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Criterion Validity and Clinical Usefulness of Attention Deficit Hyperactivity Disorder Rating Scale IV in Attention Deficit Hype

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Criterion Validity and Clinical Usefulness of Attention Deficit Hyperactivity Disorder Rating Scale IV in Attention Deficit Hype Psicothema 2017, Vol. 29, No. 1, 103-110 ISSN 0214 - 9915 CODEN PSOTEG Copyright © 2017 Psicothema doi: 10.7334/psicothema2016.93 www.psicothema.com Criterion validity and clinical usefulness of Attention Defi cit Hyperactivity Disorder Rating Scale IV in attention defi cit hyperactivity disorder (ADHD) as a function of method and age José Antonio López-Villalobos1, Jesús Andrés-De Llano2, María Victoria López-Sánchez, Luis Rodríguez-Molinero3, Mercedes Garrido-Redondo3, Ana María Sacristán-Martín4, María Teresa Martínez-Rivera3 and Susana Alberola-López4 1 Complejo Asistencial Universitario de Palencia. Salud Mental, 2 Complejo Asistencial Universitario de Palencia. Pediatría, 3 Atención Primaria de Valladolid and 4 Atención Primaria de Palencia Abstract Resumen Background: The aim of this research is to analyze Attention Defi cit Validez de criterio y utilidad clínica del Attention Defi cit Hiperactivity Hyperactivity Disorder Rating Scales IV (ADHD RS-IV) criteria Disorder Rating Scales IV en el Trastorno por Défi cit de Atención validity and its clinical usefulness for the assessment of Attention Defi cit con Hiperactividad en función del método y la edad. Antecedentes: Hyperactivity Disorder (ADHD) as a function of assessment method and se estudia la validez de criterio y utilidad clínica del Attention Defi cit age. Methodology: A sample was obtained from an epidemiological study Hiperactivity Disorder Rating Scales IV (ADHD RS-IV) en el Trastorno (n = 1095, 6-16 years). Clinical cases of ADHD (ADHD-CL) were selected por Défi cit de Atención con Hiperactividad (TDAH) en función del by dimensional ADHD RS-IV and later by clinical interview (DSM-IV). método y edad. Método: muestra extraída de un estudio epidemiológico ADHD-CL cases were compared with four categorical results of ADHD (n = 1095, 6-16 años). Los casos de TDAH clínico (TDAH-CL) fueron RS-IV provided by parents (CATPA), teachers (CATPR), either parents seleccionados mediante ADHD RS-IV dimensional y entrevista clínica or teachers (CATPAOPR) and both parents and teachers (CATPA&PR). (DSM-IV) y fueron comparados con cuatro modalidades categoriales de Criterion validity and clinical usefulness of the answer modalities to respuesta al ADHD RS-IV implementado por padres (CATPA), profesores ADHD RS-IV were studied. Results: ADHD-CL rate was 6.9% in (CATPR), padres o profesores indistintamente (CATPAOPR) y/o childhood, 6.2% in preadolescence and 6.9% in adolescence. Alternative conjuntamente (CATPAYPR). Se estudió la validez de criterio y utilidad methods to the clinical interview led to increased numbers of ADHD clínica de las modalidades de respuesta. Resultados: la tasa de TDAH- cases in all age groups analyzed, in the following sequence: CATPAOPR> CL es 6,9% en infancia, 6,2% en preadolescencia y 6,9% en adolescencia. CATPRO> CATPA> CATPA&PR> ADHD-CL. CATPA&PR was the Los procedimientos alternativos a la entrevista clínica aumentan los casos procedure with the greatest validity, specifi city and clinical usefulness in de TDAH en los tres grupos de edad, siguiendo la sucesión CATPAOPR all three age groups, particularly in the childhood. Conclusions: Isolated > CATPRO > CATPA > CATPAYPR > TDAH-CL. El procedimiento use of ADHD RS-IV leads to an increase in ADHD cases compared to con mayor índice de validez, especifi dad, utilidad clínica y capacidad clinical interview, and varies depending on the procedure used. predictiva de TDAH fue CATPAYPR. Conclusiones: la utilización de Keywords: Attention Defi cit Hyperactivity Disorder, ADHD Rating Scale una versión categorial del ADHD RS-IV produce un incremento de casos -IV, prevalence, criterion validity, clinical usefulness. de TDAH respecto a la entrevista clínica que varía en función del método utilizado. Palabras clave: Trastorno por Défi cit de Atención con Hiperactividad, ADHD Rating Scale -IV, prevalencia, validez de criterio, utilidad clínica. The main purpose of our study is to analyze the criterion Hyperactivity Disorder (ADHD) as a function of the method used validity and clinical usefulness of Attention Defi cit Hyperactivity and age. Disorder Rating Scales IV (ADHD RS-IV) in the Attention Defi cit ADHD is a frequent cause of referral of children and adolescents to clinical psychologists, pediatricians and child psychiatrists (López- Villalobos, 2002; Paiva, Saona, & Ramos, 2009), and it is considered Received: March 16, 2016 • Accepted: November 17, 2016 one of the most important clinical and public health problems in terms Corresponding author: José Antonio López-Villalobos of morbidity and dysfunction. ADHD makes increasing demands on Complejo Asistencial Universitario de Palencia. Salud Mental mental health services and gives rise to higher clinical, family, social Complejo Asistencial Universitario de Palencia. Hospital San Telmo 34004 Palencia (Spain) and academic impairment compared to the general population or e-mail: [email protected] clinical controls (Erskine et al., 2016; López-Villalobos et al., 2004). 