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      Clinical Utility of the Korean Version of the WHO Adult Attention-Deficit/Hyperactivity Disorder Self-Report Scale Screener

      brief-report

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          Abstract

          Objective

          The aim of this study was to compare the performance of the 18-item Korean version of the World Health Organization adult attention-deficit/hyperactivity disorder self-report scale (ASRS) with the six-item ASRS Screener for predicting attention-deficit/hyperactivity disorder (ADHD) group.

          Methods

          The study sample included 51 adult patients with ADHD and 158 normal controls. All participants completed the ASRS and were interviewed individually using the Mini-International Neuropsychiatric Interview. Receiver operating characteristic (ROC) curves were used to compare the ASRS (ASRS-18) with the ASRS Screener (ASRS-6) in Korean samples.

          Results

          The ADHD group had higher ASRS and ASRS subscale scores than those of the control group. ROC curve analysis revealed the ASRS was more powerful to predict ADHD group than the ASRS Screener, but the ASRS Screener also had strong concordance with clinician diagnoses.

          Conclusion

          This study shows that the 18-question ASRS outperforms the six-question ASRS Screener. However, the weighted Screener is also a valid and useful screening instrument both in epidemiological surveys and in clinical settings.

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          The World Health Organization Adult ADHD Self-Report Scale (ASRS): a short screening scale for use in the general population.

          Ronald C Kessler, Lenard Adler, Minnie Ames … (2005)
          A self-report screening scale of adult attention-deficit/hyperactivity disorder (ADHD), the World Health Organization (WHO) Adult ADHD Self-Report Scale (ASRS) was developed in conjunction with revision of the WHO Composite International Diagnostic Interview (CIDI). The current report presents data on concordance of the ASRS and of a short-form ASRS screener with blind clinical diagnoses in a community sample. The ASRS includes 18 questions about frequency of recent DSM-IV Criterion A symptoms of adult ADHD. The ASRS screener consists of six out of these 18 questions that were selected based on stepwise logistic regression to optimize concordance with the clinical classification. ASRS responses were compared to blind clinical ratings of DSM-IV adult ADHD in a sample of 154 respondents who previously participated in the US National Comorbidity Survey Replication (NCS-R), oversampling those who reported childhood ADHD and adult persistence. Each ASRS symptom measure was significantly related to the comparable clinical symptom rating, but varied substantially in concordance (Cohen's kappa in the range 0.16-0.81). Optimal scoring to predict clinical syndrome classifications was to sum unweighted dichotomous responses across all 18 ASRS questions. However, because of the wide variation in symptom-level concordance, the unweighted six-question ASRS screener outperformed the unweighted 18-question ASRS in sensitivity (68.7% v. 56.3%), specificity (99.5% v. 98.3%), total classification accuracy (97.9% v. 96.2%), and kappa (0.76 v. 0.58). Clinical calibration in larger samples might show that a weighted version of the 18-question ASRS outperforms the six-question ASRS screener. Until that time, however, the unweighted screener should be preferred to the full ASRS, both in community surveys and in clinical outreach and case-finding initiatives.
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            Validity of the World Health Organization Adult ADHD Self-Report Scale (ASRS) Screener in a representative sample of health plan members.

            Ronald C Kessler, Lenard Adler, Michael Gruber … (2007)
            The validity of the six-question World Health Organization Adult ADHD Self-Report Scale (ASRS) Screener was assessed in a sample of subscribers to a large health plan in the US. A convenience subsample of 668 subscribers was administered the ASRS Screener twice to assess test-retest reliability and then a third time in conjunction with a clinical interviewer for DSM-IV adult ADHD. The data were weighted to adjust for discrepancies between the sample and the population on socio-demographics and past medical claims. Internal consistency reliability of the continuous ASRS Screener was in the range 0.63-0.72 and test-retest reliability (Pearson correlations) in the range 0.58-0.77. A four-category version The ASRS Screener had strong concordance with clinician diagnoses, with an area under the receiver operating characteristic curve (AUC) of 0.90. The brevity and ability to discriminate DSM-IV cases from non-cases make the six-question ASRS Screener attractive for use both in community epidemiological surveys and in clinical outreach and case-finding initiatives. Copyright (c) 2007 John Wiley & Sons, Ltd.
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              Validity of pilot Adult ADHD Self- Report Scale (ASRS) to Rate Adult ADHD symptoms.

              Lenard A. Adler, Thomas L Spencer, Stephen V Faraone … (2006)
              The goal of this study was to validate the pilot Adult ADHD Self-Report Scale (pilot ASRS) versus standard clinician ratings on the ADHD Rating Scale (ADHD RS). Sixty adult ADHD patients took the self-administered ADHD RS and then raters administered the standard ADHD RS. Internal consistency of symptom scores was assessed by Cronbach's alpha. Agreement of raters was established by intra-class correlation coefficients (ICCs) between scales. Internal consistency was high for both patient and rater-administered versions (Cronbach's alpha 0.88, 0.89, respectively). The ICC between scales for total scores was also high (0.84); ICCs for subset symptom scores were also high (both 0.83). There was acceptable agreement for individual items (% agreement: 43%-72%) and significant kappa coefficients for all items (p < 0.001). The pilot Adult ADHD Self-Report Scale symptom checklist is a reliable and valid scale for evaluating ADHD for adults and shows a high internal consistency and high concurrent validity with the rater-administered ADHD RS.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Psychiatry Investig
                Journal ID (iso-abbrev): Psychiatry Investig
                Journal ID (publisher-id): PI
                Title: Psychiatry Investigation
                Publisher: Korean Neuropsychiatric Association
                ISSN (Print): 1738-3684
                ISSN (Electronic): 1976-3026
                Publication date (Print): March 2018
                Publication date (Electronic): 28 February 2018
                Volume: 15
                Issue: 3
                Pages: 325-329
                Affiliations
                [1 ]Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, Republic of Korea
                [2 ]Maumnuri Clinic, Seoul, Republic of Korea
                [3 ]Yuil Medical Clinic, Guri, Republic of Korea
                [4 ]Yonsei Psychiatric Clinic, Seoul, Republic of Korea
                [5 ]Cheongdam Yonsei Premier Clinic, Seoul, Republic of Korea
                Author notes
                Correspondence: Ji-Hae Kim, PhD Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Republic of Korea Tel: +82-2-3410-0931, Fax: +82-2-3410-0050 E-mail: jihae0931.kim@ 123456samsung.com
                Correspondence: Yoo-Sook Joung, MD, PhD Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Republic of Korea Tel: +82-2-3410-0930, Fax: +82-2-3410-0050 E-mail: yschoung.joung@ 123456samsung.com
                Article
                Publisher ID: pi-2017-07-10
                DOI: 10.30773/pi.2017.07.10
                PMC ID: 5900371
                PubMed ID: 29486543
                SO-VID: 357e7a98-1d11-4fa3-8371-8d650a4067f1
                Copyright © Copyright © 2018 Korean Neuropsychiatric Association
                License:

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 16 February 2017
                Date revision received : 13 June 2017
                Date accepted : 10 July 2017
                Categories
                Subject: Brief Report

                ScienceOpen disciplines: Clinical Psychology & Psychiatry
                Keywords: adult adhd,asrs,arsr screener,roc
                Data availability:
                ScienceOpen disciplines: Clinical Psychology & Psychiatry
                Keywords: adult adhd, asrs, arsr screener, roc

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