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How much impairment is required for ADHD? No evidence of a discrete threshold
- Source :
- Arildskov, T W, Sonuga-Barke, E, Thomsen, P H, Virring, A & Østergaard, S D 2022, ' How much impairment is required for ADHD? No evidence of a discrete threshold ', Journal of Child Psychology & Psychiatry, vol. 63, no. 2, pp. 229-237 . https://doi.org/10.1111/jcpp.13440
- Publication Year :
- 2022
-
Abstract
- Background: A diagnosis of attention-deficit/hyperactivity disorder (ADHD) requires the presence of impairment alongside symptoms above a specific frequency and severity threshold. However, the question of whether that symptom threshold represents anything more than an arbitrary cutoff on a continuum of impairment requires further empirical study. Therefore, we present the first study investigating if the relationship between ADHD symptom severity and functional impairment is nonlinear in a way that suggests a discrete, nonarbitrary symptom level threshold associated with a marked step increase in impairment. Methods: Parent reports on the ADHD-Rating Scale (ADHD-RS-IV), the Weiss Functional Impairment Rating Scale (WFIRS-P), and the Strengths and Difficulties Questionnaire were collected in a general population sample of 1st, 2nd, and 3rd graders (N = 1,914–2,044). Results: Piecewise linear regression analyses and nonlinear regression modeling both demonstrated that the relationship between symptom severity (ADHD-RS-IV total score) and impairment (WFIRS-P mean score) was characterized by a gradual linear increase in impairment with higher symptom severity and no apparent step increase or changing rate of increase in impairment at a certain high ADHD-RS-IV total score level. Controlling for socioeconomic status, sex, and co-occurring conduct and emotional symptoms did not alter these results, though comorbid symptoms had a significant effect on impairment. Conclusions: There was no clear evidence for a discrete, nonarbitrary symptom severity threshold with regard to impairment. The results highlight the continued need to consider both symptoms and impairment in the diagnosis of ADHD.
- Subjects :
- medicine.medical_specialty
DIMENSIONS
Functional impairment
SYMPTOMS
Population sample
diagnosis
DEFICIT HYPERACTIVITY DISORDER
IMPACT
CHILDHOOD
CHILDREN
Comorbidity
Audiology
03 medical and health sciences
0302 clinical medicine
Rating scale
Developmental and Educational Psychology
medicine
Cutoff
Attention deficit hyperactivity disorder
Humans
0501 psychology and cognitive sciences
ATTENTION-DEFICIT/HYPERACTIVITY DISORDER
05 social sciences
FUNCTIONAL IMPAIRMENT
Parent reports
schoolchildren
Strengths and Difficulties Questionnaire
medicine.disease
continuity
Rate of increase
Psychiatry and Mental health
Attention Deficit Disorder with Hyperactivity
symptomatology
Pediatrics, Perinatology and Child Health
STRENGTHS
Psychology
030217 neurology & neurosurgery
050104 developmental & child psychology
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Journal :
- Arildskov, T W, Sonuga-Barke, E, Thomsen, P H, Virring, A & Østergaard, S D 2022, ' How much impairment is required for ADHD? No evidence of a discrete threshold ', Journal of Child Psychology & Psychiatry, vol. 63, no. 2, pp. 229-237 . https://doi.org/10.1111/jcpp.13440
- Accession number :
- edsair.doi.dedup.....a80248acd32223a223a63b75a11a3cad