103 José Antonio López-Villalobos, Jesús Andrés-De Llano, María Victoria López-Sánchez, Luis Rodríguez-Molinero, Mercedes Garrido-Redondo, Ana María Sacristán-Martín, María Teresa Martínez-Rivera and Susana Alberola-López According to the criteria of the Diagnostic and Statistical These prevalence numbers are also equivalent to the possibility Manual of Mental Disorders in its fourth edition (DSM-IV, of a diagnosis, if the clinician only paid attention to the response American Psychiatric Association [APA], 2000), Attention defi cit to these questionnaires. At present the diagnosis of the disorder hyperactivity is characterized by a persistent pattern of inattentive, is considered basically clinical (NICE, 2009) and is usually restless and impulsive behavior which is more frequent and accompanied by questionnaires to parents and teachers, such as severe than that typically observed in subjects at a similar stage those previously mentioned. These questionnaires usually have a of development. ADHD symptoms should have an onset before cut-off point that allows people to be deemed within or outside the age of 7, persist for at least six months to a degree which is the clinical range and can lead to different estimates depending maladaptive and inconsistent with the developmental level, and on their use. The authors think that the validity of the criteria and give rise to a clinically signifi cant impairment in social, academic clinical usefulness of these questionnaires may vary according to or occupational functioning and some of the alterations caused the method used and the age range. by these symptoms should be present in at least two of these Our study will provide new fi gures on the prevalence of settings. ADHD in Spain by age and will show its variability depending The new classifi cation of the DSM in its fi fth edition ([DSM-5] on the method used. These numbers can be compared with the APA, 2013) has recently emerged: ADHD has been included in international data previously mentioned. In addition, our study neurodevelopmental disorders, the age of onset has been modifi ed focuses on the problem of the variability of the diagnosis of (symptoms should appear before age 12), subtypes have been ADHD and its consequences according to the procedure used replaced by presentations, comorbidity with autism spectrum by the clinician. This circumstance has obvious implications in disorders is allowed and the symptom threshold for adults has clinical practice. been modifi ed. Therefore, the main objective of our research is to study A recent prevalence study has found that the extension of the the criterion validity and clinical usefulness of ADHD RS- criterion on the age of onset of 7 to 12 years led to an increase IV depending on the procedure used to defi ne ADHD (parent in the prevalence rate of ADHD from 7.4% (DSM-IV) to 10.8% response, teacher response, parent-teacher responses and their (DSM-5). However, young people with a later onset age did not use in childhood (6-9 years), preadolescence (10-13 years) or differ from those with earlier onset in terms of severity and adolescence (14-16 years). comorbidity patterns, although they were more likely to belong to low-income families and ethnic minorities (Voort, He, Jameson, Method & Merikangas, 2014). A global systematic review of prevalence studies in childhood Participants and youth ADHD observed an average of 5.29% (Polanczyk, de Lima, Horta, Biederman, & Rohde, 2007). Our research is posed as a population study to evaluate the Recent meta-analysis studies on the prevalence of ADHD, prevalence of ADHD in Castile and Leon (Spain). The target following DSM-IV criteria, show rates between 5.9 and 7.1% population includes all students in primary and secondary (Willcutt, 2012), and following DSM third edition ([DSM- education from 6 to 16 years old in the region. The sample design III] APA, 1980), (DSM-III-R] APA, 1987 and DSM-IV criteria was multi-stage, stratifi ed and proportional by clusters, as stated in inclusively it rises to 7.2% (95% CI = 6.7 - 7.8) (Thomas, Sanders, the original research (Rodríguez et al., 2009). For a total population Doust, Beller, & Glasziou, 2015). The most recent meta-analysis of 212,657 and a sample error of 0.05 for an expected prevalence on the prevalence of ADHD in Spain fi nds rates of 6.8% (IC95% of 5% and precision ± 1.4 (CI = 95%), a minimum sample size of = 4.8 - 8.8) (Catalá-López et al., 2012). 932 students was required, with an increase to 1200 in anticipation The prevalence of ADHD may vary depending on the of losses. informant (parent or teacher) and on the criteria used to defi ne 1,095 cases were analyzed. The total sample had a mean age the disorder (i.e., to exceed the cut-off point in either one or both of 10.9 (SD = 3.0) and included 51.9% male (mean age = 10.7, scales). In turn, there may also be variation if we consider either SD = 3.0) and 48.1% female (mean age = 11.0; SD = 3.1).
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