADHD and ASD in adults.
authors.affiliation: Division of Psychiatry and Applied Psychology, Institute of Mental Health, University of Nottingham, Triumph Road, Nottingham NG7 2TU, UK.
authors.forename: Madeleine J
authors.initials: MJ
authors.lastname: Groom
authors.affiliation: Division of Psychiatry and Applied Psychology, Institute of Mental Health, University of Nottingham, Triumph Road, Nottingham NG7 2TU, UK; NIHR MindTech Healthcare Technology Co-operative, Institute of Mental Health and Nottinghamshire Healthcare NHS Trust, Nottingham, UK.
authors.forename: Zoe
authors.initials: Z
authors.lastname: Young
authors.affiliation: Division of Psychiatry and Applied Psychology, Institute of Mental Health, University of Nottingham, Triumph Road, Nottingham NG7 2TU, UK; CLAHRC-EM, Division of Psychiatry and Applied Psychology, Institute of Mental Health, University of Nottingham, Triumph Road, Nottingham NG7 2TU, UK. Electronic address: charlotte.hall@nottingham.ac.uk.
authors.forename: Charlotte L
authors.initials: CL
authors.lastname: Hall
authors.affiliation: Intellectual and Developmental Disabilities Service, Nottinghamshire Healthcare NHS Trust, Nottingham, UK.
authors.forename: Alinda
authors.initials: A
authors.lastname: Gillott
authors.affiliation: Division of Psychiatry and Applied Psychology, Institute of Mental Health, University of Nottingham, Triumph Road, Nottingham NG7 2TU, UK; CLAHRC-EM, Division of Psychiatry and Applied Psychology, Institute of Mental Health, University of Nottingham, Triumph Road, Nottingham NG7 2TU, UK; NIHR MindTech Healthcare Technology Co-operative, Institute of Mental Health and Nottinghamshire Healthcare NHS Trust, Nottingham, UK.
authors.forename: Chris
authors.initials: C
authors.lastname: Hollis
mesh_terms: D000293:Adolescent; D000328:Adult; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis* / Q000523:psychology; D000067877:Autism Spectrum Disorder / Q000175:diagnosis* / Q000523:psychology; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D006948:Hyperkinesis / Q000175:diagnosis* / Q000523:psychology; D007175:Impulsive Behavior / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D011594:Psychometrics; D012680:Sensitivity and Specificity; D055815:Young Adult
keywords: Assessment; Continuous Performance Test; QbTest