Date of Award

August 2017

Degree Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Psychology

Advisor(s)

Kevin M. Antshel

Keywords

ADHD, Assessment, Attention Deficit Hyperactivity Disorder, Development, Diagnosis, Lifespan

Subject Categories

Social and Behavioral Sciences

Abstract

The assessment and diagnostic process for Attention-Deficit/Hyperactivity Disorder (ADHD) is beset with complications relating to the subjectivity of symptom reporting, the nonspecific and dimensional nature of inattention, impulsivity, and hyperactivity, the high prevalence of psychiatric comorbidities, and the shifting expression of symptoms and impairment due to developmental changes from childhood to adolescence and adulthood. Actual diagnostic practices may also differ from recommended best practices. These challenges have led to the proliferation of several clinical guidelines, many of which recommend various diagnostic practices and assessment instruments. Nonetheless, relatively little is presently known about the diagnostic efficiency of these various instruments used in the diagnosis of ADHD at different developmental time points or about possible differences in ADHD presentations in pediatric versus psychiatric clinics. This study was designed to address these gaps in the ADHD knowledge base. Results of the present study suggest that clinicians should prioritize parent and clinician subjective rating scales over tests of academic achievement and neuropsychological functioning when diagnosing ADHD. Specifically, school and social functioning ratings emerged as measures with the strongest discriminatory properties. Results of this study also demonstrated that the diagnostic accuracy of the assessments were higher in pediatrically referred samples compared to psychiatrically referred samples, suggesting that there may indeed be subtle differences in the presentation of ADHD in pediatric versus psychiatric clinics, as well as differences in the comparison populations therein. The present study adds to the literature in helping clinicians in selecting the most diagnostically efficient assessment battery for ADHD across the different developmental time periods.

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Open Access

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